Uganda's Health Professionals Finally Recognize Need for LGBTI HIV Inclusion in HIV Programmes

Published: November 18, 2011

Amidst calls by gay activists for LGBTI inclusion in access to treatment, care and prevention, senior Ugandan health officials have conceded the national HIV/Aids intervention framework is “faltering badly.”

At a meeting of health planners, donors and civil society in Kampala on Thursday November 17, the stakeholders acknowledged that Uganda was “The only PEPFAR focus country with rising HIV infection rates, with an estimated 132,500 new infections annually.”

PEPFAR is the commonly used abbreviation for a US programme, the President’s Emergency Plan for Aids Relief.

The policy makers said that Uganda, once a global reference for the best management of HIV/Aids, had to change the course of interventions. “We can not do business as usual anymore. We need new approaches, based on non-discrimination including [programmes] for homosexuals,” Dr Zainab Akol, the country’s STD/Aids Control Programme Manager at the Ministry of Health said.

Dr Akol was reported by sections of Ugandan media earlier in the week as having opposed homosexual agitation for HIV/Aids care, treatment and support. The reports claimed Dr Akol blamed the cuts in Global Fund aid to Uganda on non-inclusion of MSM in the national response. Dr Akol has since clarified her remarks in a press release and told Behind the Mask in Kampala that she was “quoted out of context.”

She added that homosexuals continue to benefit from the STD clinic at Mulago Hospital, the National Referral Hospital in Kampala where they are treated without discrimination and stigma.

Addressing a health planners meeting at Kampala’s Golf Course Hotel Dr Akol suggested that while the ABC (Abstain, Be faithful and Condom use) strategy may have been successful in the last 25 years, “This approach is not adequate today.”

However, some policy makers from the Office of the President said Uganda should stick to the ABC strategy, alongside new interventions and sciences, including biomedical interventions focusing on safe blood transfusions.

Dr Jesse Kagimba, a Presidential Advisor on HIV/Aids and Board member of Uganda Aids Commission (UAC) insisted that the ABC strategy is working and must stay. However other technical policy makers argued it was not working for Uganda.

There have been heated discussions among Ugandan policy makers on the concept of promoting prevention of HIV/Aids contraction based on being faithful to one sexual partner.

Some argue that this approach is fronted particularly by US evangelical Christian groups who have substantial influence with amongst others, Uganda’s First Lady Janet Museveni.

It is worth noting that some of the same US groups, particularly one group called The Family, are the funders of Uganda’s Anti Homosexuality Bill and have been lobbying Uganda’s HIV/Aids health planners to exclude homosexuals from the national HIV/Aids intervention.

Dr Kagimba told Behind the Mask in an exclusive interview on the side-lines of the meeting that he had no problems with homosexuals being included in HIV/Aids programmes in Uganda.

He added however, “We need to first of all do studies to see how to incorporate them.”

Uhspa gay advocate Flavia Kyomukama was recently elected to the central decision-making committee of the UAC.

Thursday’s meeting, the first by health systems planners, was called by the Ministry of Health. It’s agenda was to look at how to implement new approaches to curbing the HIV pandemic in Uganda, based on an ambitious five-year National HIV Strategic Plan due for launch on December 1, 2011 at the World Aids Day ceremony to be presided over by President Yoweri Museveni alongside First Lady Janet Museveni and the Ugandan Parliamentary Speaker, Rebecca Kadaga in Kampala.

The plan, worth US$ 900million seeks to reduce new infections by 30 per cent. Currently 6.4 per cent of Uganda’s estimated 34 million people are HIV positive. However, only 20 per cent know their status through Voluntary Counselling and Testing.

Unprotected sex between heterosexuals and mother to child infections account for the leading channels of new infections, although no government studies have been done on a bridging population of bisexual relationships and MSM.

A recent study carried out on vulnerable groups found that sex workers and MSMs had higher prevalence rates compared to the general population.

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