Health GAP (Global Access Project)
www.healthgap.org

August 11, 2005
Peter Piot
Executive Director
UNAIDS
20, Avenue Appia
CH-1211 Geneva 27
Switzerland

Dear Peter Piot,

We are writing out of concern about the current HIV prevention problems in Uganda that threaten to erase the gains made in that country against the spread of HIV. We would like to know what UNAIDS has done and plans to do to address the ongoing condom shortage in the short-term, and how UNAIDS in particular plans to address the growing attacks on the use of condoms as an essential component in comprehensive prevention programs.

As you know, Uganda was a showcase to the world by reducing its national level of HIV infection from 15% to 6% over the past two decades, according to UNAIDSÕ estimates. The policies put in place since the first case of HIV was identified in 1982 are now being overtaken by programs that reflect abstinence-only approaches, with heavy financing from the US government, and aggravated by an artificial condom shortage.

In November of 2004, the ÒEngabuÓ brand of condoms was removed from health facilities across Uganda, after complaints about their smell and subsequently quality control testing. Since the mid-1990s, Engabu had been distributed for free by the Ugandan government, and accounted for a full 80% of all condoms used by Ugandans. Since November, over 24 million emergency condoms have been shipped to Uganda, but the National Drug Authority of Uganda (NDA) and Ministry of Health have refused to distribute them to the public. The government has imposed new quality assurance standards, new tariffs on imported condoms used for social marketing campaigns, and has refused to state when or how the condoms still sitting in government warehouses will be distributed.

On at least one occasion during this condom shortage, you visited Uganda and met with high-level officials about the country's HIV/AIDS policy. We would like to know if you used that opportunity to raise the issue of recent attacks on comprehensive HIV prevention with them, as we cannot find evidence of this in the news media. We recognize that UNAIDS is in period of transition in Uganda right now but are struck by its apparent silence -- other than to praise Uganda as an HIV-prevention model -- during this critical moment in the country's HIV/AIDS effort.

We need for you to use your office to mobilize mass-awareness of the Ugandan condom crisis and its implications, and to urgently mobilize whatever resources necessary to get quality-assured condoms available to the public as well as to rebuild national trust in the Engabu brand and/or quality assured condoms distributed by the government.

We look forward to hearing from you.

Sincerely,

Sharonann Lynch, Health GAP
Mark Heywood, Treatment Action Campaign (TAC)
Jodi Jacobson, Center for Health and Gender Equity (CHANGE)
Gregg Gonsalves, Gay Mens Health Crisis (GMHC)
Naina Dhingra, Advocates for Youth
Julie Davids, Community HIV/AIDS Mobilization Project (CHAMP)

cc:
Ben Plumley, UNAIDS
Kate Thomson, UNAIDS
Jim Yong Kim, Director, Department of HIV/AIDS, WHO
Stephen Lewis, U.N. Secretary General's Special Envoy for HIV/AIDS in Africa
Richard Feachem, Executive Director, Global Fund to Fight AIDS, Tuberculosis and Malaria
Jonathan Cohen, Human Rights Watch (HRW)

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