Uganda faces the ‘lion in the village’

Uganda’s success in implementing AIDS prevention and education programmes — which have reduced the rate of new infections despite poverty and war — has been held up as a model for other developing countries. One key, Ugandan President Yoweri Museveni told African leaders at the African Development Forum, has been the personal involvement of the head of state. "When a lion comes to the village, you don’t make a small alarm. You make a very loud one. When I knew of this problem, I said we must shout and shout and shout and shout."

During an address punctuated by laughter and applause, the former rebel leader departed from his prepared remarks to call for aggressive political leadership in what he termed the "war" against AIDS. "When we started, our Ministry of Health were putting out a small advertisement after TV news…. But in 1986 we only had 100,000 television sets. How many people would hear about it? I told them … this alarm of yours is a silent alarm. The best channel for making a loud alarm are the political leaders."

"When a district health officer comes to address a meeting, 20 people turn up," he noted. "But if Museveni is coming to address a rally, 20,000 people turn up. That is the time to pass the message. Talk about your politics, but talk about AIDS also." He cautioned, "you cannot just leave it to the bureaucrats…. They will just put [AIDS messages] when people are going to work and say ‘we’ve put it there.’ They don’t care. So the leadership must supervise this war."

Women were another key to Uganda’s success, the president observed. "In our struggle, we empowered women. One woman is vice-president, four are ministers, and 40 are members of Parliament." The presence of even a few women leaders, he said, has had a big impact on public attitudes. In the fight against AIDS, he said, "Women … now started saying no to men" who insist on unsafe sexual practices. "That has helped."

Uganda also mobilized civil society, the schools and the media to spread the message. "In churches and mosques," he continued, "you can get a lot of people." In the public schools, "there are school assemblies where the whole school is assembled. That is where the headmaster should give a message about AIDS." Mass media are another tool for AIDS prevention and education, he explained. "In Uganda now we’ve got 12 million radio sets.… Each family has [on average] about 3 radios. This is a very good channel."

As a result, he asserted, "Awareness now in Uganda is 100 per cent. Everybody is aware of what AIDS is and how it spreads." Awareness is vital because of the stigma and misconceptions that still accompany the disease. During his movement’s insurgency in 1984, he recalled, "I started hearing on the radio that there was a new disease for homosexuals and drug addicts [in countries in the North] and I said that is none of our business." But with Africans now accounting for over 70 per cent of the world’s AIDS sufferers, he concluded, "AIDS is now an African disease.… We can’t leave it to the Europeans and the drug companies only. We African governments must take up this battle ourselves."