[KAMPALA] Civil society activists say Uganda's presidential candidates have not placed sufficient emphasis on how they plan to tackle the epidemic should they come into office, despite rising HIV prevalence and major funding problems.
Ugandans go to the polls on 18 February. The incumbent, Yoweri Museveni, won plaudits for his efforts against the pandemic in the 1980s and 1990s - prevalence dropped from 18 percent in 1992 to 6 percent in 2000 - but his government has been criticized recently for ineffective HIV prevention campaigns, the misuse of grants from the Global Fund to fight AIDS, Tuberculosis and Malaria and frequent antiretroviral (ARV) stock-outs.
"The focus was not enough; I think candidates have general statements on health in their manifestos and little focus on HIV generally speaking," Ivan Kintu, communication and advocacy officer for the National Community of Women living with HIV in Uganda (NACWOLA).
He noted that during their campaigns and in their manifestos, all eight presidential candidates addressed HIV-related issues minimally, focusing instead on health more generally.
"Uganda's response to HIV is faltering, and it is surprising and disappointing that more focus is not being placed on ending the AIDS crisis in Uganda," said Asia Russell from the US-based lobby group, Health Global Access Project (Health GAP).
Local civil society activists have lobbied all major political parties to commit to a "10-point platform" to fight HIV/AIDS, which includes commitments to fully fund the fight against HIV, increase the number of health workers and end corruption in the health sector.
"We want whoever comes into power to use the 10-point platform," said Kintu. "I am sure if that is done there would be a big general improvement in health in Uganda."
Some major political figures have heeded the call. At a recent rally in Arua, northwestern Uganda, the leading opposition figure, Kizza Besigye, addressed the issue of HIV directly after seeing AIDS activists in the crowd.
"I see we have been joined by people with a banner saying 'No Drugs, No Votes' and who are calling for more action on the fight against AIDS," he said. "The political will on HIV of the current regime is finished; less than half of those who need HIV treatment have access. And [those who are on treatment] are due to the goodwill of the American taxpayer."
Besigye said if his party, the Forum for Democratic Change (FDC), came to power, at least 15 percent of the national budget would be spent on health.
"NRM [the ruling National Resistance Movement] shut down channels of HIV prevention over the years [a reference to prevention programmes that emphasized abstinence over condom use]," he added. "We want comprehensive prevention, not only one method."
At another rally in Arua, the Democratic Party's presidential candidate, Norbert Mao, committed himself to the 10-point platform. "I pledge to make sure that funding for HIV is never left to foreigners," said Mao, assuring the crowd that he would ensure the availability of ARVs in all health facilities and that he would fight domestic violence, which was a gateway for HIV.
According to Russell, Besigye, Mao and the Uganda People's Congress's candidate, Olara Otunno, have all expressed support for the 10-point platform.
Museveni has not responded to calls to sign the platform. The ruling party lists reducing HIV prevalence as one of its achievements, and its manifesto promises to equip and staff lower-tier health centres to be able to "deal with HIV/AIDS".
“This is extremely concerning to us, considering the urgent need for treatment scale-up and effective prevention in Uganda,” Russell said.
For many Ugandans, this election presents an opportunity for a change of guard and an improvement in healthcare in general. "[There are] only a few people on treatment and all the funds are from donor agencies; it is disheartening, children are dying, women can’t access PMTCT [prevention of mother-to-child HIV transmission] services - all the money is being used for campaigns and the rest is stolen," said Richard Hasunira, a lawyer in the capital, Kampala.
“Whether the opposition can do a better job I do not know but what I can say with certainty is that this government should have done more,” he added.