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Uganda's Shift in AIDS Policy Tied to U.S.

Tuesday, February 21, 2006

Uganda's first lady Janet Museveni is running for a seat in parliament on Feb. 23. Anti-AIDS activist Beatrice Were might have supported her a few years ago. But now she blames her for restigmatizing the disease with help from U.S. funding.

Subhead: 
Uganda's first lady Janet Museveni is running for a seat in parliament on Feb. 23. Anti-AIDS activist Beatrice Were might have supported her a few years ago. But now she blames her for restigmatizing the disease with help from U.S. funding.



Beatrice Were

NEW YORK (WOMENSENEWS)--When Beatrice Were began the Memory Project in Uganda in 1998--in which parents dying of HIV-AIDS compose memory books to leave their children--Janet Museveni, who is married to President Yoweri Museveni, was an enthusiastic supporter.

In 1999, Janet Museveni paid a visit to Were's organization, the National Community of Women Living with HIV/AIDS in Uganda, to help launch the Memory Project. "She even said, 'I must start memory books for my children,'" recalls Were, one of Uganda's most prominent HIV-AIDS activists. "I thought then that this is someone who really supported my cause."

But as Were now observes the first lady--a convert to evangelical Christianity who is running for a seat in Parliament in the country's Feb. 23 election--she sees an opponent in the shape of a former ally.

Prime among the events that lead Were to feel this way is Janet Museveni's apparent shift from concerning herself with those suffering from the various effects of HIV-AIDS to celebrating and siding with the chaste. A year ago, Were says, the first lady threw a "virgin party" for 70,000 young Ugandans and now wants to implement a nationwide virgin census to promote abstinence.

"After doing so much, now we're making a U-turn, saying 'Oh, that person is immoral,'" says Were. "How do you talk about morals instead of condoms for sex workers? Or for married women?"

Many tie the change to the shift in U.S. funding policies. Previously, one-third of funding for HIV prevention was earmarked for abstinence-only education. The new figure is two-thirds, according to a December report from the Baltimore Sun. For 2006, Uganda is slated to receive a total of $186 million from the U.S. for HIV and AIDS programs through the Global HIV/AIDS Initiative, the main source of funds for President Bush's Emergency Plan for AIDS Relief.

In President Bush's proposed budget for 2007, more than $4 billion would be set aside for HIV-AIDS prevention activities around the world, according to Women's Policy Inc, a nonpartisan think tank in Washington, D.C. That includes a $900 million increase in funding for the $2.89 billion Global HIV/AIDS Initiative over 2006.

Infected Within Marriage

The Memory Project's Were, who was infected with HIV within marriage, recently spoke with Women's eNews over breakfast in a New York diner while on a trip to receive a human-rights award for the work of her organization. She started it in 1992 after the death of her husband as a support group for a handful of friends widowed by AIDS. Now it has 40,000 members and 23 branches around Uganda, a nation of 26 million.

Were said Janet Museveni is moving in step with her husband, who has characterized Africans' sex drives as too strong for condoms.

"He's selling himself completely, putting money before the lives of his citizens," says Were.

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The World Health Organization estimates 800,000 Ugandans are infected with the virus. During the 1990s, Uganda operated a comprehensive HIV-prevention program, known as ABC, for "Abstain, Be faithful, use Condoms," credited with lowering HIV rates to 6 percent of the population in 2002 from 15 percent in 1992.

Beginning in 2001, however, Museveni's HIV strategy veered sharply. He dropped the "C" for condoms and pared the approach back to "Abstain and Be faithful." A recent survey by the Ugandan Ministry of Health found the known HIV infection rate edging higher; 9 percent of the female population is infected, and 7 percent of males.

Political Turnaround on AIDS

Jodi Jacobson, executive director of the Washington-based Center for Health and Gender Equity, ties the turnaround by the Musevenis to early 2000.

"I would pin the shift in their message to the point at which they suddenly started getting promises of U.S. funding," says Jacobson. "Before that, at least Mr. Museveni was clearly very forcefully behind a comprehensive approach. He himself would do public service announcements and radio spots, promoting condom use, with no stigma and no qualifications."

In 2001 Museveni's Presidential Initiative on AIDS Strategy for Communication to Youth was launched with U.S. funding to spread the pro-abstinence message through the country's primary and secondary schools.

A Human Rights Watch report last March strongly criticized U.S. health policy in Uganda. "As the largest single donor to HIV-AIDS programs in Uganda, the United States is using its unparalleled influence to export abstinence-only programs that have proven to be an abject failure in its own country," authors charged.

Museveni, who is standing for re-election this week, seized power in 1986 and has been widely criticized for intimidating opposition to his own party, the National Resistance Movement. Last week, three opposition supporters were shot by security forces during a campaign increasingly marred by bouts of violence. Museveni was once called a "beacon of hope" for democracy in Africa by Secretary of State Madeleine Albright, but now his government is drawing fierce criticism for stifling the press, vote-rigging and modifying the constitution so he can continue to hold office.

Funding 'Be Faithful' Prevention

Janet Museveni

Of the $186 million that Uganda is set to receive from the U.S. in 2006, the bulk goes toward treating people using antiretroviral therapy. Twenty percent of the total--or $37.2 million--is earmarked for preventing HIV transmission through sex. Now, because of the new requirements, over $24.5 million of this funding will go toward a "be faithful" policy that critics such as Were say leave women unprepared for the realities they face. Many women and girls are unable to insist on condom use within marriage, for fear of being labeled unfaithful. Others are compelled by poverty to engage in sex work.

Young women disproportionately bear the burden of this emphasis on abstinence, the Human Rights Watch report said, because in a country that restricts women's ability to inherit property, they are frequently supported financially by older men and are often unlikely to negotiate condom use within marriage for fear of being labeled unfaithful.

"Ugandan women face a high risk of HIV in marriage as a result of polygamy and infidelity among their husbands, combined with human rights abuses such as domestic violence, marital rape and wife inheritance," the report states.

Women are further hindered from exerting control over their sex lives by the absence of any laws against marital rape. Over 1.7 million people, primarily in northern Uganda, are displaced by civil conflict, producing a high level of social instability in which sexual violence can thrive, according to Refugees International, a nongovernmental organization that has been working in Uganda since 2002.

Even in areas that are not conflict zones, such as the Rakai district in the southwest, sexual violence is rampant. There, 14 percent of female teens reported that their first sexual experience was coerced, according to a December 2004 report by the New York-based Guttmacher Institute. These young women were less likely to have used contraception than those who had had consensual sex; 43 percent of them had experienced coerced sex in the past 12 months.

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--Allison Stevens contributed to this story.

Anna Louie Sussman is a freelance journalist based in New York City. Allison Stevens is Washington bureau chief for Women's eNews.