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NEWS FROM THE REGIONAL DOCTOR
Uganda’s successful fight against HIV/AIDS
Dr. med. Dirk Englisch, MD – Regional Medical Officer, German Embassy, Nairobi
As early as the 1980s, Uganda experienced the devastating impact of HIV/AIDS, with an alarming rise in HIV/AIDS-related mortality and case-fatality rates.
By the mid-1990s, Uganda had the highest HIV prevalence in the world. Complicated by armed conflicts in the Great Lakes region following a devastating civil war, the Ugandan government faced controversial issues whilst operating under severe budgetary constraints:
– AIDS treatment versus HIV prevention
– AIDS treatment versus treatment for other diseases
– Health expenditure versus other government expenditure.
At the same time, pressure mounted due to the ever-increasing number of AIDS-related illnesses, particularly tuberculosis.
Despite these enormous challenges, Uganda nevertheless emerged as one of the few countries that have so far managed to control and reverse the HIV/AIDS epidemic. How was this possible?
The political leadership, under President Yoweri Museveni himself, demonstrated the utmost commitment to developing an effective plan to improve HIV control programmes, which was to encompass all public sectors, including non-governmental organisations. In addition, all HIV-related activities were integrated into the so-called Poverty Eradication Action Plan, thereby focusing not only on halting the spread of infection but also on improving the living conditions of people living with HIV/AIDS. Through intensive training of healthcare staff, the aim was to ensure the sustainability of the efforts made to date.
Another key focus was on changing sexual behaviour: condom use, avoiding casual sexual encounters with unknown partners, fidelity/abstinence, and delaying first sexual intercourse until a later age. In doing so, the programme succeeded in reaching key target groups (sex workers, adolescents, young mothers, etc.) without triggering group stigmatisation. Voluntary counselling and testing, home-based care, prevention of mother-to-child transmission and access to HIV medication complemented these measures. Improvements to the National Blood Transfusion Service, the prevention and early and appropriate treatment of sexually transmitted infections, and the establishment of a statistical surveillance system complemented these measures.
Uganda has now reached a stable plateau in terms of new HIV/AIDS cases. Despite mismanagement, corruption and negligence, however, Uganda’s efforts over the last decade can serve as a model for other African countries.
For us Germans working in companies, embassies, schools, etc. in Africa, training local staff on HIV/AIDS – in the spirit of the often-cited ‘awareness-building’ – offers an effective way to make a lasting contribution ourselves to the fight against HIV/AIDS.
Newsletter “HABARI” – Issue 2, 2008 (online version no longer available)