In Owoor Sub-County, an elderly man living with HIV had been battling his condition alone. With little support from his family, he often went days without proper meals and lived in unhygienic conditions. Overwhelmed and discouraged, he eventually stopped taking his antiretroviral medication.
During our routine home visits, we sat with him and his family for honest conversations about care, responsibility, and why staying on treatment matters. Bit by bit, the family stepped up. They began preparing his meals, cleaning his living space, and reminding him to take his medication.
On our latest visit, the change was striking. His health had improved, his energy was back, and his outlook had shifted from despair to hope.
His journey shows how steady follow-up and genuine family involvement can restore dignity and transform the lives of people living with HIV.
Compiled by Andrew Simbo, Executive Director, Keru Womenβs Action ORUM-KWAF-Gulu
The Early Childhood Development Organisation (ECDO) has been working with the Center for Health, Human Rights and Development (CEHURD) to build stronger community systems, improve programme delivery, and expand access to essential health services. The work focuses on HIV prevention and testing, malaria prevention, TB response, and community referrals – all anchored in the theme: Improving Maternal and Child Health, Malaria, HIV, and TB Prevention in Bardege-Layibi Division, Gulu City.
This partnership is supported through the Global Fundβs health systems strengthening mechanism, implemented by TASO Uganda as the Principal Recipient (PR2) and CEHURD as the Sub-recipient (SR). Through this arrangement, ECDO has received both technical and financial support, especially through mentorship sessions on planning, implementation, financial management, reporting, and running effective community dialogues, referrals, and outreaches.
Between April and September, ECDO organized more than ten community health outreaches with the support of Alokolum HC II, Oitino HC II, and Bardege HC III. These health facilities provided trained staff, testing kits, and essential medicines, allowing successful outreach activities in Katikati, Abuga, St. Daniel, Oitino, and Cuk Lanebi villages.
More than 1,500 people received vital health services right in their communities. Each outreach drew an average of 128 participants, and more than half of all households in the targeted villages took part. That level of turnout shows how community trust in local health services is growing.
A major highlight was the increase in maternal health service uptake. Over 200 women, most of them aged 20 to 24, received antenatal care. Malaria, which accounted for 28 percent of all recorded cases, was tackled head-on through health education and timely treatment.
This progress is the result of many hands working together. The leadership of Bardege-Layibi Division, including the Community Health Officer, Community Development Officer, and Town Clerk, provided steady guidance. Health facilities such as Alokolum HC II, Oitino HC II, and Bardege HC III supplied medical staff and essential supplies. CEHURDβs mentorship, both in person and online, strengthened ECDOβs systems, leaving the organisation better prepared to manage larger projects and deliver sustainable community programmes.
Village Health Teams (VHTs) and Local Council leaders played a huge role in mobilising residents house-to-house, while families across the villages opened their compounds to host the outreach sessions. Because of this collective spirit, entire communities became hubs of learning, care, and support.
Impact Beyond Numbers
The value of these outreaches goes far beyond the statistics. They brought health workers and communities closer, built trust, encouraged accountability, and nurtured a stronger sense of shared responsibility for health. The conversations, education, and follow-up support are already shaping healthier habits and deeper awareness across Bardege-Layibi Division.
ECDO and its partners look forward to growing this work and reaching even more families. Donors, government agencies, and community leaders have a key role to play in keeping these outreach efforts alive. When support continues, access improves, and communities thrive. A healthier, better-informed, and more resilient Northern Uganda is within reach – and it starts with partnerships just like this one.
Stepping out of the lecture halls and into the bustling offices of the Center for Health, Human Rights and Development (CEHURD) was like flipping a switch. Suddenly, the legal theories I had diligently absorbed in textbooks sprang to life, pulsating with the urgency of real-world human rights struggles. My internship at CEHURD wasnβt just a resume builder; it was a profound journey that reshaped my understanding of social justice and advocacy for health rights in Uganda.
More than just paperwork: The Human Face of Advocacy
Before CEHURD, my idea of legal work was largely confined to the law library and intricate legal arguments. What struck me immediately at CEHURD was the deep human element at the core of their mission. Every case, every policy brief, every community outreach program was driven by tangible needs and rights of individuals.
