By James Thembo

Might the easy access to ARVs be fanning the HIV prevalence rate flame?

The Uganda government, actors in the health sector and indeed many Ugandans are mystified by the recent Aids Indicator Survey that shows that the HIV prevalence rate in the country has increased from 6.4 to 7.3 in only a period of six years. This news found me still thinking about what a friend who works with the Uganda Aids Information Centre had told me two months ago that with about 360 people getting infected with HIV every day, the infection rate in Uganda was hitting an all-time high. 

The minister of health’s revelation at the end of June 2012 about the increasing HIV rate did not therefore shock me. While the figures sited are high to live with, the country has lately taken drifts which would encourage the increase of HIV leading to the acceleration of the pandemic.

I think that background here is crucial for a better understanding of the changing fortunes into the negative. The Uganda HIV/Aids fight started as an earnest battle that made Uganda shine as an international case study for all world populations which were grappling with the problem with varying degrees of success or failure. For nearly two decades, president Museveni combined efforts with local and international organizations towards minimizing the problem which had already claimed the lives of many Ugandans.

Then in 2002, a major question mark about Uganda’s success was raised by the Lancet Medical Journal. It was argued that the country’s success of a dramatic decline might have been tinged with distorted and manipulated figures. At that time, government did well at the PR front, dismissing the journal’s claims as imperialist propaganda meant to

Push into oblivion everything positive from Africa.

Then in 2011, the BBC published a report that clearly indicated how Uganda was losing the fight against HIV/Aids.  A few non-solution-providing discussions followed that report and since then, the infection rate has been on an upward arc; which begs the question: What, in the strategies that are said to have worked for Uganda in the earlier days should be revisited?   What of if the plans were revisited and nothing changes for the better?

Very likely, the main problem is the ‘death’ of fear of HIV/Aids, a fear that in the earlier years had made fear for pregnancy, say, in school something more bearable in comparative terms.  With availability of ARVs, Aids is now a manageable and treatable disease where persons with the virus remain healthy and are therefore not ‘sentenced to death’ or ‘walking corpses’ as was the perception in the earlier years.

And indeed, at many accredited health centres, according to the Uganda Aids Information Centre, ARVs are provided free of charge, though private facilities charge a small fee for consultation and treatment of opportunistic infections. 

Since the publication of the recent report in Uganda, accusations and propositions are flying around, most of them in the media. While some commentators are putting the blame of the negative trend on what they call the ill-advised focus on morality traits, others are saying promiscuity is on the increase as estimated by the number of people especially in Sub-Saharan Africa who appear to have multiple partners almost as a hobby. Yet others are counseling that condoms should have been made as on-hand as free supermarket discount coupons, etc, etc.

When I shared with colleagues some aspects in the report, three of them lightheartedly told me life was too short to be spent worrying about Aids and besides, they added, there is currently means to live a healthy and productive life for even two or more decades. This is when the availability of ARVs to many who need them vividly struck me as a paradox because in that advantage also lies the danger that is likely causing spread of the pandemic!

I therefore opine that there should be vigorous media campaigns and drafters of those messages should re-introduce an element of fear for the prowling disease. Widely publicize figures like the recent ones from the Uganda Aids Commission (2011) which show that new infections rose from 120,000 in 2011 to 180,000 in 2012 with the possibility that in the next five years, the number of the infected will be around 700,000 if no effective methods to condense the trend are not put.

James Thembo is a journalist.