The United States has issued aid, police, travel, and military sanctions against Uganda in response to its Anti-Homosexuality Act (AHA), which President Obama has criticized as being contrary to human rights.  The Act was signed into law on February 24, 2014.  It imposes a life sentence for certain homosexual conduct and criminalizes the “promotion,” “aiding” and “abetting” of homosexuality; it does not include a previously proposed measure that would have criminalized individuals’ failure to report AHA violations.

The recent US sanctions:

1) Prohibit Ugandan individuals involved in serious human rights abuses–including abuses against lesbian, gay, bisexual and transgender (LGBT) persons–from entering the United States;

2) Redirect funds from Uganda’s Ministry of Health to other non-governmental organizations (NGOs);

3) Relocate a planned public health institute from Uganda and US $3 million in corresponding funds to South Africa;

4) Terminate a US $2.4 million initiative in support of Uganda’s community policing program; and

5) Terminate a United States Africa Command (AFRICOM) military aviation exercise.

Prior to the June 19 announcement of these sanctions, Western donors including Denmark, the Netherlands, Norway, Sweden and the World Bank withheld or diverted over US $118 million in assistance to Uganda–including the World Bank’s marked suspension of a US $90 million loan to Uganda’s healthcare system–in protest against the AHA’s provisions.  In March, the White House responded to the AHA by shifting funds from Ugandan partners whose public stance on homosexuality counters human rights, cancelling a Center for Disease Control survey of HIV at-risk populations in Uganda, and redirecting approximately US $3 million in funding for Ugandan tourism and biodiversity towards NGO programming.  The US Administration also froze approximately US $4 million in support of Uganda’s healthcare sector.  Uganda receives approximately US $400 million of American assistance funds each year.

While some western human rights activists praised the United States’ recent sanctions, many African LGBT organizations have expressed concerns that western sanctions are an inappropriate response to anti-LGBT legislation.  After the British Government threatened to cut aid to African countries that did not respect LGBT rights in 2011, over 50 Africa-based LGBT rights organizations issued an open letter stating that retaliatory cuts in aid would create a backlash against LGBT Africans, reinforce unequal power dynamics between African and donor states, create perceptions that LGBT issues are inherently western, and falsely elevate LGBT rights above other social justice issues in a region “where health and food security are not guaranteed for anyone.”

Impacts on the Healthcare Sector

Uganda’s ability to meet the healthcare needs of LGBT persons has been impacted.  The Ugandan Health Minister has reassured the public that health professionals will maintain patients’ confidentiality and provide services as usual, but human rights activists say that many LGBT individuals are choosing not to seek medical care out of fear that health professionals might report their sexual orientation to authorities.  Healthcare workers have reportedly expressed anxiety about providing HIV/AIDS related services to Uganda’s gay community, as these actions may be interpreted as “promoting,” “aiding” or “abetting” homosexuality, AHA violations that can result in up to seven years imprisonment.  The White House attributed its termination of support for Uganda’s community policing program to the April 3 police raid of a US-funded HIV/AIDS research, care and treatment program in Kampala, during which police accused employees of “promoting homosexuality.”  Such incidents pose serious challenges in providing comprehensive HIV/AIDS services in a country with an adult HIV/AIDS rate of approximately 7.2 percent.

Moreover, the retaliatory measures taken by the United States, the World Bank and other donors will have a significant impact on Uganda’s health sector more generally.

Economic Implications

While the AHA and Western sanctions certainly hinder Uganda’s health sector, the broader economic implications of the AHA sanctions appear less significant.  Uganda’s shilling currency fell after the AHA’s enactment due to concerns that additional cuts in aid and foreign investment would follow.  After the Anti-Homosexuality Bill was approved by the Ugandan parliament in 2013, Richard Branson, head of Virgin Group Ltd., called on companies and tourists to boycott Ugandan business, and declared that he would not be investing in Uganda because of the Bill.  After the AHA’s passing, lenders including Barclays Plc. and Standard Bank Group Ltd. stated that they were reviewing the legislation.  However, Uganda’s bustling emerging economy continues to flourish.  Uganda is generally becoming less dependent on foreign aid, and an increase in foreign direct investment is expected to occur over the next decade–in large part due to the anticipated production of oil.  Foreign assistance comprises approximately 20 percent of Uganda’s national budget.

US-Uganda Relations

Despite many countries’ strong opposition to the AHA, Uganda remains a valuable US partner in the fight against the Lord’s Resistance Army, efforts to oppose Islamic militancy in Somalia, and key US-Africa initiatives such as the President’s Emergency Plan for AIDS Relief (PEPFAR), the Young African Leaders Initiative (YALI), and the African Growth and Opportunity Act (AGOA).  The US sanctions are not expected to deter Uganda’s president, Yoweri Museveni, from attending the upcoming US-Africa Leaders Summit in Washington, DC.