Immediate Risks and Disruptions 

1. Distribution Disruptions: 

• According to the policy brief to Parliament prepared by the Uganda AIDS Commission with support from UNAIDS, stocks of ARV supplies, HIV, viral load and other lab test kits are available. However, distribution from district hubs to lower health facilities is disrupted due to reliance on US-funded implementing partners. Facilities have adequate stocks for three months, but the impact will be felt from the second quarter of 2025 if not mitigated. 
• Condom stockouts are anticipated within the next 3-6 months due to challenges with last mile distribution. 

2. Service Capacity: 

• All ART-providing facilities are operating at reduced capacity.   Some community-led, peer-led, NGO-run, and private facilities have stopped services. 
• Reduced adherence to prevention of vertical transmission and early infant diagnosis services due to decreased numbers of expert clients and mentor mothers. 
• HIV prevention services for key populations at drop-in centres, including PrEP access, HIV testing, and antiretroviral treatment adherence counselling  for sex workers, men who have sex with men, transgender persons, people who use drugs, and prisoners, have been disrupted. 

3. Human Resources: 

• It is unclear whether US-funded health workers will be integrated into the government payroll. 
• Data clerks at facilities covered by USAID are not yet back at work, impacting data collection and quality control. 

Politically Relevant Updates 

1. Government Actions: 

• The Ugandan President directed the release of UGX 6 billion for the rollout of electronic medical records (EMR) in government health facilities to improve service delivery. 
• The Ministry of Health issued guidance on improving service delivery, including integrating HIV, TB, and other chronic disease services, training health workers in integrated service delivery, prioritizing recruitment of critical staff, utilization of primary health care funds for disease prevention outreach activities and strengthening accountability for medicines and laboratory supplies. 

2. Mitigation Measures: 

• The government is reallocating domestic resources to priority HIV programs and integrating HIV services into other health services. 
• Civil society partners have conducted rapid assessments to understand the impact of the US Government funding cuts on service delivery. 

3. Human Rights and Key Populations: 

• US funding for stigma, discrimination, and enabling legal environments has stopped, and no alternative funding has been found. 
• Communities are not collecting data on human rights issues, including increased stigma and discrimination. 
• Key populations groups have conducted a rapid assessment on the impact of the US funding cuts. There is also ongoing work to conduct an assessment with people living with HIV and key populations-related services at drop-in centres.