This article comes on the heels of the Global Fund's rejection of a Ugandan grant proposal for $111 million to fight HIV/AIDS. Corruption and poor management ripple throughout Uganda's handling of its HIV/AIDS programs — the last two years have been a recurring pattern of fraud, lies and incompetence. What concerns me even more, however, is the United States' ineffectual response to a disease that is threatening to engulf the nation yet again.
A full thirty-three percent of the money USAID spends on HIV prevention goes towards abstinence. In 2004, the number of condoms provided by USAID's PEPFAR (the President's Emergency Plan for AIDS Relief) dropped by 60 percent, a decrease which coincided with the Ugandan government's confiscation of all free health-center condoms due to concerns about their quality; the condoms were tested and proven to be perfectly usable but were never re-released. These two events triggered a shortage of condoms in the country and widespread doubt of their effectiveness from which Uganda has not yet recovered.
The U.S. attitude towards condoms is frightening. In an April 2005 meeting of the International Committee of the House of Representatives to review the U.S. response to the global AIDS crisis, Ted Poe (R-TX) called them the "least effective, least popular method of birth control." The truth is that condoms are up to 25% more effective than natural family planning (the method USAID is pushing with Janet Museveni).
Still, USAID is increasingly funding abstinence-only programs to the detriment of more comprehensive, more effective organizations: in November 2004, PEPFAR overrode the recommendations of their Technical Review Committee and funded an organization deemed unsuitable for grant money. The pro-abstinence organization, Children's Aid Fund, has close ties to both the Bush administration and to Janet Museveni, which was seen as justification enough to fund their program. Furthermore, the U.S. has been steadily decreasing the amount of money it gives to international organizations that provide reproductive health services — in 2002, the government withdrew over $36 million from the World Health Organization and the UN Population Fund.
AIDS is making a comeback in Uganda, and U.S. efforts are doing little to stop it. USAID needs to get their act together and start providing factual, practical information about STDs, STD prevention and reproductive health instead of funding misguided projects that skirt the issues at hand.