SEPTEMBER 2005

HON. MAJ. GEN. JIM K. MUHWEZI THE MINISTER OF HEALTH MINISTRY OF HEALTH UGANDA.

RELEASE THE CONDOMS FUND EFFECTIVE PREVENTION STRATEGIES SAVE LIVES NOW!

As Ugandans infected, affected by or at immediate risk of HIV infection, we have watched with increasing disbelief as the governments of Uganda and the United States have undermined the comprehensive prevention strategies responsible for reducing the spread of HIV in Uganda since the first case was detected in 1982, seeking instead to replace these with ideologically-driven and scientifically discredited abstinence-only programs.

Uganda is known throughout the world for having dramatically slowed the spread of HIV in the 1990s through broad-based HIV prevention policies that simultaneously encouraged delay in sexual initiation among unmarried youth; faithfulness and monogamy among sexually active couples; and use of condoms by all sexually active persons living with or at risk of HIV infection. Central to this strategy were efforts to demystify HIV and reduce the silence and stigma surrounding both HIV infection and prevention technologies, such as condoms. As a result, many people changed their behavior, including through sharp increases in consistent and correct use of condoms. Objective scientific evaluations now show unequivocally that condoms played a critical role in reducing both the incidence and prevalence of HIV in Uganda.

Today, however, the historical record of Uganda's success in reducing HIV is being distorted to further ideological agendas. Since 2003, we have watched as the Ugandan government downplays its own proven track record in an obvious attempt to please international donors such as the United States. We have watched as our own leaders rewrite history and misleadingly attribute reduced HIV prevalence to adoption of sexual abstinence. We have watched as the U.S. government pours millions of dollars into HIV-prevention programs that provide misleading information about the effectiveness of condoms and that fail to equip people--particularly womenÑwith the essential skills needed to negotiate safer sex. We have seen billboards throughout the city of Kampala, sponsored by the U.S. Agency for International Development (USAID), the Office of the First Lady of Uganda and the Global Fund to Fight AIDS, Tuberculosis and Malaria, that exaggerate the failure rate of condoms and present "abstinence-until-marriage" as a complete HIV-prevention strategy, despite the fact that a large share of women are getting infected within marriage. We have seen Ugandan organizations stop supplying condoms either to gain or to avoid losing U.S. funding.

Over the past year, access to condoms in Uganda has been reduced dramatically. In late 2004, the government of Uganda issued a nationwide recall of Engabu condoms claiming these were defective, and causing a catastrophic shortage of the only condoms previously made freely available in government health clinics. At the same time, the government placed onerous new taxes and quality-testing requirements on all condoms imported for social marketing and for sale on the private market. This in turn led to price increases of more than 500 percent for condoms imported for these purposes, effectively eliminating the only other sources of affordable condoms in the country.

Today, condoms are largely absent from public clinics, and the government has undermined public confidence in the effectiveness of condoms against HIV. At this writing, an estimated 34 million condoms have passed post-shipment quality tests but remain impounded in warehouses in Uganda because of the government's failure to bring them to market. We are struck by the sudden shortage of free government and other subsidized condoms at a time when the government is collaborating with the United States to expand abstinence-only programs throughout Uganda. We do not believe this is coincidental.

We believe that the mismanagement of the Engabu recall, the ongoing delay in re-supplying public health facilities with free condoms, and the failure of the Ugandan government to launch an educational campaign to restore confidence in both the Engabu brand of condoms and condoms generally represent clear evidence of the government's involvement in campaigning against condom use.

We condemn the diversion of valuable HIV/AIDS funds away from programs that provide a full range of HIV-prevention options and toward those that focus exclusively on abstinence and fidelity for HIV-prevention. We believe such approaches are not only unrealistic and scientifically unsupportable, but also threaten the lives of millions sexually active adults and young people, including married people, sero-discordant couples, and women in polygamous marriages. We also believe that such programs may have other unintended consequences, such as reinforcing early marriage and child marriage in keeping with an obsession with virginity.

