Uganda Stands Firm on Health Spending Freeze

Uganda's Ministry of Finance is standing firm on its decision that, despite an expected grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria, the country's total health expenditure will not exceed a pre-determined limit of $107 million for the 2002-2003 financial year. Finance officials maintain that they are not going to adjust the allocation for the health sector no matter how much donors, who meet nearly half of Uganda's health expenditures, are willing to provide. The restriction, they say, is part of a wider policy to control expenditures in all government departments, in order to stabilize the national economy and reduce dependence on donors. The ministry is particularly concerned about temporary, unsustainable inflows that might cause distortions in the economy.

According to a report released at an October meeting of donors and government officials in Kampala, health sector funding had increased by 52 percent since the previous financial year but remained far short of what is needed.

Health officials say that because HIV/AIDS is one of the country's top problems, the strict limitation in health expenditure will not restrict the amount of money flowing in the fight against HIV/AIDS. They hope to receive $52 million from the global fund to spend on HIV/AIDS over the next three years.

Clinicians estimate only 2 percent of individuals who need antiretroviral therapy can afford the drugs. Epidemiologists fear that Uganda's HIV prevalence, declining for a decade now, seems to be stabilizing. Health officials are hoping the global fund grant will help them in overcoming these challenges. However, the spending limits imply that the budgets of some units within the health sector may have to be cut to make way for the global fund grant, which must be spent on HIV/AIDS interventions approved by the Fund.

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