Uganda has made remarkable progress in the fight against HIV/AIDS. HIV prevalence has fallen from a peak of about 18% in the late 1980s to roughly 4.9% today, while new infections have declined from about 96,000 in 2010 to an estimated 34,000 in 2025, and annual AIDS-related deaths have dropped by 65% over the same period.
Yet with 1.5 million Ugandans still living with HIV and thousands of new infections occurring every year, the country must continue looking beyond health facilities for solutions.
Poverty and economic vulnerability can increase exposure to circumstances that heighten HIV risk. For people living with HIV, financial hardship can also make it difficult to afford transport to health facilities, nutritious food and other necessities that support continued care. A household with a stable source of income is better placed to meet basic needs, access healthcare and make informed decisions about its health.
Economic empowerment is particularly important for women and young people, who remain among the populations most vulnerable to HIV. Greater economic independence can strengthen their ability to make decisions about their health and negotiate safer choices.
One area that deserves greater attention is the connection between economic empowerment and HIV prevention. This connection is not abstract. Poverty and unemployment have pushed many young girls, boys and widows into unsafe transactional and commercial sex, which UNICEF notes contributes to 22% of all new HIV infections in Uganda. A 2025 study by Ssewanyana and McEwan found that adolescent girls and young women account for nearly 70% of new infections among young people, driven largely by power imbalances and economic dependence on older partners. This is where the PDM presents an important opportunity to address this tragedy.
PDM was designed to transform households from subsistence production into the money economy by providing access to financing, enterprise development and markets through parish-level structures. Each parish SACCO receives up to UGX 100 million a year in Parish Revolving Fund financing, which members borrow to start or expand small businesses, and government continues to release fresh tranches, including UGX 529 billion disbursed to more than 10,589 SACCOs in November 2025. President Museveni’s countrywide PDM assessment tours have documented families who have used these funds to move from subsistence farming into small trade, poultry, agro-processing and other enterprises. Despite cases of misuse and embezzlement, many households have genuinely benefited and are entering the money economy. Although it is not an HIV programme, its focus on household economic empowerment can complement Uganda’s HIV response.
The opportunity, therefore, is not to turn PDM into an HIV programme, but to mainstream HIV prevention and treatment information into its existing structures.
PDM beneficiaries regularly interact through SACCOs, enterprise groups and other community platforms. These gatherings can provide opportunities to share accurate information on HIV prevention, testing, treatment, stigma reduction and available services.
The same structures can also strengthen referrals. A PDM beneficiary who needs HIV testing, treatment or counselling should be able to know where to obtain those services through linkages between parish structures, local governments, health facilities and community organisations.
Approached this way, PDM does more than create economic opportunity: by giving would-be victims of exploitation and unsafe sex economic power and secure livelihoods, it also acts as a mitigating factor against the spread of HIV/AIDS.
Such an approach would allow Uganda to address economic and health challenges together without creating parallel programmes.
This is particularly relevant as Uganda works to strengthen domestic financing for the HIV response. With increasing pressure on countries to sustain health programmes using domestic resources, making better use of existing community structures could help extend the reach of HIV interventions.
However, the success of this approach will depend on how well PDM itself is implemented.
Economic empowerment cannot contribute to better health outcomes if funds fail to reach intended beneficiaries. There must be strong accountability, continuous monitoring, financial literacy, business support and market linkages.
Corruption, extortion and misuse of funds must also be firmly addressed. Officials like Resident District Commissioners, who are constitutionally mandated to monitor government programmes and root out fraud at district level, can play a key role in enforcing this accountability at the grassroots.
Equally important is ensuring that vulnerable groups, including women, young people and people living with HIV, are not excluded from economic opportunities because of stigma or discrimination.
People living with HIV are not merely recipients of services. They are farmers, entrepreneurs, professionals, parents and productive members of society. Economic inclusion can strengthen their dignity, independence and participation in community development.
Uganda’s experience has shown that HIV is not only a health issue. It is also influenced by social and economic conditions.
The fight against HIV must therefore continue beyond hospitals and health centres into homes, communities, workplaces and economic empowerment programmes.
PDM offers an opportunity to strengthen this broader response. If HIV prevention, treatment literacy, stigma reduction and referral mechanisms are deliberately incorporated into its community structures, the programme could contribute to building households that are both economically resilient and healthier.
Ending AIDS as a public health threat by 2030 will require more than medicine. It will require empowered individuals, resilient households, informed communities and sustained access to health services.
Uganda should therefore seize the economic empowerment opportunities presented by the PDM to bring its development and HIV/AIDS prevention ambitions closer together.
A healthier Uganda and a wealthier Uganda should not be separate ambitions. They can and must move together.
The writer is a member of the Uganda AIDS Commission.
The post NAMARA JUDITH NINSIIMA: Can the Parish Development Model (PDM) Help Uganda End AIDS as a Public Health Threat by 2030? appeared first on Watchdog Uganda.