Harm Reduction Information Note: Uganda

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Harm Reduction Information Note - Uganda

This information note has been compiled by Harm Reduction International (HRI) in collaboration with the Ugandan Harm Reduction Network (UHRN), to support Global Fund Grant Cycle 7 processes. It compiles data and information related to harm reduction in Uganda, alongside priorities for programming identified through community consultations.

Epidemiological context

  • There are an estimated 9,500 people who inject drugs in Uganda.
  • HIV prevalence among people who inject drugs is 17%.
  • A small-scale study among 67 sex workers who use drugs found a HIV prevalence rate of 3%.
  • HIV prevalence among prisoners: 4%.
  • Prevalence of hepatitis B and hepatitis C among people who inject drugs are 8.4% and 2% respectively.

HIV prevention, treatment and harm reduction for people who inject drugs

  • Needle and syringe programmes (NSP) were introduced in Uganda in 2018. The programme was closed in 2019, then resumed in 2021. There are no NSPs in prisons.
  • Uganda opened its first opioid agonist therapy (OAT) programme in 2020 and introduced take-home doses during the COVID-19 pandemic. There are no OAT programmes within in prisons.
  • HIV testing and HIV status awareness among people who inject drugs: 45%
  • ART coverage among people who inject drugs living with HIV: 78%
  • Coverage of HIV prevention among people who inject drugs: 8%

Harm reduction financing

  • Harm reduction in Uganda has been funded by international donor support to civil society organisations.
  • There has been no domestic financing for harm reduction.
  • The Ugandan Ministry of Health’s Harm Reduction Guidelines (2020) enabled the establishment of the first OAT programme. The Medically Assisted Therapy (MAT) clinic was launched in December 2020 and is based at Butabika National Mental Health Referral Hospital.
  • The Global Fund NFM3 (2021-2023) grant has supported a harm reduction package for people who use drugs (including people who inject) through facility and community drop-in centres. In addition, the US government through the CDC supports the MAT clinic at Butabika Mental Referral.
  • Harm reduction is not included in the minimum package of interventions for Universal Health Coverage in Uganda.

Advocacy priorities for people who use drugs in Grant Cycle 7

  • Support and scale up NSP.
  • Capacity building of harm reduction stakeholders.
  • People who use drugs annual community-led funding gaps landscape analysis/index.
  • Advocacy for establishment of a community and civil society basket fund for the HIV and AIDS response.
  • Addressing barriers to equitable access to healthcare for all people who use drugs in their diversity.
  • Operationalisation of a budget advocacy plan developed in 2022 for harm reduction investment in Uganda, including advocacy for domestic investment (under resilient and sustainable systems for health and community system strengthening).

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