The Global Fund has taken firm action against Uganda, slashing its health sector grant allocation by over shs 245 billion (USD 66.5 million), following months of warnings and Uganda’s continued refusal to implement safer HIV testing protocols recommended by the World Health Organization.
In a letter dated June 26, 2025, and addressed to Health Minister Dr. Jane Ruth Aceng, the Global Fund announced it was reducing Uganda’s allocation for the 2023–2025 grant cycle from USD 600,327,533 to USD 533,744,174.
“This is a difficult and unavoidable decision,” the letter reads. “We regret to inform you that we will need to reduce the GC7 allocation for the remainder of the grants’ implementation period.”
While framed as part of a global reprioritization process, the timing and nature of Uganda’s cut have sparked speculation it is linked to governance issues, specifically, the Ministry of Health’s refusal to replace outdated HIV test kits supplied by ABBOTT Laboratories, despite repeated calls to do so by experts, donors and World Health Organization (WHO).
The Global Fund had earlier funded Uganda’s Uganda Virus Research Institute (UVRI) with shs1.6 billion to assess new testing protocols.
The results favored the adoption of a three-test algorithm to replace “Determine” kit, which has been flagged for failing to detect HIV during the early infection window period.
Yet, despite a November 2024 circular announcing the shift, the Ministry backtracked under political pressure.
Stakeholder meetings were canceled and reports later emerged that suppliers were allegedly financing top politicians to block the change and protect business monopoly.
The Global Fund letter urges Uganda’s Country Coordinating Mechanism (CCM) to “reassess the detailed activities and apply measures to ensure continuity of essential programming while deferring non-essential areas.”
The biggest reductions hit the Ministry of Finance-managed grants, UGA-H-MoFPED and UGA-M-MoFPED, which lost USD 30.5 million and USD 30.8 million respectively. Only the community-focused UGA-M-TASO grant was spared, with the Fund emphasizing the “critical importance of maintaining integrated Community Case Management (iCCM).”
In a slight reprieve, the Fund included USD 1.14 million in the revised allocation for Uganda to pilot LEN PrEP, a six-month injectable for HIV prevention, stating: “Your country has been identified as a potential early adopter of this new drug.”
Uganda had until July 14, 2025, to respond and realign grant amounts. “If the Global Fund does not hear from the CCM… we will proceed on the basis that the new grant amounts set out in this letter have been approved,” the letter warned.
As public pressure mounts and donor patience wanes, Uganda’s Ministry of Health faces a critical moment of reckoning. Continued resistance to reform may come at the cost of not only funding but lives. By the time of filing this report, no official at Ministry of Health was willing to comment on this “sensitive” matter.
