Thursday, April 9, 2009

The Uganda Miracle That Was

The world has hailed Uganda's success on AIDS for so long that few have noticed that the glory days happened long, long ago. But Ugandans know. A chilling report on the epidemiology in Uganda, by Fred Wabwire-Mangen, stated bluntly last year (Here's a Powerpoint Version)that the declines in new HIV infections are over.

" 1. The previously heralded precipitous decline in HIV prevalence and incidence in Uganda stopped in 2002. HIV prevalence and incidence are now on the increase in Uganda

2. HIV-related sexual behaviours have deteriorated especially for men. There is evidence of: a rise in the number of life-time sexual partners and concurrent sexual partnerships; an increase in sex with non-regular partners, and a decline in condom use both for any sex and in the context of higher-risk sex."

A trio of Uganda AIDS experts tried to ring the alarm bells with articles in major Ugandan papers in January (here's a link to a copy of them). But I've sensed little energy around the issue on my visit here to Kampala, the national capital. Ugandans speak often of the AIDS epidemic in the past tense, and AIDS experts here are convinced that widely available treatment has taken the energy out of prevention campaigns. Now there's a dilemma to ponder: Is there any way to have good treatment and aggressive prevention programs at the same time?

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