Startling News Out of Uganda

Washington, DC - December 18, 2006

Two recent studies have illuminated an alarming trend in Uganda: HIV policies that do not link or integrate family planning and reproductive health programs are missing the mark and putting more people at risk of contracting HIV. The first, conducted by the Uganda AIDS Commission, shows that married couples now account for the highest proportion (42%) of new HIV infections in Uganda. The second, a recent Guttmacher study, found that 40% of births in Uganda are unintended. The evidence is mounting: The current approach to family planning and HIV prevention is not working. As the global leader in both, the U.S. must shape its policies and funding to respond to the reality Ugandans—and women around the world—are facing.

According to the Uganda AIDS Commission, lack of knowledge of HIV status, engaging in sex with multiple partners, and lack of condom use are among the reasons for the high infection rate among married couples. Currently, PEPFAR-funded HIV/AIDS prevention programs overemphasize abstinence—an inappropriate message for married couples. This is further evidence that PEPFAR’s requirements do not always make good use of limited funds. Countries receiving PEPFAR and other reproductive health assistance must be able to determine for themselves the most appropriate approach for addressing critical health issues—without misguided policy and funding prescriptions that hamper individual countries’ efforts.

In addition to ill-suited policies, the neglect of funding for family planning programs has very real consequences for Ugandan women and their families. The unmet need for contraception is 35%, the lifetime risk of maternal mortality is 1 in 13, and it is projected that one million people living in Uganda will become HIV-positive in the next five years. According to former U.S. Ambassador to Uganda Steven Browning, 90% of pregnant HIV-positive women do not wish to have more children.

These statistics illuminate a dangerous and deadly future for this country if current policy and funding trends continue. This closer look at Uganda reveals many of the holes in the current U.S. prescription to address high and growing rates of HIV and unintended pregnancies. PAI urges the U.S. to set aside the policy restrictions that keep countries from designing integrated HIV and reproductive health and family planning programs that meet the needs of their populations.

Population Action International (PAI) works to improve individual well-being and preserve global resources by mobilizing political and financial support for population, family planning and reproductive health policies and programs.