Without a doubt the impact of HIV/AIDS has been by far more severe in Sub-Saharan Africa than any other area of the world. 25 years ago, AIDS was practically non-existant in the region. However it has grown to be the number one lethal disease in the area, claiming more deaths than malaria. The United Nations estimates that roughly 3.2 million adults and children became infected with the disease in the year 2003. Of those, 2.3 million people died of AIDS-related illness in the same year. Around 39 million people have been infected in total since the start of the epidemic in sub-Saharan Africa (that’s roughly the entire population of Canada!).
For my report, instead of spending too much time looking at the scientific aspects of the AIDS virus, or how it affects Africa as a whole, I have decided instead to focus on one Sub-Saharan country and the effects AIDS has on it. The country I chose is Uganda
What is AIDS/HIV?
AIDS is an acronym for Acquired Immunodeficiency Syndrome or Acquired Immune Deficiency Syndrome and is defined as a collection of symptoms and infections resulting from the depletion of the immune system caused by infection with HIV.
AIDS/HIV in Uganda:
The reason I chose to look at AIDS in Uganda is because it is one of the few African countries where the HIV prevalence rates have actually dropped and it is also seen as a rare example of succes in a place where its nieghbours are facing a severe aids crisis. Located in East Africa, bordering Kenya and Sudan, Uganda is quiet a small country in size compared to its neighbours. Some basic demographic information regarding AIDS in Uganda is given below:
Population: 27,269,482 (estimates for this country explicitly take into account the effects of excess mortality due to AIDS; this can result in lower life expectancy, higher infant mortality and death rates, lower population and growth rates, and changes in the distribution of population by age and sex than would otherwise be expected)
Infant Mortality Rate: total: 67.83 deaths/1,000 live births
HIV/AIDS – adult prevalence rate: 4.1% (2003 est.)
HIV/AIDS – people living with HIV/AIDS: 530,000 (2001 est.)
HIV/AIDS – deaths: 78,000 (2003 est.)
Origin of AIDS/HIV in Uganda:
AIDS began to spread in Uganda on the shores of Lake Victoria in the late 1970’s. Many believe that it is from here that HIV spread all across the globe. The first AIDS case was actually diagnosed in Uganda in 1982 when there was little understanding of what AIDS actually meant, and the fact that HIV caused it. The victims of AIDS during the 80’s in Uganda were only looked after on a local scale, with no real outside help, expect the community caring for them.
Around 1986, the former President of Uganda, Yoweri Museveni, responded to the escalating crisis by taking on a personal tour of the nation to inform people to avoid AIDS. He did this by encouraging citizens to abstain from sex prior to marriage and use condoms. During the same year, Uganda’s first AIDS control program was established
Why Has AIDS Spread So Fast in Uganda?
Uganda has been a victim of a civil conflict between rebel forces combating a government sponsored militia for well over 20 years now. The war has claimed thousands of lives but more importantly is largely responsible for the sudden spread of AIDS in Uganda. Civilians become taken as slaves or prisoners and the Lords Resistance Army kidnapped at least 20,000 children of who 20% are girls. These girls unfortunately end up becoming involved in sex abuse and caused the virus to spread. Around half of the escapees from the rebels are recorded to be infected with some sort of sexually transmitted disease. It is now believed that the rebels carry out mass-rapes with the intention of spreading the HIV virus, as a weapon against the civilian population.
The Effects/Problems of AIDS in Uganda:
AIDS has had a staggering effect on life expectancies, death rates, infant mortalities and also the economy of Uganda.
With regards to the impact on life expectancy, AIDS is erasing decades of advances in extending life expectancies in Uganda. Before AIDS, Uganda had a life expectancy of around 68 years, in 2010 it is projected the life expectancy will be around 35
Along with the sharp drop in life expectancy, the crisis of AIDS has caused the death rate in Uganda to shoot upwards In 1998, AIDS increased the crude death rate in Uganda by approximately 52 percent. By 2010 the crude rate will be 64 percent higher than it would have been without AIDS. HIV/AIDS-related illnesses are the leading cause of mortality in adults 15 to 49 years old, and to date, more than 1.8 million people have died of AIDS-related diseases.
The impact that HIV/AIDS had on children is also horrific in Uganda. Forty-seven percent of the Ugandan population of 21 million is under age 15. At the end of 1997, 7.3 percent of AIDS cases were under age 12. In the year 2000, the infant mortality rate is expected to be approximately 11 percent higher than it would be in the absence of AIDS. There are currently an estimated 1.7 million orphans.
Women, due to their low social and economic status in Uganda, combined with their larger biological susceptibility to HIV, are at a higher risk of infection than men. This gender inequality causes as many as 15 percent of pregnant women in Uganda to test positive for AIDS (1999).
With 90% of AIDS cases in Uganda coming from 20-49 year olds, an important economic burden is created (since this age group makes up the most economically productive population). AIDS has caused productivity to fall and cost for business to rise even in places where labor is intense. The socio-economic impact of AIDS is hard to swallow in Uganda. This diminished labor force affects economic prosperity, investments from abroad, and disrupts sustainable development.
Agriculture and farming are also strong hit by the virus because a loss of agricultural labor might cause farmers to move on to crops that require less labor – which undoubtedly affects the production. Around 80% of the Ugandan population is located in rural areas where HIV/AIDS has affected socio-economic development hard. The private costs for caring for patients with AIDS, including expenditure on medicine, drugs, and funerals are also hefty. A recent calculation has suggested that the rate of economic growth has fallen by 2-4% in Uganda.
Why Was The Response So Effective?
Nicknamed the ABC approach, the Ugandan government started off by first encouraging abstinence until marriage. The next step was then to advise those who are sexually active to be faithful to a single partner or reduce number of partners. Lastly, the people were advice to always use a condom.
The main method of getting this approach around was by word of mouth. The Ugandan population has thems elves to thank really for the reduction in the HIV prevalence rate. A high level of AIDS awareness has been created amongst people generally. In the early stages of the epidemic, the government recruited the citizens to form community-located organizations to fight AIDS, such as the TASO organization which now provides emotional and medical support to people who are HIV positive in Uganda.
The swift government approach to battle the epidemic is also largely responsible for the sharp decline in HIV prevalence rates. They key message of avoiding casual sex was taken as very simple and the government withheld from throwing scientifically sophisticated reasons such as forms of prevention and so on until later when a decline in HIV figures already took place.
One of the most important things to note about Uganda’s method of dealing with the epidemic was the way the government was open and honest about it. Since 1986, a message has been spread saying that “yes, there is HIV in the country”. This approach was viewed as brave since so many other African politicians were reluctant to talk casually about sex – however the openness was very rewarding.
Uganda has been hailed as a very rare success story in the fight against AIDS, commonly being referred to as the most effective national response in the whole of sub-Sahara.
What the Future Holds?
It is vital that other Sub-saharan governments look at the success of Uganda and try to employ similar fighting schemes. As for Uganda itself, the battle is not near over and the work and effort must continue to minimize AIDS. Currently there is a lack of urgent action. Too much time is wasted on unecassry planning. Instead everyone must act now and contribute in every way they can.