Joint campaigns pay dividends

1 December is the day commemorated around the world as the World AIDS Day. On this day the international community celebrates the progress it has made in the fight against the dreaded disease and highlights the challenges therein.

This year’s celebrations focused on the theme “Women, girls, HIV and AIDS.” It’s now estimated that 42 million people around the globe are living with the disease and that more and more people get infected each year with no known cure in sight.

In Uganda a surveillance unit at the Ministry of Health estimated at the end of 2001 that slightly over 1 million people were living with the disease. The total HIV/AIDS related deaths since the onset of the epidemic is estimated at 940,000 about 2 million orphans.

But thanks to government intervention, Uganda in the past decade alone witnessed the most dramatic change in the trend of the epidemic. The country is seen as a success story in the fight against HIV/AIDS in Sub-Saharan Africa. UNAIDS now estimates that Uganda’s HIV/AIDS prevalence has declined from 30 per cent in the early 1990s to 4.1 per cent presently.

At the core of the anti-AIDS campaign has been abstinence from sex for young people, being faithful to one’s partner for married people and the use of condoms, where one cannot apply the first two options under the popularly known ABC strategy. President Yoweri Museveni led in the fight against the pandemic, seeking to promote fidelity and abstinence as a sure way of keeping Aids at bay.

In 1986, the government of Uganda established the AIDS Control Programme (ACP) in the Ministry of Health. This marked the beginning of a structured government response against the epidemic. And in 1992, the Statute of Parliament established the Uganda AIDS Commission (UAC) to coordinate the multi-sectoral efforts in the fight against the pandemic.

But the government has not been alone in the fight against the deadly disease. Of the three chairpersons of UAC, two are bishops from the Anglican and the Catholic churches.

Community initiatives too have been the backbone of HIV/AIDS’ work in the country. And it is estimated that over 1,300 such organisations are involved in HIV/AIDS related work throughout the country. Together with the government, these NGOs, faith -based and civil society organisations carry out mobilisation and sensitisation at the grassroots communities.

Openness on the part of the President as well as other government and community leaders/activists has led to a general non-discriminatory approach to the AIDS scourge. And at the level of the Catholic Church, mission health units designed AIDS mobile home care projects. They also set up special programmes for infected and the affected people such as orphans, widows/widowers.

When the virus was first identified in a small fishing village in Rakai, a district bordering Tanzania on the shores of L. Victoria in 1982, little knowledge existed about it. By the end of the 1980s, the disease had rapidly spread to epidemic levels and in the early 1990s prevalence peaked at over 30 per cent in the most hit districts.

Then up came the issue of AIDS orphans, which is fast reaching unprecedented levels. In worst hit areas children as young as 10 years or so head families upon the death of their parents. And where the parents are living with the virus, the children are faced with the emotional stress of their infected parent/s.

At the level of households it aggravated the poverty situation in homes as it removed the wage earners from employment and productive activities. It is estimated that 80 per cent of the reported AIDS cases are among people aged 15-45, the age group that constitutes the largest part of the potential productive labour force. This means increased loss of skilled manpower thus affecting the country’s productivity.

But following the combined efforts, prevalence rates have stagnated in recent years. However, the conflict in northern Uganda threatens to reverse the gains made so far, with the prevalence rate in that area remaining higher than the national one.

The Lord’s Resistance Army rebels are estimated to have abducted about 30,000 children in the last decade and these are promptly married off or just used as sex slaves by rebels who already have multiple sexual partners.

And in the IDP camps, the trend of unprotected sex is a cause of worry. Due to lack of basic necessities, married as well as young people are involved in commercial sex in a bid to earn a living, thus stifling government’s efforts against HIV/AIDS.

Rising poverty levels have also been known to exacerbate the HIV/AIDS situation. Many people can’t access healthcare services for purposes of testing, leading to more infections.

Meanwhile UNAIDS noted with concern that the prevalence rate among women is higher than that of men. This is due to a multiplicity of reasons. Because of culture, many women have little or no say when it comes to safe sex – they are literally at the mercy of their partners most of whom insist on having unprotected sex, making them vulnerable to infection.

Another factor that militates against HIV/AIDS fight is lack of information especially at the grassroots. Most HIV/AIDS campaigns are concentrated in the urban centres and that means rural people have less information on the epidemic. In fact many would allege witchcraft as the source of their ailment.

But with the sustained political goodwill spearheaded by the present government much has been achieved in the HIV/AIDS fight. The first AIDS Information Centre (AIC) opened in 1990 for anonymous Voluntary Counselling and Testing (VCT). And by 1993 many of these centres were opened in urban areas as more and more people became interested in knowing their HIV status.

In all, Uganda’s emphasis on VCT at a time when the WHO Global Programme on AIDS and other international organisations were not yet recommending it as a preventive measure has been seen as unique.