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Uganda: The Real ABC’s of an Epidemic

The first documented case of HIV/AIDS in Uganda occurred in 1982. From that small but ominous beginning, the curse of AIDS soon engulfed the country of Uganda, much as it swept across the African continent through the 1980s and into the 1990s. For Uganda, the epidemic was especially tragic given the nation’s desperate efforts to recover from the dark years of the dictator Idi Amin from 1971 to 1979 and subsequent years of political instability. By the early 1990s, the infection rate in Uganda of HIV reached 30 percent, and there was widespread agreement that if action were not taken quickly, the very survival of the country would be jeopardized.

President Yoweri Museveni, who came to power in 1986, settled on an aggressive government-sponsored plan that involved posters, radio messages, training, education, and public rallies and that called on the support of community leaders, local churches, and general public. The message was said to be as simple as the “ABCs”: “Abstinence, Be Faithful, and if necessary, use Condoms.”

Character over Condoms

A funny thing happened in Uganda, however. While condoms were suggested for those who refused to abstain, the greater focus of the campaign was not on the “C” but on the “A” and the “B”: abstinence and faithfulness. Ugandans, especially young Ugandans, were urged to wait until marriage before having sex, or to return to abstinence if they were not virgins. Wives and especially husbands were asked to remain faithful to their spouses. And when the “C” was stressed, it did not mean condoms but the embrace of the Catholic Church in Uganda and the suggestion that the proper meaning of “C” should be “character formation.”

The mantra of changing behavior rather than perpetuating a condom culture resulted in startling developments. In the late 1980s, 50 percent of females 15 to 17 years old had engaged in sex; this was down to 34 percent by 2000. Uganda’s Demographic and Health Survey of 2000-2004 indicated that 93 percent of Ugandans had altered their sexual behavior to avoid HIV/AIDS.

The results were immediately apparent when Uganda’s infection rate began declining. Adult HIV rates dropped from about 30 percent in the early 1990s to 8 percent in 2002. Today, the infection rate hovers at 4.1 percent. President Museveni spoke at a World AIDS Conference in Bangkok in 2004 and declared forcefully that condoms should not be the definitive public health intervention against HIV/AIDS. He was joined in this call to reality by the Kenyan first lady Lucy Kibaki, who regularly teaches school girls that they should delay sex until after marriage and forget about condoms. (See “Why the ABC Message Worked,” page 22.) Uganda’s success made it a model for other African countries and also played a major influence in the current AIDS relief program undertaken by the Bush administration.

Uganda’s progress against AIDS is a story of promoting the culture of life. Everywhere in Africa the Church’s stand on the real ABCs—abstinence, be faithful, and character formation rather than condoms—has been adopted, the HIV/AIDS rates are substantially lower. The 2003 World Factbook of the Central Intelligence Agency reported, for example, Burundi had a 62% Catholic population and a 6% AIDS infection rate; Angola had a 38% Roman Catholic population and a 3.9% AIDS rate; Ghana was 63% Christian with a Catholic population of 12% (in some regions it is as high as 33%) and a 3.1% AIDS rate. In stark contrast, those countries that have steadfastly clung to the myth of condom use as the primary means of preventing the epidemic also have the highest rates of HIV/AIDS. In Botswana, where only 5% of the population is Catholic, 37% of the overall population is infected with HIV/AIDS. In South Africa, with a 7% Catholic population, 22% of the total population is infected.

The UN’s Failure

Undeterred by the success of the Ugandan methods and enraged by an approach that challenges the assumptions of the Western sexual revolution, the UN and other nongovernmental organizations (including UNICEF, the UNFPA, the World Health Organization, and Centers for Disease Control) are placing pressure on Uganda and other countries to offer only condoms as a solution to their problem. In an interview with LifeSiteNews, Martin Ssempa, a Ugandan AIDS activist, denounced the obdurate position of the United Nations and its UNAIDS program, noting, “UNAIDS has no success story. UNAIDS cannot point at any country where they have given advice and that country has brought HIV down” (LifeSiteNews, October 25, 2007).  The situation is an ironic one. The Martyrs of Uganda gave their lives by refusing to engage in lurid sexual activities and to surrender their faith. Uganda today is being offered a similar choice by the Western culture of death. Only this time, by adhering to the faith and doing what is right, the Ugandans, along with the rest of Africa, will actually be saving their lives. In both cases, moral courage remains the key to a future of hope.


Why the ABC Message Worked

Looking back, I can say that the message of abstinence and faithfulness has been effective in Uganda for four main reasons. First of all, it is simple and uncompromisingly strong in its intention, and it is delivered continually and with consistency. Secondly, the alarm that was sounded by the political leadership has been taken up and magnified a thousand times by every responsible citizen. The third reason for the effectiveness of the message of abstinence and faithfulness is that it was based on the traditional and cultural beliefs and moral framework of the people of Uganda . . . The fourth reason why the message of abstinence and faithfulness has been effective in Uganda is that people have been confronted with the horror of death, first hand and at close quarters. There is no person, young and old, in Uganda, who has not witnessed a loved one, a family member, or a neighbor, suffer horribly and die prematurely because of AIDS. In such a situation, facts tend to speak for themselves. The sight of fallen comrades is a strong deterrent, and a clear sign that a change in behavior is called for . . .
—Lucy Kibaki, First Lady of Kenya, in 2004

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