Uganda: Pepfar Makes U-Turn

Posted on August 4, 2010  |  Related Issues: Women, Girls, and HIV, U.S. Foreign Policy & Funding, August 4, 2010--(Kampala and Washington DC) Today advocacy organizations in the US and Uganda welcomed the announcement that the U.S. global AIDS program, PEPFAR, has reversed severe restrictions that capped enrollment of new HIV patients on life saving treatment in Uganda, following criticism and outcry from people with HIV, clinicians, advocates, and public health experts in the US, Uganda and around the world.

In a statement by Ambassador Eric Goosby, the Coordinator of PEPFAR, the U.S. government committed to increasing investments of additional resources for HIV treatment in Uganda. Specifically, the White House has pledged to return to the rate of new patient enrollment taking place before treatment caps were put in place--approximately 3,000 new patients each month until 2013. Advocates fear that the treatment caps, in place for almost one year, have already set back the country response to HIV, as a result of HIV treatment waiting lists expanding to crisis levels. This situation followed an instruction by PEPFAR to AIDS treatment providers to cap new HIV treatment enrollment."The White House has responded to criticism and grave concern from people with HIV, activists and other experts," said Asia Russell of Health GAP. "Now partners are picking up the pieces, reconstructing efforts to scale up to reach HIV treatment access for all. There is no time to waste." Advocates urged PEPFAR to implement this new policy as quickly as possible, with minimal bureaucratic delay and with clear guidance to providers about how they can restart new patient recruitment.

As a Senator and Presidential candidate, President Obama promised publicly and in writing to spend at least $50 billion fighting AIDS over 5 years, as the U.S. 'fair share' response to the pandemic. Instead, U.S. AIDS funding has been virtually flat-lined by the Obama White House and Congress.

The advocates called on the White House and Congress to commit to progressive scale up in HIV treatment to reach one third of those people in clinical need-as it has already pledged to do-even while leveraging increased commitments from national governments and other donors. "Shifting away from HIV treatment scale up misses the opportunity to save lives," said Dorcas Amoding of Community Health and Information Network Uganda.

"Stepping back from treatment scale up will result in substantial numbers of new infections as evidence shows significant prevention benefits associated with universal HIV treatment coverage," added Agnes Apea of the National Community of Women Living with HIV/AIDS (NACWOLA) Uganda. "Moreover it will simply postpone-and likely increase-ballooning treatment costs, because people will present later, when they are seriously ill and already requiring complex care. An urgent course correction is needed-so that communities benefit fully from the direct and indirect benefits of HIV treatment, contributing to reduced rates of new HIV infections, declining HIV prevalence, and-potentially-an eventual end to the pandemic."