Why is HIV prevalence rising despite the interventions?
Dec 02, 2008
On World AIDS Day, this week, I made a comment in Parliament which I later suspected may be misreported or misinterpreted by some elements in the media.
By Janet Museveni
On World AIDS Day, this week, I made a comment in Parliament which I later suspected may be misreported or misinterpreted by some elements in the media.
I therefore, thought it wise to expound on what I meant, not only to forestall any possible misrepresentation but also because I would like to share my thoughts and concerns with the public at large concerning the way we are currently handling the HIV/AIDS programme in Uganda. Like me, some of you may have legitimate reservations, in view of the rising rate of infection in the country.
The point I made in Parliament yesterday was, in essence, that while we have, in recent years, received a great deal of money for our HIV and AIDS programme in Uganda, and we are grateful for it, our performance in this same period of time has been dismal. And yet, in the early days, during the advent of the AIDS programme, when we had precious little money for any HIV/AIDS activity, we managed to reduce the prevalence rate from a very high 30% to 6%.
When our sterling performance made us the world star in the control of the pandemic and we showed the way forward, the world rose up to support us. We were inundated with funding, and, incredibly, we started to go down. Today, the prevalence rate is going up, in spite of the numerous programmes and projects that are being funded all over the country.
This unexplained, but not inexplicable, contradiction should cause all thinking Ugandans, but especially Parliament, to pause and ask themselves: what has caused this regression in the midst of plenty? It is the job of Parliament to understand that sometimes even when the money is not necessarily stolen the programme activities that are mushrooming everyday and being funded may not be helping to prevent AIDS but may actually be fuelling the rate of infection.
Let us take a simple example of the huge bill boards we see around town and along the major highways; and let us single out the one about stopping cross-generational sex. My brother Hon. Ben Wacha brought out this question and because I did not want to go into a lengthy answer, I just informed the house that, that is another topic altogether. But I too, whenever I see those bill boards, I cannot help but wonder whether they are telling the young person that promiscuity is wrong only when it is indulged in with someone older but it is quite okay when it is with a fellow teenager. Messages that are not well thought-out end up causing more damage than good, because they lay themselves open to misinterpretation. But, that aside, I find it strange that when I drive to Ruhaama County, my constituency, or, indeed, to any other rural area, I do not find this concentration of HIV/AIDS bill boards there! Yet that is where more than 80% of our people live. And if you consider the cross-generational sex message within the context of our rural folk, what is the cultural interpretation and reaction to it? We know, for a fact, that culturally, older men often do marry much younger women. Is that, necessarily, a bad thing? Are all older men immoral and HIV-positive, necessarily? And are all young girls chaste and free of HIV/AIDS? Is it not possible for a young woman to genuinely love an older man? What message, exactly, are we giving out here? We have a responsibility, as Parliament, not only to investigate corruption but also to delve into the whys and wherefores of the allocation and use of HIV/AIDS funds, to ensure appropriate use that will result into maximum impact.
Otherwise, trivial activities that are cutely styled up will continue to receive a disproportionate amount of funding at the expense of more down-to-earth activities that would better serve the majority of our people — the semi-literate population living far from cities, the fishing villages, the sex workers at border posts; the kind of people who would not relate to the programmes on which we may be currently spending money.
Parliament must start insisting on having a say in the formulation of HIV/AIDS programmes, not just in whether the money was actually spent or stolen, well after the fact, which is much like closing the stable after the horse has already bolted! How much money should we be spending on condoms, for instance, as against that which is spent on the other methods of prevention? How much money is spent on administrative costs, on treatment of infected and affected children, on clinics for pregnant women, on remunerating our medics, and so on and so forth?
Money is good only when it helps us achieve the desired results. Are we satisfied that the technocrats are getting it right? It is okay for us as Parliamentarians to sit and listen to these long technical reports full of statistics once in a while but I think that it is even better if we get more seriously involved.
Let me remind Ugandans how the infection rate was so dramatically reduced during those lean early years, before donor funding became so readily available. Success was a result of the concerted and focused effort of all sections of society, and that effort was almost entirely fund-free and voluntary; it was the “do or die†push of a people that knew how desperate their situation was. I recall, for example, that Houses of Worship played a major role in those days, by word of mouth, through the pulpit; but later, these same Houses of Worship developed HIV/AIDS departments which handled the issue and which received donor and government funding. The word of mouth message from the pulpit petered out; the onus was shifted on to the department, people paid to do the job.
Today, every government Ministry, every church, every mosque, has “mainstreamed†HIV/AIDS and they are all tapping into the funding; but what are they really doing about stopping AIDS and how effective are they? Similarly, Parliament has its own token HIV/AIDS Committee; but is this enough involvement? My colleagues in the HIV/AIDS struggle believe that in this battle we have many people who merely want to slow down HIV/AIDS but there are only a very small group who are really out to stop HIV/AIDS once and for all. I would like to invite my colleagues the Members of Parliament to go all out to stop HIV/AIDS.
Therefore, friends since we are already in a hole; let us seriously find out how to get ourselves out, instead of digging ourselves deeper into it by having a laissez-faire attitude. AIDS may not be as visibly scary today as it used to be, but our people are getting infected in greater numbers, and there is still no cure in sight.
