USAID 'What Happened in Uganda?'

AIDS in Africa.net

Uganda AIDS Commission

Uganda Fight against HIV - Hope in the Face of Despair

Uganda's fight against HIV provides a hopeful example of success. Not only has the HIV rate begun to decline, but perhaps as importantly, Ugandans themselves have driven the implementation of the social, economic and medical aspects of their programs to fight HIV.

HIV/AIDS was first recognized in Uganda in 1982 and by 1993, it's people had the highest HIV infection rates in the world. Over 1.5 million children have been orphaned since the epidemic began -- losing their mother or both parents to AIDS. However, a structured government response begun in 1986 that involved collaboration with international organizations and NGOs has resulted in reversal of serious prevalence rates.

Source: WHO

Uganda, situated in the eastern part of central Africa, shares borders with Kenya, DRC, the Sudan Rwanda and Tanzania. Lake Victoria forms a large part of Uganda's southern border.

Estimated population, 2000 -- 20.9 million of which there are 51% females and 49% males.

Average life expectancy in1995 -- 48 years from birth, estimated to be about 45 years for males and 50.5 years for females.

Average life expectancy in 2000 -- estimated to be about 42 years from birth because of the current HIV/AIDS pandemic. (WHO)

(Map from: World Health Organization, Profile on Uganda)

TABLE 1: HIV INFECTION RATES (%) AT SELECTED ANTENATAL SITES, 1989-1999

Source: Ugandan Ministry of Health (2003) St. Mary's Hospital Lacor, Gulu Sentinel site

Routes of HIV Infection in Uganda

* Heterosexual transmission accounts 84%
* Mother to child transmission accounts for 14%
* Contaminated blood/blood products, use of unsterilized needles and syringes, use of unsterilized instruments accounts for a cumulative 2%

Source: WHO

Political Achievements of Ugandan Government

According to a World Health Organization (WHO) analysis 'success in reducing the prevalence of HIV in Uganda is the result of a broad-based national effort backed up by firm political commitment, including the personal involvement of the head of state, President Yoweri Museveni. From the outset, the government involved religious and traditional leaders, community groups, NGOs, and all sectors of society, forging a consensus around the need to contain the escalating spread of HIV and provide care and support for those affected' (WHO). The public commitment of President Museveni to HIV programs and the establishment of Uganda AIDS Commission (1992) to coordinate multi-sectoral approach to HIV/AIDS prevention and control have been key characteristics of the support the government has given to the fight against HIV/AIDS in Uganda.

Achievements of the Ugandan Ministry of Health

According the World Health Organization (WHO), the Ugandan Ministry of Health has been responsible for a number of considerable achievements, made possible by the impetus and support of the overall governing body. Since 1993, HIV infection rates among pregnant women, a key indicator of the progress of the epidemic, have been more than halved in some areas and infection rates among men seeking treatment for sexually transmitted infections have dropped by over a third.

The mean age at first sex contact rose from 14 years to 16 years. More teenage girls reported condom use than any other age group -- a trend reflected in falling infection rates among13-19 year old girls in Masaka, in rural Uganda. Reduction of sex with non-regular sexual partners from 52.7% to 14.1%. In the capital city Kampala, the level of HIV infection among pregnant women attending antenatal clinics fell from 31% in1993 to 14% by 1998. Meanwhile, outside Kampala, infection rates among pregnant women under 20 dropped from 21% in 1990 to 8% in 1998. Elsewhere, among men attending STI clinics, HIV infection rates fell from 46% in 1992 to30% in 1998. Among 15-year-old boys and girls, the proportion who had never had sex rose from about 20% to 50% between 1989 and 1995. (WHO; ACP/MOH KABP Study 1995)

Ugandan HIV Control and Prevention Programs

* Same-day results for HIV tests and counseling
* Social marketing of condoms
* Self-treatment kits for sexually transmitted infections, backed up by sex education programs
* Sex education programs in schools and on the radio focused on negotiating safe sex and
* Encouragement of teenagers to delay the age at which they first have sex

Uganda in an African Context

HIV/AIDS is a massive problem that threatens the physical health and economic stability of Africa, a continent already riddled with political and social unrest, poverty and disease. Understanding why Africa has reached its current levels of human and natural degradation involves a historical reading that often escapes the classrooms of Western educational systems. But even with that historical understanding, successful solutions to the problems faced by the African region remain elusive. Unfortunately, there is a sense that Africa's problems are too overwhelming to address with any redeemable level of success. The continued violence, poverty and insecurity faced by most African nations has caused a general feeling amongst Westerners that perhaps the most that can be done for this blighted area of the world are short-term disaster relief programs and peace-keeping military interventions. Uganda's multi-sectoral approach to addressing the HIV problem is a hopeful example of an African nation utilizing its own human capital and political leadership to tackle a problem of far-reaching magnitude. Though unique in its cultural, geographical and political composition, students learning about Africa can look to the reversal of HIV in Uganda as a sign of hope for the sustainable development of this region of the world.

References

Ugandan Ministry of Health, 'ACP/MOH KABP Study', 1995. Retrieved August 2003.

Ugandan Ministry of Health, 'AIDS: Situational Summary, Graphs and Tables'. Retrieved August 2003

Ugandan Ministry of Health, 'An Overview of HIV/AIDS in Uganda'. Retrieved August 2003

WHO, 'Health, a Key to Prosperity: Success Stories in Developing Countries'. Retrieved September 2003

WHO, 'Profile on Uganda'. Retrieved September 2003