What you need to know:
- The HIV national average prevalence has reduced from 18 percent in 1997 to 5.4 percent in 2020.
As Uganda commemorates World Aids Day today, government scientists have said the country is on track to end HIV/Aids as a public health threat by 2030.
It is now four decades since the first case was reported in Rakai District, but the disease is still killing more than 20,000 people each year.
Infections totalling nearly 38,000 are also registered annually in the country, according to statistics from the Uganda Aids Commission (UAC).
Dr Nelson Musoba, the director-general of UAC, told Daily Monitor yesterday that there is a clear sign that the country is soon defeating HIV/Aids.
“We have tremendously reduced the [HIV] epidemic from a national average prevalence of 18 percent in 1997 to 5.4 percent in 2020,” he said.
Dr Musoba said the HIV prevalence among sub-groups of the population like the armed forces, sex workers and truck drivers was as high as 30 or 40 per cent in the 1990s.
However, data from the commission also indicates that the prevalence rates among sex workers at 31 percent, men who sleep with men (13 percent), and persons who abuse drugs (17 percent), are still higher than the national average.
There is also a distinct variation in prevalence rates between highly urbanised regions and those that are majorly rural.
Prevalence is higher in urban areas. Health experts say this could be due to entertainment venues such as bars and discos where alcohol consumption is helping to drive high-risk sex.
Dr Musoba said the country has also significantly reduced rates of new infections.
“We significantly reduced mother-to-child transmission of HIV. More than 95 percent of Uganda’s pregnant mothers are tested and they know their HIV status and so those infected are following prescribed methods to prevent transmission of the virus to the baby,” he said.
UAC statistics show that there were 5,300 babies born with HIV. This indicates a 77 percent reduction when compared to 23,000 cases of mother-to-child transmission in 2010.
Annual Aids-related deaths, similarly, dropped by 61 percent from 34,000 in 2010 to 22,000. There was, however, a slight increase in deaths last year when compared to 21,000 registered in 2019, with Dr Musoba blaming it on pandemic restrictions that occasioned different disruptions in terms of “access to medication.”
Dr Sam Okware, who was serving as the head of epidemiology at the Ministry of Health when the outbreak was reported in Rakai, said all but two of the 52 people he joined forces with to launch Uganda’s Aids fight in 1997 were claimed by the scourge.
Dr Okware, who heads the Uganda National Health Research Organisation (UNHRO) at the Ministry of Health, said a lot has, however, changed over the years.
“Around 1997, the community was broken up because of the HIV/Aids epidemic. People were dying and in some communities in Rakai, the disease almost wiped out the entire community of a small town called Kasensero in the district,” he recalled.
He added: “By then, everybody thought that HIV was homosexually transmitted and they didn’t believe that it could spread from a man to a woman during intercourse. But when cases started increasing in Uganda, people started suspecting that it was possibly mosquito transmitting the virus since there were no homosexuals in Uganda. But our study in Rakai proved that heterosexual activity can cause transmission and it was an eye opener globally.”
The UNRO boss said it was from the findings that they initiated the first campaign against the scourge dubbed “ABC.” This focused on abstinence, being faithful to sexual partner and using condoms.
Dr Stephen Watiti, the chairperson of National Forum of Persons Living with HIV Networks Uganda, said their members struggled to adhere to medication during Covid-19 lockdown because of lack of food and access to medicines.
Prof Pontiano Kaleebu, the UVRI director, said researchers have been instrumental in combating the HIV/Aids pandemic not just nationally but globally.
“You remember Nevirapine [drug] study for preventing mother-to-child transmission of the virus that was done here [by Ugandan scientists] was internationally recognised,” he said.
Prof Kaleebu said there were other studies done locally to demonstrate the usefulness of usual anti-TB drugs in people with HIV/Aids who are suffering from TB.
The studies showed us that taking drugs for TB prevents development of TB among HIV-infected people.