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UGANDA: HIV trust fund in the works
Making funding local
KAMPALA, 3 October 2012 (IRIN) - The government of Uganda is planning to establish a US$1 billion-dollar HIV trust fund to finance local HIV programmes.
According to a working paper released in September, Justification for Increased and Sustainable Financing for HIV in Uganda, the fund will generate cash through levies on bank transactions and interest, air tickets, beer, soft drinks and cigarettes, as well taxes on goods and services traded within Uganda. Small fees will also be levied on civil servants' salaries; corporate and withholding tax will be increased slightly; and a small tax will be added to telephone calls and to each kilowatt of electricity consumed.
"We appeal to Ugandans to look at this proposal. It's a good initiative. We need people to support it," David Apuuli Kihumuro, director general of the Uganda AIDS Commission, told IRIN/PlusNews. "We are not introducing something from the blue. Our neighbours - Kenya, Tanzania and Rwanda - have already prepared similar proposals."
Kenya's National AIDS Control Council has proposed a number of similar measures
, including a mobile phone tax and an air ticket tax. Zimbabwe's AIDS levy
, a 3 percent tax on income, raised over US$20 million in 2010.
Uganda has suffered severe funding crunch
, limiting its ability to operate HIV programmes, including those to expand safe male circumcision
and prevent mother-to-child transmission
"The matter is important and urgent…" Kihumuro said. "The new infections levels remain unacceptably high. The interventions are on a scale that is insufficient."
Recent statistics show that Uganda's HIV prevalence has risen from 6.4 percent to 7.3 percent over the past five years.
Boosting HIV resources
Kihumuro noted that 68 percent of Uganda's HIV funding comes from donors, and 20 percent from HIV-positive people and their families, while only 11 percent comes from the government and 1 percent from the private sector.
The trust fund money is expected to go towards, among other things, condom distribution, safe male circumcision, PMTCT services, improving blood safety, and reducing sexually transmission infections.
The plan will be shared with the Ministry of Finance, which will work out the logistics of imposing the various taxes, before being sent to parliament for debate and approval.
The country's development partners have welcomed the move as a much-needed initiative to boost the country's fight against HIV.
"We have not had the chance to review the mechanics of the trust fund yet, but realizing more national resources to address the HIV/AIDS epidemic is a step in the right direction," Reuben Haylett, deputy coordinator for the US President's Emergency Plan for AIDS Relief, told IRIN/PlusNews over email.
"Uganda has to make difficult choices to have a socially sustainable funding strategy for HIV... It's high time they allocate the right resources to address the problem," said Musa Bungundu, UNAIDS country director.
But not everyone is happy with the plan; gay rights groups say it fails to address the needs of men who have sex with men (MSM) and women who have sex with women.
"It is an unfortunate oversight on the government's side," said Pepe Julian Onziema, programme director of Sexual Minorities Uganda (SMUG).
Homosexual activity is illegal in Uganda. Still, Onziema said, "There are African countries that prohibit homosexuality in their laws and yet have included gay men in their HIV/AIDS policies. Combating the spread of AIDS by considering all persons involved and affected does not in any way mean the government is legalizing or promoting it - it just means it's doing all it can to combat the spread of a deadly disease."
"It's not that we have neglected them," Kihumuro said, responding to the criticism. "The question of the magnitude of the gay community in Uganda is largely unknown. We can't start planning for the number of people we don't know."
The limited data on the subject show that HIV is a significant problem among MSM. The 2008/2009 Crane Survey
of high-risk groups in Uganda reported that the HIV prevalence among MSM was 13.7 percent
Local HIV stakeholders have also cautioned that, should the fund come to fruition, there will be a need for vigilance to ensure it remains free of the graft that has blighted the country's HIV finances
"It's a good initiative. It must be accompanied with discipline. The implementers must be honest, disciplined and with good morals. Otherwise it will be messed up with corruption and mismanagement like Global Fund," Shalom Mwanguzi Nyenje, chairman of Shalom Evangelical and Prisons Outreach Ministries, told IRIN/PlusNews.