Uganda, with 1.5 million HIV/AIDS victims—8 percent of the population—has decided to take on the scourge as a national challenge. And with government backing, foreign experts, including the U.S.-based Centers for Disease Control, think that a multi-pronged assault on the disease could reduce AIDS incidence here to at least half the current level.
The Uganda approach requires AIDS testing of most of the population, counseling on how to change sexual practices, better access to relatively cheap medicine, preventive measures and public education. “If we don’t switch ourselves on [to tackle AIDS], we are finished,” Dr. Francis Omaswa, the director-general of Uganda’s government health service, told Powell and his party. “But if we do, maybe other things could follow.” AIDS, he said “has provided us with an opportunity to rise to the challenge and to design new ways of doing things that can transform our lives for the better.”
The attitude of confronting the disease head-on, an approach chosen by president Yoweri Museveni himself, is itself a critical factor in the anti-AIDS campaign. “It’s been shown that having an open government, strong leadership, a president who supports providing information to the populace is an awfully good way to start,” says Jonathan Mermin, director of the CDC office in Kampala.
And in Uganda, there are thousands of community-based initiatives to educate the public on ways to reduce the risk of the spread of AIDS. Today in this east African country, as in much of the rest of the continent, HIV is transmitted mostly through heterosexual sex. Originally spread at least in part through “Boda-Boda” drivers—the motorcyclists who travel from border to border and offer rides to young women—sufferers now include married couples with a partner who either strays or contracted it in an earlier relationship.
AIDS: A 20 Year Toll
• 1981 - 1984: The Search For A Cause
• 1985 - 1994: The Epidemic Spreads
• 1995 - present: An Era of Hope
Newsweek
On average, and depending on the frequency of sexual relations, infectious disease experts estimate a 9 percent chance per year that an AIDS-afflicted partner will transmit it to the other. According to Mermin, the mere testing of partners lessens the risk of transmission by leading to increased awareness and precautions.
Health authorities also try to strike pre-emptively to keep AIDS patients alive longer. To reduce the chances of the infected partner contracting other diseases like tuberculosis, AIDS patients are encouraged to take Isoniazid, which costs $10 per year; to avert bacterial infections, affected patients are urged to take a daily pill of Cotrimoxazole, at a cost of $15 a year. To prevent diarrhea or other water-borne infections, CDC promotes the use of a plastic water vessel with a dilute chlorine solution at a cost of $15 a year.
Uganda’s second-most common form of transmission is from mother to infant, with some 30,000 to 40,000 infants born annually with HIV. One dose of the anti-retroviral nevirapine for the mother and another for the infant reduces the chances of transmission by 50 percent, according to CDC’s Mermin.
One of the biggest problems for Uganda is the death of a household’s male breadwinner, which can lead to the destruction of the livelihood and the break-up of the family. About one in five AIDS victims dies of cryptococcal meningitis, a fungal infection of the brain and spinal cord. While a Pfizer-produced drug called Fluconazole can treat this illness, few Ugandans can afford the $2,000 a year—about five times the average citizen’s annual income—needed for the medication.
Shortage of funds impacts other areas too. Mermin estimates that if $15 per citizen were spent for every year for the next five years, it could change the status of HIV/AIDS from a pandemic to just another disease. That amounts to roughly $150 million. For Ugandan health workers, the big question now is whether the U.S.—which just committed $50 million to the country—will do more to help them get the job done.
