The Ugandan government is to make combination antiretroviral therapy (HAART) available free of charge to 2,000 people with HIV/AIDS who are unable to pay for the drugs, in addition to the 10,000 or so currently believed to be paying for their own treatment in the country. The cost of this programme is to be covered by Uganda’s first grant from the Global Fund to fight AIDS, TB and Malaria, although it is still not clear when the Global Fund will actually commence payments.
As announced by the Ugandan Minister of Health, Jim Muhwezi, and reported in the New Vision newspaper on 13 August, communities in each sub-county will be asked to identify two people to go onto treatment. An additional 300 will be treated through The AIDS Support Organisation (TASO); 300 through the Mulago-based Academic Alliance for AIDS training and treatment; 200 children will be treated through the Mildmay Centre and 100 healthcare workers will also receive treatment.
While this represents only a modest expansion of access to treatment in Uganda, it may set an important precedent and is a challenge to other countries since Uganda has in many respects led the African public health response to AIDS. It would appear that the thinking behind the allocation of this treatment is further to encourage every community throughout Uganda to face up to the current reality of HIV and AIDS. The level of take-up will therefore be a test of the extent to which public education has really succeeded in limiting social stigma for people living with HIV.
The Global Fund’s payments system has yet to be fully defined, as the option of paying money through an existing international funder appears to have been rejected in favour of setting up new arrangements, country by country, with independent monitoring.
Further information about the Global Fund is available here.