PEPFAR Money Came At The Right Time, For The Right Groups And Right People, Thankfully!

PEPFAR money is very much needed for various HIV Prevention and Care activities by different organizations and institutions across the Uganda.

 Uganda will be able to win the fight against HIV, because no organization will be denied  this money. Denying them money will mean "no one left behind" was  rhetorical and not meant as a practical strategy. This also goes to show Taste-bias. Or, let us face it: They are simply ignorant about the appropriate actions HIV Prevention and Care requires. Up to now there are some Implementing Partners (IPs) denying grass root HIV Prevention and Care Community Based Organizations (CBOs) funds on very flimsy excuses outside epidemic control goals.

This money will increase critical activities that promote diagnosing, treating and preventing HIV in areas or among population groups with high rates of new HIV cases. This will be entrenched into the treatment cascade goals.

Once the awards are disbursed to recipient organizations, they will help enhance the implementation of their proposed plans and contribute to critical ending of the HIV Epidemic.

Many organizational plans, aim to leverage experience, mobilized beneficiaries, data and tools available to reduce new HIV diagnoses by 95 percent by 2030.

Working directly with community organizations, highly effective methods to mobilize, test, diagnose, prevent, treat HIV, ensure adherence, nutrition and livelihood projects to improve social integration will be implemented.

There are some organizations, which have devised  tailored ways of reducing the burden of HIV among  high risk networks, have established targeted mental health programmes and built strong relationships with local health authorities, community-based groups, health facilities and other organizations involved in the Ending the HIV Epidemic initiative.  This has strengthened referral mechanisms, ensured rapport with service providers and directly increased chances for optimal ARV adherence.

PEPFAR funding will make it possible to identify and evaluate strategies to diagnose new cases of HIV, help connect people living with HIV or at risk of HIV acquisition with medical care and HIV prevention services, and ensure they continue to receive care to treat or prevent HIV. It will now be possible to implement new initiatives in the HIV treatment and prevention areas. These include: mobilizing people, accessorizing resources, holding planned community-based outreach events, testing and those with positive diagnosis will be provided daily antiretroviral therapy that suppresses HIV to undetectable levels. There are those organizations which have been in touch with people living with HIV for a long time. It will be possible to manage adverse effects of drugs, address issues that arise after living longer with HIV, consolidate positive living club activities, devise stable housing plans, nutrition and livelihood projects which impact ARV adherence/ viral load suppression.

With funding made available, organized and planned home visits will be possible as part of enhancing or increasing adherence. Organizations can plan health education talks through which they can provide Information, Education and Communication on a number of things: Condom use, condom disposal, safer sex negotiation, disclosure of Sero-status, mobilization for Safe Medical Circumcision, or consequences of  Khat, Alcohol, Tobacco and Drug Use in relation to HIV Prevention as well as give talks on prevention of sexual transmitted infections.

Newer goals and approaches are provided and communities can look forward to such goals like: Increased Safe Male Circumcision events in communities; Viral Load Suppression (VSL); Undetectable=Untransmittable, or U=U); Sexual Partner Reduction Skilling,  pre-exposure prophylaxis (PrEP), a single pill that can reduce the risk of acquiring HIV by more than 95 percent when taken daily; and emergency post-exposure prophylaxis (PEP), which can prevent HIV infection if begun within three days of exposure and taken for an additional 28 days. Implementation strategies have now explored social media platforms and today, organizations have developed continued conversation spaces such as WhatsApp, Instagram or Facebook Groups.  They are able to conduct planning meetings, exchange reports and strategic information using these online platforms. All these demonstrate success and best practices in HIV Prevention and Care.

Providing that money through the Implementing partners (IPs) in Uganda, will make many organizations contributors to the End to HIV Goal. Even while organizations are scrutinized for strengths, the above points should not be dismissed. If we are to win the fight against HIV, no organization should be denied money because if they are denied it will mean "no one left behind" was  rhetorical and not meant as a practical strategy. Denial of funds means that there are IPs which are biased against say, LGBTIQ+ or Priority Populations they deem undeserving. Some of these disbursing officers have been in the habit of despising organizations which have developed the resilience of grassroots only gained after being around for a long time. These "despised" organizations have helped mobilize Key Populations, raised HIV Prevention and Care consciousness and contributed to critical HIV Prevention and care conversations at the grassroots. It is for this, that they should be given PEPFAR funds. There is debate that KP organizations may not use the funds properly, just because some do not have "well established" offices with furniture and a kitchen!" My advise is that the funds should be  disbursed because most KP organizations submitted proposals outlining the need for money to be used to support establishment of those structures that audit teams look forward to assess. Hopefully, this will not be used to dismiss these organizations as non-deserving of funds. There is need to acknowledge the fact that KP Organizations have stood the test of time using proactive structures aligned to the kind of funding they had.