In early 2025, 22-year-old Jokpee Emmanuel arrived at Reach Out Mbuya in Kampala, Uganda, expecting to attend the Friends Forum—a safe space for young people to gather, share and support each other. Instead, he was met with a sign on the gate: “Due to the suspension of United States funding, Reach Out Mbuya will be closed for 90 days. We regret the inconvenience caused.” 

The Reach Out Mbuya community health initiative is not just a health facility. It is a lifeline. For years, it served Uganda’s most vulnerable communities, offering care that goes far beyond medicine. For Jokpee, who was born with HIV, Reach Out provided access to antiretroviral therapy, emotional support, school tuition and dignity. “Reach Out was like a second home,” he says. “They did not just give me medicines. They cared for me and reminded me that I am more than my diagnosis. I could live a full life.” 

The closure followed a suspension of United States funding through PEPFAR, which had long supported community-led HIV responses in Uganda. The impact was immediate and severe. Community-led and community-based centres such as Reach Out Mbuya are central to public health in many low-resource settings. They offer holistic, personcentred services catered to local realities. They respond to the social, emotional and economic realities of people’s lives. These systems have been essential to the global HIV response, driving down infections and improving quality of services and life, especially among marginalized groups. 

Jokpee was forced to seek care at an overcrowded Government facility. He waited six hours, only to be told antiretroviral medicines were out of stock and to return the following week. “A week without antiretroviral medicines! That is how resistance develops. That is how people die,” he says. 

He eventually received a one-month supply of medicines, but the fear of another stockout remained. Although the Government of Uganda worked to fill the gap through national health facilities, it could not match the reach or personal connection of community-based programmes. 

In the weeks that followed, Reach Out Mbuya managed to reopen, with support from a PEPFAR-funded programme called Kampala HIV Project. Most staff returned, restoring most of the centre’s core services. The number of clients accessing the centre is slowly increasing but is still below previous levels. 

Jokpee’s story is a warning. When community-led and -based systems lose support, people fall through the cracks. If it were not for places like Reach Out Mbuya, Jokpee and his peers would be at risk of being left behind in the HIV response. 

Sustained investment in community-led responses is the only way forward if we are to end AIDS as a public health threat by 2030.