Background, methods: Uganda is the only country in Africa with a clear epidemic reversal. HIV and sexual behavior changes are known; however specific program activities of that period and changes in level of support are needed to fill in what happened. Therefore early Uganda National AIDS Program (UNAP) documents were reviewed including the first Uganda program evaluation (1989) and 1990 Five Year Plan and Budget. HIV data are from sentinel surveillance sites, sexual behavior (KABP), and costing studies for 9 countries from WHO and USAID files. Results: The HIV prevalence at 8 sentinel sites was 5.8 – 27.8% in 1989; declining to 3.1 – 11.0% (mean reduction 36.4%) by 1995. KABP studies showed 65% decrease in casual sex; “condom use ever” increased 2 – 8 fold. The UNAP 5 year plan began in 1990, employed over 45 Ugandans supported by 6 WHO staff to implement a multipronged country-wide intensive general public information, education and destigmatization program, including community based mass mobilizations in every district in the country, intensive training of 18 sectors (e.g.women’s groups, police, teachers, clergy), and 8 channels of mass media programming; supplemented by condom promotion. Care and counseling where major components. Financial support increased from $1 million to $18 million/year between 1987 and 1990 - sustained to present; approx. $2/ person and $75/infected person; three to ten times the expenditure of 9 other countries. Conclusion: Uganda’s massive and sustained IEC campaign, strong management, and sufficient financing reversed a horrible AIDS epidemic; these elements are still missing from most countries.
Learning Objectives: 1. Describe the history and main components and activities of the Uganda national level AIDS program during the years it reversed its epidemic. 2. Describe the three most important differences between the Uganda AIDS program and that of the other national AIDS programs in Africa during the years 1989-95 (more data on other countries will be included in the presentation). 3. Discuss some of the key issues regarding what is necessary at country level to reverse an AIDS epidemic.
Keywords: International, Developing Countries
Awards: Excellence in Abstract Submission on an International Topic--Award Winner - WinnerPresenting author's disclosure statement:
Organization/institution whose products or services will be discussed: none
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.