In the wake of dwindling international aid, Uganda stands at a critical crossroads: either increase domestic investment in health or risk jeopardising essential services for its most vulnerable populations.
For years, Uganda’s healthcare system particularly programs serving key populations such as people living with HIV, sex workers, and LGBTQ+ individuals has leaned heavily on foreign donors, most notably the U.S. government. However, the recent suspension of key funding streams has exposed a dangerous gap.
“This shift in global funding has made it abundantly clear: we must take charge of our own health agenda,” said Aliyi Walimbwa of the Ministry of Health. “The government is committed to redesigning service delivery models that integrate primary care, community outreach, and strategic financing.”
The call for domestic investment was echoed during a side event at the 2025 National Health Financing Dialogue, held at Speke Resort Munyonyo. The event, themed “The Integration Agenda: What’s the Remaining Space for Civil Society Organizations in Domestic Health Financing?” brought together government officials, civil society actors, and development partners to explore sustainable paths forward.
At the heart of the discussion was the role of civil society organisations (CSOs) longtime lifelines in Uganda’s healthcare delivery system. With donor funds shrinking, many CSOs face an uncertain future.
“We are at a turning point,” said Grace Namata, Program Officer at Akina Mama wa Afrika. “Uganda must reduce its over reliance on aid and invest in its national priorities. Transparency and public participation in budget oversight are no longer optional they are essential.”
Namata emphasised the importance of citizen involvement in tracking how public funds are spent, especially in Parliament. “If people understand where their taxes are going, they’ll be more empowered to demand better services.”
Throughout the forum, speakers championed community-driven approaches to health financing. They called for funding allocations that support youth-friendly services, maternal health, HIV treatment, and mental health outreach areas where CSOs have proven especially effective.
Richard Lusimbo, Director General of the Uganda Key Population Consortium, called for greater resource mobilisation within the national budget. “Community-based organisations are reaching people who would otherwise be invisible to the system. They must be adequately financed to continue doing so.”
Flavia Kyomukama, Director at the National Forum of People Living with HIV/AIDS Networks in Uganda, issued a passionate appeal to government leaders: “Don’t sacrifice public health for military hardware. National security is important, but so is health security. We can’t cast our votes if we are sick and dying.”
Her message struck a chord with many in the room. Macklean Kyomya, Executive Director of the Alliance of Women Advocating for Change, urged a shift in strategy from confrontation to cooperation. “Dialogue, not force, is how we build resilient systems. Communities, especially those affected by HIV, must be empowered to monitor services and demand improvements.”
UNFPA’s SRHR Coordinator, Julian Lunguzi, concluded the dialogue with a powerful reminder: “Communities must be the engine of change. When they raise their voices when they report gaps and demand accountability governments listen.”
The side event was jointly organised by Akina Mama wa Afrika and VSO International in partnership with the RMNCAH+N Platform Uganda and the MakeWay Program. Collectively, they reinforced a resounding message: Uganda’s path to universal health coverage lies not in aid dependency, but in bold domestic leadership, inclusive governance, and an empowered civil society.