Lydia Mungherera knows better than most people what’s at stake in the unfolding crisis over global AIDS funding. She is a medical doctor, an activist, and woman living with AIDS, and she’s growing increasingly concerned about the ramifications of flat-funding for the President’s Emergency Plan for AIDS Relief, a cornerstone of the international response to HIV/AIDS.
Dr. Mungherera sees the battle from those three fronts, as her native country of Uganda faces drug stock-outs and treatment slot shortages. Some clinics in Uganda are beginning to turn patients away, she said, and others, hampered by drug shortages, are giving out only 2 of the three drugs in the HIV regimen, which is a recipe for drug-resistance and treatment failure.
“The hopelessness we had in the 1980s, when we had no treatment, is what we are going back to now,” Dr. Mungherera said at a community meeting in Washington on Monday. “The basic issue of right to life is being disrupted.”
Uganda had a very successful family-based approach to HIV testing and treatment, but that is starting to fall apart, she said. “You can’t treat the father and not treat the child or the mother,” she said, referring to increasing scarcity of new openings for treatment.
She said testing programs are also being undermined, because people don’t want to get tested if there’s no treatment available. “Seventy percent of Ugandans don’t know their status,” she noted, “but what are we going to tell those people who come for testing? I’m sorry, there’s no treatment?”
Dr. Mungherera, who has worked with The AIDS Support Organization (TASO) since 1999 and is the founder of Uganda Cares, the first treatment centre to give free antiretroviral drugs in the Masaka District, said she was particularly worried about the Obama Administration’s Global Health Initiative. The GHI calls for a more integrated approach to global health and a new focus on health systems and child and maternal health. But the $63 billion, six-year formulation of the GHI seems to ensure that some funding will have to taken from PEPFAR to make the other pieces of the program work. And undermining PEPFAR will hinder all the other goals of the GHI, a consequence the some top U.S. officials do not seem to understand or acknowledge.
Dr. Mungherera said, for example, that integration of mother and child health services is a great idea, “but you can’t start integrating services when people are dying.”
Dr. Mungherera has particular expertise on the impact of HIV on women and girls in sub-Saharan Africa. She created Mama’s Club, a community-based psychosocial support group for HIV-positive mothers and their children. In this video below, she talks more about the links between HIV and child and maternal health, in the context of the GHI’s “women and girl-centered approach” to global health.