This decision affects a multi-year $1.5 billion development portfolio, placing critical sectors such as health, agriculture, education, biodiversity, energy, and democratic governance in uncertainty.
USAID is Uganda's largest single donor of health aid, playing a strategic role in combating major health challenges including HIV/AIDS, tuberculosis, malaria, maternal and child health issues.
The freeze poses significant risks to ongoing programs, particularly those under the President's Emergency Plan for AIDS Relief (PEPFAR), which serves hundreds of thousands of Ugandans.
As of December 2023, Uganda reported 1,492,407 people living with HIV, with 490,000 adult men and 910,000 adult women affected.
The country has made significant strides toward the UNAIDS 95-95-95 targets, with 92% of those living with HIV aware of their status, 90% receiving antiretroviral therapy (ART), and 94% virally suppressed.
However, the funding freeze could disrupt treatment programs and hinder Uganda's goal to eliminate new HIV infections by 2030.
Uganda faces the world's highest malaria incidence rate, with approximately 478 cases per 1,000 population annually. The disease is responsible for over 12 million cases each year, making it the leading cause of sickness and death in the country.
Malaria accounts for up to 40% of outpatient visits, 25% of hospital admissions, and 14% of all hospital deaths. The estimated annual mortality rate ranges from 70,000 to 100,000 deaths, surpassing that of HIV/AIDS. Daily, Uganda loses over 13 people to malaria.
TB remains another significant health challenge, with Uganda ranking among the top 30 countries worldwide in terms of TB cases. The disease claims approximately 30 lives daily.
The funding freeze is expected to disproportionately affect vulnerable populations, exacerbating existing health disparities.
The Ugandan government is exploring strategies to mitigate the impact of the funding freeze. Dr. Diana Atwine, Permanent Secretary of the Ministry of Health, emphasised the need for diversified funding sources and increased domestic investment in health.
Currently, PEPFAR and other international donors provide about 80.9% of HIV funding, with the government contributing 14% and private non-out-of-pocket funds making up 5.4%.