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Rough Cut: Uganda: The Condom Controversy
Background Facts and Related Links
More on Uganda's efforts to fight the spread of HIV/AIDS and links to reports on U.S. funding of AIDS prevention in Africa.

Emerging from War

After a long period of civil war and chaos under the military dictatorship of Idi Amin in 1970s and the presidency of Milton Obote in the early 1980s, Uganda's current president, Yoweri Museveni, emerged in 1986 to bring about an era of relative peace and security. Museveni had helped topple Amin in 1979, and also organized a rebellion against Obote in what he viewed as an illegitimate rise to power. Museveni's National Resistance Army swept through the countryside and finally took the capital of Kampala in January 1986, where he was sworn in as president. While the years of Amin and Obote witnessed massive human rights abuses and economic collapse, with an estimated half a million people killed in state-sponsored violence, Museveni's presidency brought democratic reform.

Uganda Currency

Soon after Museveni took power, Uganda began to work with the International Monetary Fund and the World Bank to revitalize the economy.

The new president introduced a system of elected decentralized government known as "resistance councils" (later called "local councils") to manage affairs at a district and parish level. These councils gave many Ugandans their first exposure to the process of democracy. But on a national level, Museveni kept a tighter hand, instituting what was essentially a one-party system and claiming that political parties divided Uganda along ethnic and religious lines, which only led to more civil strife. Although Ugandans could form opposing political parties, they were not allowed to officially field candidates for elections.

Soon after Museveni took power, Uganda began to work with the International Monetary Fund and the World Bank to revitalize the economy. New policies designed to stabilize prices, and create a new infrastructure helped lower inflation and grow the economy. These accomplishments quickly made Uganda's leader a favorite of Western powers.

AIDS Policy

abstinence poster

Observers credited Uganda's success, in part, to the use of different messages to different groups.

In the late 1980s and early 1990s, more decisive action by the premier helped Uganda become a relative success story in combating the rapid spread of AIDS in Africa. According to estimates by the U.S. Census Bureau and UNAIDS, 15 percent of Uganda's adult population was infected with HIV in the early 1990s, but that number dropped to 6.5 percent by 2004. Unlike most African leaders, Museveni quickly recognized the devastating affects of the virus and responded in 1986 by creating the AIDS Control Program. It was the first program in sub-Saharan Africa to establish policy guidelines regarding AIDS prevention. The government began an aggressive media campaign involving posters, radio messages and rallies to raise awareness of the virus.

By 1992, the government recognized that AIDS was a public health catastrophe that carried with it psychological, ethical and legal ramifications for both individuals and the country. To combat these problems, the government established the "Multi-Sectoral AIDS Control Approach" and the Uganda AIDS Commission to develop a broader strategy. A new, more open approach encouraged candid discussions about the spread of HIV/AIDS and aimed to help reduce the stigma surrounding the disease. The government trained teachers in AIDS and HIV education and mobilized community and church leaders to take up the cause.

The ABCs of AIDS Prevention
Observers credited Uganda's success, in part, to the use of different messages to different groups. Young people were encouraged to wait for marriage before sex or to return to abstinence if they were not virgins. For sexually active people, the message of "zero grazing" meant staying with one partner and avoiding casual sex. The use of condoms was also promoted to anyone engaging in casual sex. In trying to highlight successful approaches to the AIDS epidemic in Africa, the United States began referring to the Ugandan approach as the "ABC strategy"(abstinence, being faithful and condom use). The phrase originated in Botswana in the late 1990s, with the slogan "Avoiding AIDS is as easy as ABC" and was rarely used elsewhere until the United States latched onto it in 2002.

Virginity Pledge

A student signs a "virginity pledge".

In President Bush's 2003 State of the Union Address (the same one that outlined the justifications for an invasion of Iraq), he announced the President's Emergency Plan for AIDS Relief (PEPFAR), a pledge of $15 billion over the next five years to fight HIV/AIDS worldwide. PEPFAR tweaked Uganda's ABC strategy through "population-specific interventions:" abstinence for youth, health tests and faithfulness for married couples and condom use for individuals practicing high-risk behavior like prostitution and substance abuse. The PEPFAR definition does not include general promotion of condom use to young people. The new law also earmarked 33 percent of the AIDS prevention funds to used for abstinence-until-marriage programs.

Janet Museveni, wife of the Ugandan president, had long been a proponent of abstinence-only programs, which she described as the perfect blending of Christian teachings and traditional African values. She created the National Youth Forum in 1991, which encourages Ugandan boys and girls to stay "sexually pure" until their wedding day. But President Museveni only recently, in what is viewed widely as a departure from his previous positions, has publicly supported abstinence-only approaches. While speaking before large international audiences, he's also started denouncing condom use as a means of HIV prevention.

Sources: AVERT.org, BBC, CIA Factbook, Human Rights Watch, The New York Times, U.S. State Department.


Related Links

A Little Goes a Long Way
FRONTLINE/World's Clark Boyd travels to Uganda to explore the impact of microfinance and, in particular, how one San Francisco-based nonprofit is using the Web to connect borrowers with lenders online, person-to-person. The Uganda companion site also features an extended background on the country's history, economy and the recent rebel movements in northern Uganda.

The Return

In this FRONTLINE/World Rough Cut, Omar Sachedina takes a personal journey to Uganda to tell the story of his parents, who along with 60,000 other Asians living in the country, were expelled from Uganda in 1972 during the military dictatorship of Idi Amin.

BBC Country Profile: Uganda
The BBC provides a political and economic profile of Uganda, with all the latest news coverage from the country and a timeline of significant events in its history.

U.S. State Department Profile: Uganda
The State Department offers extensive background on Uganda, including demographics, history, economy, leadership and travel information.

"The Less They Know, the Better"
The 80-page Human Rights Watch report on abstinence-only HIV/AIDS programs in Uganda documents the recent removal of critical HIV/AIDS information from primary school curricula and argues that U.S.-funded abstinence-only programs are jeopardizing Uganda's successful track record in the fight against HIV/AIDS.

God and the Fight Against AIDS
New York Review of Books writer Helen Epstein explores the controversial role played by Christian evangelical groups in Uganda's fight against HIV/AIDS.

HIV & AIDS in Uganda
AVERT.org, a U.K.-based information site and charity, provides detailed reports on the fight against HIV/AIDS in Uganda. In 2005, AVERT.org was selected by the British Medical Association as the winner of its Patient Information Award for Web sites.

The President's Emergency Plan for AIDS Relief
The homepage of the President's Emergency Plan for AIDS Relief (PEPFAR) details the efforts and programs taking place as a result of the $15 billion pledge to fight AIDS.

Yoweri Museveni Profile
The United Nations' Integrated Regional Information Networks details the rise to power and 20-year presidency of Uganda's Yoweri Museveni.

FRONTLINE: The Age of AIDS
In May 2006, on the 25th anniversary of the first diagnosed cases of AIDS, FRONTLINE examines the AIDS pandemic in a multipart series called The Age of AIDS. The series covers social stigma, stunning scientific breakthroughs, bitter policy battles and inadequate prevention campaigns as HIV/AIDS spreads throughout the world.

--Matthew Vree

Uganda Map