New Vision (Kampala)

Uganda: Leaders Must Join HIV Prevention Campaigns

In the late 1980s and the 1990s, AIDS was a scourge. At least everyone saw it as that. Dramas on TV, in theatres, communities and schools made sure they painted a blunt picture of its devastations.

A small, frail, sickly, dying frame marked with multiple scars was the representative image of whoever got infected. You could tell who had it.

HIV/AIDS was a one way passage to a slow painful death. Abstinence and faithfulness campaigns thus took centre stage and everyone seemed to listen, learn and practice.

Those who couldn't do either at least used condoms at all times. Everybody seemed involved in protecting themselves from a condition so deadly.

Infection rates thus started going down and Uganda as a country was thrown in the global limelight for its efforts towards fighting HIV.

Years later, after the introduction of successful HIV treatments; people infected with HIV are able to live healthy normal lives without fear of dying and leaving their children behind. It is possible to have children who are not infected. It is possible to be HIV positive and die of old age.

As a result, people have relaxed and in response, infections rates have hit an all-time high. What was remarkable progress has in no time turned into an uphill battle once again.

According to the AIDS Information Centre, although 99% of Ugandans aged between 15 and 49 are aware of HIV; a recent AIDS indicator survey in 2011 showed an HIV prevalence of 7.3% among people aged 15-49 years.

Uganda estimates showed an increase in new infections from 129, 000 in 2010 to 130,000 in 2011. HIV is highest among men and women living in central region 1 (communities along Lake Victoria Shores) and lowest among those in mideastern region (e.g. Mbale, Tororo, Busia).

Among adults it is 7.3% with prevalence being higher among women. Infections are more common among women and men who are widowed, divorced, or separated than those who are single, never married or cohabiting.

Why the increase in infections:

The increase in prevalence is partly attributed to the success of the treatment strategies. "While the infection rate remains the same, people who get infected no longer die, so the population remains the same," reveals Dr Nkoyooyo Abdallah, Programs' Director AIDS Information Centre.

He also adds that complacency in the general public is another reason, saying that now people live positive, happy, healthy lives as long as they adhere to the treatment. Because fewer people are dying, people are not as afraid of infection as they were before when AIDS meant dying.

Lillian Tatweba from Uganda AIDS Commission says the high number of new infections in the country is compounded by challenges of social, economic, political, and legal barriers to effective demand an uptake of preventive HIV/ AIDS services.

Uganda's theme this year is Re-Engaging Leadership for Effective HIV Prevention, with the slogan Accelerating Action Towards Zero New Infections. The national theme for Uganda is contributing to the global theme, which is Zero New Infections, Zero Discrimination, Zero AIDS-Related Deaths.

"We observed that complacency among leaders at all levels regarding HIV, says Tatweba, explaining that one of the key reasons the HIV prevalence rate is going up is leaders have stopped talking about it.

"We want leaders at all levels; parliamentarians, LCs, RDCs, sub-county Chiefs, household leaders to be involved in the campaign to reduce infection to zero,' she adds saying "If leaders at all levels come on board again; the resurgence of HIV can be averted.

ENGAGE: Vice President Edward Kiwanuka Ssekandi receiving a pack of condoms from Sarah Mutesi, the Behaviour Change Communications Officer, Uganda Health Marketing Group (UHMG). This was during last years' World AIDS Day at Kololo Airstrip. All leaders need to engage in sensitising people about HIV/AIDS

We need to have the leaders start advocating like they used to before when we registered great success." We are thus developing an advocacy tool containing messages clear cut for different categories of the population, because before some messages were not clear enough.

The country developed a National HIV Prevention Strategy, which highlights the key messages to be passed as regards to prevention "In order to address existing challenges and reverse the HIV epidemic, the country developed a national HIV Prevention Strategy and Plan that is aimed towards reengaging leaders in the fight against the epidemic," says

Tatweba explaining that there is evidence that countries which demonstrated effective leadership based on Uganda's experience were able to control the prevalence levels of HIV significantly in the past. Dr Nkoyooyo says ensuring that the intervention put in place are acted upon is the only way success will be achieved. PMTC services so that no child gets HIV at birth.

Combination prevention strategies such as circumcision, behavioral change, communication among discordant couples. If we follow those guidelines we will achieve our goal.

This year's event is in Rakai Kasensero fishing village, where the first HIV case was diagnosed in Uganda. It is a historical place and also the region with the highest prevalence rate of HIV.

Drive to getting to zero new infections:

A new World AIDS Day report by the Joint United Nations Programme on HIV/AIDS (UNAIDS), shows that unprecedented acceleration in the AIDS response is producing results for people.

There is declining new HIV infections in children, the area where perhaps most progress is being made is in reducing new HIV infections in children.

Half of the global reductions in new HIV infections in the last two years have been among new born children. Fewer AIDS-related deaths have been registered. The report shows that antiretroviral therapy has emerged as a powerful force for saving lives. In the last 24 months the number of people accessing treatment has increased by 63% globally.

Universal access to antiretroviral therapy for people living with HIV has been realised, while TB deaths among people living with HIV also reduced by half. All people living with HIV and households affected by HIV are addressed in all national social protection strategies and have access to essential care and support.

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