Complacency, low funding take a toll as HIV prevalence hits 7.3%

By Joel Ogwang                                                                     

 

 

A national demographic and health survey conducted in 2011 shows that the national HIV/AIDS prevalence has hit a seven-year high of 7.3%, up from 6.4% in 2006, according to Christine Ondoa, the former health minister.

 

“We have relaxed a bit and national prevalence has gone high,” she says. “The prevalence is high among married couples and low through mother-to-child transmission.”

 

The news comes as a setback to the country after years of a vigorous, and sustained fight against the epidemic, which catapulted Uganda to stardom as a model in the battle against HIV.

 

HIV statistics 

The first 10 years of Uganda’s real ‘war’ on HIV/AIDS recorded tumultuous successes, with the fear model that worked wonders and forced people to change their sexual behaviour.

 

As a result, the national prevalence rate dropped from 30% in the early 1980s to 6.4% in 2006, according to the Uganda HIV/AIDS Sero-Behavioural Survey. 

 

This, however, followed a string of up-and-down turns. By the end of 1992, the prevalence rate was estimated at 18.3%, with some centres registering rates above 30%, but reduced from 15% in the early 1990s to 5% in 2001. 

 

In 2002, the prevalence rate rose to 6.2% and 6.5% in 2004, dropping to 6.4% in 2006. New HIV/infections, meanwhile, were estimated at 70,170 cases, with AIDS cases at 73,830 and deaths at 75,290 in 2002. 

 

Since 1982 when the country’s first cases of HIV were detected on the shores of Lake Victoria in Rakai district, about 2.6 million Ugandans were infected while 1.6 million people lost their lives to HIV/AIDS related illnesses, with 76,000 in 2005 alone.

 

To-date, a total of 1. 2 million Ugandans are living with HIV/AIDS and, while 577, 000 of them are in need of anti-retrovirals, only 310,000 can access the treatment. 

Prevention work at grass-roots level began in this era, with a number of organisations educating their peers about HIV, with the first community-based organisation formed being The AIDS Support Organisation (TASO).

 

The AIDS Information Centre and the Uganda AIDS Commission (UAC) also emerged. TASO became the largest indigenous organisation providing HIV/AIDS services in Uganda and Africa, and providing emotional and medical support to thousands of people infected and affected by HIV/AIDS.

 

“Back then, the Government prioritised the health sector,” says Dr. Ben Khingi, a consultant surgeon in Kampala. 

“This is no longer the case as seen from human resource development, remunerations and health facilities. We have good policies, but we come short of implementing them.”

 

The 1990s was also the time popular music icon, Philly Bongole Lutaaya publicly declared his HIV status, becoming the first Ugandan to do so.

 

Through his popular music and educational tours, the Lutaaya was, and still remains a hero. He used music and gave HIV a human face at a time when it was almost ‘treasonable’ to be HIV positive,  considering that the infection was completely associated with promiscuity and prostitution which are against African values. 

 

Nonetheless, Lutaaya’s vocal endowment helped spread understanding, compassion and respect for people living with HIV.

 

 

It must be remembered that 1990 was a cruel year as many people died of HIV since there was no treatment. 

As such, many people who were infected from the 1980s were reaching the end of their survival period. In 2000, the health ministry estimated that 800,000 people had died of AIDS-related illnesses since the beginning of the                       epidemic.

However, the colossal gains Uganda has made in reducing the HIV prevalence, granting her a model status in Africa, seem to have been sacrificed on the alter of complacence.

 

The last five years have seen an increase in the HIV infection rate, with over 65% of infections occurring amongst the married! 

 

A total of 135,000 new infections are registered annually, 30,000 of these children and 700,000 women.

“One big problem we have is multiple partners,” says Ondoa. “Zero-grazing is no longer a norm, with some HIV positive men infecting their wives and children.”

 

Free anti-retroviral (ARVs) drugs have been available in Uganda since 2004. It is thought that the introduction of the HIV drugs led to complacency about HIV as AIDS it is no longer an immediate death sentence. 

 

However, the biggest problem in the fight against HIV is that of babies born with the virus 20 years ago.

These have matured and engage in sexual intercourse with those who are HIV negative, consciously or otherwise infecting them in the process.

 

The other problem is that amongst young girls, it is pregnancy, and not HIV, that is dreaded most.

“I was taken aback when a girl told me if I didn’t use a condom, I would make her pregnant,” says Musa Kato, a university student. “I don’t know why she never mentioned HIV!”

 

In its fight against HIV, Uganda has emphasised the ABC strategy that emphasizes abstinence, being faithful and, condom use. 

 

Condoms remain the most widely available and cheapest means in the fight against HIV. However, false confidence is growing among new couples who give up their use even without even knowing their partners’ sero status.

 

“Poverty is also contributing to new infections,” says Ondoa. “Our funding is not high, but it is also due to low tax collections and low production. Once taxes rise, the health sector will be adequately funded. But, also, health indicators show we are progressing.”

 

With Quality Chemical Industries (QCIs) now manufacturing ARVs, experts believe this is easing the hassle of procuring the drugs from abroad and reducing the cost of treatment. 

 

Government officials estimate that the price of generic drugs will go down from $9-15 to between $2-9 per patient per month.

 

The health ministry plans to use a policy of rapid testing, and diagnosis of communicable and non-communicable diseases will be incorporated into HIV.

 

Uganda has, over the last five years, implemented the ABC strategy in a bid to scale down HIV infections. 

This is no longer effective as new infections soar. “HIV is a behavioural issue,” says Ondoa. “Fighting HIV starts with an individual’s change in sexual behaviour.”

 

Uganda is at crossroads in the history of the HIV epidemic. After a dramatic reduction in HIV prevalence following an early comprehensive HIV prevention campaign, there are signs that the number of people living with HIV are starting to rise         again.

 

Experts believe that complacency and the perception of AIDS as a normal disease may be leading to the increase in the risky behaviour that early prevention campaigns sought to reverse.