On February 11, 2025, Straight Talk Foundation, in its role as Country Secretariat for MenEngage Uganda Network, joined the Uganda AIDS Commission, UNAIDS, and 19 other Civil Society Organisations in a high-level engagement with Uganda’s Parliamentary Committee on Health. The meeting aimed to present a policy brief titled“Policy Brief on the Executive Orders of the President of the United States of America and its effects on the National HIV Response in Uganda.”
Key Focus Areas of the Policy Brief
The brief outlined the implications of recent U.S. Executive Orders on Uganda’s HIV response, particularly on the Presidential Fast-Track Initiative launched in 2017 to end AIDS as a public health threat by 2030. The five pillars of PFTI include:
- Engaging men in HIV prevention, especially to protect adolescent girls and young women.
- Accelerating the Test and Treat strategy and achieving 95-95 targets.
- Eliminating mother-to-child transmission of HIV.
- Ensuring financial sustainability for the HIV response.
- Strengthening institutional effectiveness through coordinated multisectoral efforts.
The 2024 JAR report shows that 92% of the 1.49 million people living with HIV have been tested and know their status, 90% of them are receiving antiretroviral therapy, and among those on treatment, 94 are virally suppressed.
Despite the tremendous progress Uganda has made, the HIV epidemic remains generalized and severe. Out of every 100 people living with HIV in the world, 4 are in Uganda considering that with a population of 46 million people Uganda has 3.8% of the 39 million people living with HIV in the world. In light of the above, the overall objective of presenting a policy brief was to provide an analysis of the Executive Orders and their implications on the National HIV response, and to seek Parliament’s support for additional resources for the HIV response.
During the discussions with the Parliamentary Committee on Health, several recommendations were put forward to address the potential impact of the U.S. Executive Order on Uganda’s HIV response. A key proposal was to increase the national budget allocation for HIV-related commodities. Parliament, together with the Ministry of Finance, Planning and Economic Development, was urged to prioritize HIV services by allocating an additional 300 billion Ugandan shillings to cover essential medicines, laboratory supplies, and other resources previously provided by PEPFAR. This funding would supplement the existing commitment of a 50 billion shillings annual increment. In the long term, this increase would help cover the full cost of antiretroviral therapy and other critical commodities, enabling partners to focus on complementary support such as training, social protection, supervision, and technical assistance.
Further, the need to enhance and restructure HIV mainstreaming budget allocations was emphasized. While the current 0.1% allocation shows potential, its effectiveness has been hampered by inadequate funding and poor adherence to guidelines. A proposal was made to increase this allocation to 0.5%, which could generate an additional 200 billion Ugandan shillings to fill the gaps left by any immediate withdrawal of PEPFAR support. Maintaining a minimum but effective package of HIV prevention, care, and treatment services is essential to achieving the national goal of ending AIDS as a public health threat by 2030. Priority areas for funding include the restoration of viral load monitoring through the hub-and-spoke system, re-establishing key prevention services to identify and treat new infections, expanding psychosocial counseling to address adherence challenges, and ensuring logistics support for the delivery of HIV commodities to private not-for-profit facilities.
Lastly, there was a call for Uganda to fast-track the development of an HIV sustainability roadmap. This roadmap would provide a strategic framework to guide the country’s transition from the current donor-dependent emergency response to a sustainable, government-led HIV program that is integrated into the national primary healthcare system and supported by both governmental and community structures.
Stakeholders emphasized that the HIV response in Uganda has been heavily donor dependent. The new Executive Orders jeopardize the transition to a self-reliant model. Therefore, now more than ever, it is critical for the Government of Uganda to take full leadership in sustaining and scaling up HIV services to protect the gains made and achieve the goal of ending AIDS by 2030.