NCDs, budget cuts hamper HIV fight in Busoga

The Uganda AIDS Commission has also raised alarms, reporting an increase in HIV/AIDS prevalence, particularly among young people in urban centers.

The fight against HIV in Uganda's Busoga sub-region is facing significant setbacks, as non-communicable diseases (NCDs) and severe budget cuts strain both patients and healthcare providers.

Recent reports from The AIDS Support Organisation (TASO) in Jinja highlight a worrying trend: 59 clients have died from treatment-related complications since October last year.

Many of these deaths are attributed to the growing challenge of managing both HIV and NCDs, which has severely impacted patients' ability to adhere to their medication regimens.

During the 27th Annual General Meeting of TASO Jinja, healthcare experts and stakeholders voiced deep concern over the increasing prevalence of NCDs among people living with HIV.

These diseases—including diabetes, hypertension, and cardiovascular conditions—are complicating an already challenging treatment landscape.

As a result, there has been a marked increase in the "pill burden," or the number of medications patients must take daily, which has led to poor adherence and, tragically, a higher mortality rate among those affected.

Daniel Wambuzi, a medic with Family Hope Uganda, a nonprofit organization supporting people with HIV, explained that NCDs can restrict patients' diets, complicating their ability to follow a healthy regimen that supports HIV treatment.

"This dietary conflict can cause confusion and ultimately affects adherence," Wambuzi noted.

Dr Peter Mikago of the Uganda Protestant Medical Bureau further elaborated on the impact of NCDs, emphasising that these diseases not only add complexity to HIV treatment but also strain the limited resources available to healthcare providers in the region.

To alleviate the "pill burden," Dr Mikago advises fellow health workers to optimize the use of fixed-dose combinations, where a single tablet contains three different medicines, thereby simplifying patients' treatment regimens and improving adherence.

Adding to these challenges, recent budget cuts and reductions in donor aid have severely hindered TASO Jinja's ability to deliver essential services.

According to Godfrey Caesar Mafabi, regional manager of TASO Jinja, the organisation has had to reduce its staffing from 112 personnel to just 15 permanent staff members.

This reduction has particularly affected community outreach programs, which are vital for HIV prevention and education efforts.

"We have now adopted multitasking among staff; for instance, a medical officer also serves as a manager and sometimes a driver to bridge the gap caused by reduced human resources," Mafabi explained.

"When TASO Jinja started in 1991, it had 198 clients. Today, we have 7,300 clients, with 123 new clients registered between October last year and July 2024. It's challenging to operate within a limited budget given the high number of clients," he added.

"The reduced funding has hit us hard. We're struggling to maintain the level of service we know our clients need," Mafabi stated.

The financial strain was further emphasized by Rose Mary Namate, the Honorary Treasurer of TASO Jinja, who warned that without urgent intervention, the situation could deteriorate further.

The Uganda AIDS Commission has also raised alarms, reporting an increase in HIV/AIDS prevalence, particularly among young people in urban centers.

This trend is especially concerning as the country aims to end HIV as a public health threat by 2030—a goal that now appears increasingly difficult to achieve without significant action.

With only six years left to meet this ambitious target, stakeholders in Uganda's health sector are calling for renewed efforts and increased resources to combat the dual challenges of HIV and non-communicable diseases.

While the road ahead is daunting, coordinated action could still turn the tide in this critical fight.