Ugandan health advocates are urging the government to prioritize local funding for sexual and reproductive healthcare, as reduced foreign aid and restrictive donor policies threaten access to HIV treatment for vulnerable groups. The appeal emerged during the closure of the five-year We Lead program, a Dutch-funded initiative that empowered marginalized youth to advocate for their health rights.
Margaret Nannyombi, Programs Manager at Uganda’s Sexual Reproductive Health and Rights (SRHR) Alliance, warned that adolescent girls and young women living with HIV face growing barriers to lifesaving care. “Many relied on organizations providing transport to clinics for antiretroviral therapy. With that support shrinking, their survival is at risk,” she said at the project’s national closeout event. While the We Lead program itself avoided direct impacts from U.S. funding restrictions like the Trump-era Global Gag Rule—which barred aid to groups discussing abortion services—Nannyombi noted broader ripple effects. Partner organizations in Uganda’s HIV response network faced resource cuts, exposing systemic reliance on unstable foreign aid.
The We Lead project, active across 80 districts, trained over 15 local partners to equip young women—including those with disabilities, HIV-positive status, or displacement experiences—to champion policy reforms. Its legacy includes district-level bylaws combating child marriage and improving healthcare accessibility. In Kamuli District, for instance, health facilities now face legal requirements to accommodate young women with disabilities, a shift advocates attribute to grassroots campaigns.
“These women aren’t waiting for outsiders to speak for them. They’re challenging leaders directly,” Nannyombi said, highlighting how participant groups now leverage national programs like the Parish Development Model to secure economic opportunities. However, she cautioned that political cycles risk sidelining these gains: “Electoral periods often mute youth voices. Sustained progress depends on government commitment.”
Despite foreign aid volatility, the project’s final report cites measurable strides. Over 1,000 young advocates engaged policymakers, while newly registered community groups accessed livelihood funds, blending health advocacy with economic resilience. Yet experts stress that Uganda’s domestic investment remains critical as global donors pivot priorities. With 1.4 million people living with HIV nationwide—56% of whom are women—activists argue that consistent local funding could prevent backsliding on hard-won advances.
“We’ve built a foundation,” Nannyombi said. “The next step is clear: Uganda must own the solutions to protect its most vulnerable.”
