Denver-Based Organization Fights to Provide HIV Treatment for Ugandan Community
Dr. Ategeka Gilbert’s small clinic in Uganda treats 15,000 people living with HIV. He has begun rationing antiretroviral medication to patients. “This will take us back to the 1980s, when HIV was uncontrolled and people were dying in large numbers. If USAID doesn’t reinstate funding, we will lose many lives,” Gilbert said.
By Giles Clasen
In Uganda, where more than 1.4 million individuals live with HIV, access to life-saving antiretroviral (ARV) medications has been severely limited due to the Trump administration's decision to freeze USAID's funding to Africa and other parts of the world.
Crazy Love Africa is launching a funding drive to purchase and deliver ARV medications to those they support in Uganda. The Denver-based nonprofit has been empowering women and children living with HIV in Uganda for more than 10 years by providing micro-business grants, education, and community building.
“The number one success of our program is that all of our women are still alive,” said Jess Wiederholt, founder of Crazy Love Africa. “That may seem obvious, but in Uganda, that’s not a given. Without consistent access to medication, people with HIV can’t survive.”
The organization currently supports more than 50 women and children in Uganda and has plans to double its reach in the coming months when they complete work on a new community center.
Dr. Ategeka Gilbert receives support from Crazy Love Africa and is at the frontline of the crisis. His small clinic serves more than 10,000 adults and 5,000 children living with HIV in and around Ft. Portal in the southwest region of Uganda, and he said he is already seeing repercussions of the Trump administration's policies.
“This will take us back to the 1980s, when HIV was uncontrolled and people were dying in large numbers. If USAID doesn’t reinstate funding, we will lose many lives,” Gilbert said in a phone interview.
Currently, Ft. Portal has some of the highest rates of HIV infection in Uganda, but the disease was spreading at a much higher rate before the arrival of ARV medications. This included transmission from mothers to children.
In February, the Uganda health ministry announced that the country must close the HIV and TB clinics supported by USAID.
The closures are due to funding losses from the USAID-managed program, President’s Emergency Plan for AIDS Relief (PEPFAR), first launched in 2003 by President George W. Bush. PEPFAR is credited with saving the lives of more than 20 million individuals in Africa.
Dr. Sarah Rowan, an HIV and STI treatment and prevention specialist with Denver Health who has spent time treating patients in Africa, warned of the dire consequences if PEPFAR funding is not reinstated.
A recent UNAIDS report estimates that if PEPFAR is not restored, there will be an additional 6.3 million AIDS-related deaths in Africa by 2029 – a number larger than the entire population of the state of Colorado. The report also estimates an additional 8.7 million new adult HIV infections and 350,000 new child infections, as HIV is passed from mother to baby.
"The modeling is really clear — we will see deaths skyrocket," said Rowan.
Rowan said that PEPFAR had not yet reached its goals
Without continued funding, clinics worldwide could run out of life-saving ARV medications within months.
“Right now, we know if people start ARVs before significant immune damage, they will have the same life expectancy as someone who doesn’t have HIV,” Rowan said. “There’s also little to no chance of transmission at all when people have access to medication and can maintain an undetectable viral load.”
Perhaps most devastating, Rowan pointed out, is the fate of thousands of babies who will be born with HIV if mothers lose access to ARVs, which prevent the spread of HIV from mother to child.
“This isn’t just a funding issue — it’s a moral issue,” Rowan said.
Gilbert said ARV medications are a miracle to his community because they not only save lives but also limit the spread of the disease.
"Here in Uganda, you are either infected or affected by the disease," said Gilbert, who has two sisters and other family members living with HIV.
Gilbert said individuals with access to ARVs are able to live a normal life, work, and raise children.
"But if someone misses their medications, HIV is so, so, so damn bad," Gilbert said.
Even before the USAID cuts, it was not an easy task to convince individuals to begin taking ARV medications.
There is a severe stigma to HIV infection in the country, and individuals hide their infection to avoid being ostracized. Many women and children have been abandoned by their husbands and fathers in Uganda.
"If a woman was to find out she was HIV positive, of course, she would look to her partner and be like, ‘Where did I get this?’ And he may also be HIV positive, but once he finds out she's HIV positive, he would leave her because she's tainted," Wiederholt said.
Rowan also emphasized the far-reaching impact of such cuts, not just on individuals but on global stability and local economies.
“When you prioritize women and girls in the HIV response, economic prosperity follows,” she said, highlighting how investment in healthcare translates to stronger economies.
Just being seen entering a clinic to receive treatment could lead to being shunned by their neighbors.
Poverty and limited access to transportation can also prevent an individual from accessing the drugs.
Natgouza Susan is a social worker in Ft. Portal working with individuals and families living with HIV. She said she often spends hours with individuals helping them understand that ARVs can help them live normal lives.
"Whenever I go to a house, I do comfort them so that even though there are many challenges in life, at least they know they have someone to lean on. I wish we could still offer medication, but we don't know what the future will be, so I just offer comfort now," Susan said by phone.
Susan said she fears that many people will give up hope. She also said she has heard many people say that they believe God is punishing them in response to the USAID cuts.
“If we can get support, we can live. But right now, we are waiting, and we are scared,” Susan said.
Gilbert said he is losing sleep because he has had to start rationing medication. He is hoping the USAID freeze will end before his patients begin missing doses.
But on Monday, March 10, Secretary of State Marco Rubio announced on X, formerly Twitter, that the purge of USAID programs is complete, and 83% of the agency's programs have been eliminated.
For now, Gilbert’s only solution is to limit the amount of medications patients can receive during their visits while he tries to find any other solution.
“Patients used to get refills for three to six months at a time. Now, they get one month – sometimes less,” Gilbert said. “Some people travel long distances for treatment, and if they can’t afford transport every month, they miss doses. When they miss doses, the virus mutates and becomes resistant. This is how we lose lives.”
Wiederholt is working to find alternative sources for HIV medications, including generic options from China, Canada, or the U.K., but the financial burden is staggering.
“If we bought a month’s supply of medication in the U.S., it would cost about $3,000 per person per month. In Uganda, with USAID funding, it was around $150 a year to treat a person. Without USAID, people simply can’t afford to survive.”
The loss of HIV treatments won’t just harm Uganda — Dr. Rowan warned it could have global consequences.
“As we've seen again and again when it comes to pathogens and microbes and viruses and bacteria, diseases don’t recognize national boundaries. So, we're really hurting our own country by destabilizing the world and taking away vital medical services,” she said.
For those in the U.S. wondering why they should care about what happens in Uganda, Gilbert has a simple answer.
“When governments support each other, everyone benefits. If Uganda’s healthcare system collapses, it destabilizes the country. That affects trade, migration, security, and global health. We need each other,” he said.
You can donate to Crazy Love Africa's efforts by visiting: https://donorbox.org/life-saving-medical-fund
See more photos in the April issue of the Denver VOICE.