July 30, 2012
Almost 260,000 people with HIV/AIDS in Uganda are being treated by the U.S. President's Emergency Plan for AIDS Relief program launched by President George W. Bush in 2003 -- treating nearly half of the 600,000 in need of antiretrovirals there. PEPFAR, said Dr. Stella Talisuna, has enabled thousands of Ugandans to "get back on their feet."
Concurrently, however, new government data show HIV prevalence in Uganda has risen from 6.4 percent in 2004 to 7.3 percent in 2011. The number of Ugandans with HIV has increased two-fold since 2004, from 1.2 million to 2.4 million.
Critics say Uganda's past success in reducing the HIV infection rate has been undermined by a shift in focus from prevention to treatment. Ugandans "now see AIDS as much more like diabetes, one of these chronic diseases you can live with indefinitely," said well-known social critic Timothy Kalyegira. Official figures show Uganda's rate is rising primarily because people are having multiple sex partners.
Years ago, Uganda rolled out the "ABC" HIV prevention policy: abstain, be faithful, or use condoms. A generation of students watched videos on how AIDS ravages the human body, and they were encouraged to postpone first intercourse.
"There is need for continuous dissemination of information," said Joshua Musinguzi, head of the country's AIDS control program. "Individuals have the power to make the correct decision if they want to. The menu is there: ABC."
Meanwhile, U.S. officials are pressing Uganda to devote more of its own resources to AIDS and other health issues, noting that dependency on foreign donors is unsustainable in the long term. Country coordinator Michael Strong said PEPFAR is scheduled to transition from service delivery to technical assistance, and Ugandan officials must step up their role going forward.