We further condemn the false morality under which these shifts are being made. At a time when public rhetoric about faith, religion, and morality is at a fever pitch, the dramatic shift toward abstinence-only programs needlessly threatens the lives of millions of Ugandans now at risk of HIV infection and re-infection.

We demand that the Ugandan government take the following urgent steps in order to prevent any further deterioration of its successful HIV-prevention policies:

1) RELEASE THE CONDOMS: The Government of Uganda should release all condoms in storage in Uganda--for sale or donation--by the end of September 2005.

2) LIFT THE TAX: Repeal recent taxes on imported condoms, and male branded condoms available at their previous prices, before the Engabu recall.

3) EDUCATE THE PEOPLE: Take concrete steps to restore public confidence in Engabu condoms and in the effectiveness of correct and consistent condom use as an HIV prevention strategy.

4) ELIMINATE ABSTINENCE-ONLY PROGRAMS: Shift funding for abstinence-only or abstinence-until-marriage programs to programs that provide comprehensive information about safer sex and the correct and consistent use of all available methods of HIV prevention, including male and female condoms; provide individuals and couples with the skills necessary to negotiate safe, consensual sex; and address the underlying conditions, such as gender-based violence, economic and social disparities and lack of basic human rights that leave so many women and girls vulnerable to HIV Infection.

5) PROBE THE RECALL: Investigate the steps leading up to the recall of Engabu condoms, and provide a public explanation for the ongoing condom shortage and for price increases.

6) FACE THE PUBLIC: Hold a public forum in which concerned individuals have an opportunity to confront high-level government officials with their concerns about the shortage of condoms and the evident shift toward ABSTINENCE-ONLY approaches.

7) INTENTION TO SUE: As citizens of this country we believe that the continued shortage of condoms is a violation of our right to access of essential health commodities. While our priority is dialogue, we shall not rule out use of legal means if government does release the condoms by end of September 2005.

We highly appreciate the time you will take to read and respond positively to our recommendations and we pledge our full support should the US government put undue pressure on you. We urge you to put national interest first.

C.c. Office of the President. Committee of Social Services, Parliament of Uganda. Committee on HIV/AIDS, Parliament of Uganda. Uganda AIDS Commission.

Signed:

Signatures of concerned organisations and individuals
Signatures from Uganda
Capson Sausi - Action Aid Uganda
Faustine Nakazibwe - Action Aid Uganda
Kyokutemba Denis - FUCAGIFO
Nakuya Victoria - Action Aid Uganda
Rebecca Musoke - Action Aid Uganda
Bugonzi Nasta - Action Aid Uganda
Josephine Lubwama - Action Aid Uganda
Elizabeth Ddungu - Action Aid Uganda
Beatrice Were - Action Aid Uganda
Kwiri K. Topher - Action Aid Uganda
Nickson Ogwal - Commonwealth Educ. Fund
Lerok Joan - Commonwealth Educ. Fund
Rose Ejang - Action Aid Uganda
Christine Achieng - Action Aid Uganda
Deo Katusabe - Action Aid Uganda
Sarah Okwaare - Action Aid Uganda
Zaituma Fuambe - Action Aid Uganda
Anthony Makumbi - Action Aid Uganda
Godfrey Kakala - Action Aid Uganda
Muhumuza P - Action Aid Uganda
Priscilla Uwamahoro - Action Aid Uganda
Hyooba Andrew - Action Aid Uganda
Hilda Muwanga - Action Aid Uganda
Kwesiga F.R. - Action Aid Uganda
Bwang David - Action Aid Uganda
Okino Charles - Action Aid Uganda
Tusiime Alice - POWL (U)
Dorothy Namutambi - Friends of Canon Gideon Foundation
Fortunate Kyogabirwe - Support on AIDS & Life Through
David Oyat Abana - NAFOPHANU
Mukunde Juliet - Uganda Young Positives
Namakula Prossy - NAFOPHANU
Lillian Mworeko - ICW
Walter Okumu - UTAM
Dr. Lydia Mungherera - UTAM
Atuhaire Clara - HEPS-Uganda
Komuhangi Julian - HEPS-Uganda
Isingoma John - Ultimate Media Consult
Winnie Banga -AGHA-Uganda
Mutabazi Stewart - AGHA-Uganda
Muhinda Aaron - HEPS-Uganda
Luyombya Henry - Global Youth Coalition on AIDS
Major rtd. R. Ruranga - NGEN+
Rosette Mutambi - HEPS-Uganda
Zziwa Semugabi - HEPS-Uganda
Nakanwagi Gertrude - HEPS-Uganda
Bas van den Kallen - HEPS-Uganda
Ngabiirwe Winnie - AGHA-Uganda
Ruhindayo Michael - Health Rights Action Group
Mukunde Penninah - Health Rights Action Group
Karecera Peter - HEPS-Uganda
Aturinde John - HEPS-Uganda
Gumaoshabe Apollo - NAWOU
Baselle John - NAWOU

