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Dr. Diana Atwine, the permanent secretary at the health ministry, has expressed optimism that Uganda can achieve its goal of ending HIV/AIDS by 2030 through prevention efforts and improved treatment adherence.

The world is preparing for World AIDS Day on December 1, to raise awareness of the AIDS pandemic caused by the spread of HIV. The day is also used to remember those who died of the disease. It is one of the 11 official global public health campaigns marked by the World Health Organisation (WHO).

Thanks to recent improved access to antiretroviral treatment, the death rate from the AIDS has decreased globally by 64% from its 1.9 million peaks in 2004 to 680,000 in 2020). John Musenze asked the permanent secretary at the health ministry, Dr Diana Atwine, about Uganda’s efforts to end AIDS by 2030

Will Uganda achieve ending HIV/ AIDS by 2030?

Yes, it is possible if we go with our projections. By 2030, we will be able to prevent new infections. In fact, for example mother-to-child. Even now, no child should be born with HIV. If by 2030, everyone knows their status, those that are HIV-positive are on treatment and those on ARVs are helped to adhere and suppress their viral load, we will have achieved the 2030 target.

HIV in Uganda is skewed; it is more in certain areas than others and in young girls than boys. What is the ministry doing to target those high pockets specifically?

We are creating awareness campaigns and trying to ensure that adolescent young girls remain in school to avoid early sex. We are thinking of introducing self-testing in schools where young girls and boys can know their status and then be helped.

Those that are out of school need to be engaged and made busy with activities. That is why there are the presidential skilling projects. Parents also need to talk to their children about protection. In social counselling, men have been ignored, but they, too, need to utilise the available preventive options to stay negative.

We also need to change the message because this is a different generation. For the rest in what is thought to be ‘safe regions and gender’ you still need to be careful; HIV moves with anyone. If you ignore your protection, it will find you.

Uganda has participated in preventive research, like the microbicide vaginal ring. Other countries took up and rolled out these options. But for us, there is no government roll out!

We are introducing the injectable drug early next year, among others. We wait and see which one is more effective, as well as the cost implication before moving in to support one or another. The vaginal ring is expensive for us. The injectable ARVs that are coming may not be given to all the 1.4 million people living with HIV. We will look at who is more vulnerable. They will take an ARV injection every two months, instead of daily medicine. We plan to start early next year.

Ideally, we would like to roll out all preventive technologies for our people, but the budget attached to them incapacitates us.

Almost 90% of the ARVs come from developing partners, yet Uganda is criticised for human rights and laws unacceptable to the donors. Aren’t we taking risk in case donors switch off?

The health ministry still has a good relationship with our donor partners, and we do not expect them to pull out. They have seen that even with the new law that was passed, we, as a ministry, have not stopped anyone from getting any health care because of their orientation.

Yes, most of our ARVs come from developing partners because their budget is $150m (about sh562.5b). Government is now contributing $50m (about sh187.5b). This is about 33%. If you look at where we have come from, government was contributing less than 10%. So, we are improving.

Government has also supported local pharmaceutical companies, like Cipla, by reducing the taxes and giving other incentives.

Importation of the drugs is expensive because it carries a 12% import duty. But our development partners insist on importing these drugs, yet drugs purchased in Uganda have a 3% tax. The good thing PEPFAR (the US assistance agency) is also helping local companies and drug manufacturers. So, we will keep talking to all supporting partners to consider investing in local companies.

‘Protect yourself’

What is your message for this year’s World AIDS Day?

I want to tell fellow Ugandans that HIV/AIDS is still around, and it is upon us to protect ourselves. Those who are living with HIV, adopt positive living and you will live out your life span.

If you are HIV-negative and sexually active, even with one partner, test regularly. Those who are negative, stay negative; if you find yourself positive, start medication.