Lord help us…

Uganda’s pioneering Aids programme, which showed the world that the epidemic could be turned around in Africa, appears to be in crisis as the government stands accused of obstructing the distribution of millions of condoms while preaching that no sex is the best prevention policy for single people.

They will argue that the abstinence-only policies being promoted by the first lady, Janet Museveni, and financed by the US government are not, on their own, going to stop the spread of the disease.

The battle over prevention tactics appears to be coming to a head just days after questions have been asked about the financial management of Uganda’s flagship Aids programmes.

Last week the Global Fund for Aids, TB and Malaria pulled all its funding from Uganda’s programmes.

The phenomenal success of Uganda’s fight against Aids is largely credited to its president, Yoweri Museveni, who took the bold decision to speak out publicly about what was considered a shameful disease and tell people how to combat it. Prevention strategies, including the promotion of condoms, were central.

But in the last couple of years, the Ugandan and US governments have shown increasing interest in promoting abstinence and fidelity in marriage, with condoms given out only to those who cannot manage either.

New billboards have appeared in Uganda, signed by the office of the first lady and bearing the logo of USAid – the US development agency. One has a picture of a glamourous, smiling young woman, saying “She’s saving herself for marriage – how about you?”

Activists argue that while abstinence until marriage and fidelity inside marriage are admirable concepts, human weakness, prostitution, the subservience of women in African society and the difficulty of changing behaviour dictate that condom use must be at least as well promoted, and condoms must be easily available.

But the condom supply has dried up, say campaigners. According to the US pressure group the Centre for Health and Gender Equity (Change), condoms are difficult to find in the cities, and are unavailable in many rural areas. Change says that the same pattern is beginning to occur in other parts of Africa.

“The crisis in Uganda has been created by the actions – and inaction – of the government of Uganda and the Bush administration, the primary donor for HIV/AIDS programmes in Uganda, and a major force in undermining effective HIV prevention programmes throughout sub-Saharan Africa and central America,” said Jodi Jacobson, executive director of Change.