Old and new AIDS challenges in Uganda

You hear a lot about Uganda in discussions about HIV/AIDS.  The country rose to prominence as a much touted HIV-prevention success story, after substantially lowering its HIV rates over the course of several years.  Yet recent reports indicate that HIV is back on the rise in this African country, which is causing serious concerns and a lot of re-thinking.

Ironically, the publicity attracted by Uganda’s success may have helped to undermine its gains.  According to this article (the second featured below),

By 2000, Uganda was regarded as a model for Africa in the fight against HIV and Aids due to strong government leadership, broad-based partnerships and effective public education campaigns which all contributed to a decline in the number of people living with HIV between 2000 and 2004.

However, debate over the best strategy, which pitted pro-abstinence and faithfulness supporters against those in favour of condom use – and growing complacency, is putting the country’s gains against HIV and Aids at risk.

Uganda, which employed an aggressive and widespread ABC campaign to reduce the number of new infections, became a prize everyone wanted to claim.  International activists emphasizing abstinence and faithfulness squabbled with those emphasizing condom use in an often ugly battle over which part of ABC should get the credit.  (I’ve seen aspects of this first-hand — trust me, it’s not pretty.)  Not surprisingly, these tensions led to questions about who was running the show, and bred controversy within Uganda over the use of foreign and local methodologies.

So there’s a little background.  The following articles and editorials address many of these issues as they examine recent worrying trends in Uganda, and what to do about them.

>> The Big Picture on Aids, New Vision (Aug. 25)
In this wide-ranging, informative, and rather charmingly written opinion piece, Ugandan AIDS advocate Cathy Watson talks about what she learned at the recent International AIDS Conference.  After highlighting a number of issues and trends — including the passion among advocates at the conference, the “pride and visibility” of marginalized groups, research and work on HIV/AIDS among certain high-risk groups (commercial sex workers, men who have sex with men, and injection drug users), and the functioning of ARVs — Watson discusses her main conclusion.  “Despite the tremendous advances in knowledge,” she writes, “there remains one single terrible fact. After a-quarter of a century, success against HIV/AIDS is slipping spectacularly out of our grasp.”  She then discusses the situation in Uganda in more depth.

>> Country Losing Fight Against HIV, The Monitor (Aug. 22)
Excerpt:  Dr Kihumuro Apuuli, the director general of the Aids Commission, the government agency that coordinates the country’s response to the epidemic, said despite reducing HIV prevalence rates from highs of 30 per cent in the early 1990s, more Ugandans are becoming infected each year.  “Uganda used to be a champion in HIV prevention, but now we are doing poorly,” Dr Kihumuro said. “When HIV patients take ARVs and become better, they relax and start playing sex carelessly which has increased our infection rate.”

>> Can Uganda Win the War? New Vision (Aug. 10)
Excerpt:  The 2007 AIDS epidemic update report states that starting in 1992, a significant decrease in HIV prevalence were observed in Uganda alongside evidence of substantial behavioural change that inhibited the spread of HIV.  “However, that trend appears to have stabilised in the early 2000s and there are now concerns that the HIV epidemic could grow again,” the report states. […] Health ministry officials have blamed the concerns on complacency in the public.

>> Crisis Management Holds Back Aids Fight – Expert, The Monitor (Aug. 10)
Excerpts:  According to Dr Peter Mugyenyi, HIV/Aids programme implementers in Uganda need to move from what he calls crisis management to quality, sustainable and integrated programmes within the national health system. […] In Uganda, more than 75 percent of the money for HIV/Aids treatment, care and support services comes from Pepfar. But research has increasingly found that the parallel programmes funded by Pepfar are creating discrepancies that have negative effects to the recipient countries’ health systems.

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~ by h.e.g. on August 26, 2008.

One Response to “Old and new AIDS challenges in Uganda”

  1. it is not only the discrepancies in traditional approachres to HIV and AIDS management but also the fact that the VCT coverage in Uganda has been low due to the war in the north nbut hasrecently increased with the increase in coverage,secondly the desease has at certain times been used by the army as a weapon against the pop[lation in the north besides, corruption and commercialisation of the health courtesy of the armateur capitalism being practiced by the regime has helped in the slackening of comunity health improvements stategies due the increse in poverty levels contrywide though the corrupt regime relies on the media to claim that its very successful inb reducing poverty levels in Uganda yet the reverse is actually truer to details especially in the north where government is till now refusing to compensate the livestock its army looted between 1986-2003.

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