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AIDS war: Are we advancing, retreating or in disarray?

By Bob Roberts Katende

Loss of a dear one is one thing that different people react to differently. Not even the mighty on earth can easily come to terms with this somber moment.

The awakening I received in Primary 5 at only 11 years was rude enough to make me think harder even before I became of age. It was at this tender age that my mother, the most prized possession I had, revealed to me that she was HIV positive. Because of the messages the school authorities had inculcated into our minds about HIV/AIDS, it was clear that it was a matter of time for my mother to die.

But little did I know that that moment would come so soon. Things happened very fast. My step-father was the first to fall sick and in less than eight months, he had lost his sight. He then died of severe headache which doctors  said was meningitis. I wept, not for my step-father, but for the moment my mother would also be leaving for an unknown world.

In my P.7 holidays, my mother began falling sick. What began as a simple fever on New Year eve turned into her death exactly a month since she was admitted to Mulago Hospital. Days before her death she had called me to her bedside and said something that still lingers in my mind­. Take care of your siblings. I know, she added, you are young but you will find a way. I looked at her lifting her frail hand as she tried to get hold of a cup of water. But she could not find the cup as she too hard lost her sight just like her late husband. I knew death had beckoned. Tears rolled down my cheeks. She heard me sobbing and asked me. If you are crying now, where do you expect me to get the courage that I will be fine? She did not live long to counsel me.

I began wondering how our future would be without our parents. I braced myself for hard times. The sight of seeing my siblings being shared out among relatives was heartbreaking. It would take three years to meet them at the burial of our last born who unfortunate had been born HIV-positive.

The ensuing problems of paying my tuition fees and spending some years out of school were painful. As I look toward my graduation next month, I cannot imagine the long winding journey I have endured.

My story is not unique. Its a reflection of over two million HIV/AIDS orphaned children in Uganda, some of whom have gone through a trying experience of heading families commonly known as child-headed families. Its a term used in Uganda and sub-Saharan Africa to refer to homes headed by children because their parents died of HIV/AIDS.

Things have changed. People now have a chance to live longer thanks to antiretroviral therapy,” says Dr Stephen Watiti, an HIV/AIDS activist.

According to the 2009 UNAIDS report, there are over 33.4 million infected persons in the world of which 1.3 are Ugandans (4%). This means Uganda has 4% of the world’s total HIV-infected population.

Out of the infected Ugandans, 360,000 are in urgent need of ARVs, but only 180,000  have access to the life saving drugs.

It is this disparity in access to ARVs that prompted the world to make this year’s World AIDS Day theme: Universal Access and Human Rights.

Anti-AIDS activists argue that HIV patients have a right  to live. Therefore denying them access to ARV treatment of any form is a violation of this fundamental human right.

However, in poor countries the story may slightly be different as many, if not all, have the biggest percentage of their ART (anti-retroviral therapy) programme supported by some of the worlds biggest funders such as the USAs Global Fund and Presidents Emergency Plan For AIDS Relief (PEPFAR).

For the past two years donor funds have been scaled down because of the global financial crunch.  Yet there are more infections annually than the number of people who join the treatment line, according to Dr Watiti.

Although the UNAIDS report indicates a fall in new infection to 2.7 million people, Uganda’s HIV prevalence has stagnated at 6.4% for more than 10 years. Dr Watiti blames this on complacency and normalisation. Because we have managed to put many people back to work who would be dead by now, people think that AIDS is no longer a threat and that explains their reckless behaviour.

The emphasis on treatment rather than preventive measures has produced double negative effects: increased transmission rates in married couples which now stands at 43% and children. According to a study, Modes of Transmission, which was led by Fred Wabwire Mangen, an associate professor of epidemiology at Makerere Universitys School of Public Health, new HIV/AIDS cases are increasingly occurring among married couples aged 30 to 40. The study further notes that about 650,000 Ugandans are unknowingly living with HIV-positive sexual partners and that almost 85,000 of these individuals or 13%, will contract the virus this year if nothing is done to increase awareness about the situation.

Since the release of that study findings by the Uganda AIDS Commission, there have been vigorous media campaigns dubbed Get Off the Sexual Network, in order to check the prevalence.

We need to emphasise the ABC model (Abstinence, Be Faithful and Condom usage, Watiti advises. If we dont scale up the achievements we had attained, it would be like mopping a room while the tap is still running, he reasoned.

Another threatening phenomenon that is falling through the cracks is the increased number of babies born with HIV. According to statistics from the AIDS Control Programme (ACP), over 30,000 babies are born annually with HIV.

The A|CP Manager, Dr Zainab Akol, was quoted at a recent function saying If urgent measures are not taken, we are losing out on the war against HIV/AIDS.

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