The dramatic growth in the delivery of health care services throughout Uganda in recent years is a remarkable accomplishment, one in which the United States, through the US President’s Emergency Plan for Aids Relief (PEPFAR), plays a key role. In the past year, PEPFAR funded the testing of over a million pregnant Ugandan women as a first step in preventing transmission of HIV to their newborns. As of March this year, over 218,000 Ugandans are receiving antiretroviral treatment, of which 184,000 are directly supported by the American people.
The United States is currently investing $280 million a year in Uganda to fight HIV and Aids. Since 2004, our investment totals $1.4 billion. This high level of funding is particularly significant today in a time of tightening budgets and economic constraints. I am proud of the support that the American people are providing to Uganda to help fight this disease, despite the worst economic conditions in the US since World War II.
Even with this enormous contribution from the US, the demand for HIV and Aids services, especially ARVs, is rapidly outpacing the ability to deliver them to those who are in need. The gap between supply and demand means many Ugandans are unable to get life-saving ARVs when they need them. The need for ARVs is immediate; and this crisis requires both short-term and long-term solutions.
To address Uganda’s short-term ARV needs, the American people will add new HIV funding above and beyond our current annual budget of $280 million. These new funds, invested over a two-year period, will increase enrollment of new patients on ARVs by at least 36,000 this year, with an additional 36,000 Ugandan patients next year. This means by 2012, the American people plan to directly support more than 250,000 Ugandans on ARVs. To be successful, this programme also requires a greater partnership with – and engagement by – the Government of Uganda. The success of this effort will influence future funding decisions.
With these new funds, America will purchase an immediate shipment of ARVs (ARV Infusion) to the National Medical Stores and Joint Medical Stores for quick distribution to government and not-for-profit clinics and hospitals to bridge the gap until Global Fund drugs arrive.
Addressing Uganda’s long-term HIV and Aids needs requires a renewed commitment from the people of Uganda, the Government of Uganda, the Global Fund and other donors. The US government is not - and cannot - be the only source of funding for Uganda’s HIV and Aids prevention, care, and treatment efforts. US aid programmes never seek to lead another nation’s response, but to work with host governments to identify opportunities where US support can make a needed contribution. This is an ongoing process.
The US is already addressing the long-term need for new donor streams by engaging the Global Fund to better support the HIV response in Uganda. At the same time, we will continue to assist the government to identify new funding streams, working with bilateral and multilateral donors. The government’s recent funding increase for ARVs is encouraging although decreased budget allocations to the Ministry of Health are a concern.
I am optimistic about Uganda’s potential to address its long-term needs in the fight against HIV/Aids. I am grateful to our partners in Uganda for once again reaffirming that optimism and look forward to continued and increased engagement by the Government of Uganda on HIV and Aids programmes.
Mr Lanier is the US ambassador to Uganda