Martin HenryIT APPEARED as 'slim' disease around the shores of Lake Victoria in Uganda in the late 1970s. But nobody knew what it was. It wasn't until 1982 that the first case of AIDS was diagnosed in Uganda.
The situation is grim for Sub-Saharan Africa, the most ravaged region in the world. Life expectancy, after significant earlier gains has tumbled to 47 years when it could have been 62 without AIDS.
There are millions of AIDS orphans; and the loss of productive workers in the prime of their lives is hobbling economies and reversing development. The vast majority of people living with AIDS in Africa are between the ages of 15 and 49, in the prime of their working lives. Last year 2.3 million people died from the disease. That's a little less than the entire Jamaican population at a rate of 6,300 per day.
Virtually everywhere in the region the level of infection is rising. There were over 3 million new cases in 2004. But prevalence is falling in Uganda.
15 YEARS OF CIVIL STRIFE
When Yoweri Musevini, a practising Christian, assumed the presidency in 1986 Uganda was just emerging from 15 years of civil strife going back to the Idi Amin era and AIDS was already decimating the country.
The President responded to the emerging crisis by going on a nationwide tour with a simple message; some would say a simplistic message. He told people that it was a patriotic duty to avoid AIDS, that they should abstain from sex before marriage, then remain faithful to their partner, and, in third place, use a condom. As simple as ABC: Abstain, Be faithful, and Condom use.
The country was mobilised, from government to grassroots, around this simple prevention strategy based on moral principles, which in more sophisticated places people felt could not work. By UNDP estimates, half of the population does not have access to official health care facilities.
ABC CAMPAIGN
HIV prevalence peaked several years into the ABC campaign. No instant success. In a 1995 survey by Cambridge University, some 90 per cent of the population knew someone who had HIV/ AIDS. But then the decline in infection took hold.
Reported virginity in the 15-19 age group went up from a male/female average of 30 per cent to 50 per cent between 1989 and 1995. The age of first sex went up. There has been a marked decline in casual sex partners, and a rise in condom use.
Secular, scientific, sophisticated Westerners can't really explain in their terms why the ABC
campaign has worked, when it shouldn't have. Uganda is a poor, seriously underdeveloped, war-ravaged country. It is number 146 of 177 on the UNDP 2004 Human Development Index, with a per capita income of US$1,390 [Jamaica is number 79 with a per capita GDP of US$3,980]. With three-way fighting among government and two rebel groups, the Ugandan government has been accused of excessive spending on the military. But the country has managed to reverse the prevalence of AIDS.
POLITICAL COMMITMENT
There was strong and early political commitment to what was essentially a moral programme of AIDS prevention. President Museveni and his government led from the front. In meetings and speeches the president consistently kept emp-hasising that fighting AIDS was a patriotic duty requiring openness, communication and strong leadership at all levels.
Faith-based organisations, with their massive influence, were early enlisted in the fight. Christian and Muslim leaders were mobilised. These organisations trained thousands of peer educators to run with the message. A massive and sustained media campaign was conducted involving influential leaders and entertainment stars, and extensive word-of-mouth communication was used with thousands of AIDS counsellors and educators in the field. Openness was encouraged and there were changes in law and public policy to support the campaign.
SEXUALLY TRANSMITTED INFECTIONS PROJECT
The government borrowed US$50m from the World Bank and topped this up to US$75m from other donors and its own financing to run the Sexually Transmitted Infections Project. [In J$ terms that's like $4.5 billion today]. Testing and counselling were made widely available.
Fighting AIDS was linked to the government's Poverty Eradication Action Plan. The entire population was mobilised for the fight through multiple channels around the simple ABC message.
More places need to learn their ABC. 'Illiteracy' has been the greatest aid to AIDS.
Martin Henry is a communication specialist.
