A few weeks ago, the US government put to a halt the United States President’s Emergency Plan For Aids Relief (PEPFAR) for 90 days as it assesses the viability of its operations.
PEPFAR is the global health funding to address the global HIV/Aids epidemic and help save the lives of those suffering from the disease. As of 2023, PEPFAR has saved over 25 million lives, primarily in sub-Saharan Africa.
So, whereas there is optimism the programme may resume, the abrupt withdrawal of funding has led to the closure of critical harm reduction centers, leaving thousands of patients in distress and uncertainty, including those at Uganda Harm Reduction Network (UHRN’s) Medically Assisted Therapy (MAT) clinics, writes ERNEST JJINGO.
A popular female hip-hop artiste who prefers not to be named for fear stigmatization, says her future looks bleak if operations the Medically Assisted Therapy (MAT) clinic at Butabika don’t resume. The artiste was one of the biggest stars in the country a decade ago.
But along the way, her addiction to drugs derailed her career and it took rehabilitation to get her back on track. One form of counselling she admits helped her was at the Uganda Harm Reduction Network (UHRN), a drug user-led national network that works to advocate for practical interventions aimed at supporting and addressing issues of people who use and inject drugs (PWUIDs) especially youth.
“I had battled addiction for years and rehab was my turning point. They gave me the treatment and counseling I needed to get my life back on track,” she told The Observer in 2023. Now on the mend, she is just one of the hundreds of beneficiaries from harm reduction programmes that also provide methadone and buprenorphine therapy.
However, she says she has little hope with the recent US government administration’s decision to pause nearly all foreign aid, including significant funding to Uganda’s health sector through PEPFAR, USAID and Centre for Disease Control (CDC).
So, whereas PEPFAR is the umbrella that funds and oversees the program, USAID implements development- focused aspects while CDC provides technical, scientific and disease surveillance support.
UHRN has been one of the biggest beneficiaries of support from the trio.
“I am worried about what the future holds because my life would be a complete mess without the counselling and harm reduction efforts,” she says.
“I know so many fellow artistes who are also benefiting from the programmes. We need the government and other stakeholders to step in before more lives and careers are lost. I hope common sense prevails and the decision is reversed.”
She is not alone. In fact, there are thousands of PWUIDs, particularly those dependent on opioid treatment, whose health will be adversely affected. This is because the abrupt withdrawal of funding has led to the closure of critical harm reduction centers, leaving thousands of patients in distress and uncertainty.
For instance, UHRN has been providing life-saving interventions for drug users at its two Medically Assisted Therapy (MAT) clinics, one at Butabika National Referral Mental Hospital and another in Makindye, a Kampala suburb.
With these facilities now shut down after the US government pulled the plug, patients are being turned away, forcing them to endure painful withdrawal symptoms without critical support.
HEALTHCARE CRISIS
Reached out for a comment, a top official at the Butabika National Referral Mental hospital who preferred anonymity because of the sensitivity of the situation, expressed deep concern over the stoppage of funding and closure of the MAT clinic.
“We were providing essential treatment to over 1,000 patients, ensuring they manage their opioid dependence. Without these interventions, many of them are at risk of severe health complications, relapse, and even death,” she says.
“The sudden withdrawal of support is going to leave us scrambling for alternatives, but the truth is, there are no immediate solutions.”
This funding had been instrumental in not only treating opioid dependence but also reducing the harms associated with injection drug use, including the risk of HIV/Aids transmission. The withdrawal comes at a time when Uganda is seeing a rise in drug use, particularly among secondary school students and young creatives in the music and film industries.
STRUGGLE TO KEEP AFLOAT
Meanwhile, Twaibu Wamala, UHRN executive director, describes the funding cut as a “devastating blow” to Uganda’s drug harm reduction efforts.
“We were just beginning to make real progress in curbing the dangers of drug abuse. Our interventions had reduced overdose cases and helped patients reintegrate into society,” Wamala says.
“Now, with limited financial support, all our efforts may be reversed. These patients have few options to turn to, and some are already resorting to risky behaviors.”
Ministry of Health records show the MAT program had offered a ray of hope to many PWUIDs, especially young people who had struggled with addiction. So, the closure of the centers will leave many vulnerable, with no structured support system in place.
UNCERTAINTY
The Health ministry estimates that Uganda has approximately 70,000 opioid users, many of whom relied on donor-funded programs for treatment and rehabilitation. So, the abrupt funding halt leaves both patients and healthcare providers in limbo, with no clear strategy to bridge the funding gap.
Despite the grim outlook, UHRN and Butabika hospital officials remain hopeful that alternative funding sources can be secured to resume the much-needed services. However, without immediate intervention, Uganda’s drug dependency crisis is poised to worsen, thereby endangering the lives of thousands of vulnerable individuals.
On January 30, Diana Atwine, the Health ministry permanent secretary, warned all staff supported by PEPFAR, USAID and CDC that all their activities related to disbursement of financial assistance, and other relevant agency activities were paused with immediate effect.
“Accordingly, given that your operations and emoluments were directly supported by United States government and such activities have since been suspended, you are informed to halt work for which you had been contracted, as we engage with the United States government on the way forward,” she noted.
“In the meantime, the government is exploring ways of integrating essential services into the routine healthcare to minimize disruptions. As such, contracted staff that are willing to continue working in the spirit of patriotism as volunteers until we harmonize with United Sates government are encouraged to contact the respective hospital directors or my office, for those deployed at the ministry headquarters, for integration into the existing healthcare system.”
So, it remains to be seen whether USAID activities will resume after the 90-day freeze but should it be completely withdrawn, Uganda’s healthcare system faces a huge void to fill.
jjingoernest1@gmail.com
Sorry, Editor! You have done nothing to hide the identity of the artist you said didn’t want to be identified. You have described her in detail for anyone to know exactly who you are talking about – someone from the former Blue Three!
Do better next time. If you want to hide someone’s identity, don’t give a narrative the way you have done! Shame, shame!
AND SOME UGANDAN fools have been criticizing the United States and forgetting that the same country out of compassion of the American people was supporting sick Ugandans to keep alive! So this is a good decision to help those African senile leaders and people who think they can abuse the “hand that feeds them” and keeps them alive- to come to their senses.