Conference Abstract | Volume 8, Abstract NACNDC/19JASH030 (Poster C49) | Published: 20 Nov 2025
Winnie Mugabekazi1,&, Peter Waiswa2, Asher Emma2, Ezekiel Nimusiima1, Shadrack Wanyina1, Amos Munguriek1, Eunice Akiteng1, Clarisse Mupenzi1, Anthony Bateyo2, Ivan Muhwezi1
1Makerere University Joint AIDS Program, Kampala, Uganda, 2Makerere University, School of Public Health, Kampala, Uganda
&Corresponding author: Winnie Mugabekazi, Makerere University Joint AIDS Program, Email: winniemugabekazi8@gmail.com, ORCID: https://orcid.org/0009-0008-8909-5080
Received: 12 Aug 2025, Accepted: 20 Oct 2025, Published: 20 Nov 2025
Domain: HIV Epidemiology
Keywords: HIV laboratory services; donor funding cuts; health system resilience; workforce capacity; Uganda
©Winnie Mugabekazi et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Winnie Mugabekazi et al., Impact of U.S. government funding cuts on HIV laboratory services: A qualitative study at the MJAP ISS Clinic in Uganda. Journal of Interventional Epidemiology and Public Health. 2025;8(ConfProc6):030. https://doi.org/10.37432/JIEPH-CONFPRO6-00030
Donor investments, particularly from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), have been central in strengthening HIV care systems across Sub-Saharan Africa. Recent reductions in U.S. government funding have raised concerns regarding the continuity and quality of essential HIV services. This study examined the operational, workforce, and service delivery impacts of funding cuts on HIV laboratory services at the Makerere University Joint AIDS Program (MJAP) ISS Clinic in Uganda.
A qualitative study design was used, involving 15 in-depth interviews with clinic staff, including medical officers, nurses, and laboratory personnel. The interviews explored experiences and perceptions related to changes in staffing, service delivery, and institutional response following donor funding reductions. Data were analyzed thematically using NVivo 14, focusing on service disruptions, workforce capacity, and adaptation strategies.
Funding cuts resulted in substantial disruptions to HIV laboratory service delivery. Participants reported staff shortages, increased workloads, and frequent stockouts of essential laboratory supplies, which collectively undermined service quality. Departments were merged, and staff were required to take on multiple roles beyond their formal training, contributing to emotional exhaustion and burnout. Despite these challenges, staff demonstrated resilience by extending work hours, sharing tasks, and collaborating with external partners to maintain critical services. However, these adaptations were described as temporary and unsustainable under prolonged funding constraints.
The findings reveal the vulnerability of donor-dependent health systems in the context of abrupt funding reductions. While staff resilience enabled short-term continuity of HIV laboratory services, the long-term sustainability of these services remains uncertain. The study underscores the urgent need for increased domestic investment, strategic workforce planning, and strengthened supply chain systems. Incorporating deliberate donor transition planning into national HIV programming is essential to safeguard core services and enhance health system resilience against future funding shifts.
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