Remarks for Uganda’s World AIDS Day Event On Behalf of the AIDS Development Partners (December 1, 2014)

Deputy Chief of Mission Patricia Mahoney

December 1, 2014

Fort Portal, Uganda

I am honored to be with you to commemorate World AIDS Day.  It is a day to remember those whom we have lost, celebrate the lives we have saved, and recommit ourselves to the continued fight against HIV.

Achieving an AIDS-free generation is a shared responsibility, and I want to recognize today the ongoing public health partnership between the government and people of Uganda with the AIDS Development Partners including Ireland, the UK, Denmark, Sweden, the US and the UN.  Together, we have made great strides.

Like what?  Well, 11 years ago, AIDS was a death sentence.  It threatened Uganda’s very foundation – orphaning millions of children, overwhelming the health care system, and inhibiting economic development.  Today, as a result of steadfast global commitment, new infections have declined nearly 33 percent over the past decade, and AIDS-related mortality has decreased by 30 percent since its peak in 2005.  In sub-Saharan Africa, new HIV infections are down by one-third since 2005; AIDS-related deaths have declined by nearly 40 percent since their peak; and access to lifesaving HIV treatment has increased by more than forty-fold.

In Uganda, the American people have invested over $2.6 billion – that’s almost 7 trillion UGX – to fight HIV over the past 11 years.  But more important than the dollars spent are the lives transformed by this remarkable public health intervention.

The statistics are impressive:

  • Over 640,000 HIV-positive Ugandans live healthy and productive lives because the American people support their  antiretroviral therapy (ART);
  • In each of the last two years, PEPFAR support gave over 88,000 HIV-positive pregnant women the chance to give birth to HIV-free children.  And with the help of Her Excellency, First Lady Janet Museveni, the champion of elimination of mother-to-child-transmission, the number of babies born with HIV fell from over 8,000 in 2012 to 4,088 this year.
  • And this year we supported more than 8.6 million HIV tests – helping Ugandans know their status and take responsibility for their lives and the lives of those they love.

I am proud of the contribution the U.S. has made in this effort, along with other committed donor governments and multilateral organizations.

While we celebrate this progress, we also have to acknowledge that HIV still threatens Uganda’s future, still kills Ugandan people, and still has no cure.  We all know we have a lot more to do to ensure that Uganda will have the healthy and productive population it needs to build a prosperous, secure, and democratic future.  Despite the best efforts of the AIDS Development Partners in providing HIV care, treatment, and prevention services, some startling realities exist:

  • More than 1.6 million people still live with HIV.
  • Last year, over 61,000 Ugandans died from AIDS-related causes.
  • Over 131,000 people became infected with HIV.
  • Almost 35,000 HIV-positive pregnant and lactating women missed enrolment in eMTCT in 2013, despite accelerated efforts to decentralize services and availability of antiretroviral drugs.
  • And let’s not forget those 4,088 babies who were born HIV-positive this year.

We’re a long way off from zero new infections and AIDS related deaths.  That gap is unacceptable, especially because we have the knowledge and tools to close it.   

I think I speak for all of the AIDS Development Partners when I say that we will continue to play our part, but if we really want to get to zero we must work in even closer partnership with Uganda so that Uganda can bring more resources to the table to bolster the efforts of its international allies.

Responsibility for the fight against HIV rests with all of us, and it is critical for all national stakeholders to make a greater commitment to financing the response.  Donors simply cannot continue to fund 87 percent of the response to HIV in Uganda.  PEPFAR funding levels in Uganda have remained stable to date, but the combined resources from PEPFAR, the Global Fund and other donors must be supplemented by the government to fully support Uganda’s aggressive scale-up goals for ART—and to sustain this response in the future.

A very important step in the right direction is the HIV Trust Fund, which demonstrates Uganda’s commitment to increasing domestic funding for the fight against HIV.  We encourage the Ministry of Health, the Uganda AIDS Commission, and the Ministry of Finance to act quickly and transparently to operationalize the fund and ensure that resources are targeted toward high-impact interventions that will control the epidemic.

And while we recommit ourselves to the goals of zero new infections and zero AIDS-related deaths, we also have to ask about the third goal:  zero discrimination.  How close are we to that?  In this era of constrained budgets, we need to focus our collective energy and resources on those Ugandans at greatest risk for infection, which includes sexual minorities.  And to combat this epidemic successfully, we need an environment in which those Ugandans at greatest risk of infection feel safe and free to access counseling, testing, care and treatment–an environment that is free of discrimination.

Uganda reached the “tipping point” in 2013 when, for the first time, the number of people enrolled on ART exceeded the number of new HIV infections, and the trend of new HIV infections has declined over the last three years. That progress could be squandered if legislation is passed that criminalizes public health efforts to reach key populations affected by AIDS. We can’t afford that.  Uganda can’t afford that.

We’re at a crossroads.  We all know which way to turn, so let’s do it.  We must reach those most at risk for becoming infected, and stop that from happening. We must get HIV-positive individuals on ART. We must test every pregnant woman, and for those who are positive, treat them so their baby will be born free of HIV. We must encourage correct and consistent condom use. We must foster an environment of non-discrimination so thatevery Ugandan is free to access services.

That’s a pretty clear roadmap, and I know we can get there together as partners.  The goal of my government and the AIDS Development Partners is to help you make the dream of a healthy, secure, prosperous, and democratic Uganda a reality.  We are proud to work with you as friends and partners as you shape that future.  Together, I know that we will make the dream of an AIDS-free generation a reality in Uganda.