Today, Uganda joins the rest of the world to celebrate the World AIDS Day with the theme: “Getting to Zero new HIV Infections, Zero discrimination and Zero AIDS related Deaths.”
The local theme that was selected by the Uganda Aids Commission is “Re-engaging leadership for effective HIV prevention.” Leadership is defined to include individuals, households, communities and institutions to national levels.
PACE implements a positive living project that caters to people living with HIV by providing a life prolonging Package of commodities like a mosquito net, condoms, water vessel and safe water treatment tablets. PACE reaches over 150,000 clients across 95% of district coverage. They are also mentored on how to live positively by adopting the positive living life style.
Uganda as a country this year has seen several programmes being re-launched or scaled up to address the increasing number of new HIV infections. Prevention-of-mother-to-child transmission (PMTCT). The focus has now been shifted to elimination rather than prevention, thus the transition now to elimination of mother-to-child transmission (EMTCT.
According to the chairperson of the Uganda Aids Commission Prof Vinand Nantulya, this year, the EMTCT programme has registered tremendous progress with less than 10,000 babies born with HIV compared to 25,000 babies born with the virus in 2011.
“By the end of 2015, we will have less than 5,000 babies born with HIV because we have seen what it takes to achieve zero infections,” he says. Under this programme, every woman who tests positive for HIV positive is started on ART treatment regardless of their CD4 count.
“HIV-positive mothers carry a high chance of transmitting the virus to their babies. But this can be stopped if we put these mothers early on treatment. And if the mother adheres to treatment, she will have a baby who is free of HIV,” Prof Nantulya.
In 2011, an estimated 25,000 babies were born with HIV, according to figures from the Uganda Aids Commission. The commission estimates that this number has since reduced to 10,000, and will be further halved by the end of 2014.
“We are driving towards, a situation where no baby should be born with HIV. We attribute the success we have registered so far to the campaign on elimination of mother-to-child transmission championed by the First Lady,” notes Prof. Nantulya.
He however notes that male involvement remains low yet their support is key to reducing the mother-to-child infections since majority of the infections come from fathers.
“The fathers are not showing up for testing, very few men are coming up and we want them to take interest in their health so that they can know their HIV status so that we put them on treatment if they test positive. We know that most of the infections that go to the baby originally start from the father.
The father infects the mother, and the mother infects the baby,” he says. This year has been characterised by numerous reports of condom shortage, a key method of preventing HIV/Aids. Prof Nantulya says such shortages have contributed to the inconsistent and ineffective use of condoms in the country. “We are pushing for the availability of condoms because we know that to use a condom and benefit from it, you must have consistent supply,” he adds.
But the Uganda country director of the United Nations Joint Porgramme on HIV/Aids (Unaids), Musa Bungudu, attributes this incorrect and inconsistent use of condoms to individual sexual behaviour and responsibility.
Bungudu insists abstinence and faithfulness remain the most cost effective way of preventing HIV. “Behavioural change should be emphasised, and options like condom use should only come in when the first two have failed.”
He adds: “People are not taking charge of their health, the reason they stop using condoms when there are no free supplies, yet condoms are very cheap on the market. People should understand that it is their health.”
Treatment as prevention
Various studies have found that when people living with HIV are treated early, the viral load in their immune system is suppressed and this reduces their chance of infecting others. New World Health Organisation guidelines on HIV require that every individual who tests positive should be put on treatment as soon as possible.
But Uganda is yet to implement this guideline because of the cost implications involved.
Bungundu says for Uganda to adopt this guideline, it has to make significant contribution to its HIV budget and not leave the burden to donors.
Currently, about 577,000 people living with HIV/Aids in Uganda are on treatment. Uganda has adopted some of the guidelines put in place by WHO such as offering treatment to all pregnant women regardless of their CD4 count and treating those who are found to be co-infected with Tuberculosis.
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