Thursday 8 June 2017

Civil Society Organisations pledge to work with government to end HIV/AIDS by 2030
Civil Society Organisations (CSOs) have pledged to continue advocating for strong visible partnerships with government and the private sector among other stakeholders to end HIV/AIDS by 2030.
Speaking on behalf of Civil society at a CSO dialogue meeting with the UNAIDS Executive Director, Michel Sidibe, Canon Gideon Byamugisha said CSOs pledge to advocate for strong, visible partnerships with government and private sector in terms of policy analysis and formulation, strategic planning, practical programming, human resource training, messaging and communication, domestic funds mobilization, research, documentation and reporting.
He added that to achieve the above, CSO will rebuild, re-energize and resource a strong social-cultural faith sector’ movement of active citizens, empowered youth, engaged men and women and of effective community level leaders.
They also intend to raise CS focused resources to the tune of 115 billion to counteract and reduce stigma, shame, denial, discrimination, inaction and mis-action that is associated with HIV and AIDS related infections, transmissions, illnesses and deaths.
Sidibe was happy about the meeting and promised to inform president Museveni about civil society’s concerns and recommendations towards achieving the 909090 UNAIDS ambitious targets.
He also advised that we (Uganda) come up with a new narrative about HIV by linking it to issues such as maternal health, child health, cervical cancer and TB among others. He said we should stop treating HIV/AIDS in isolation because this is an old and tired story.

The UNAIDS 90-90-90 target calls on countries to ensure that 90 per cent of people living with HIV diagnosed by 2020, 90 per cent of diagnosed people are put on antiretroviral treatment and 90 per cent of people on treatment have fully suppressed viral load by 2020.
UNAIDS Executive Director, Michel Sidibe takes a photo with members of the Uganda Civil Society after a dialogue meeting on June 7, 2017

Michel Sidibe during the dialogue meeting with Uganda Civil Society 
Sarah Tumwebaze
Media and communications officer 
CSOs want no secretariat and no board for the NATF 

Civil Society Organisations (CSOs) have asked that the National AIDS Trust Fund (NATF) should be managed neither by the Ministry of Health nor the Uganda AIDS Commission.
Speaking at a CSO meeting that was held in Kampala recently, Ms Alice Kayongo, the Regional Policy and Advocacy Manager at AIDS Healthcare Foundation said the NATF should have no secretariat and no board.
She explains that, “With this option, funds raised will be remitted directly to the Ministry of Finance and Economic Development (MoFPED), the accountability line will be clear, requests will be made by National Medical Stores (NMS) and submitted to the Permanent Secretary (PS). PS requests for funds to procure commodities and funds are transferred directly to supplier.”
Ms Kayongo adds that with this option, there will be no room for diversion, no secretariat, no board, no fund manager, no conflict of interest, easy to track additionality, easy accountability and the funding will be ring fenced/kept out of consolidated fund.
Ms Sylvia Nakasi, the Research, Advocacy and Policy Officer with Uganda Network of AIDS Service Organisations (UNASO) says the NATF that was developed as a response to a clause in the HIV/AIDS control bill which was passed in 2014 and gazzeted in January 2015 states that the fund secretariat will be at the ministry of health.
However, CSOs say this will increase expenses because they will need board members, a fund manager and staff hired. MoH will also be able to invest funds raised, the board will determine how to use funds raised among other expenses.
The other option, which was fronted by Dr Nelson Musoba, the Acting Director General of the Uganda AIDS Commission (UAC) was for the fund to be housed by UAC. However, CSOs say this option has disadvantages as when its housed by the MoH.

Therefore, they believe that the best option is to have no secretariat and no board but only paper work. “This means no one will touch the money and it will be used for its intended purpose which is to procure goods and services for HIV & AIDS Counseling Testing and Treatment,” Ms Kayongo explains.
CSO meeting to discuss progress of the National AIDS Trust Fund (NATF).
Sarah Tumwebaze
Media and Communications officer
U.S. expands infectious disease research and training partnership with Uganda

The government of Uganda and the United States signed an agreement to further their collaboration on infectious disease research and training.
The agreement that was signed in Kampala by US Ambassador to Uganda, Deborah R. Malac and Permanent Secretary for the Ministry of Health, Dr Diana Atwine will enable further biomedical research cooperation between the two countries in preventing, diagnosing and treating the heavy burden of infectious diseases in Uganda.
Importance of the agreement
This new agreement will strengthen and expand the Uganda-U.S. partnership for training and research on HIV/AIDS, malaria and other emerging diseases.
Being an African leader in biomedical research; Uganda’s scientists and institutions play a key role in global infectious disease therefore, with this agreement, U.S. and Uganda scientists will share data, collaborate on research projects and benefit from training opportunities both in Uganda and in the U.S.  
Additionally, the agreement provides for the long-term placement of the National Institutes of Health (NIH) scientists in Uganda to focus on joint activities. It will also facilitate the continuation of the International Centers for Excellence in research program in Uganda.

