By Stephen Ouma Bwire
Uganda’s Ministry of Health has taken some progressive steps forward when it comes
to strengthening programming for key populations – including transgender people
and people who use drugs in their new guidance.
However, service coverage for key populations and adolescents remains worryingly low. There’s still substantial resistance when it comes to expanding access to SRHR services and education for adolescents. There are no concrete plans to change laws that criminalize key populations, and there’s been a surge in violence towards sex workers and LGBT people due to COVID-19.
At national level, Uganda’s political leadership appears more committed to HIV prevention than previous years. At an Inter-Ministerial meeting organised by the Global Prevention Coalition towards the end of 2019, Uganda’s Ministry of Health committed to increase domestic financing for HIV, allocating 0.1% of all public sector budget to HIV prevention and coordination activities. The speaker of parliament has also been pushing to set up an AIDS Trust Fund and a new national health insurance scheme.
Although Uganda’s legal and social environments remain extremely hostile towards key populations, and particularly towards LGBT people and sex workers, some political representatives are showing more understanding and support towards marginalized groups, at times standing in solidarity with them.
The Minister in charge of the Presidency released a supportive statement in solidarity with key populations when police raided and arrested 20 LGBTQ+ members, although they stopped short of calling for their release, or holding the police to account for their actions.
The same Minister has also been advocating in parliament for HIV prevention for all Ugandans regardless of their sexual orientation and together with the Uganda AIDS Commission was instrumental in putting Uganda forward to host the next ICASA conference. Similarly, the Minister of Health released a press statement in support of a lesbian woman who was attacked by a health professional, urging for disciplinary
measures to be taken.
The Uganda AIDS Commission (UAC), although not well resourced, continues coordinating the HIV response at national level jointly with the Ministry of Health. Key populations activists report that their voices are listened to by the National Prevention Committee, the Ministry of Health’s Key Populations Technical Working Group and the
Global Fund Country Coordinating Mechanism. In 2020, UAC completed the National HIV Priority Action Plan for Key and Priority Populations (2020/2021 – 2022/2023).
The plan is accompanied by a key populations drop-in centre manual and a key populations training manual, which includes modules for health workers on stigma-free care, as well as a module on the prevention of gender-based violence.
After many years of advocacy by community activists, people who inject drugs and transgender people have both been included in the newly developed guidance documents. In 2020, there has been a notable shift towards greater
support for harm reduction programming.
The Ministry of Health together, with the Uganda AIDS Commission and in partnership with civil society organisations (CSOs), has developed guidelines to steer the implementation of harm reduction interventions.
These have been followed by the establishment of the first Medically Assisted Treatment facility for people who use and inject drugs in Butabika National Referral Hospital in Kampala.
There has been less progress in the policy and legal landscape for adolescents and young people, however.
The National Health Policy for Adolescents, which has been on hold since 2018, has not yet been passed mainly because it recommended lowering the age of consent for accessing sexual and reproductive health services to 15.
Similarly, the Sexuality Education Framework, launched in 2018, to provide students in primary and secondary schools with basic information on sexuality and gender issues, is not being rolled out because the Ministry of Education has not developed appropriate curricula materials and activity plans.
The curricula development process stalled because of criticism received from the Inter-Religious Council of Uganda, which complained that the framework – already very conservative in its approach to sexuality – does not
reflect Uganda’s traditional values.
ENDS
