Monday, 27 October 2014

Civil Society Statement to the 7th Joint Annual HIV&AIDS Review

10th September 2014

 

The Guest of Honour

Honourable Ministers

Honourable Members of Parliament

Permanent Secretaries

The Director General of Uganda AIDS Commission

The Director General of Ministry of Health

Development Partners

Representatives from the Local Governments

Representatives from the Private Sector

Dear Colleagues

 
Ladies and Gentlemen,

 
I feel greatly honoured and privileged to participate in this important partnership forum which marks the 7th Joint Annual HIV/AIDS Review. On behalf of the Uganda Network of AIDS Service Organisations, I would like to take this opportunity to welcome all the distinguished participants to this forum.

 
Ladies and Gentlemen

The 7th Joint Annual Review is carried out in the spirit of partnership between all

Sector stakeholders and takes the comprehensive view of the national response to HIV/AIDS. During this meeting as we assess the performance of the National Strategic Plan (NSP) and use the platform to generate consensus for the identified priority interventions for the new NSP, it is our strong hope that we shall jointly hold discussions on emerging issues on selected topics and agree on the progress on the response, recommendations, priorities and resolutions for the upcoming NSP 2015/16-2019/20.

The Uganda Network of AIDS Service Organisations raises the attention of the delegates here, the government, the UN system, development partners and all other stakeholders to the following issues.

Ownership and Leadership of the Response; Guest of honour, we would like to acknowledge the good working relationship between the Uganda Network of AIDS Service Organisations and the Government of Uganda; The government has continued to demonstrate its commitment to the national fight against HIV/AIDS through various ways, for example on 31st July, President Yoweri Museveni signed the HIV and Control Bill into a Law. Even though it has some unacceptable clauses, this law has positive provisions like a nationwide fund for HIV care, and outlaws discrimination against HIV-positive individuals in workplace and schools. We also recognize the great support from the AIDS Development Partners. Ugandan households contribute substantially towards the national response at the individual, family and community levels.

Recommendation: The revised NSP should advocate for the revision of the new law and removal of clauses that criminalise HIV.

 
Millennium Development Goal No.6 targets, among others, to have halted by 2015 and begun to reverse the spread of HIV/AIDS. We are deeply concerned that given the current rate of progress, Uganda has no chance to achieve this target. Tables are turning on the Uganda HIV/Aids success story. The gains made in the last two decades are fast getting eroded by the increasing number of new infections. Statistics from UNAIDS show that Uganda is the third highest contributor of all new HIV infections in the world — third to South Africa and Nigeria. A new report released by the UN agency on July 16 puts Uganda in third position among the top 15 countries that accounted for more the than 75% of the 2.1 million new HIV infections that occurred last year. Recommendation: The revised NSP should clearly provide specifications on how different stakeholders, including UAC, MOH, CSOs, Local Governments, Political leadership, youth among others are going to get involved in the revival of strong campaigns in the HIV/AIDS response.

 
Financing of the HIV and AIDS Response; Uganda has continued to steadily increase investments in the health of her citizens. The health sector spending, that also includes those of HIV/AIDS, has increased from as low as Shs239bn in 2001 to Shs852bn in 2013. In the last five years, this significant increase in resource allocation to the health sector resulted in doubling the total health expenditure from Shs418bn to Shs852bn between 2007-2013. However the National response is heavily dependent on international donors; at the level of spending on HIV and AIDS described above, it means that with more than 80% spending coming from ADPs, Uganda’s national HIV/AIDS response is heavily dependent on external support as out of the US$ 1.747bn used in the national response between 2007/08 and 2012/12, a total of US $1.565bn was contributed by international donors. According to the NASA study that included on and off budget expenses known to government as well as private spending that is not usually captured by government indicated that between 2008/09 and 2009/10 funding from public sources contributed approximately 10.5% of expenditures on HIV/AIDS while private out-of-pocket sources contributed roughly 21%; the largest source of funding came from donors at 68%.

We are grateful to the development partners on whose support; the civil society has largely depended to make a contribution to the national response.  Your continued support will be critical in addressing the pending gaps. We strongly recommend that the revised NSP projects a target annual increase in the proportion of domestic funding going into the national response.
 
It is estimated that up to 1.6million Ugandans are currently infected and with at least 1.3 million who need to be enrolled on anti-retroviral treatment, following WHO’s new guidelines that require a patient to be started on antiretroviral treatment when their CD4 cell counts falls below 500. We have managed to put 577,000 people, with another 240,000 expected this year, but this still have a gap close to 500,00 that cannot be enrolled on treatment for lack of resources. Recommendation; As drugs for treating AIDS related conditions are available, the NSP should ensure that all those eligible are provided the necessary treatment. In order to reach zero new infections and deaths due to HIV/AIDS, as the national response succeeds in prolonging the lives of People Living with HIV, there will be need to invest in prevention to drastically reduce the number of new infections. We also recommend task shifting to allow community health workers to do rapid HIV testing in the public sector and nurses to be trained to initiate and maintain people on treatment.
 

The essence of smart investment in HIV is based on sound evidence, science and shared responsibility, can lead to millions of lives saved and an AIDS-free generation. It is also envisaged that the investment will ensure that significant returns can be achieved on a sustainable basis. This will require more political commitment and tough decisions to be made at political, technical and operational levels.

 
NB.
The event took place at Imperial Royale Hotel in Kampala between 10th-11 September. The above statement was read by Dr. Raymond Byaruhanga the Chairperson of Board of Directors, UNASO.
Dr. Raymond Byaruhanga reading the CSO Statement at the 7th Joint Annual AIDS review