“These services have ceased completely. All clinic staff have been laid off,” states Macklean Kyomya, the executive director of the Alliance of Women Advocating for Change, which operated a drop-in center supplying HIV/AIDS testing, counseling, antiretroviral treatment, and other essential services.

According to Kyomya, her organization received notification on February 4 from its funding agency, the Uganda-based Infectious Diseases Institute, indicating that all financial support had been withdrawn. This institute was financed through the U.S. Agency for International Development (USAID).

On January 20, President Donald Trump signed an executive order immediately halting most international assistance for a 90-day assessment period. This suspension encompasses operations managed by USAID and the U.S. State Department, which collectively oversee vital health services worldwide. One significant program affected is the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), established in 2003, which has been pivotal in providing crucial medications and services to both prevent HIV/AIDS transmission and treat those infected.

Although U.S. Secretary of State Marco Rubio issued a waiver on January 28 allowing certain “existing life-saving humanitarian assistance programs” to continue, it remains uncertain which, if any, HIV/AIDS services will be preserved under this waiver. Moreover, uncertainty looms regarding the resumption of funding for these programs post the 90-day evaluation period. Inquiries directed to the U.S. State Department by Global Press Journal went unanswered.

The United Nations estimates that approximately 1.5 million individuals in Uganda live with HIV/AIDS, with around 1.2 million relying on antiretroviral therapies — many of which are funded by U.S. contributions.

This crisis extends far beyond Uganda, impacting over 20 million people globally, including more than half a million children, who received antiretroviral treatment in 55 countries via PEPFAR. The circumstances in Uganda represent a troubling preview of a broader crisis that is expected to escalate as individuals lose access to the medications vital for managing or preventing the virus.

Flavia Kyomukama, executive director of the National Forum of People Living with HIV Networks in Uganda, recently disseminated an urgent message via WhatsApp, advising healthcare providers to inform patients to promptly refill their prescriptions for antiretroviral medications.

The communication cautioned patients to visit health clinics “before they close their doors, as health workers at these facilities have begun the process of packing up.”

According to Robert Kiwanuka, program manager at Muvubuka Agunjuse in Kampala — an organization that has offered free treatment to young people, commercial sex workers, and individuals with HIV-positive partners — U.S.-supplied resources and personnel have already faced significant cuts.

“Some individuals have begun approaching us, inquiring, ‘What’s next?’” states Kiwanuka.

Despite having some supply of medication, many have expressed uncertainty about their plans for the upcoming months.

The situation, according to Kyomya, is poised to become disastrous.

“Vulnerable populations will go underground,” she warns. “We are likely to witness a rise in new HIV cases, and those currently on antiretroviral therapy may develop resistance if they experience interruptions in treatment.”

Julie Fischer, an associate research professor at Georgetown University’s Center for Global Health Science and Security, emphasizes the critical nature of ongoing antiretroviral drug distribution.

She notes that there is a limited timeframe during which the medication is most effective in preventing HIV infection. For infants, expedited treatment is particularly crucial to prevent transmission from HIV-positive parents, typically required within hours.

UNAIDS reports that nearly all HIV-positive pregnant women in Uganda receive treatment aimed at preventing the transmission of the virus to their newborns.

If this percentage declines, Fischer warns, the resulting damage could be extensive and long-lasting.

“The repercussions can persist for years, not only affecting those individuals who miss out on treatment but also their families and communities,” she remarks.

Accounts from individuals seeking clinic services paint a picture of desperation that drives both adults and teens into high-risk situations for HIV contraction.

Hadijja Nalubega, who was only 15 when her mother fell ill and could no longer work, shares her experience. She attempted to find employment to support her family but ultimately resorted to exchanging sex for money, which she used for food and her sisters’ school fees.

Now at 20, Nalubega has received complimentary reproductive health services for several years at Muvubuka Agunjuse. She recalls an incident where she had sexual relations with a man who appeared unwell.