Editorial
24 August 2008
opinion
The HIV/Aids story continues and for Uganda things do not look good at all. Briefing journalists this past week upon return from the 17th International Aids Conference in Mexico City, the head of the Uganda Aids Commission, the country's top body charged with fighting the pandemic, did not have any good news for the nation.
Dr Kihumuro Apuuli instead had a depressing package. He warned bluntly that the country is losing the battle against HIV/Aids.
Not only is the country failing to treat those in need of life prolonging medicines, but more people are getting infected everyday.
While only four out of every 10 Ugandans in need are accessing antiretroviral drugs, another 132,000 are getting infected annually. With a mere 125,000 people on treatment out of the 312,000 in urgent need of medication yet 132,000 are getting infected annually, we appear to be fighting a losing battle indeed. There is currently an estimated one million Ugandans living with HIV/Aids.
From an Aids success story that saw the prevalence going from a high of 30 percent (in pregnant women) and 18 percent in the general population in the early 1990s to a low 5 percent by 2000, Uganda's prevalence has again risen to 6.4 percent where it has squared off over the last 2-3 years.
Knowing its epidemic well, Uganda designed an appropriate response. It was a multi-pronged approach. Amidst meagre resources, our success was the result of encouraging behaviour change such as increased abstinence and monogamy, delaying age at which younger people first had sex, and more frequent use of condoms. And the element of political leadership by President Museveni cannot be overemphasised.
However, when donor money came flowing in after 2001, it came with attached strings which espoused abstinence and fidelity at the expense of the proven combined efforts that had worked wonders. Scientific evidence that had showed that the Aids response required a multiplicity of strategies was disregarded.
But the good news is that the re-authorised US President's Emergency Fund for Aid Relief (Pepfar) is flexible.
Emphasis is no longer on abstinence, fidelity, and treatment - that has brought about complacency and 'normalised' Aids leading to an increase in risky behaviour.
Use of the funds will be quite flexible, meaning that we could easily see some of the money going into condom-provision. Indeed, what Uganda needs is to go back to the proven multifaceted 1990s approach, which used a mix of strategies. If needs be, a return to the 1990s scary messages such as "Aids Kills" would be in order.
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