Uganda's HIV Patients Divided on Move to Integrate Care into Public Facilities

Uganda’s government is shifting HIV services from dedicated clinics to mainstream public health facilities due to sharp cuts in international donor support, including from PEPFAR, which previously covered over 90% of funding.

This change affects 1.4 million individuals relying on antiretroviral therapy, sparking mixed reactions. Patients like Maxensia Nakibuuka, who has lived with HIV since 1998 and uses a wheelchair, express deep anxiety over losing the privacy and familiarity of specialized centers. ‘They are putting me in line with other people,’ she said, warning that many might abandon treatment to avoid mixing in general queues.

Prof Vinand Nantulya, a veteran in HIV programs, cautions that the health system lacks preparation for this integration. He stresses the need for adequate funding to replace donors, arguing rushed changes risk reversing progress and increasing infections through stigma and poor privacy in crowded facilities.

HIV activist Peace Anne Baguma reluctantly accepts the shift but highlights manpower shortages and infrastructure gaps that could deter shy patients. Dr Stephen Watiti agrees integration has potential if properly funded, recalling how well-resourced standalone clinics ensured reliable care.

Supporters like Rev Canon Gideon Byamugisha and Milly Katana see it as efficient and necessary, given Uganda’s growing population and funding realities. They argue HIV can now be managed like other chronic conditions, provided stigma is tackled and referral systems strengthened.

Government official Dr Alex Riolexus Ario defends the policy, noting health workers are trained for HIV care and standalone programs are unsustainable without funds. Critics like Flavia Kyomukama point to abrupt implementation without community input, already causing longer waits and adherence issues.

The transition’s success hinges on addressing these concerns to safeguard decades of HIV gains.

Source: Daily Monitor