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Cut in Uganda’s Health Budget Alarms AIDS Activists

Women wait with their babies to be tested for HIV at a hospital in Bududa, eastern Uganda, September 27, 2011.
KAMPALA - Uganda is at the beginning of a months-long budgeting process for the country’s next fiscal year. AIDS activists are already alarmed at a proposed reduction in the health budget and are demanding more money to curb the country’s epidemic.

The possibility of funding cuts come despite ambitious targets set by the government last December to virtually eliminate mother-to-child HIV transmission by 2015. Kampala also pledged to double the number of new HIV patients on treatment this year, as it attempts to reduce a rising HIV rate of nearly 7 percent.

But rather than improvements, some HIV-positive Ugandans say they have seen a reduction in available services.

Nakisozi Mastula was diagnosed with HIV in 2005. Each month she goes to a clinic for a CD4 test, which will tell her if she needs to start anti-retroviral therapy. She also gets Septrin, a drug she takes daily to combat possible infections.

“Earlier this morning, it was my day to go back for my CD4 count and to get Septrin," she said. "But when I reached the hospital, the CD4 count was not operating. I did not receive my Septrin. If I miss Septrin, I’m starting losing hope.”

AIDS activists have expressed concern that Uganda's proposed budget for the next fiscal year includes a 6-percent cut in health funding to $307.5 million. That is less than 10 percent of the country’s overall budget. Joshua Wamboga of The AIDS Support Organization said the country’s efforts to curb the disease could be undermined by a lack of financial commitment.

“We are saying we need to scale up enrollment on HIV treatment to be able to reverse the HIV infection trend," said Wamboga. "And that will take leadership. Leadership of this country Uganda.”

Government officials said the cut to the health budget reflects construction projects in that sector that have been completed and no longer require funding. But activists said the country needs to invest more money in health if it is going to meet its ambitious HIV goals.

Florence Buluba, the executive director of the National Community of Women Living with HIV/AIDS, said a severe shortage in medical workers overall has an outsized impact on HIV-positive pregnant women. Women who turn to health centers to help them prevent HIV transmission during and after pregnancy find little assistance, said Buluba.

“They are confronted with poor attitudes, especially in health centers, just because the health providers are few. The personnel at the health centers is not sufficient enough to address to the number of patients. Then we also find out that those who attempt to get the treatment are not followed up. So we find out that the babies are born. They are not given the treatment and they end up being infected," she said.

The budget is months away from being finalized and activists hope there is still time to increase funds. Sam Lyomoki, chairman of Parliament's Social Services Committee that oversees the health budget, is calling for increased funding.

“On this matter, the committee this time is very serious," he said. "And they are not going to accept a situation where we comment and finance doesn’t want to support the recommendation.”

After committees conclude their reports, the budgets will be returned to the various ministries, including health, for revisions. Lyomoki said he is hopeful more money will be forthcoming. If not, he said his committee would look at reallocating money from expenditures like conferences and workshops toward filling staffing gaps and beefing up HIV programs.