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PEPFAR Big Success in Uganda, Says AIDS Doctor

The head of a Ugandan AIDS organization says PEPFAR – The President’s Emergency Plan for AIDS Relief – has brought a tenfold increase in funding to fight the pandemic in his country. Dr. Alex Coutinho is in the United States to tout the success of PEPFAR, but also to warn the battle against the disease is far from over. VOA’s Joe De Capua reports.

Dr. Coutinho is executive director of TASO, considered the largest HIV care and treatment organization on the continent. It cares for 50,000 people, who are HIV positive. He’s touring Washington, DC and California with Ambassador Mark Dybul, the US Global AIDS Coordinator and the man in charge of PEPFAR.

Uganda is one of the few African countries that seriously faced the pandemic in the early 1980’s, when little was known about the disease. Dr. Coutinho says Uganda was successful in a number of areas.

“In prevention, we were able to bring down the HIV prevalence (rate) from 18 percent to the current six-point-five percent. But it stagnated at six-point-five percent. So, in that sense, the success has happened. We need to kick in a new success to bring it lower than six-point-five percent. The other is that we’ve managed to start over 100,000 people on anti-retrovirals therapy. And that’s mainly with PEPFAR funding. And that’s an ongoing success,” he says.

He says the funding increase under PEPFAR has had “a tremendous impact.”

“Just five years ago, the amount of money available in Uganda was about $20 million per year. Now it’s well over $200 million,” he says.

PEPFAR accounts for up to 80 percent of the money spent on HIV/AIDS in Uganda. And the head of TASO says besides getting many people on anti-retrovirals, it’s brought – what he calls – real results.

“Up to a million people have been tested. Close to a million orphans are being supported through PEPFAR funding. Over 40-million condoms have been purchased with PEPFAR funds, So, these are just a few indicators of the tremendous impact PEPFAR has made,” he says.

While receiving much praise, PEPFAR has had its critics. Those who say the $15 billion dollar, five year program is too restrictive in its funding. Or that it’s been hijacked by a conservative agenda attempting to push abstinence-only programs. Asked whether he’s encountered those controversies, Dr. Coutinho says:

“My organization, TASO, hasn’t. I am aware that the debate around abstinence and use of condoms has generated a lot of debate, even in Uganda. What we have found is that some people, conservatives, particularly sometimes from certain religious groups in Uganda, have used the opportunity of PEPFAR to distort the guidelines and push a message that is often not consistent with the PEPFAR guidelines coming down from Washington. But I think people are more aware of that and a much more balanced message is starting to emerge.”

He’s worried, though, the younger generation in Uganda is not taking HIV/AIDS as seriously as their predecessors. He admits it’s harder to get the message across.

“Partly because people have been hearing this message for years and years and people get a little bit weary of the same message. Secondly is that AIDS is not as visible as it used to be because as people go on treatment they get better. So the constant reminders that AIDS is still with us in Uganda and is still a disease that ultimately can lead to death is not as visible for young people,” he says.

The Ugandan physician says he’ll tell Americans that in Africa, HIV/AIDS is mostly a heterosexual disease. And that it’s the biggest cause of orphans on the continent.

He says that a major scale-up of all prevention programs is needed, not just for abstinence, being faithful or condoms, the so-called ABC approach. Unless that’s done, he says, more and more people will need anti-retroviral drugs, straining current treatment programs.