U.S. Embassy Kampala | December 4, 2021
(as prepared for delivery at Reach Out Mbuya’s Banda offices, Nakawa Division, Kampala)
Good afternoon! I am delighted to join you today for this very special occasion – celebrating 20 years of existence of Reach Out Mbuya Community Health Initiative, or ROM as we commonly call it. Congratulations on this milestone! I am especially touched to see not only current, but also past ROM leaders, including CDC Prevention Branch Chief Stella Alamo-Talisuna, who was ROM ED from 2006-2014; so many partners; and of course clients. I am honored to continue the tradition of having an American Ambassador participate in your milestone events. I understand one of my predecessors, Ambassador Jimmy Kolker, officiated in 2019 when you celebrated PEPFAR’s 15-year anniversary, and I look forward to sharing some of today’s photos with him. His past presence and mine today represent the enduring strength of an effective partnership. I am so happy to help expand it.
The United States government recognizes that a healthy population is the foundation for a country’s social and economic development. Therefore, every year we invest over $500 million in Uganda’s health sector, the bulk of which goes to supporting HIV programs through PEPFAR, which is the U.S. President’s Emergency Plan for AIDS Relief. PEPFAR is the United States government’s response to the global HIV epidemic, representing the largest commitment by any nation to address a single disease in history.
With the establishment of PEPFAR in 2003, Uganda became a focus country for the program, supporting implementation of HIV prevention, care, and treatment services to those infected and affected by HIV and AIDS. To date, PEPFAR has invested over $4 billion dollars in Uganda’s fight against HIV. Thanks to our U.S. government agencies, including the Centers for Disease Control and Prevention, or CDC, and the U.S. Agency for International Development (USAID), the U.S. Mission in Kampala has enjoyed close collaboration with ROM, right from the start of PEPFAR’s establishment here and continuing to date. Currently, ROM is receiving PEPFAR funds through CDC’s partners, the Infectious Diseases Institute and Mildmay-Uganda, as well as implementing the USAID Integrated Child and Youth Development Activity in Kampala District through the Bantwana Initiative of World Education.
I am particularly pleased to learn that the first PEPFAR client in the world, John Robert Engole, is a ROM client and he is right here with us today! ROM and Mr. Engole’s story are an important part of the very successful legacy of PEPFAR and of partnership in addressing the global pandemic of HIV. In my work as a U.S. Ambassador, I get to hear quite a lot about health challenges the world over. The current COVID-19 pandemic and the emerging and re-emerging outbreaks such as Ebola are new, and for many so virulent that they often push the existing HIV and TB pandemics down the priority list, raising the possibility of losing progress we have made and re-emerging as fresh epidemics. I also hear, a lot, about lives affected and devastating loss, and about the resources still needed to tackle these challenges. But along with these sad stories are stories to lift us up and inspire us. Stories of people like Dr. Margrethe Junker, who co-founded ROM to respond to the community’s needs, and stories of beneficiaries like Mr. Engole. These demonstrate resilience, impact, and sustainability – core principles of PEPFAR, that U.S. support aims to foster.
From a simple church initiative to provide home-based care and pray for the sick within the parish area at the peak of AIDS, you began providing TB care and referrals to hospitals using the nurse-led approach from which Uganda learned significant lessons. You expanded partnerships to provide nutritional support to poverty-stricken patients. You established a livelihood program that included a state-of-the-art tailoring workshop for your clients, and you started an Orphans and Vulnerable Children’s program funded through individual sponsors to address economic hardships for your clients and their families. You saw a need, and you addressed it head on.
And all of this was long before you began receiving funding from PEPFAR as a subgrantee of the Mildmay Center in 2004. Many of you who lived through it know that period was a crisis period, and many health leaders and policy makers were focused their attention on money and medicine for prevention and treatment. Critical aspects of healthcare such as emotional, psychological, spiritual, and nutritional support unfortunately took a backseat. But not here at ROM. I commend you for ensuring that addressing these issues were at the forefront of your mission and continue to be guiding principles for your efforts to this day.
This past Wednesday, we commemorated World AIDS Day under the theme, ‘End Stigma, End AIDS, End pandemics.’ While overall deaths from AIDS have declined over the years thanks to PEPFAR-supported ART treatment, HIV still causes far too many new infections, particularly among young people. Unfortunately, fear of stigma or ostracism make many reluctant to openly share their HIV diagnosis with partners and loved ones. Conversations such as what we have had today are so very critical, and if extended to places of worship, schools, workplaces, and especially homes and community gatherings, will go a long way in helping us to end HIV.
There is another threat to our collective health, as well: TB. While not a new disease, the TB epidemic has been worsened by the HIV and COVID-19 pandemics. I am therefore gratified that ROM provides comprehensive HIV and TB services, including counseling and testing, prevention of mother-to-child transmission (PMTCT), and Prevention with Positives in the city’s highly populated, underserved communities that most need these services. I learned that ROM was the first health facility in Uganda to eliminate Mother to Child Transmission and I have listened with admiration to testimonies here that with low-cost models like ROM’s, it is possible to achieve high quality services.
In closing, I wish to note that Uganda, like many African countries with PEPFAR presence, has experienced challenges and disruptions to its programs due to COVID-19. Ugandans have lived through two lockdowns with the two waves of COVID-19 that saw many health care facilities filled to capacity, a number of deaths attributed to COVID-19, long-term closure of schools, and slow vaccine roll-out due in part to delays of getting vaccines into the country and now vaccine hesitancy among the broader Ugandan public. These challenges have impacted and will continue to critically impact HIV, TB, and other health programs, contributing to preventable deaths.
As we celebrate 20 years of ROM, let us celebrate life by getting our COVID jabs if we have not yet done so and encouraging friends and family to do the same. Remember, when you have underlying conditions like HIV and TB, you have a higher risk of severe disease once infected by COVID-19. The United States has now provided almost 6.5 million COVID-19 vaccine doses to Uganda with nearly three million more arriving this coming Monday. The vaccines are here, but they won’t do any good unless everyone avails themselves of the opportunity to protect themselves and their families against the coronavirus. As they say, “don’t count the things you do, but do the things that count.” Get your jab quick. For now, let us join ROM to toast to the 20 years of doing things that count.