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Uganda Remains Bright Spot in African AIDS Crisis
(CNSNews.com)—Among the nations of Africa, where 12 million people have died of AIDS and 23 million have the disease presently, Uganda stands out as one country where the government has taken effective action to fight the epidemic—by focusing not on safe sex, but on changing risky behavior.
In the past decade, the infection rate has dropped 25 percent, and a whopping 50 percent in urban areas. The percentage of infected mothers who pass the disease on to their new born infants has fallen from 40 percent to 15 percent, as a result of increased treatments for HIV carriers and better prenatal care.
Uganda was one of the first nations in Africa to publicly admit that it had a problem, declaring the disease a national crisis in 1986—ten years before most countries—and adopting a vigorous national plan to combat AIDS in 1992. Today, Uganda leads Africa in research for an AIDS vaccine.
Yet these initiatives do not tell the whole story of Uganda’s relative success in fighting AIDS, for along with the nation’s early admission that it had a problem, the government there has chosen a different approach than many of the AIDS prevention programs presently in place in Africa, especially those sponsored by various agencies of the United Nations.
Uganda, rather than relying solely or immediately on distributing condoms to people at risk for the disease, the government of President Yoweri Museveni has made a concerted effort to get citizens to change their behavior. The president himself has spoken out frequently on the need to remain abstinent before marriage and monogamous within marriage.
“We’ve approached AIDS from several directions,” Tayebwa Katureebe, an attache at the Ugandan embassy in Washington, D.C., told CNSNews.com. “The first is to get people to recognize that they will not get AIDS if they don’t engage in the sort of behavior that causes AIDS. That means, abstinence, monogamy, and only then, condoms.”
Katureebe said that the Ugandan government has involved local tribal leaders, as well as religious leaders from the country’s Catholic, Christian and Muslim communities in spreading the message of abstinence and monogamy.
The Ugandan government also hopes that its program would be replicated in other areas of Africa, where AIDS positivity has reached as high as 30 percent in some sub-Saharan countries.
The message seems to be particularly important in Africa, where promiscuity is more of a cultural norm than in the West and men taking multiple sexual partners is not uncommon. Some very traditional villages still engage in a practice called “sexual cleansing,” where a woman who has fallen sick has sex with several men in hopes of being cured by semen, which is thought to have purifying qualities.
Such practices—as well as the prevalence of prostitution throughout the continent, especially along north-south trucking routes—have made Africa especially vulnerable to the spread of AIDS.
Uganda’s approach differs from the approach of the UN throughout the continent. Through agencies such as the Joint Programme on HIV/AIDS (UNAIDS) and the World Health Organization, the global body has flooded the continent with male and female condoms made by UN-owned manufacturers, such as the UN Female Health Corporation.
Secretary General Kofi Annan recently told reporters that despite lingering objections from religious and cultural leaders about the promotion of condoms, the UN would continue to encourage their use.
“Governments have got to do something. We must end the conspiracy of silence, the shame over this issue,” said Annan. The notion that promoting condom use is encouraging promiscuity, he added, “won’t do.”
However, there is new evidence that condoms may actually help fuel the AIDS crisis by discouraging essential lifestyles changes, such as limiting the numbers of partners or remaining monogamous.
A recent report in the British medical journal The Lancet found that “increased condom use will increase the number of [HIV/AIDS] transmissions that result from condom failure.”
More importantly, condom use may actually discourage the sort of lifestyle changes that are essential to stopping the spread of the virus in Africa, as people “switch from inherently safer strategies of partner selection or fewer partners to the riskier strategy of developing or maintaining higher rates of partner change plus reliance on condoms.”
In the short term, the researchers conclude, the “benefits of condom use to individuals exposed to HIV or sexually transmitted diseases are substantial and well-documented, . . . [but] it is much harder to show that condom promotion has had significant impact on HIV epidemics.”
Torres, Justin. “Uganda Remains Bright Spot in African AIDS Crisis.” CNSNews (April 10, 2000).
Reprinted with permission of CNSNews.com
Copyright © 2000 CNSNews.com