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NickLaing

Country Director @ OneDay Health
8000 karmaJoined Working (6-15 years)Gulu, Ugandaonedayhealth.org

Bio

Participation
1

I'm a doctor working towards the dream that every human will have access to high quality healthcare.  I'm a medic and director of OneDay Health, which has launched 35 simple but comprehensive nurse-led health centers in remote rural Ugandan Villages. A huge thanks to the EA Cambridge student community  in 2018 for helping me realise that I could do more good by focusing on providing healthcare in remote places.

How I can help others

Understanding the NGO industrial complex, and how aid really works (or doesn't) in Northern Uganda 
Global health knowledge
 

Comments
1075

Sorry I wasn't talking specifics of agencies, I just meant congress cutting their funding, will edit thanks!

I really doubt we have the info yet even for a BOTEC. The situation will vary wildly from org to org and country to country. The best place people to comment here might be staff in USAID conduits like Chemonics and ABT associates, who would know the financial situation at scale for USAID funded orgs in low income countries.

I think this is an OK ask, but the bigger long term issue is that PEPFAR stays funded after the review - that seems to me both a bigger deal and perhaps more tractable than "unpausing" right now. It seems pretty unlikely that decision would be reversed but I don't know much about the US political system or Trump's way of operating

You're right that the funding has stopped, although there will be a bunch of dedicated money in foreign accounts which will keep paying many people. There will be chaos though. For example we have 3 nursing staff under a contract paid by USAID and I'd be very surprised if they just don't get paid now (I'll tell you in a week).

What I mean by 1 (sorry I phrased it wrong at first, is that HIV meds in Uganda are still available and probably in other supported countries for the next few months. Its only after the pause that the shit will really hit the fan if USAID decides to permanently stop funding.

My ask would be to ensure PEPFAR funding continues after the pause. 

Wow that's interesting! I have no inside information but would have guessed like 70-80 percent chance that funding for HIV meds would continue but maybe I'm way off the mark

Thanks @Omnizoid for highlighting this important moment. I've received a bunch of Whatsapp messages from Ugandan friends who are very very worried about what this might mean not only for patients (the main issue), but also for jobs and the livelihood of many local NGOS.

One small comment is that I think the title might be slightly misleading. If these steps happened   (none of which have happened yet), then millions could die. But I think all these steps all happening is pretty unlikely 

  1. Congress (edit) does actually stop PEPFAR funding permanently - I think they are just reviewing it at the moment. Medication supplies for ARV drugs are still there for the next 3 months , there's just a chance they'll stop it after that period. (Unlikely)
  2. Other countries don't fill in the funding gap if the US pulls out permanently (Unlikely)
  3. Low income country Governments don't reprioritise funding and free HIV treatment comes to a halt in some countries (Unlikely) - although there could be a large negative effect on other health services if countries were forced to pull money from other healthcare towards ARV treatmen.

And to reiterate, thanks for the article and its still a very very big deal

Thanks so so much for this insight and sharing, yes it's raw but not boring in the slightest and I think it's exactly the kind of thing we need to hear on the forum here. 

What do you think immigration policies should be from your country?

I haven't and doubt you will but interested to hear if there are any examples!

It's true we've discussed this already...

Yep I completely agree with all that and would always write a letter for anyone! The kind of things he might be talking about I think are a bit more extreme like.

  • Funding people to masters courses especially at foreign universities.
  • Actively making connections with people in Western countries helping people get jobs and study opportunities there.
  • Helping people write really really good foreign visa and scholarship applications, putting a lot of time and effort into them and even potentially co-writing sections with people.

    I've done all these things to varying extents and am less inclined to do so now to the same extent given the questions of the OP.

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