The writer is the First Lady and MP for Ruhama County
On World AIDS Day, this week, I made a comment in Parliament which I later suspected may be misreported or misinterpreted by some elements in the media.
I therefore, thought it wise to expound on what I meant, not only to forestall any possible misrepresentation but also because I would like to share my thoughts and concerns with the public at large concerning the way we are currently handling the HIV/AIDS programme in Uganda. Like me, some of you may have legitimate reservations, in view of the rising rate of infection in the country.
The point I made in Parliament yesterday was, in essence, that while we have, in recent years, received a great deal of money for our HIV and AIDS programme in Uganda, and we are grateful for it, our performance in this same period of time has been dismal. And yet, in the early days, during the advent of the AIDS programme, when we had precious little money for any HIV/AIDS activity, we managed to reduce the prevalence rate from a very high 30% to 6%.
When our sterling performance made us the world star in the control of the pandemic and we showed the way forward, the world rose up to support us. We were inundated with funding, and, incredibly, we started to go down. Today, the prevalence rate is going up, in spite of the numerous programmes and projects that are being funded all over the country.
This unexplained, but not inexplicable, contradiction should cause all thinking Ugandans, but especially Parliament, to pause and ask themselves: what has caused this regression in the midst of plenty? It is the job of Parliament to understand that sometimes even when the money is not necessarily stolen the programme activities that are mushrooming everyday and being funded may not be helping to prevent AIDS but may actually be fuelling the rate of infection.
Let us take a simple example of the huge bill boards we see around town and along the major highways; and let us single out the one about stopping cross-generational sex. My brother Hon. Ben Wacha brought out this question and because I did not want to go into a lengthy answer, I just informed the house that, that is another topic altogether. But I too, whenever I see those bill boards, I cannot help but wonder whether they are telling the young person that promiscuity is wrong only when it is indulged in with someone older but it is quite okay when it is with a fellow teenager. Messages that are not well thought-out end up causing more damage than good, because they lay themselves open to misinterpretation. But, that aside, I find it strange that when I drive to Ruhaama County, my constituency, or, indeed, to any other rural area, I do not find this concentration of HIV/AIDS bill boards there! Yet that is where more than 80% of our people live. And if you consider the cross-generational sex message within the context of our rural folk, what is the cultural interpretation and reaction to it? We know, for a fact, that culturally, older men often do marry much younger women. Is that, necessarily, a bad thing? Are all older men immoral and HIV-positive, necessarily? And are all young girls chaste and free of HIV/AIDS? Is it not possible for a young woman to genuinely love an older man? What message, exactly, are we giving out here? We have a responsibility, as Parliament, not only to investigate corruption but also to delve into the whys and wherefores of the allocation and use of HIV/AIDS funds, to ensure appropriate use that will result into maximum impact.
Otherwise, trivial activities that are cutely styled up will continue to receive a disproportionate amount of funding at the expense of more down-to-earth activities that would better serve the majority of our people — the semi-literate population living far from cities, the fishing villages, the sex workers at border posts; the kind of people who would not relate to the programmes on which we may be currently spending money.
Parliament must start insisting on having a say in the formulation of HIV/AIDS programmes, not just in whether the money was actually spent or stolen, well after the fact, which is much like closing the stable after the horse has already bolted! How much money should we be spending on condoms, for instance, as against that which is spent on the other methods of prevention? How much money is spent on administrative costs, on treatment of infected and affected children, on clinics for pregnant women, on remunerating our medics, and so on and so forth?
Money is good only when it helps us achieve the desired results. Are we satisfied that the technocrats are getting it right? It is okay for us as Parliamentarians to sit and listen to these long technical reports full of statistics once in a while but I think that it is even better if we get more seriously involved.
Let me remind Ugandans how the infection rate was so dramatically reduced during those lean early years, before donor funding became so readily available. Success was a result of the concerted and focused effort of all sections of society, and that effort was almost entirely fund-free and voluntary; it was the “do or die†push of a people that knew how desperate their situation was. I recall, for example, that Houses of Worship played a major role in those days, by word of mouth, through the pulpit; but later, these same Houses of Worship developed HIV/AIDS departments which handled the issue and which received donor and government funding. The word of mouth message from the pulpit petered out; the onus was shifted on to the department, people paid to do the job.
Today, every government Ministry, every church, every mosque, has “mainstreamed†HIV/AIDS and they are all tapping into the funding; but what are they really doing about stopping AIDS and how effective are they? Similarly, Parliament has its own token HIV/AIDS Committee; but is this enough involvement? My colleagues in the HIV/AIDS struggle believe that in this battle we have many people who merely want to slow down HIV/AIDS but there are only a very small group who are really out to stop HIV/AIDS once and for all. I would like to invite my colleagues the Members of Parliament to go all out to stop HIV/AIDS.
Therefore, friends since we are already in a hole; let us seriously find out how to get ourselves out, instead of digging ourselves deeper into it by having a laissez-faire attitude. AIDS may not be as visibly scary today as it used to be, but our people are getting infected in greater numbers, and there is still no cure in sight.
The writer is the First Lady and MP for Ruhama County