I remember one particular afternoon, poring over affidavits related to a maternal health case. The statistics on maternal mortality in Uganda are sobering enough, but reading the personal accounts of families who had lost loved ones due to preventable complications-the grief, the frustration, the demand for accountability was truly humbling. It was a powerful reminder that behind every legal document is a life, a story and fight for dignity.
– Malcom Buule
Diving deep: My Role in the fight for Health Rights
My tasks at CEHURD were incredibly diverse, offering me a holistic view of human rights advocacy. My days were not only filled with conducting legal research for a strategic public interest litigation case, and sifting through national and international legal frameworks to build robust arguments, but also with drafting policy briefs aimed at influencing health legislation.
I also had an opportunity to witness firsthand the power of community engagement when I participated in community engagements in Aletbong District in Northern Uganda. I traveled with two colleagues who gave me the chance to experience community visits firsthand. Our objective was to conduct mobile Legal Aid camps, which aimed at providing legal services and sharing important information with the communities. During the visits, I gained a deeper understanding of the real legal challenges people face and offered legal advice where I could. I believe that those who received this information experienced meaningful changes in their lives.
CEHURD understands that legal change isnβt just about court victories; itβs about empowering communities to know and demand their rights. Observing workshops where health rights were demystified for ordinary citizens was incredibly inspiring. It reminded me that true advocacy is a collaborative effort, bridging the gap between legal expertise and lived experiences.
Beyond internship
My internship at CEHURD was far more than a professional experience; it was a transformative one. It solidified my passion for human rights law and equipped me with the practical skills that no text book could ever teach. I learned the importance of resilience, the power of collaboration and the profound impact that dedicated legal professionals can have on society.
Leaving CEHURD, I carry with me not just a deeper understanding of health and human rights but a renewed sense of purpose. It ignited a fire within me to continue contributing to a more just and equitable world, where everyone has the right to health and dignity.
The writer is a lawyer and a member of the Makerere University Public Interest Law Clinic (PILAC), who was on secondment to CEHURD from the Makerere School of Law.
Ugandaβs healthcare landscape is at a critical juncture. As international funding streams face unprecedented uncertainty, the country must urgently transition from donor dependence to domestic sustainability in medicines and health products. This was the central theme of the National Dialogue on Access to Affordable Medicine & Health Products, held on June 24, 2025, in Kampala.
The dialogue, convened by CEHURD in partnership with KELIN and supported by ITPC Global, brought together key stakeholders to address the mounting challenges posed by recent US policy shifts, including withdrawal from WHO and potential PEPFAR funding cuts. With over 70% of Ugandaβs health commodity funding historically coming from donors, the implications are stark and immediate.
The dialogue builds on the findings of a recent Market Intelligence Study on priority HIV and TB products in Uganda[A1]Β , which found that the governments contribution to the health commodity budget particularly HIV, TB, and HCV treatments is lacking, while recommending that the government should reduce dependency on International donors through the development of sustainable funding strategies to cover gaps as donor priority pivots to Climate Change and other Global Challenges.
The Scale of the Challenge
Kenneth Mwehonge from HEPS-Uganda delivered sobering statistics during his keynote presentation. The US currently provides 63% of global HIV funding, while in Africa, only South Africa allocates the recommended 5% of its budget to health β everyone else falls short. Ugandaβs dependence runs deeper than many realize, with Essential Medicines and Health Supplies (EMHS) representing the second-largest health sector expenditure after human resources.
The numbers paint a concerning picture: over 46% of Ugandaβs commodity budget for FY24/25 remains unfunded, creating a funding gap of nearly $500 million. Critical areas like Non-Communicable Disease commodities face a 99.6% funding shortfall, while STI/OI medicines show a 90.3% gap.
