The recent Executive Order by US President Donald John Trump in which he directed a 90-day pause on foreign programs has so far left over 2,000 health workers across Uganda jobless, creating significant gaps in the country’s health sector.
The decision has vigorously disrupted essential health programs that have been funded by USAID (AIDS, TB, Family planning and Malaria) threatening the delivery of critical services and leaving vulnerable communities at risk.
Speaking with Dr. Herbert Luswata, the President of the Uganda Medical Association (UMA), he expressed concerns about the fate of medical workers employed under USAID programs. Although the official statement indicated 90 days, there is significant suspicion that most of these medical workers are likely to permanently lose their jobs. Unfortunately, many of them have not yet started looking for alternative employment.
“They may say, after their assessment, that the US is no longer going to continue this kind of funding. This means these health workers will not return to work, nor will they receive any form of compensation or earnings. When you consider 2,000 health workers including doctors, nurses, and lab technicians it is an incredibly large number,” he said.
This challenge comes at a time when Uganda is already grappling with another issue: the lack of junior medical officers. The Uganda Medical Association (UMA) has been advocating for the deployment of about 3,000 medical officers to health centre IIIs to start providing essential services. However, if the current situation persists, the number of unemployed health workers could rise to 5,000.
“As the Uganda Medical Association, our primary concern is for the clients the Ugandans who will suffer as a result of this crisis. These are people who have been relying on essential services such as HIV/AIDS treatment, antiretroviral therapy (ARVs), malaria prevention, the distribution of medical supplies, family planning services, and programs to improve maternal and child health survival,” he explained.
According to Luswata, the government must urgently prioritize the health sector as it prepares the national budget. He emphasized the critical need for increased funding to address the pressing challenges facing the health system.
“We need more money in the health sector,” Luswata said. “In the current financial year, which ends in 2024/2025, the health sector received only 27% of the budget allocation. However, this percentage was not exclusive to health it was combined with allocations for other essential sectors like education, water, sanitation, and hygiene. These combined allocations, covering around five critical sectors, amounted to approximately 10.216 trillion shillings.
When you put this into perspective, this figure is alarmingly low. According to the Inspector General of Government (IGG) report from 2023, Uganda loses nearly the same amount of money—10 trillion shillings—annually to corruption. This means the money that could transform our health sector is essentially being lost to inefficiencies and graft. It’s unacceptable.”
Luswata further stressed the implications of underfunding the health sector, noting that critical services such as access to medicine, the recruitment of medical personnel, and improvements to healthcare infrastructure remain underfunded. “If we fail to prioritize health, the ripple effects on other sectors and the population’s wellbeing will be catastrophic,” he warned.
Can our current budget foot Gaps in these 90 days?
He added, “I think the government needs to rethink its priorities and focus more on social services such as health, education, and water. These are essential services that directly impact the lives of people on the ground, and we need to allocate more funding to these areas.
I don’t believe that the government of Uganda cannot provide these services even those currently funded by US money. If we consider the Shs10 trillion allocated in the current financial year and compare it to the same amount lost annually to corruption, as highlighted in the IGG report, it’s clear that we have the potential to redirect those funds.
This means the government can find an equivalent amount of money within our budget to sustain these services. These services can be funded using Ugandan taxpayers’ money, and there’s no valid excuse for failing to do so. The government of Uganda must take responsibility and act honestly to ensure these critical services are maintained,” he emphasized.
He added the parliament should quicken the wage act to operationalize the new public service structure so that the Ministry of Health can deploy all medical officers in health centres in the country to fill up the gaps in the national referral hospitals, and regional referral hospitals, which will help to push beyond the less than 60% of employment coverage.
“I think it is not right for our government to rely so much on this kind of donations because when such things happen and then you start going through a panic, a full count is a bit embarrassing. So, we request the government. This is a budget process. It’s Grace is coming now. We have time to adjust our budget and provide enough funding to the health sector. At least we should be able to provide 15% to health alone, not following it with other sectors. And all these things will be history. These health workers should be redeployed into government facilities and services and reallocated, and the government should own them.”
Dr. Diana Atwine the Permanent Secretary Ministry of Health also stressed that the government must not come on board and prioritise the health sector more. “Our partners have communicated through the executive order of the US president and this is halting the activities until they do reviews but activities are ongoing because the Uganda government provides a budget to run our health services the partners come and supplement, not only the US government that has been funding, we have Global fund, GAVI, they are there and have not topped.”
She added that the current state is a blessing in disguise for the government to revise its preferences as far as budget allocation is concerned. “This allows us to sit at the table and see what are the critical areas which we can not postpone and can not do away with, this is what we are doing this week so that we come up with a broader picture before we engage the ministry of finance.”
What is likely to happen if the Government fails to bridge these funding gaps?
According to Luswata, if the government does not change their priorities and provide enough funding to the health sector, there will be a very big problem.
“Maternal mortality is going to rise significantly, and neonatal mortality will also increase. These areas have benefited greatly from US government funding, which has been instrumental in ensuring the survival of mothers and children during labour. However, if the government fails to step in and allocate adequate resources to these critical sectors, we will face devastating consequences, with more mothers and children losing their lives during childbirth due to inadequate care and resources,” he said.
He added that for HIV patients, the situation is equally concerning. The death rate among HIV-positive individuals has been relatively low, especially for those adhering to their antiretroviral treatment (ARVs). This progress has been made possible through consistent funding and support. However, without government intervention, Uganda risks losing this progress, resulting in an increase in HIV-related deaths and a surge in new infections. The gains we’ve made in managing HIV/AIDS could be completely undone if this funding gap is not addressed.
“The area of family planning is another critical concern. We have been witnessing alarming numbers of young girls some as young as 13 or 14 years old falling victim to unwanted pregnancies. Many of these cases result in unsafe, criminal abortions, which have led to countless preventable deaths. Without access to family planning services, we will see a rise in unwanted pregnancies, particularly among young girls, and a corresponding increase in deaths caused by unsafe abortion procedures.
He continues to assert that the lack of investment in family planning will lead to higher fertility rates and an increased burden on mothers, especially those without access to proper maternal care. This will further exacerbate maternal mortality rates. The cascading effects of this crisis will not only affect individual families but will also place an immense strain on the already overstretched healthcare system.
“This is a very serious and urgent issue that demands immediate government attention. The lives of mothers, children, and entire communities are at stake if these gaps are not filled,” he emphasized.
Do you have a story in your community or an opinion to share with us: Email us at Submit an Article
