The Social Geography of the Spread and Impact of HIV/Aids in Uganda

Abstract

Since the first identification of HIV/Aids in Uganda in 1981, at Kasensero and Rukunyi locations of Rakai District on the shores of Lake Victoria, the government of Uganda has demonstrated an open and supportive response to the epidemic. The Uganda Aids Control Programme (ACP) was established in 1986 with a mandate to control the spread of HIV and to assist people and families infected and affected by HIV/Aids. In 1991 the Ugandan government adopted a multi-sectoral approach to fighting HIV/Aids by establishing the Uganda Aids Commission (UAC). Despite these efforts HIV/Aids has continued to seriously affect Uganda. At the beginning of 1998 an estimated 800,000 people out of a population of 17 million were HIV-positive. This included at least 25,000 children. By 2002 approximately two million out of a population of twenty-two million were thought to be infected. Most are between 15 and 35 years old, Thus the epidemic affects the most productive age group and greatly hinders development. Uganda has a mainly young population with a tremendous dependency burden. The economy is based on labour-intensive agriculture with the agrarian sector contributing 54 percent of GDP and accounting for 90 percent of exports (MFPED 1998). The terrible irony of Aids is that HIV infection is concentrated in the countries that are least able to cope with the sickness, death and loss of productivity it brings. Close to 90 percent of all people with HIV live in sub-Saharan Africa and other developing countries. Yet these countries account for a mere eight percent of global economic production. Moreover the gap between rich and poor countries with regard to HIV/Aids is increasing. Investment in HIV prevention and access to expensive life-prolonging drugs are cutting new infection rates and progression to Aids in industrialised countries, but in the developing world infection rates are still on the rise, and drugs to slow the progression from HIV to Aids are largely unavailable. In Uganda the rural labour force is expected to fall by two million by the year 2010 due to Aids (Stover 1990). The loss of so much of the economically most active population, along with their skills and experience, further increases the de ple left behind are unable to contribute meaningfully to economic activity.