The Ugandan Civil Society Organizations have today 30TH August 2017 called on the Government for bolder action in the response to HIV. Lead by the International Community of Women Living with HIV, the CSOs in a press conference held at Mariba Building in Kololo urged government to look into issues of Human Resources for Health, protection of human rights of people living with HIV, improve investment in HIV as well as improve on the quality of HIV prevention, care, treatment services. The press conference coincided with the opening day of the 10th Joint Annual Review (JAR) of the AIDS Response at Hotel Africana.
“Whereas CSOs acknowledge important progress made by government and all partners in Uganda including increased enrolment of people living with HIV on ART from 570,373 (2013) to 898,197 (June 2016); treatment coverage of 60% ; adoption of Uganda consolidated HIV prevention, care and treatment guidelines (which also includes PrEP and Test and Treat guidelines), decline in MTCT of HIV from 28,000 (2001) to 3400 (2016), decline in HIV incidences from 140,000 (2013) to 83,000 (2015 ) and a decline in the HIV prevalence from 7.3% (2012) to 6% (2017); there are indications however that Uganda is still below our expectation in the HIV response,” the press statement read in part.
Led by Happy Margaret the Advocacy Manager at ICWEA, the CSOs highlighted that During the JAR 2016, Uganda committed to institutionalize the positions of professional counselors in the health sector among other cadres. The progress has not been forthcoming as expected. The situation is made worse by the fact that some of the donors (particularly PEPFAR) supported cadres that are critical in the HIV response such as counselors and biomedical engineering technicians among others are not in the national health sector structure.
They also pointed out that there was a strong commitment at the JAR 2016 to strengthen the community structures for follow up of lost and lost to follow-up pre-ART and ART clients. One such commitment was the adoption of the Differentiated Service Delivery Models that is anticipated to contribute to achieving UNAIDS ambitious 90-90-90 target. Investment in the DSDM is one of the mechanisms for responding to loss to follow up, poor adherence and treatment retention.
The press statement also points out that Women living with HIV in all their diversity continue to experience all forms of violence including Sexual Reproductive Health & Rights violations. The CSOs asked for Violence perpetrated by those who have authorities including intimate partners, police and healthcare providers must be investigated and prosecuted. “The unequal power relation between women and men acerbates violence against women living with HIV because majority depend on their male-counterpart economically. All these have a lot of negative consequences on access to HIV care, retention and adherence.”
The non-conducive environment for adherence, retention and subsequently viral load suppression was also a key issue that the CSOs sought government to address. Poor adherence and retention in HIV care has a lot to do with the HIV care and treatment environment. There is need to address the root causes of poor adherence and retention in HIV care among the young men and women (who are categorized as the population with persistently high rates of new HIV infections). This will require an array of interventions including health care providers to addressing the specific needs of young men and women in HIV care and treatment setting. They also decried the presence of institutionalized and perceived stigma and discrimination which they said continues to affect PLHIV and MARP. They particularly pointed out cases where employers subject their employees to mandatory HIV testing and terminate their services based on HIV status. “This contravenes the provisions in the HIV prevention and Control Act 2014 and even the commitments made at the JAR 2016. Institutionalized and perceived stigma and discrimination are a results of a failed health care system and should be condemned with all possible efforts,” The statement reads.
