HIV/AIDS in Uganda
Uganda was one of the first sub-Saharan African countries to be hard hit by the AIDS epidemic.
Since the first AIDS case came to light back in 1986 more than two million people in the region have been infected. Around 800,000 of those have died leaving a staggering one million children orphaned.
There are now more than one million people living with the virus in Uganda and AIDS is still the main cause of adult deaths.
But Uganda, unlike many other African nations, admitted right from the start that it had a major problem on its hands. Its leaders realised that if action wasn’t taken immediately a third of the population would be dead by 2010.
As in the majority of African countries, HIV transmission is mainly heterosexual, accounting for about 80% of cases. Mothers passing the illness onto their children cause about 15% of cases, while infected blood products and the use of unsterile equipment account for just 1%.
Women still have a very lowly place in society and sexual violence is rife. They are afraid to insist their partner wears a condom and any expectation of fidelity is, generally speaking, out of the question.
It’s a migratory population where the men go off for months to work in the cities and like everywhere where there is a high concentration of men, there are sex workers desperate to earn any money.
It’s hard to believe that a country which was in so much despair 20 years ago is now leading the way in curbing the spread of the virus. Its prevention work is seen as a model for the rest of sub-Saharan Africa. Since 1992, HIV prevalence in Uganda has dropped by more than 50% and the most significant decline has been seen among 15-24-year-olds (the most sexually active group).
Infections among pregnant women have almost halved since 1993 and for sex workers in Kampala, the figure has dropped from 80% to 28%. It’s a remarkable achievement for a poverty stricken country ripped apart by civil unrest.
So what has Uganda done right? Not only did it acknowledge the epidemic from the beginning but its government, particularly president Yoweri Musevini, took an active lead. Community groups, faith organisations and religious leaders were recruited to play an active role in the prevention of HIV and the care and support of victims and families. Sex education programs began in schools focusing on safe sex and encouraging abstinence. Condoms became widely available and were widely marketed.
Uganda developed one of the most comprehensive HIV/AIDS programs in Africa at a time when other African countries preferred to turn a blind eye to this ticking time bomb. The World Bank provided $50 million to fund the Sexually Transmitted Infections Project in 1994 which played a crucial part in halting the spread of the virus.
The ABC message was widespread – Abstain, Be faithful, use a Condom – and same day voluntary counseling and testing services were set up.
In 1997 antiretroviral drugs became available for pregnant women and the number of children born with the virus slowly began to drop.
However, due to the expense of antiretroviral drugs the widespread use of them to keep AIDS at bay is still very limited and in some remote areas of the country healthcare is practically zero.
Up until the middle of 2004 Ugandans had to pay for these drugs but slowly free drugs are filtering through to areas throughout the country.