Uganda’s health minister is denying charges that his country is facing a shortage of condoms. He says the government procured about 60-million condoms recently, with millions more on the way. However, AIDS activists and others reject the minister’s assurances and accuse the government and the United States of trying to orchestrate a policy of abstinence over condom use in Uganda.
AIDS activists say the condom shortage began last year due to disrupted supplies from Population Services International and Marie Stopes International. They say the situation was made worse when some consumers complained that Uganda’s leading brand of condom – Engabu – had a bad odor.
Subsequent tests indicated the Engabu condoms had failed not only an odor test, but sample batches failed the “freedom from holes test.” Despite follow up tests and claims by the manufacturer that the condoms were safe, public confidence in Engabu plummeted.
What’s more, activists claim the United States is using most of the money from PEPFAR, the President’s Emergency Fund to Fight AIDS, to support faith-based abstinence only programs in Uganda. In other words, deemphasizing condom use.
Supporting that position is Stephen Lewis, the special UN envoy for AIDS in Africa.
He says, "There is no question in my mind the condom crisis in Uganda is being driven and exacerbated by PEPFAR and by the extreme policies that the administration in the United States is now pursuing in the emphasis on abstinence far and away beyond that of condoms. And that distortion of the preventive apparatus of ABC, with which we’re all familiar, is resulting in great damage. And undoubtedly will cause significant numbers of infections, which should never have occurred."
At the time of this story, there was no response to several calls and an e-mail to the office of the US Global AIDS Coordinator, Ambassador Randall Tobias. However, on the Global AIDS Coordinator website it says, “Uganda is well known for its ABC programs and other prevention initiatives.” ABC standing for Abstience, Be Faithful and Condoms. However, the website adds, “US programming is increasingly emphasizing A and B.”
In the past, President Bush himself has said that all aspects of the ABC approach – Abstinence, Be Faithful and Condoms – were equally important.
Activists say, however, the bad image for the Engabu condom has resulted in about 30 million perfectly safe condoms sitting in a warehouse. Activists have volunteered their time to place new name labels on the condom packages so they could be distributed.
And despite government statements about procuring tens of millions of condoms, activists say government clinics are no longer distributing free condoms. And packages of condoms that can be purchased have tripled in price from about 16 cents to over 50 cents.
Beatrice Ware of ActionAID Uganda is herself HIV positive and a leading African AIDS activist. She accuses her government of now having a policy that has “unleashed” new stigma.
"We have a new wave of stigma in the sense that AIDS is now being treated as a moral issue. And those of us who are promoting condoms are looked at as bad people. We are looked at as people who are promoting what is not morally correct," she says.
She says President Museveni, one of the first African leaders to speak out about AIDS and promote condom use, has changed his position. She says that is causing a lot of confusion. Uganda often has been praised for taking an early stance on the pandemic, which has kept its infection rate low.
UN special envoy Lewis also says it is “absurd and irrational” to try to mainly promote abstinence in all circumstances.
"How for the women who are in married situations does abstinence apply? If they have no opportunity to emphasize the need for a condom for a partner or a husband about whom they may have suspicions – how do they save themselves from infection? Abstinence doesn’t work in marriage obviously. Nor does it work where you have determined sexually active adolescents and young people, who will always be sexually active," he says.
The condom controversy follows the recent announcement by the Global Fund to Fight AIDS, Tuberculosis and Malaria to halt funds to Uganda. The fund cited evidence of fiscal mismanagement.
Uganda’s Health Minister says the allegations of condom shortages are just a rumor designed to hurt the country’s image. And in recent months, officials there had denied there had been any pressure from the Bush administration to promote abstinence over condoms. (