Uganda: As Anti-Homosexuality Law hits services, funding, its impact on current and future HIV treatment access raises concerns

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Ugandan police action at U.S. Military HIV Research Program site “has significantly heightened our concerns about respect for civil society and rule of law in Uganda,” State Department official says

Following a week that saw a U.S. funded program in Uganda closed by the country’s Anti-Homosexuality Law, leaders of organizations representing physicians and researchers  in HIV responses worldwide wrote to U.S. Global AIDS Coordinator Ambassador Deborah Birx today stressing that efforts to get life-saving treatment to Ugandans living with HIV must continue.

HIVMACenterletter“We are writing now to reiterate two points that we and some 900 of our colleagues have made earlier in a letter to President Obama,”  wrote leaders of the Infectious Diseases Society of America’s HIV Medicine Association and the Center for Global Health Policy, which produces this blog. “That the U.S. must respond in concrete and unyielding terms to the Ugandan government’s unlawful behavior and codification of a law that represents a major violation of human rights. And that this response cannot take the form of a retreat from our medical and ethical obligations to those who depend on U.S. support for their lives.”

Their letter came amidst reports that health services have been curtailed following donor cuts to government and faith-based programs, and that plans to accelerate treatment access in Uganda were being reconsidered. Just two years earlier, the U.S. State Department singled out Uganda as  needing an intensified response, because of its lagging rate of treatment coverage. Rising HIV incidence and declining condom use make Uganda unique in an area where numbers of new infections are beginning to be exceeded by numbers of people starting treatment for HIV. Uganda is home to more than a million and a half people living with HIV, more than 580,000 needing treatment. Failures to address the needs of populations at greatest risk, including men who have sex with men, have challenged efforts to stem the tide of Uganda’s epidemic.

“With little evidence that President Museveni and his government will ensure that lifesaving HIV care is preserved for its citizens, the greatest harm would be done to those already most threatened, with the withdrawal of services to support the health and well-being of gay Ugandans who depend upon U.S. funded prevention and treatment services,” the physicians’ letter says. “The enactment of the anti-homosexuality legislation makes it clear that relevant and sensitive prevention services for marginalized populations including men who have sex with men will not be made available.”

The most recent official word on the United States response to Uganda’s Anti-Homosexuality law on the U.S. Embassy website is dated March 28th and headlined “No changes in U.S. Assistance to Uganda.” That statement, both carefully worded and sweeping, promises that “none of the announced changes in U.S. assistance affects essential care and treatment in our health services . . . Nor do they hinder any other program central to our shared vision of a peaceful, prosperous, healthy, and democratic Uganda.”

By that time, the U.S. had made a series of adjustments to its funding for health services in Uganda, including ending payments to the country’s Ministry of Health Staffers, and cutting funding to the Inter-Religious Council of Uganda which supported the law, and which was an umbrella organization for faith-based groups carrying out U.S.-funded HIV responses. In the week and a half since that, President Yoweri Museveni announced Uganda would launch a new fund for HIV responses, the Ugandan government presented a legal defense of the law asserting that mandatory HIV tests and life in prison for gay people did not represent human rights violations, and the Ugandan police arrested a U.S. program staffer at the Makerere University Walter Reed Project in Kampala. The project, which stemmed from one of the first programs to bring antiretroviral treatment to Uganda through the President’s Emergency Plan For AIDS Relief remains closed, with the last statement on its status dated April 3, and referring questions to the U.S. Mission in Kampala.

The U.S. Mission, in turn, referred questions to the U.S. State Department in Washington, DC, which responded to a request for further information with the following, today:

  • We remain deeply concerned by Ugandan authorities’ April 3 raid on the Makerere University Walter Reed Project (MUWRP), a U.S.-funded health clinic and medical research facility. We are also concerned by the arrest of one of the facility’s employees, allegedly for conducting “unethical research” and “recruiting homosexuals.” The incident has significantly heightened our concerns about respect for civil society and rule of law in Uganda, and for the safety of LGBT individuals.
  • We are aware that on April 8 Ugandan police issued a press release that made spurious allegations about the activities of MUWRP employees, including patently false assertions about events occurring on April 4. We believe the police raided MUWRP due to its connection with the U.S. Government based on the principled stance we have taken in support of LGBT persons in Uganda and around the world.
  • The Makerere University Walter Reed Project is engaged in efforts to improve public health and save lives. It conducts important research and services related to Ebola, Marburg disease, and HIV/AIDS. We’re committed to continuing that work, but have suspended temporarily the MUWRP’s operations to ensure the safety of staff and the integrity of the program.
  • Attacks on and intimidation of health care workers are unacceptable. The safety of health workers must be respected.
  • At present, all lifesaving HIV services supported by the Project are being maintained, and MUWRP is working directly with its patients to ensure there is no interruption in their care moving forward.

4 thoughts on “Uganda: As Anti-Homosexuality Law hits services, funding, its impact on current and future HIV treatment access raises concerns

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