AIDSOver the past few years, Uganda has been able to get a grip on its HIV epidemic, to a good degree. Since the massive scale-up in treatment that started around 2004, many people are now on Anti-Retroviral Therapy (ART), which can prolong the life of HIV-infected individuals by more than 15 years if administered and managed correctly.

Anti-Retroviral Therapy is complicated though, in many aspects.

First, for the patient:

  • It is a life-long therapy, that requires drugs every day, complemented by sufficient nutrition.
  • There may be side effects.
  • The environment for the patient may not be optimal, social isolation and stigma are still frequent occurrences.
  • There is always the risk of resistance, the on-going process of the virus that slowly mutates to become resistant to some drugs. This gets worse when people skip (voluntary or involuntary because of drug stock outs) some treatment days.

Secondly, for the health sector:

  • The epidemic puts a major burden on the health system. It can barely cope.
  • HIV-positive individuals must be continuously monitored to make sure that their outcomes are improving, and that the drugs are working.
  • Drugs must always be available, in sufficient quantities.
  • New developments and knowledge in HIV means continuous training.
  • Samples must be tested, sometimes not where the samples are taken from, but at reference labs.
  • Health workers are not sufficient, and it is hard to retain them at health facilities. They prefer working in the city, rather than rural areas.

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PREVENTION:

The best medicine therefore is still prevention:

  • Prevention of new infections.
  • Prevention of infection to children of infected mothers.
  • Prevention of infection in married couples whereby one of the two is infected.
  • And prevention of everyone else.

Known strategies that work include abstaining and being faithful. Condoms are extremely effective, but are not as heavily promoted anymore as they used to be. Newer methods include the female condom and medical male circumcision; the latter has become policy for Uganda.

THE PROBLEM:

However, prevention efforts are failing. The number of new infections is on the rise, compared to earlier years when Uganda was touted as a success story in the fight against HIV in Sub-Saharan Africa.

According to the UNAIDS annual global report of 2010 (with data from 2009):

  • There are currently around 1.2m people living with HIV in Uganda. In 2001, there were 980,000 people living with HIV
  • Women and children are disproportionally more infected. There are around 610,000 women and 150,000 children infected in 2009.
  • Of all adults between 15-49 years, around 6.5% is infected, but major regional differences exist. In Kampala, it is estimated to be 8.5% (2009 data).
  • In 2009, it was estimated that 120,000 new infections took place.
  • The number of deaths from HIV is decreasing. In 2009 there were an estimated 64,000 HIV-related deaths, with 89,000 in 2001.
  • Uganda has spent close to  $270m on HIV in 2007, of which only 2.5% was funded by domestic public spending.
  • In 2008, approximately 153,000 people received ART, and in 2009 this number was slightly above 200,000
  • But it is estimated that around 520,000 people would need ART, based on their disease progression, although Uganda reported that this number slightly above 373,000
  • The world bank estimates Uganda’s population growth to be around 3.3% (2009).

These numbers are worrying, because the country cannot afford this epidemic. All individuals who are currently HIV positive will require treatment at some point. As of now, less than 20% of all who are infected are being treated, yet the health system is already struggling to keep up with the demand. International funding is under pressure – yet the number of new infections is on the rise.

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From: Epidemiological Fact Sheet on HIV and AIDS, 2009: UGANDA

If these infection rates continue to increase what will happen to Uganda? What’s the way forward?

LET’S DISCUSS!!!

If you are an open minded person whose opinions are formed on the basis of science, logic, and reason and are interested in meeting like-minded individuals – you are welcome to join us at the meeting.

The June 2011 Freethinkers’ Night is going to take place on Thursday, 30th June, at 4 Points Bar & Restaurant, Centenary Park, Kampala, starting 6PM. Entrance is FREE.


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