Industry Perspectives on Local Manufacturing
Dr. Adrian Kivumbi from the Uganda Pharmaceutical Manufacturersβ Association highlighted both progress and persistent challenges in local production. Uganda now boasts 26 registered pharmaceutical companies with over $500 million invested, yet the sector struggles with financing constraints. Notably, 70% of the health budget remains donor-funded, creating vulnerability when products like Lumartem begin disappearing from shelves.
The path forward, according to Kivumbi, lies in three strategic areas: partnerships, Intellectual Property reform, and pricing strategies. He pointed to successful models in India, where local manufacturers receive government protection, and noted growing interest from major pharmaceutical companies like Novartis and Pfizer in providing affordable medicines to African markets.
Intellectual Property: Barrier or Bridge?
James Lubwama from the Uganda Registration Services Bureau provided crucial insights into intellectual property challenges. The fundamental issue isnβt just awareness but the strategic use of technical ambiguities in patent applications that make drug reproduction nearly impossible without specialized knowledge.
Uganda has shown leadership in implementing IP flexibilities, with over 200 drug patents blocked from registration annually. The countryβs IP office maintains over 117 million documents and offers enhanced protection for both drug compounds and manufacturing processes. However, ongoing international discussions about delinking research costs from manufacturing costs remain critical for sustainable pricing.
Government Response Strategy
Dr. Martha Ajulong from the Ministry of Health outlined the governmentβs multi-pronged approach to building resilience. The ministry is implementing the Hub and Spoke model to improve hospital accountability and has secured new funding to fill gaps left by USAID, including ongoing recruitment to address human resource shortages.
The EAC pool procurement mechanism, negotiated in March 2025 in Kigali, offers promising opportunities for collaborative purchasing power. However, Ajulong acknowledged that regional mechanisms face challenges, including mistrust among member states and preference for EU suppliers over supporting regional partners.
Funding Transition and Regional Cooperation
Diana Tibesigwa from AIDS Healthcare Foundation emphasized the need for strategic conversations about remodelling global funds and determining national priorities. Her key question resonated throughout the dialogue: βHow do we negotiate debt for health?β
Ugandaβs membership in the African Union and East African Community presents opportunities for leveraging pool procurement mechanisms, yet implementation remains slow. The digitization of health systems and supply chains down to community levels represents a critical sustainability strategy for projects previously supported by international donors.
Innovation in Quality and Manufacturing
The National Drug Authority has demonstrated remarkable progress, growing from 6 manufacturers in 2010 to 56 today, including 32 drug manufacturers, 5 traditional medicine manufacturers, and 19 medical device manufacturers. The authority is now pursuing GAP (Good Manufacturing Practice) maturity level 3, indicating serious commitment to international quality standards. However, knowledge gaps persist among healthcare providers who often prefer foreign products despite locally manufactured alternatives being equally effective and more accessible.
A Critical Moment for Action
The dialogue concluded with a clear recognition that Uganda stands at a crossroads. The transition from donor dependence to domestic sustainability is no longer optional β itβs urgent. As Kenneth Mwehonge emphasized in his closing remarks, βUganda can no longer afford to wait or wish for donor aid to last forever. We must seize this moment to rebuild our health supply chain around resilience, equity, and innovation.β
The path ahead requires unprecedented coordination between government, private sector, civil society, and regional partners. Success will depend on Ugandaβs ability to transform this crisis into an opportunity for building a more resilient, locally owned healthcare system that serves all citizens effectively.
With the right political will, strategic investments, and collaborative partnerships, Uganda can emerge from this funding crisis stronger and more self-reliant than ever before. The dialogue has set the stage β now comes the critical work of implementation.
For more information, please contact:
Seth Nimwesiga | Legal & Policy Advocacy Officer
Center for Health, Human Rights and Development (CEHURD)
At 15 years of age, Aidah (pseudo name) still remembers the unfortunate nights that her father sexually abused her. On several occasions, the father would allegedly leave their bedroom, sneak into Aidaβs room and sexually abuse her. He sternly warned Aida never to tell what he was doing to her to the mother or anyone, or else he kills her. Nakaggwa, Aidaβs mother observed that she was limping and asked Aida what had happened. Aida was frightened to speak up but she secretly told her mother what her father did to her every night.