Ambassador Malac noted the importance of this continued collaboration and its positive effects on the health of all Ugandans. “The U.S. government remains committed to supporting medical research that improves health across the globe, including Uganda,” she said adding. “We look forward to working together to develop new and improved ways to combat HIV/AIDS, malaria and other diseases that impact Ugandan and millions of others around the world.”

Sarah Tumwebaze

Media and Communications officer
Civil Society Organisations National AIDS Trust Fund recommendations

Civil society organisations (CSOs) have recommended amendments to the National AIDS Trust Fund Statutory Instruments.

According to a joint CSOs statement, CSOs are strongly supportive of the establishment of the AIDS Trust Fund, “It represents an important opportunity to generate additional revenue for high impact efforts to end the AIDS crisis in Uganda. However, there are several areas of major concern regarding the draft Statutory Instruments that need to be addressed before these Instruments are passed by Parliament,” the statement reads in part and the recommendations are highlighted below:

1. Appointment of a representative of civil society and of people living with HIV and AIDS: We request that these two critical representatives only be selected by their respective constituencies. Donor governments have indicated the same standard for their representative. 

Action: amend 10 (2) (4) The members of the Board, except for a representative of the donors, a representative of people living with HIV and AIDS, and a representative of the civil society organisations; shall be appointed by the Minister, in consultation with the Minister responsible for finance. 

2. The amount of funding that would be raised by the currently proposed tax is too small to make an impact: Uganda’s unmet need for life saving HIV services is substantial. The National AIDS Trust Fund must include sources of revenue beyond 2% of the existing beverage tax described in the HIV/AIDS Prevention and Control Act. Sources of additional taxation that would generate substantial additional resources should be prioritized of extractive industries such as oil and natural gas, payroll tax and/or simply collecting a proportion of overall national revenue.

Action: HIV Committee of Parliament must as a matter of urgency work with the Ministry of Finance to identify additional sources of revenue so that the AIDS Trust Fund makes a strong impact in closing Uganda’s HIV funding gap.

3. High impact interventions and additionality of revenue: The NATF must be additional rather than deducted from existing sources of HIV funding or displacing existing funding sources. Additionality must be monitored and tracked externally and a ‘maintenance of effort’ clause could be required to ensure the NATF is not deducted from Government investments.

In practice, the only way to truly ensure additionality is through using NATF funds to invest in inputs for which there is a clear baseline—in particular HIV treatment and other highest impact commodities. Monitoring additionality for other interventions such as trainings would be almost impossible. Revenue raised by the Fund should be ‘ring fenced,’ meaning that it cannot be directed for any other purpose—even if that means that revenue raised by the Fund sits idle.

Action: 7 (a) (i) and 7 (a) (ii) are too broad, and not consistent with the spirit of the mother law, which rightly focuses on commodities rather than soft inputs such as trainings or workshops. They are too vague and should be removed.

4. Transparency, meeting structure, and decisions of the Fund: In principle, meetings of the Board should be as transparent, open and democratic as possible. In practice that means observers should be welcome to attend meetings, minutes of meetings should be published rapidly, and all decisions made by the Trustees should be communicated to the public.

Action: Amend 17. Transactions of the Board to state: “17. (3) Board meetings shall be open to any observer and Board minutes and Board decisions shall be widely published (eg on a website and in print media), including decisions regarding how monies raised by the Fund will be spent, transactions of the Fund, and the results of all audits of financial accounts.” Further Amend “Schedule, Meetings of the Board” to reflect this approach to Board governance, eg “Meetings of the Board (5): The Chairperson shall permit observers to attend all meetings and the decisions of all meetings shall be widely and publicly transmitted, such as transactions of the Fund, and the results of all audits of financial accounts.”

5. Independence of the Fund: The Fund should be established as an independent body, housed separately from possible beneficiaries including the Uganda AIDS Commission and the Ministry of Health. The governance structure should be transparently and independently managed by a multi stakeholder group that has no fiduciary interest. In addition, the accounting books associated with the Fund must be available at all times for scrutiny by any party. Revenue raised by the Fund should be ‘ring fenced,’ meaning that it cannot be directed for any other purpose—even if that means that revenue raised by the Fund sits idle. 

