4S03 : Infectious Diseases - IN THE WAKE OF THE HIV/AIDS EPIDEMIC : UGANDA
Introduction

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The History of Uganda
Introduction
About Uganda : Government, Population, Prominent Groups, Traditions, and Religion
An Overview of the HIV/AIDS Epidemic in Uganda : A Cultural Approach to the HIV/AIDS Epidemic
Uganda's National and Governement Responses (the MACA project)
HIV/AIDS : A Ugandan Perspective-PART I
HIV/AIDS : A Ugandan Perspective-PART II
Intervening to Thwart the Epidemic : Ugandan and Western Intervention - PART I
Intervening to Thwart the Epidemic : Ugandan and Western Intervention - PART II
Intervening to Thwart the Epidemic : Ugandan and Western Intervention - PART III
Intervening to Thwart the Epidemic : Ugandan and Western Intervention - PART IV
The Multi-sectoral AIDS Control Approach (MACA)
Against All Odds
FIGURE 1: Prevelance Rates Charts
FIGURE 3: Factors Contributing to Uganda's Success Chart
FIGURE 4: Distribution of HIV/AIDS agencies by interventions
References

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"The disease is all around uswithin our community, our families, our housesand it will defeat our best efforts at peace and development unless we defeat it first."

 

Kofi Annan, UN Secretary General

 

 

In the 20 years that it has been with us, AIDS has continued its relentless spread across continents.  By the end of 2000, the United Nations Joint Programme on HIV/AIDS (UNAIDS) reported that 36.1 million men, women and children were living with HIV around the world and 21.8 million had died. Though AIDS is now found in every country, it has most seriously affected sub-Saharan Africahome to 70% of all adults and 80% of all children living with HIV, and the continent with the fewest medical resources in the world. 

 

AIDS is now the primary cause of death in Africa and it has had a devastating impact on villages, communities and families on the continent. In many African countries, the numbers of new infections are increasing at a rate that threatens to destroy the social fabric. Life expectancies are decreasing rapidly in many of these countries as a result of AIDS-related illnesses and socioeconomic hardships.  And of the 13.2 million children orphaned by HIV/AIDS worldwide, 12.1 million are in Africa. 

In the past, AIDS-control activities relied on giving information about HIV transmission, and imparting practical skills to enable individuals to reduce their risk of HIV infection and care for themselves if infected. There is a growing awareness, however, the sociocultural factors surrounding the individual need to be considered in designing both prevention and care interventions.  As the epidemic continues to ravage the low- and middle-income world, it becomes increasingly evident that diverse strategies to confront the wide-ranging and complex social, cultural, environmental and economic contexts in which HIV continues to spread must be researched, tested, evaluated, adapted and adopted.

 

Today, in 2003, interventions to stem the spread of HIV worldwide are as varied as the contexts in which we find them. Not only is the HIV epidemic dynamic in terms of approaches to treatment, prevention strategies and disease progression, but sexual behaviour, which remains the primary target of AIDS-prevention efforts worldwide, is widely diverse and deeply embedded in social and cultural relationships, as well as environmental and economic processes. This makes the prevention of HIV very complex. In addition, care for people infected with HIV depends not only on the local health infrastructure of the country or village, but on social and family structures, beliefs, values and economic conditions.

 

Monitoring and evaluation of prevention programmes have shown that prevention does work. In countries that have quickly implemented well-planned programmes with support from political and religious leaders, HIV prevalence has been kept consistently low, and has even decreased in some countries in the last five years (UNAIDS, 1998). Yet, cases of decreased HIV prevalence are still the exception and many developing countries are struggling to find innovative, cost-effective strategies that are relevant to the status of the epidemic in their nation. Especially in countries where prevalence and incidence of HIV are still climbing rapidly, as well as in those countries where morbidity and mortality associated with HIV are alarmingly high, AIDS programme leaders are searching for creative solutions to increase access to both prevention and care services.

Pioneering programmes in Africa have demonstrated to the world the importance of local responses to HIV/AIDS, which aim to empower communities through local partnerships consisting of social groups, service providers and facilitators. Effective community-centred efforts have generally been empowering, i.e. strengthening a communitys capacity to make decisions, and enabling, assisting communities in mobilizing the resources required for them to act on those decisions.

 

In countries such as Kenya, the United Republic of Tanzania or Uganda, where resources are limited, there is a desperate need for care, support and prevention alternatives that are readily available, accessible and affordable, given the vast number of people who do not have access to government health units or hospitals. And, given the stigma associated with HIV/AIDS in many African communities, to be viable, these alternatives must take into consideration the feelings of patients, their ability/inability to pay for the health services and their sociocultural and economic realities.

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