What happens when life-sustaining foreign aid is shut down abruptly?

It’s been difficult to keep up with all the news, but I want to talk about what we have seen in Uganda.

Impact on healthcare in Uganda

Here are some key things that have happened:

• All US government grant recipients received stop work orders during the last week of January. The public healthcare system in Uganda receives about 50% of its funding from the US government and partners.
• Many of the staff of organizations supported by the United States President’s Emergency Plan For AIDS Relief (PEPFAR) were told to stay at home, and it has not been clear if and how people can distribute antiretroviral medicine (ARVs) to people living with HIV. In Uganda alone, this supports over 1.4 million people living with HIV who are at risk of death within weeks if they do not take their daily medicine. There is no other way to access ARVs in the country. The US government has sent follow-up orders to distribute medicine, but there is still confusion on the ground, and many patients are reaching out to find a way to get their medicine.
• There has been an ebola outbreak, and CDC and USAID usually partner with the Government Uganda and other partners to address outbreaks, but funding and disease specialists are not easily mobilized.

So things have been shaken up very abruptly, and it is not yet clear what will happen in the coming months.

Impact on HAC

Health Access Connect (HAC) has been operating for over 10 years, and we received a USAID Development Innovation Ventures (DIV) award in August 2024. Getting this award was a big Win for us, and we have been working hard to hire staff, move around the country, and get a randomized controlled trial (RCT) research project started. This pause order came right as we were getting ready to roll out to many new village outreach sites, and our research partners were preparing to start collecting data. It is not clear if our grant will be able to restart and when.

What we’re doing

We have had to quickly respond to the situation:

• We moved all affected staff to 50% work time and salary.
• We have halted activities that are funded by our USAID award.
• We are focusing on keeping existing outreach clinics going and keeping our capacity high.
• We may have to make difficult decisions on staffing and activities in the coming weeks depending on decisions that are made about USAID awards.

We have started a fundraising campaign to help us continue to provide healthcare service to the most marginalized communities in the months to come. If you would like to support us in this, you can visit https://healthaccessconnect.org/donate

We will continue to provide updates. No matter what happens, we will use whatever means we have to ensure that remote communities have access to healthcare. Thank you for your interest and support!