BMJ 2014;348:g1862 doi: 10.1136/bmj.g1862 (Published 3 March 2014)

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NEWS Financial donors warn Ugandan government over anti-gay law Anne Gulland London

Foreign monetary donors have warned the government of Uganda that they may withdraw funding after the signing of an anti-homosexuality law in February.

The legislation included life sentences for anyone found guilty of having gay sex, as well as clauses criminalising the “promotion of homosexuality.” However, the bill seemed to be a watered down version of earlier drafts and no longer included a clause making it illegal to fail to report a person being homosexual.

The law, which strengthened existing legislation outlawing homosexuality, had originally proposed the death penalty in some cases, but this has now been removed after an international outcry. US secretary of state John Kerry said that the day the bill was signed was a “tragic” one for Uganda, adding that “this legislation is not just morally wrong, it complicates a valued relationship.” He said that the US government was reviewing its relationship with Uganda, “including assistance programmes.”

Global Humanitarian Assistance, an organisation that monitors aid money, said that Uganda received $1.6bn (£1bn; €1.2bn) in aid in 2011—equivalent to 9.9% of its gross national income—making it the 34th largest recipient of humanitarian assistance in the world.[1] In its 2013 annual report UNAIDS, the joint United Nations programme on HIV/AIDS, estimated that 1.5 million people with HIV lived in Uganda.[2] The United Kingdom suspended payments to the Ugandan government last year over human rights concerns and said that the £97.9m (€118.7m; $163.7m) that it had planned to donate in 2013-14 would be redirected to aid agencies and non-governmental organisations.

Denmark said that it would “restructure” the 50 million Danish krone (£5.5m; €6.7m; $9.2m) that it gave to the Ugandan government each year, channelling donations instead to civil society and the private sector. And Norway said that it would withhold the 50 million Norwegian krone (£5m; €6m; $8.3m) that it donated every year and would instead increase support to “human rights and democracy defenders.” Hillevi Engström, Sweden’s minister for international development cooperation, warned Uganda that “our aid is not given unconditionally.” The Global Fund to Fight AIDS, Tuberculosis and Malaria, which since 2003 has disbursed nearly $250m for AIDS and HIV programmes to Uganda, has expressed concern over the law. For personal use only: See rights and reprints http://www.bmj.com/permissions

“Our funding is under regular review, and we consider all options. Our first priority is always to do whatever is most effective in addressing the needs of those affected by the disease,” the fund said in a statement.

In an interview with the BBC the Ugandan health minister Ruhakana Rugunda said that patients would not be discriminated against because of their sexual orientation. “Health workers will live up to their ethics of keeping the confidentiality of their patients,” he said. In an open letter to the Ugandan president in February doctors, researchers, and academics, including the UN’s special envoy on AIDS and HIV to Africa and former Ugandan vice president Speciosa Wandira-Kazibwe, warned that the bill would further “exacerbate the marginalisation, discrimination and exclusion of people known to be or suspected of being homosexual.” It said that in the capital, Kampala, the prevalence of HIV among homosexual men was 13%, compared with 4.1% among heterosexual men. The letter added, “After years of success in the fight against HIV, Uganda’s incidence has been rising since 2005—contrary to the trends of virtually all other countries with high HIV burden in sub-Saharan Africa. We are gravely concerned that the passage of this bill will exacerbate that negative trend.” A worker for the Ugandan Action Group for Health Human Rights and HIV/AIDS, whose executive director was one of the cosignatories to the letter, said that any withdrawal of funding from donors would exacerbate an already poor health situation in the country, where drug stock-outs were common.

“We visited 10 health facilities recently which said that people are coming for testing for sexually transmitted diseases and HIV but there are no drugs to treat them [if the tests are positive]. They get referred to another health facility or have to pay for the drugs themselves but often they can’t afford them,” he said. “We have been suffering drug stock-outs for some time but the law is adding another injury to the insult,” he added. 1 2

Global Humanitarian Assistance. Country profile: Uganda. www. globalhumanitarianassistance.org/countryprofile/uganda. UNAIDS. Global report: UNAIDS report on the global AIDS epidemic 2013. Dec 2013. www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2013/gr2013/ UNAIDS_Global_Report_2013_en.pdf.

Cite this as: BMJ 2014;348:g1862 © BMJ Publishing Group Ltd 2014

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BMJ 2014;348:g1862 doi: 10.1136/bmj.g1862 (Published 3 March 2014)

Page 2 of 2

NEWS

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Financial donors warn Ugandan government over anti-gay law.

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