Uganda v. Condoms

In 1986, not long after his guerrilla force seized power in Uganda, Museveni sent 60 top officers from his bush army to Cuba for training. Several months later Fidel Castro approached Museveni with a staggering bit of news: Medical exams in Cuba had revealed that 18 of the 60 officers were HIV-positive. Years of war, pillage, displacement, and rape had entrenched HIV in Uganda as early as the late 1970s. Perhaps because his army was threatened, Museveni took Castro’s warning to heart. Within one year he was leading a nationwide mobilization against AIDS that drew in bishops, imams, and public health experts, as well as thousands of small community groups nationwide. The program would become known as ABC, for “Abstain, Be Faithful, or wear a Condom”–very much in order of emphasis. Children should abstain from sex until marriage and then practice “zero grazing”–i.e., fidelity. “You tether your animal around a tree, and it can only feed where it is tethered,” Nantulya says with a chuckle. Billboards with this message are omnipresent in Uganda. By last year the number of pregnant Ugandan women testing positive for HIV antibodies had fallen from 21.2 percent at the height of the epidemic in 1991 to 6.2 percent. By contrast, in neighboring Kenya the rate is roughly 15 percent; in Zimbabwe it stands at 32 percent; and in Botswana fully 38 percent of mothers-to-be are HIV-positive–with rates continuing to rise in each country. Senegal has also done well against the plague: HIV rates there have remained low. By far the most striking epidemiological feature of Uganda’s success is the drastic reduction in multiple partnering...