Country Situation Analysis

UN Support to the National Response

Contacts

UNAIDS Global Report 2006 Data

Country Situation Analysis

The 2004–05 Uganda HIV/AIDS Sero Behavioural Survey (UHSBS) is the first nationally representative, population based, HIV serological survey to be carried out since 1988. Results from this survey show a prevalence rate of 6.4% among men and women aged 15–49 and 15–59 years. The survey shows that prevalence is higher among women (7.3%) compared to men (5.2%). There is also a high regional variation in HIV infection particularly in conflict-affected districts above 8%.

The Ministry of Health has made great strides in increasing the number of people on treatment. An estimated 189 000 people need antiretroviral drugs in Uganda, and as of September 2005 the numbers of people currently using antiretroviral drugs is 67 369 (most of these are adults). The government has also launched the HIV/AIDS Counselling and Testing (HCT) policy and is commended for the increased number of people tested for HIV with an estimated total of 700 000. For a variety of reasons, there was a breakdown in planning, budgeting and procure of key commodities such as condoms; HIV test kits and antiretroviral drugs and prevention of mother-to-child transmission. Uganda experienced a national shortage of condoms partly due to the recalling of a shipment of condoms that failed the quality tests in late 2004.

On funding and coordination, many donors continue to provide budget support which is in turn allocated to key government sectors in the HIV response. Some budget support funds were withheld in 2005 leading to problems with the predictability of resources through the government system. The HIV response is still dominated through large vertical programmes for both government and nongovernmental organizations and the institutional architecture for HIV is complex with many programme-specific coordinating bodies. However, many development partners are engaged in joint strategic planning and programming to promote further harmonization and alignment (e.g. through UJAS and UNDAF). Macroeconomic discipline, with pressure to adhere to sector ceilings, continues to affect government planning and budgeting for AIDS and the balance between project aid and general budget support.

AIDS mainstreaming across government remains a challenge with inconsistent understanding of mainstreaming, ad hoc budget allocation in sectors and weak planning processes.

Challenges

• External funding of HIV programmes in Uganda has increased in recent years through vertical programmes. New mechanisms and operational modalities have been set up to channel these funds. This raises issues of increased transaction costs, risk of duplication, over-expenditure on overhead costs and challenges for monitoring the use of resources. In addition restrictions posed by the Medium Term Expenditure Framework (MTEF) ceilings are causing hardship to the health sector;
• Access to prevention, care and treatment of HIV services in the conflict-affected districts in Northern Uganda where HIV prevalence is above 8%;
• A sustained flow of commodities is fundamental for successful prevention and care and to maintain public confidence in systematic approaches to the HIV epidemic. Prevention must remain—or be brought back—to the absolute centre of HIV-related activities on all levels of the system—inside and outside the health-care sector with key emphasis on vulnerable groups such as young people, discordant couples; and
• Enhanced support to the institutional capacity of the national leadership role to provide leadership and guidance.

UN Support to the National Response

• UN development partners worked with the government and other partners to put in place an interim plan to minimize disruptions to the beneficiaries following the Global Fund suspension. This ensured continuity of life saving treatment.
• Strengthened district response through World Bank support to the Uganda HIV/AIDS Control Project (UACP). The project was designed to support the operationalization of the National Strategic Framework 2000/1–2005/6.
• In line with the UN Development Assistance Framework, and the Paris Declaration, developed an HIV Plan for the North aimed at strengthening collaborative efforts among the UN and aligning these with a Government of Uganda led approach.
• In line with increased WHO technical support to the Ministry of Health in scaling up antiretroviral therapy in Uganda.

As a precursor to Joint UN programming and team work, the UN Theme Group on HIV/AIDS plans to:

• Support the development of the new National Strategic Framework 2006/7–2010/11, greater mainstreaming and ownership of sectors, and the alignment of UN and other development partners behind it.
• Strengthen partnership committee and functioning of planning and prioritization within partnership and National AIDS Commission.
• Map current UN human, financial resources, programmatic work and skills mix of the agencies in the area of HIV and assess this against the United Nations Development Assistance Framework and National Strategic Framework.
• Develop an issues paper and analysis on prevention and provide an overview of current UN action in the area of prevention and support government of Uganda revitalization of prevention work.
• Map out the existing UN response to HIV in the north and propose a coherent plan in line with the National Committee on AIDS in Emergency Settings.
  
  

Martin Mogwanja
Chair, UN Theme Group on HIV/AIDS
(UNICEF Representative)
Plot 17/19, Clement Hill Road
P.O. Box 7047
Kampala
Tel: +256 41 234 591
Mobile: +256 77 222 341
Fax: +256 41 259 146
Email: mmogwanja@unicef.org

UNAIDS Country Coordinator
Malayah Harper
Tel: +256 41 3355 00/11/12
Fax: +256 4134 0113
Postal address: UNAIDS, c/o WHO
6 Hannington Rd.
P.O. Box 24578
Kampala, Uganda
Email: harperm.unaids@ug.afro.who.int / harperm@unaids.org

NAC
David Kihumuro Apuuli
Uganda AIDS Commission
213 Sentema Rd.
P.O. Box 10779
Mengo, Kampala, Uganda
Tel: +256 41 273588
Email: uac@uac.go.ug, apuulik@uac.go.ug

Networks of Organisations working on HIV

UNASO (Uganda Network of AIDS Service Organisations)
Hannington Syahuka
Block 773 Kabakanjagala Rd.
P.O. Box 27346
Mengo, Kampala, Uganda
Tel: +256 41 274730
Email: unaso@unaso.or.ug

Networks of people living with HIV

Nafophanu (National Forum of People Living with HIV/AIDS in Uganda)
Prossy Namakula
11 Portal Avenue, Adam House Block B, No. 2
P.O. Box 7033
Kampala, Uganda
Tel. +256 41 250525
Email: nafophanu@infocom.co.ug

UNAIDS Global Report 2006 Data

Country profiles provide key information on the status-quo of the HIV pandemic in the countries of the region. Data is updated by the UNAIDS Country Offices within a span of one year