Global Fund Cuts Pose Serious Challenges for Uganda’s Health Sector
The recent reduction in funding from the Global Fund has raised significant concerns about the state of Uganda’s health sector. Senior officials within the Ministry of Health have highlighted a major decline in financial support for critical diseases such as HIV, malaria, and tuberculosis. This cutback has created a substantial gap that requires urgent attention from the government.
Specifically, the Global Fund has reduced its contributions by $30 million (Shs107 billion) for HIV, $31 million (Shs110 billion) for malaria, and $650,000 (Shs2.3 billion) for tuberculosis. These reductions are attributed to donors failing to meet their commitments. The Global Fund, which has been a key financier of Uganda’s health initiatives, depends heavily on donations from countries like the United States. However, recent changes in U.S. foreign aid policy, including the dissolution of the U.S. Agency for International Development (USAID), have further complicated the situation.
This shift in aid policies is not unique to the U.S. Many global donors are reducing direct support to developing nations due to economic challenges worldwide. This trend is particularly concerning given the World Bank’s recent findings, which indicate high out-of-pocket health expenditures in Uganda. The report also highlights that Uganda allocates a significantly lower percentage of its GDP to health compared to neighboring countries such as Burundi, Kenya, Malawi, and Rwanda.
Uganda currently invests around one percent of its GDP in health, while these peer countries allocate two percent or more. This underinvestment has had tangible consequences, particularly in the form of high mortality rates among newborns and pregnant mothers. The country’s commitment to increasing health sector allocations was outlined in the Abuja Declaration, which called for at least 15 percent of the national budget to be directed toward health.
Despite some progress, the Uganda Demographic and Health Survey of 2022 shows that newborn deaths remain stagnant at 22 per 1,000 live births. This figure represents a slight improvement from 27 per 1,000 in 2016 but still falls short of the target set by the National Development Plan III, which aims to reduce this rate to at least 20 per 1,000 by 2023/2024.
Another pressing issue is the availability of innovative treatments such as Lenacapavir, an HIV prevention drug that requires only two injections per year. The government plans to access this medicine through the Global Fund, but it will only be available to 17,000 individuals. This limitation is alarming, especially considering that Uganda has approximately 26 million adolescents and adults who may require this medication if they perceive themselves to be at high risk of contracting HIV.
The reliance on external funding underscores the need for the government to prioritize essential public health needs. A more robust investment in the health sector would not only improve health outcomes but also contribute to the overall development of the nation. It is crucial that the government takes immediate action to address these challenges and ensure that all citizens have access to the healthcare they need.
