Uganda’s Ministry of Health is at risk of losing critical funding from the Global Fund, a major donor in the fight against HIV/AIDS.
This comes shortly after the United States government froze and cut its support to Uganda’s health sector through USAID, causing a major funding crisis worth UGX 604 billion.
Now, Uganda could lose more money due to what insiders call negligence and poor decision-making by the Ministry of Health.
The Global Fund is not happy with how the Ministry is using its funds, especially in the area of HIV testing.
Why the Global Fund Is Concerned
The Global Fund has accused Uganda’s Ministry of Health of not using money effectively. One major concern is how the Ministry has handled the evaluation of new HIV testing kits.
In 2024, the Global Fund gave the Uganda Virus Research Institute (UVRI) $450,000 (over UGX 1.6 billion) to test and review new HIV testing technologies. The testing was completed, and UVRI submitted its recommendations.
However, the Ministry of Health has delayed putting these findings into action.
Insiders say this delay may be because some top officials in the Ministry want to keep using the old HIV testing kits for personal interests, even though they are less effective.
This decision is putting millions of Ugandans at risk and could cost the country more donor support.
A Ministry circular dated November 29, 2024, had announced plans to switch to a new national HIV testing algorithm.
But the Ministry later reversed this decision, reportedly due to disagreements among top officials. They also organized two stakeholder meetings to discuss the new algorithm, but both were canceled at the last minute.
It seems there is a split in the Ministry. The technical experts want to follow the science and use better testing kits. But the top leadership is resisting the change, possibly to protect business interests tied to the current kits.
In response to these issues, the Global Fund wrote a warning letter to Uganda’s Ministry of Finance (which handles donor money) on April 24, 2025.
The letter ordered a pause on spending in several areas, including buying cars, IT and lab equipment, organizing meetings and conferences, and carrying out studies and surveys.
The Old Testing Algorithm Is Dangerous
Uganda has been using the same two-step HIV testing system for over 10 years. But according to the World Health Organization (WHO), this old method is no longer enough. Since 2019, WHO has recommended that countries like Uganda switch to a more accurate three-test algorithm.
One of the most serious problems with the current two-test method is that it cannot detect HIV during the “window period.”
This is the early stage after infection when the virus is present in the body but cannot be detected by some older test kits.
People who test negative during this period may still be HIV positive and knowingly or unknowingly spread the virus to others.
This is very dangerous, especially for a country like Uganda where the fight against HIV/AIDS is ongoing.
The continued use of outdated testing kits that miss HIV during the window period puts thousands of lives at risk and undermines years of progress.
On the other hand, the new WHO-recommended algorithm, which uses three different types of tests, is much better at identifying HIV early—including during the window period. This means infected individuals can start treatment sooner, reduce the chances of spreading the virus, and live healthier lives.
It also saves the country money by avoiding misdiagnosis and unnecessary treatment.
Most countries in the region with similar HIV patterns have already made the switch to the new method. Uganda is lagging behind, and experts say this delay is dangerous and costly.
Pressure Mounts from Stakeholders
Several groups have raised their voices about the Ministry of Health’s slow response. A supplier of HIV testing kits has written to the Ministry of Finance, questioning why the new testing strategy has not yet been implemented, even after the Ministry announced it in November.
The Uganda Medical Laboratory Association (UMLTA) has also written a petition to the Ministry of Health. In the letter, they express frustration over the delay and highlight the known weaknesses of the current test kits. They argue that the new testing strategy not only provides better results but is also cheaper and more efficient.
The standoff between the Ministry of Health and Ministry of Finance is also growing. Sources say officials at the Ministry of Finance are worried about how the Ministry of Health’s poor decisions are putting billions of donor money at risk. These funds are crucial, especially now that the USAID funding has been cut.
What Happens Next?
At this point, the Ministry of Health is at a crossroads. It can either follow the scientific recommendations and adopt the more accurate three-test HIV algorithm or continue with the outdated two-test system that puts lives at risk and may lead to the loss of more funding.
Experts warn that the failure to act quickly could not only endanger public health but also result in the country losing billions meant for HIV/AIDS programs. With donor confidence shaken, the Ministry must make urgent decisions that put the health of Ugandans first.
The Permanent Secretary Diana Atwine couldn’t be reached to explain the delay in implementing the new HIV testing method.
Hon Jane Acheng, the Minister of Health was not available when contacted.
Emmanuel Ayinebyoona, the Ministry’s publicist was also not available by the time of filing this report.
What you must know:
Ministry of Health is risking the loss of major HIV/AIDS funding from the Global Fund, shortly after USAID froze support.
The Ministry received shs 1.6 billion from the Global Fund to test new HIV kits but delayed implementing the findings.
The current two-test HIV algorithm used in Uganda cannot detect HIV during the window period, which is very dangerous.
The new three-test method, recommended by WHO, can detect HIV during this early period and avoid misdiagnosis.
Stakeholders like the Uganda Medical Laboratory Association and suppliers have criticized the Ministry’s delay in adopting the better testing kits.
Donors are now pausing funding and warning the Ministry to improve its decision-making or risk losing even more support.
