HIV patients struggle for medication after abrupt USAID funding halt

The abrupt suspension of U.S. funding to Uganda’s health sector has triggered wide-spread anxiety among people living with HIV/ Aids, as critical services and medication access remain uncertain, The Observer has learned.

In January 2025, the U.S. government announced a 90-day suspension of all foreign assistance, including funds from the President’s Emergency Plan for AIDS Relief (PEPFAR)—a program that has been instrumental in Uganda’s fight against HIV/Aids, tuberculosis, malaria, maternal and child health, and family planning.

More than 1.2 million Ugandans currently rely on U.S.-funded antiretroviral therapy (ART). Despite an emergency humanitarian waiver ensuring temporary access to HIV treatment, many patients are uncertain about the future, fearing potential disruptions to their medication and essential healthcare services.

CLINIC CLOSURES AND MEDICATION SHORTAGES

For Laura Angel Kyakunzire, who has lived with HIV since childhood, the situation is growing dire as USAID-funded standalone clinics struggle to reopen. Some, like the Infectious Diseases Institute (IDI), remain closed, forcing many patients to skip doses or ration their medication.

“There is growing concern about what will happen when the remaining drug supplies run out,” she told The Observer. “Many patients relied on USAID-funded clinics such as those run by Baylor, which have been badly affected by the funding cut.”

When the suspension was announced, some clinics, including Kawala and IDI, managed to notify patients to pick up their refills for up to 90 days. However, due to the abrupt shutdown, many missed these alerts, leaving them stranded without medication.

“Follow-up calls stopped, airtime was cut off, and transportation services were frozen. Many patients were left without access to life-saving drugs,” Kyakunzire added.

People with disabilities, who previously benefited from door-to-door medication delivery, have been especially affected. Even clinics that have partially reopened are struggling to meet demand.

“I used to get my medication from Baylor’s main branch in Mulago, which remained open due to alternative funding sources. Luckily, I received a refill for December 2023 to May 2024. However, follow-up activities and medication delivery have been suspended, leading to long queues at the clinic,” she noted.

RISING COSTS AND FEAR OF DRUG INACCESSIBILITY

A mother living with HIV, who spoke to The Observer, shared her fears about the financial strain the funding halt has placed on her family. She and her husband, both HIV- positive, receive treatment from different clinics. Having just given birth days after the U.S. funding suspension, she worries about the future cost of medication.

“We were told that if the U.S. completely withdraws its support, HIV medication will become unaffordable given the current economic hardship. ARVs require good nutrition, and we already struggle to afford basic needs. If we have to buy our medication, we don’t even know how much it will cost,” she said.

Only three days after the suspension, she was charged Shs 10,000 for Nevirapine, a drug that prevents mother-to-child HIV transmission. After giving birth, she was asked to pay again for the same medication for her newborn – a drug that was previously provided free of charge. She also noted that peer mentors and educators—who were funded by now-closed clinics—have stopped working.

“They used to check in on us, remind us to take our medication, and offer advice. Now that they’re gone; we feel abandoned,” she added.

FEARS OVER STIGMA AND SERVICE DISRUPTIONS

The transfer of patient files from standalone HIV clinics to general hospitals has raised concerns among some patients, who fear it could increase stigma.

“Standalone HIV clinics were safe spaces where everyone was in the same situation. Now, being forced to seek care at general hospitals, where people with different conditions are treated, makes HIV-positive patients feel exposed and judged,” she explained.

Beyond medication access, other essential services such as counselling, viral load monitoring and tuberculosis (TB) screening have also been affected. For instance, at Kamwokya Community Clinic, refills are now only available on Mondays and Thursdays, with no other screenings conducted. This is particularly concerning since viral load tests help determine the effectiveness of HIV treatment.

With peer support systems collapsing, drug shortages worsening, and stigma concerns rising, many people living with HIV/Aids remain uncertain about their future.

GOVERNMENT HEALTH FACILITIES OVERWHELMED

Ruth Ninsiima, executive director of the Friends of Canon Gideon Byamugisha Foundation, told The Observer that HIV clinics closed within a week following the U.S. suspension, leaving patients stranded. According to Ninsiima, patients who received early warnings rushed to collect their medication, leading to stockouts at major clinics.

Some facilities were forced to dispense half or even a quarter of the usual doses. Additionally, some government hospitals, like Kabarole hospital, have started charging Shs 1,000 consultation fees before dispensing ARV refills. Ninsiima also noted that, due to the closure of HIV clinics, some patients have been prescribed inappropriate drug combinations because doctors failed to review their medical records properly.

PATIENTS RESORT TO DRUG RATIONING

Flavia Kyomukama, executive director of the National Forum of People Living with HIV/Aids Networks in Uganda (NAFO PHANU), confirmed that while ARVs remain available, some private health facilities have increased prices from Shs 2,000 to Shs 5,000.

“Some patients have started rationing their medication, taking ARVs every other day instead of daily to make their supply last longer. Others have begun sharing their medication with loved ones,” she said.

Kyomukama warned that such practices reduce drug effectiveness and increase the risk of resistance, leading to serious complications. She also criticized the government’s slow response, stating that the Uganda Aids Commission has presented an order paper for parliamentary discussion on March 5, 2025— but for many patients, the damage is already being felt.

As uncertainty looms, people living with HIV/Aids in Uganda continue to face one of the most challenging moments in recent years, with many unsure whether they will receive the life-saving medication they rely on.