Anonymous

By coincidence, I have an interview scheduled with the executive director of a major research and treatment institution just hours after they met with what remains of the leadership of the U.S. Agency for International Development in Uganda.

Their organization draws funding from USAID that sustains life-saving treatment for thousands of people living with HIV.

Those funds are now being slashed by 40 percent. They had been summoned to USAID to explain how the institution planned to operate under the reduced budget. They also had to confirm that their programs would adhere to the parameters laid out in a State Department waiver that has allowed the institution to resume some limited services. They can do no community outreach and offer no prevention services, except to keep mothers from passing HIV onto their newborns.

Before telling me about the meeting, they request anonymity. They worry about the retribution their institution will face if their identity is revealed.

USAID are also in a frenzy. They asked us to do a work plan and a budget, which we did. So they called us so that they can give us, once again, the things that we should stick to under the waiver. But also to give us feedback on our budget, on the work plan that we shared.

So now we have had the waivers, the communication, we have to cut down the budgets up to about 40 percent. The waiver is for 30 days. Nobody knows what will happen after 30 days. 

They don’t know what is next. They know for the 30 days. I said, When did the 30 days start? What happens after the 30 days? We don’t know. They said, We also don’t know if we have a job tomorrow.

They’ve been told by our National Medical Stores¹ that about 3 percent of sites have sent in requests for commodities, which include [anti-retroviral therapy]. So they will run out. I think there is some drug in the country, but how long it will last? I don’t know.

They tried to engage the USAID officials on the struggles the Ministry of Health would face as it attempted to assume the programs America was abandoning. As a temporary solution, Ugandan officials announced plans to collapse specialized HIV services into the general outpatient wards at government-funded health centers and hospitals.

It is something we could have started to do earlier, but now it is abrupt. The people who have not been seeing these patients have to be trained, they have to be supported. USAID have told us we do not keep any staff for technical support, training and mentoring and supervision.

If we cannot train the people who are now going to take over…

When we told USAID, they said that is government responsibility. We know it is government responsibility. But do they have the muscle and the capacity to overnight take over and train everybody?

You know, you sympathize with the ministry. What can they do? They have to do something. So they’ve done that. Whether it is going to go properly or not, to whom it may concern. Our targets for 2030, for epidemic control², I don’t see how we can meet them in these conditions.