Our triumphalist narrative about Aids is dampened by statistics

Sunday December 1 2019


By Musaazi Namiti

We are marking the 30th World Aids Day today with some very good news, although it is not new news. One of our own, Winnie Byanyima, was recently appointed by the UN secretary general, Antonio Guterres, to head UNAIDS, the UN agency that is responsible for combating HIV/Aids globally, something we should be proud of as a country.

Ms Byanyima is the third executive director of UNAIDS. Her degrees, like those of her predecessor Michel Sidibe, have nothing to do with medicine/epidemiology—but many agree that, given her international work experience and the fact that she is from a country that was ravaged by HIV/Aids and managed to fight the scourge with considerable success, she fits the bill.

The theme of this year’s World Aids Day is “Communities make the difference”, and Ms Byanyima says in a video on her organisation’s website that “communities are the best hope for ending Aids”.

Uganda has communities, but they have yet to eliminate HIV/Aids, although the country has been hailed for bringing the disease under control.
That said, Aids is still stealing lives even as anti-retroviral therapy is becoming considerably cheaper (and free in some places) than it was decades ago.

The story of HIV/Aids is close to the hearts of millions of Ugandans because it is not easy to find a Ugandan who has not lost a family member or a friend to HIV/Aids. But for me, it is even closer mainly because of my close ties to Rakai, a district which was the epicentre of the Aids pandemic in the 1980s and early 1990s.

When I first visited Rakai in 1987, the district was reeling from the pandemic. Funerals of Aids victims were more common than parties; entire families were being wiped out; children orphaned at a tender age had become heads of families and breadwinners yet they themselves had to be looked after.


Foreign correspondents reporting about HIV/Aids in Africa would not have a complete story without a trip to Rakai. It was a poignant story that tugged at your heartstrings.

Thanks to government efforts and a spirited national campaign to rein in HIV/Aids, Rakai is now dealing with few cases of infection. People are getting anti-retroviral therapy. Life is now back to normal and has been for decades. Organisations such as the Uganda Aids Commission, the Aids Control Programme, the Aids Information Centre and TASO are still pressing ahead with their commendable work.

But our triumphalist narrative seems to ignore the statistics. The statistics are still worrying. Here are a few examples. In May 2018, Dr Diogo Nantamu, the Jinja District Health Officer, was quoted by the local press as saying that some 237,653 people in the 10 districts of Busoga (of which Jinja is one) tested HIV-positive during February, March and April.

That does not mean that they contracted the virus in those months, but if her figures are accurate, they create a very disturbing picture.
The Elizabeth Glaser Paediatric AIDS Foundation says 1.3 million persons in Uganda are living with HIV. At least 95,000 are children under the age of 15. Among pregnant women, the Foundation adds, nearly 20 per cent do not have access to anti-retroviral therapy (ART) to prevent mother-to-child HIV transmission.

According to the World Health Organisation, 37.9 million people worldwide were living with HIV at the end of 2018. And in the same year, says UNAIDS, around 770,000 people, of whom an estimated 470,000 were in sub-Saharan Africa, died from AIDS-related illnesses worldwide.
The good news is that the figures mean 56 per cent fewer deaths than in 2004 (the peak) and 33 per cent fewer than in 2010. It is much easier to steer clear of HIV/Aids in this century than it was in the past century, mainly because of awareness campaigns, but it seems some people will continue getting infected.

Women, for example, who are struggling to find work and have sometimes begged friends for food or even gone without food for days are never going to demand that the men who have promised them some money in exchange for a bit of sex wear condoms, especially if those men insist on BBC, or body to body contact.

What’s more, some people just want to have fun regardless of the consequences, and some cultural practices preclude use of prophylactics.
As President Museveni told an HIV/ Aids conference in Thailand in 2004: “In some cultures, sexual intercourse is so elaborate that condoms are a hindrance.”

The writer is a journalist and former Al Jazeera digital editor in charge of the Africa desk