Sarah Tumwebaze
Media and Communications officer
CSOs task government to absorb PEPFAR staff

Civil Society Organisations (CSOs) have called upon government to absorb health workers that are under the President's Emergency Plan for AIDS Relief (PEPFAR).
Speaking at a meeting in Kampala recently, the CSOs said PEPFAR has been supporting many health workers in the country but for purposes of ownership, there is need for government to take responsibility of its people.
Currently, of the 2,632 health workers that were under PEPFAR, only 580 (22 per cent) health workers have been absorbed, 438 (17 per cent) left the system and the remaining 1605 (61 per cent) ae yet to be absorbed.
There is fear among CSOs that should PEPFAR pullout, there will be a crisis in the health sector especially as regards to HIV/AIDS. The CSO called government to gradually take on these health workers to ensure that they continue helping in the fight against HIV.

Sarah Tumwebaze

Media and Communications officer
People Living with HIV have asked government to increase domestic funding towards HIV

 People Living with HIV (PLHIV) have asked government to address the “glaring gaps” that are deterring Uganda from realising the 90 90 90 targets.
Speaking at the International Candlelight day Memorial at Bweyale Church of Uganda Primary School in Kiryandongo District yesterday, PLHIV under their umbrella organization, National Forum of People Living with HIV & AIDS Networks in Uganda (NAFOPHANU), said issues such as the constant stock out of HIV & TB medicines, high dependency on donor funds to finance HIV interventions, limited implementation of the HIV policies, guidelines and strategies, gender based violence, poverty, hunger, inadequate HIV counselling as well as the predominant prevalence in HIV related stigma and discrimination are some of the issues that need to be addressed if Uganda is to achieve the ambitious UNAIDS targets by 2020.
Currently, the government of Uganda only allocates 10 per cent of the required funds to the AIDS response. 23 per cent is provided by households while 67 per cent is from AIDS development partners.  
Ms Ritah Namaizi, the Coordinator of PLHIV Masindi advised that as per the memorial’s theme, “Joining hands to scale up HIV prevention” and in the spirit of showing ownership of implementation of health strategies, plans and policies; Government should scale up domestic funding. She added, “There is also need for increased budget allocation for community systems strengthening to improve HIV community based monitoring. The establishment of National HIV & AIDS Trust Fund provided for under the HIV Control and Prevention Act 2014 should be expedited to improve funding towards the AIDS response.”
However, the guest of honour at the memorial, Father Simon Lokodo, State Minister for ethics and integrity in the Office of the President, said the president has directed that the AIDS fund be established.
“The president wants to take on the direct leadership of the HIV response in Uganda and as part of this campaign, he has directed that the AIDS Fund be established and funds be allocated to it through the ministry of finance.”
However, the draft AIDS Trust Fund regulations that were passed by cabinet early this year contentious clauses that Civil Society Organisations (CSOs) led by Uganda Network of AIDS Service Organisations (UNASO) and Uganda Cares presented before the HIV committee in Parliament.

Issues of concern include the need to increase sources of revenue beyond 2 per cent of the existing beverage tax, the need for transparency in the meeting structure and decisions of the fund, the process of appointing a CSO and PLHIV representative and the need for the fund to be established as an independent body.

People living with HIV presenting their statement during the International Candlelight day memorial
Sarah Tumwebaze
Media and Communications officer

Monday 11 January 2016

Policy Brief on Inclusion of HIV Messages for Older Persons in the National HIV Behavioural Change Communication Programmes-2015


Uganda was one of the countries that were affected with AIDS epidemic in the 1980s, but has successfully gained international reputation for combating HIV&AIDS. The prevalence of HIV in Uganda fell from 18% in the late 1980s to as low as 6.4% in 2005 (MOH, 2006). In 2011, the prevalence rose  to 7.3% (MOH, 2012) which meant that Uganda is one of the few countries in the World where the prevalence  is rising despite the various interventions being implemented. The UNAIDS put the number of new infections at 150,000 in 2011, up from 120,000 in 2004 (PEPFAR, 2014) and these excludes older persons. According to Uganda AIDS Commission, approximately 80% of HIV infections arise from heterosexual transmission, 20% from mother-to-child infection and less than 1% from blood-borne infection. Nationally, only 36% of women and 43% of men aged 15-49 have a comprehensive knowledge of HIV&AIDS(MOH, 2012).

 Key Concerns

HIV messaging among Older Persons: Older persons and the general population don’t have similar levels of knowledge about HIV&AIDS due to variations in messaging. It is clear that there is lack of HIV messages targeting older persons. This means that other factors are also likely to be responsible for the difference in knowledge and prevalence of HIV in the general population and that of older persons. Sexual behaviour, living conditions and the lifestyle of older people especially those who have money are some of the factors that make older people particularly vulnerable. While as, some older persons can read and write, many of them are very illiterate as they can neither read nor write. 

Posted by Esther Namirimu/Communication Officer of UNASO.