Uganda’s ABC Strategy Revisited

During this last week or so I’ve been reading about the history of HIV/AIDS in Uganda. The international charity Avert has an excellent webpage which discusses this and how strategies such as the ABC campaign helped to significantly reduce the rate of HIV infection.

This ABC campaign started in 1987 and encouraged people to Abstain from sex and to delay the age at which a young person first has sex or Be Faithful to a lifelong partner and if you are unable to do these, then use a Condom.

The good news is that some 25 years later the most recent AIDS survey shows that more than 9 out of 10 women and 8 of every 10 men can still tell you that remaining faithful and using condoms are the best ways to avoid becoming infected with HIV.

Condomize

UNAIDS Executive Director Michel Sidibé said at the recent AIDS 2012 conference in Washington:

Let us not forget that the condom remains the cheapest and highly effective method we have to stop the spread of HIV… It is time for all of us to condomize!

However this same survey also shows that during the last 12 months for those that had more than one partner, only 1 in 8 used a condom the last time they had sexual intercourse. Condoms can be very effective but only if used correctly and consistently.

Condomize deflated

So it seems that Public Health professionals cannot solely rely upon people behaving as they know they should and we cannot rely solely on the correct and consistent using of barrier methods such as condoms. We need to combine these together with biomedical methods of prevention such as earlier treatment of those already infected, treating more of those who are infected, treatment for the non-infected partner in a discordant couple, eliminating Mother to Child transmission and voluntary male medical circumcision.

I enjoyed reading an article about this same issue by Andrew Green in Voice of America last month.

Helping to Improve Maternal Health in N. Uganda

Women living in Uganda face a 1 in 35 chance of dying as a result of complications during pregnancy or delivery; that’s 134 times greater than the same risk faced by those living in the UK. (WHO, 2010: 26)

At least 16 Ugandan women die each day whilst giving birth and perhaps up to 10 times that number suffer complications that significantly affect their on-going quality of life.

In the UK, 7 children are shared between 10 adult women; in Uganda each woman has, on average, 7 children.

More than 20,000 Ugandan babies are born each year infected with HIV passed from their mother.

So maybe Ugandan women should just have less children, wouldn’t that help to solve these problems? If only it was that simple. Trying to impose our Western culture or world-view on others is not the answer; we must work with those that we want to help, to provide solutions that they will find acceptable and appropriate.

Recent research shows that more than two thirds of women who want to use modern family planning are unable to get regular, sustainable access to it. (Guutmacher, 2009)

Suubi Trust is working with local health teams throughout Uganda to help resolve these issues. In Lira, Northern Uganda, it is partnering with a local faith based organisation, Charis, to implement solutions that will help to improve maternal and child health for the poor living in the local communities.

Some of the local women who will benefit from the Maternal-Child-Health services being provided at the Charis healthcentre in Lira, N. Uganda.
Click for more photos...

These include ante-natal services in which women can access the necessary treatment to help prevent mother to child transmission of HIV and receive family planning after delivery.

We are building a Maternity Theatre that will help provide safe delivery, with emergency obstetrics care, such as c-sections, as and when needed. Friends and supporters of Suubi Trust have raised the necessary funds for this and a generous donor has offered to buy all of the necessary equipment.

The theatre will be operational by September 2012 at which time we will be seeking donor support to sponsor ANC and Safe Delivery for those local women who could not otherwise access such services.

You can read more about this project by clicking here and here.

The Yer Yotkom Project

The Yer Yotkom Project
‘Choose Health’

In the midst of all the trauma in the last week we have had some really good news. Clea, one of our volunteers from the UK, working as part of the management team at International Medical Foundation, has just had news that we have been granted £270,391 to run a 3 year program in Lira aimed at increasing access to integrated sexual and reproductive health (SRH) services for men, women and youth.

Access to such services in Northern Uganda lags far behind the rest of the country.

One of the key issues that the project aims to address is that of preventing mother to child transmission of HIV (PMTCT). Uganda is the world’s 6th highest burden country in terms of PMTCT, with an estimated 82,000 women in need of services.

Yer Yotkom translates as ‘Choose Health’ in Lango, the language spoken in the Northern areas.

Well done Clea.

Help Prevent Mother to Child Transmission

Every minute of every day, a child is born with HIV. We must stop this and we can. Treatment is now available to help a mother prevent the transmission of HIV to her child.

Just because a Mum is HIV positive doesn’t mean that her child has to be born with the virus; it is relatively easy to prevent. Why wouldn’t we support such intervention when it can make such a huge difference? This short video about one child’s story is worth watching, just 2 mins.

PMTCT is an integral part of our proposal for funding which is being submitted to The Global Fund at the end of this month.

If you are on facebook then please consider joining the cause to help end transmission of HIV from Mother to Child by 2015. Please sign the petition, I signed as number 13,124, http://apps.facebook.com/causes/petitions/466?m=719cafb6#sign

Causes on Facebook | We need YOU to help end the transmission of HIV from Mother to Child by 2015.

Causes on Facebook | We need YOU to help end the transmission of HIV from Mother to Child by 2015..

I have signed as number 13,124 on the petition.

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About this Petition:

Every minute of every day, a child is born with HIV. We must stop this and we can. Treatment is now available to help a mother prevent the transmission of HIV to her child. All nations need to be united behind the goal to provide access to this treatment for every mother so that by 2015 virtually no child will be born with HIV. The Global Fund to fight AIDS, Tuberculosis, and Malaria is the main channel for funds to achieve this breakthrough. If the Global Fund gets enough resources for the coming three years, the world can succeed in this goal. If the world cannot find the money necessary to finance the Global Fund, this and many other goals in global health will fail.

By signing this petition, you will join a global call to provide the funding necessary to achieve the goal of an HIV-free generation by 2015. We need you to tell your government that you want to live in a world where no child is born with HIV and that therefore you support your country’s contribution to the Global Fund.

Many years from now, your children or grandchildren will ask you: “What did you do to fight HIV/AIDS?”

Don’t stand by. Get involved today for a future generation free of HIV. Sign the petition.