President Museveni has continuously blamed increasing HIV prevalence in Uganda on non-governmental organisations’ promotion of condom use, sex work and circumcision. “There are so many conflicting messages” observes Mr. Museveni.
From the assertions Mr. Museveni and the government of Uganda are making, it appears they find fault with any other strategy that does not proclaim Abstinence, Being faithful and Condom use, the original ‘ABC message’ of the government when HIV first surfaced in the country in the 1980s. It is also not clear whether there could be some compromise between the government-led ABC strategy and the multiple approaches taken by NGOs.
Whether Uganda can revert to an exclusive ABC strategy to fight HIV after more than 23 years is a question that needs a lot of pondering. Can such a strategy succeed, with slight modifications? How relevant can such a strategy be in an environment of increased research and new challenges? Will the tools of so many years ago be relevant in tackling a problem that has metamorphosed and brought in so many new changes to the health sector?
In an effort to defeat the scenario of ‘too many cooks spoiling the broth’ – who are presumably based in the private NGO world – could a nationally funded campaign match the enormous resources pumped into the NGOs sector? It could be true that the NGOs are enormously funded for their variety of approaches to tackling HIV and AIDS, ranging from medical male circumcision to enhancing the greater involvement of people living with HIV and AIDS in HIV programmes. But the Ugandan government thinks ABC is the best strategy there ever was to fight HIV.
This is the strategy that was employed in the late 1980s and late 1990s, which saw Uganda drastically reduce HIV prevalence from 15% in 1991 to 6% in 2007. The world is her witness to this! Many of those who work to stop increasing HIV infections would of course wish the Ugandan government and all the proponents of the ABC strategy good luck. But unfortunately most of the funds for HIV and AIDS in Uganda come from foreign donations and the government of Uganda provide a minimal budget to the health sector for HIV interventions
We can just hope that the Ugandan government will be successful with its old strategy of fighting HIV using the ABC strategy since this is the big drum being sounded by the president of Uganda as he so strongly believes in it.
“I think the only way to prevent Aids is through abstinence and being faithful to each other for those who are married,” he has said on several occasions.
But what about serving this purpose by incorporating issues of the changing times? Such as the focus on zero new HIV infections through preventing parent to child transmission, the reduction of stigma, and strategies aimed at key populations most at risk? Uganda still needs more HIV counselling and testing services funded from the public sector.
And as if on prompt, government owned and sponsored electronic media have been running a series of ABC messages of recent. As before, the emphasis is on abstinence for youths and faithfulness for those who are married. The slightest variation of these messages from the ones of the 80s and 90s is the slim caution that those already found to be HIV positive should seek medical attention.
One wonders whether Uganda can afford the blame game at a time when new HIV infections are increasing. The 2011 Uganda AIDS Indicator Survey finds that prevalence of HIV among adults increased from 6.4% in 2005 to 7.3% in 2011. The Ugandan Ministry of Health indicates that new infections increased by 11.5% between 2007/8 and 2010/11.
Even when it appears that some ABC messages have been overrun by time –such as the failure to recognise the important place of people living with HIV in Uganda’s response and the vast research that calls for several other interventions – it is debatable whether the success stories of the past, when Uganda gained world acclaim for promoting the ABC strategy and drastically cutting infection rates, can be repeated in 2013.