HIV On The Rise Again in Uganda

Motorcycle taxi driver Richard Okiror has seen the devastating cost of AIDS firsthand. He has watched people wasting away and dying from a virus that infected nearly one-fifth of all adults in his country. His own parents died of AIDS in the 1990s when he was a teenager, leaving him an orphan.

Yet today, in an era of life-saving medicine, he notices that his friends are less worried by the virus. Some of them, he says, are even paying extra money to prostitutes for sex without a condom.

“People don’t take it as seriously as before,” he said. “It’s a disease that doesn’t kill you very fast.”

Others put it even more bluntly. “People look at HIV as a cough,” said Joseph Matovu, a Ugandan health analyst. “You get it and then you are cured.”

With the growing availability of antiretroviral drugs, people can live with the virus for decades. And because they see fewer people dying from AIDS, they are less likely to take precautions.

“We have stagnated, and there’s evidence of increasing infections,” said Asuman Lukwago, the permanent secretary in Uganda’s health department. “There’s a new generation of young people who are unaware of the dangers of not using condoms.”

In the early days of the AIDS crisis, Uganda was hailed as one of the greatest success stories. With a massive education effort, it reduced its national HIV rate to 6 per cent of adults, compared with 18 per cent at the peak of the pandemic in the early 1990s.

But now its HIV rate is creeping back up again. New infections are increasing, and the sense of urgency has vanished. Uganda is one of the few countries in the world where the decline in HIV infections has stopped and even reversed. It has become an early warning signal to the rest of the world: If the fight against AIDS fades into complacency and neglect, the disease can roar back again.

“It’s very worrying,” says Denis Kibira, a health researcher in Uganda. “In the next five or 10 years, we’re going to face a real crisis.”

Over the past decade, the national HIV rate has edged back up to 6.7 per cent. An estimated 129,000 Ugandans became infected with the virus last year – a rise of 11 per cent in the past four years – and experts predict the number of new infections will rise to 140,000 this year.

“Every year it rises by 10,000 or 15,000 and soon it will be 20,000 or 30,000,” says Raymond Byaruhanga, director of the AIDS Information Centre, a Uganda non-governmental group.

But while the complacency of ordinary people might be one reason for the rise, government policies are equally important factors. And two key governments – those of Uganda and the United States – have contributed to the rise in HIV infections here, analysts say.

Ugandan President Yoweri Museveni, who played a key role in fighting AIDS in the 1990s, has been noticeably less outspoken on the AIDS issue in recent years. He has even publicly questioned the value of male circumcision – one of the most important tools in reducing HIV transmission, according to all the latest scientific evidence.

His government has failed to make progress toward universal HIV testing, another key weapon against the virus. Only about 40 per cent of Ugandans have been tested for the virus, so most never receive the counselling sessions that help galvanize them into behavioural changes.

Perhaps the biggest factor, however, is the increasing emphasis on abstinence and faithfulness as the official response to the AIDS pandemic.

In the early days of the crisis, Uganda adopted an “ABC” policy: Abstinence, Be faithful, and wear a Condom. But today the policy seems to be “AB” without the “C.”

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.

TOGETHER WE REMAIN STRONG!