In 1982, the world’s first AIDS victim succumbed to the disease in the Rakai District of Uganda, marking it as the birthplace of this epidemic. By the late 1990s, 15 percent of all adults in the country and almost 30 percent of all those living in urban areas were reported as infected with the virus (Avert, 2011). Currently, about 6.5 percent of Ugandans are living with HIV, and the country is lauded as a success story in the effort to lower transmission rates and prevent AIDS-related deaths. It has become a case study for the political, social and economic issues raised by the public health catastrophe, and what may be successful responses to them. Unfortunately, what the recent numbers and statistics do not reveal are several underlying barriers to treatment and prevention. After years of declining infection rates, prevalence of HIV is again beginning to rise in Uganda.
Below are three ironies (from my experience living in Uganda) that illustrate why the UN’s vague declarations aren’t enough to cure our global communities of the devastation wrought by HIV/AIDS.
1. Antiretroviral (ARV) drugs are made free to any Ugandan with HIV. There are several clinics (funded largely by international organizations like the UN) that are designated to dispense these drugs.
Unfortunately, ARVs are less effective if you have any pre-existing health conditions (like chronic malaria—almost universal in the region) or if you don’t have access to clean water and a healthy diet. Furthermore, the multiple medications in an ARV cocktail must be taken at specific times during the day. If you are unable to stick to the strict regimen, you can develop a resistance to the medicine. A majority of Ugandans walk long distances to acquire medication, so bad weather conditions and impassible roads can make it difficult to take the medication when needed.
Increased funding won’t make it easier for individuals to consistently access clinics and care or improve their responses to the drugs.