Inadequate and Unsustainable HIV Funding a Time Bomb for Uganda

1985 Views Kampala, Uganda

In short
It was noted that the national HIV response is heavily funded by donors with government only funding 11 percent and out of pocket contribution is 8 percent. Omona emphasized that heavy dependence on donors to implement the HIV/AIDS programme is risky and dangerous.

The inadequate and unsustainable HIV/AIDS funding in Uganda is a risky venture and could turn into a time bomb for the country.
 
Kenneth Omona (MP Kaberamaido County) notes that the HIV/AIDS control Bill 2010 does not provide for adequate funding modalities of HIV treatment yet Uganda has a high donor dependency.
 
The Health committee report on the HIV/AIDS control Bill is seeking to oblige government to provide adequate funding to combat the scourge.
 
It was noted that the national HIV response is heavily funded by donors with government only funding 11 percent and out of pocket contribution is 8 percent. Omona emphasized that heavy dependence on donors to implement the HIV/AIDS programme is risky and dangerous.
 
The Health committee’s report proposes the creation of an HIV Trust fund in cognizant with the challenges associated with funds but with strict measures that it is not touched in the treasury like the Road Fund.
 
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In 2009 Uganda adopted a policy of Universal access to Anti-Retroviral treatment, however, presently the number of persons living with HIV/AIDS that are eligible for ART with CD-4 Count of 350 per cubic millimeter which is below 540,94 out of which only 48 percent were receiving treatment leaving out  52 percent.
 
Pediatric coverage stands at 28 percent of eligible children being put on treatment by the end of 2010.
 
Parliament is due to debate the HIV/AIDS prevention and control Bill 2010 which is now at its second reading but with need for amendments on some controversial clauses.
 
One of the most controversial clauses is clause 13 that mandates HIV tests for criminal proceedings. The clause provides that a person convicted of drug abuse, charged with a sexual offence or convicted of an offence involving prosecution shall be subjected to HIV testing for purposes of criminal proceedings.  The committee observed that for those already convicted the HIV test would not have any judicial value.
 
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Clause 3 talks about reasonable care to be taken to avoid transmission of HIV. During the health committee’s consultations with stakeholders, there was concern that there would be practical difficulties in implementing the clause due to the wide spread poverty within the majority of the population and the lack of the necessary facilities in some parts of the country.
 
Clause 5 of the Bill demands that counseling should be conducted by only qualified medical practitioners who have completed an HIV counseling training programme and approved by the Ministry of Health.
 
However, religious leaders raised concern that the attempt by the Bill to ignore their role in counseling will not be good and it was proposed that counseling should be done by other recognized counselors rather than limited it to medical practitioners.
 
On the other hand the health committee opinioned that it was not necessary to extend the application of clause 5 to religious leaders because the pretest and pro-test counseling that are subject to the clause only apply when one is going to take a test which is done at a health facility.
 
The second concern was on the competence of the Minister to approve counseling training programme and whether the national association of counselors should not be the most suitable. But the Health committee concurred that the Minister was better suited to approve the counseling programme.
Clause 12 talks of consent test for HIV and provides that consent is not necessary for testing when it is unreasonably withheld except or in an emergency due to medical or psychiatric conditions and a medical practitioners decides that it is in the interest of the patient.
 
There was concern that test without consent would be an infringement on the right to privacy since HIV is not a health emergency and there is currently no emergency treatment for HIV.
 
The arguments were on the premise that while in the early 90’s Uganda’s prevalence was 18.5 percent to 6.2 percent in 2002-03, the 2011 sero survey and the UN Aids pandemic update 2012, report that despite years of HIV dramatic success, prevalence has increased from 6.4 percent in 2005 to 7.3 in 2011.
Omona says this is more scaring because Uganda is one of the only three countries in Africa where HIV/prevalence rates are increasing joined by Angola and Mozambique.
 
He thus challenges all actors to focus on the goal of Universal access to ARVs treatment and a shared vision of the future of zero deaths from HIV related deaths, zero new infections, Zero stigma and discrimination of those infected with HIV.
 
The main routes of HIV transmission are heterosexual relations and mother to child transmission that need urgent attention. The groups most at risk are commercial sexual workers, long distance truck drivers, fishing communities and men who have sex with men.