βHe forces himself on me every night. He threatened to kill me and stop paying my school fees if I reported him. I am tired of this, mother! It is very painfulβ Aida said
With this information, Nakaggwa had to find all possible ways of ensuring that her child is protected. Unfortunately, the country was under COVID 19 lockdown and movement was highly restricted so they could not escape the violence. That fateful night, Nakaggwa opted not to sleep. βI was ready for anything. I stayed awake and watched as he got out of bed. After a few minutes, I slowly followed him and found him on top of our child. When I shouted, he quickly opened the door and ran out. I told him I had seen himβ
Nakaggwa braved the COVID 19 restrictions, she ran and reported the matter to police. The police officers arrested the perpetrator and detained him. Unfortunately, the community turned against Nakaggwa calling it an abomination for a wife to put a husband in prison. They ignored the illegal actions that the accused had imperilled upon his own child.
Within a short period of time, Nakaggwa was referred by a health care provider to the Center for Health Human Rights and Development (CEHURD)βs Legal Aid Clinic for legal support. In May 2020, she requested the legal aid clinic to support her in her bid to access justice for her daughter. The matter has been in court wherein the alleged abuser was remanded as the case awaits hearing and judgment.
On 18th March 2025, a team from CEHURD paid a courtesy visit to this family. This visit was meant to establish how the family is coping with the situation, discuss the progress of the case and find means of supporting them to thrive despite the challenges faced. It was a visit meant to restore hope in the family whose legal battles have taken a while in the justice system and may cause the victims uncertainty.
With her beautiful smile, Aidah was happy to see us. βMom, (as she referred to one of us) I am glad to see you. My mother tells me that you are in the background following up our case to ensure that we get justice. Thank you for taking care of me, loving me and for having my case proceed in court.β She noted.
The interaction with this family revealed several things. First, the family is very grateful for the legal support that CEHURD continues to provide to ensure justice is accorded to Aida. This is despite the communityβs initial resentment for the family to sue the father/ husband for abusing his own child. The bravery and resilience that Nakaggwa put up to challenge this community perception make her a hero. Initially, the community threatened to burn Nakaggwaβs family in the house. At one moment, her step broke into the house with a sharp panga to harm them but she quickly called the local council leadership and police for help.
However, the family is afraid that the perpetrator might be released from prison and return to the community seeking vengeance against them. Our visit prepared this family for different possible outcomes of the case, based on our experience with such matters and discussed possible solutions with Nakaggwa in preparation for such uncertainties.
Aidah still struggles with health challenges that are a result of this abuse. In this meeting, Aida noted that she is struggling with nightmares as well as pain inΒ the backbone and pelvic bones among others.
While Aidah is currently out of school due to lack of finances for school fees, she is still eager to pursue her education. In the meantime, she hawks simple merchandise and assists food vendors to cover her basic needs like sanitary and health requirements. This also helps her spend limited time in the community that continues to stigmatise and threaten her and her mother with violence. She eagerly looks forward to an opportunity to return to school.
βI am currently hawking food, but I am tormented by men who make sexual advances toward me. They make me sick and remind me of the abuse I endured from my father. I wonder why they cannot tell that I am still young. I continue to face stigma from the community, but I am not threatened.Β I am positive and very strong. I know that I am a winner and that I shall overcome. My desire is to become a midwife, sexual abuse will never kill that dream,β Aidah reckoned.
Aidahβs case is one of many that occur annually in Uganda. CEHURDβs Legal Aid Clinic receives close to thirty (30) cases of Sexual and Gender-Based Violence a quarter. The Annual Police Crime Report for 2024 indicates that girls who were survivors of sexual violence aged between 9-14 years were 2,514. This number is high despite the several laws and interventions on SGBV which calls for more actions to combat such cases. CEHURD calls upon the government to invest in interventions aimed at putting a stop to SGBV, including constructing and managing shelters for survivors of SGBV.
The writer is the Deputy Executive Director at the Center for Health, Human Rights and Development (CEHURD). For any health rights violation, call our toll-free 0800300044.