Signatures from outside Uganda
Dr J.L.M. Lelijveld - Woodbridge, Suffolk, IP13 6LT, UK.
Anne Van Lancker - Population, Sexual and reproductive health and rights, HIV/AIDS and sustainable development, Belgium
Dr Felicity Manson - One World Action, UK
Jamie Uhrig - Consultant in HIV prevention and care, Thailand
Nu Van Nguyen - Member of the Unified Committee To Oppose Communism in California, USA
Anna-Britt Coe - Department of Sociology, UmeΠUniversity, Sweden
Nik M. Fahmee - Malaysian AIDS Council, Malaysia
Brian Haill - The Australian AIDS Fund Incorporated, AUSTRALIA
Eva Capa - Copenhagen University, Denmark
Radhika Chandiramani - TARSHI (Talking About Reproductive and Sexual Health Issues), India.
Janet Feldman - KAIPPG International, USA
James Onyango - KAIPPG Kenya
Daryl Thomas - Sexual Health Educator, Australia
Tendayi Westerhof - Public Personalities Against Aids Trust, Zimbabwe
Mac Bain Mkandawire - Youth Net and Counselling (YONECO), Malawi
Zanaa Jurmed - CEDAW Watch Network Centre, Mongolia
Joyce Hunter - HIV Center for Clinical & Behavioral Studies/NYSPI, New York
Shona Schonning - Community of People Living with HIV/AIDS
Joanne Csete - Canadian HIV/AIDS Legal Network, Canada
Konjit K. - Free lance Consultant , Ethiopia
Roula Scoutari - FEMINIST NET, Greece
Lucy Russell - United Kingdom
Mohammad Ziaul Ahsan - Organizatiom For Social Development of Unemployed Youth, Bangladesh
Kristen Velyvis - University of Wisconsin-Madison, USA
Cynthia R. Pearson, Ph.C - University of Washington
April Diana Niver - Initiatives in Educational Transformation, USA
Gordon W. Perkin MD - Bill & Melinda Gates Foundation, USA
Chicago Women's AIDS Project
Stephen Talugende - United Nations Operations in Burundi
Jodi Jacobson - Center for Health and Gender Equity (CHANGE)
Laura J. Ghiron - University of Michigan School of Public Health, USA
Jose S. Barzelatto - The Center for Health and Social Policy, USA
Sally Fisher - Working to End Violence Against Women and Girls and HIV/AIDS
Megan M. Raspa - The Well Project
Kaytee Riek - The Campaign to End AIDS
Barbara B. Crane - IPAS
Vicente D’az - Fundaci—n Mexicana para la Planeaci—n Familiar, A.C.
Mr. Michael Clulow - Independent Development Consultant, Peru
Aimee R. Thorne-Thomsen - Pro-Choice Public Education Project, USA
Sue H. Patterson - Founder and President of WINGS, Guatemala
Julie Davids - Community HIV/AIDS Mobilization Project (CHAMP), New York
Dr. Hilary Standing - Health and Social Change Programme, UK
Mountaga TOURE - AMPPF, Mali
Teresa Hernandez Cajo - Feminist Lawyer, Peru
Leslie R. Wolfe - Center for Women Policy Studies, USA
Beverly Winikoff - Gynuity Health Projects, New York
Martha Tholanah - Zimbabwe
SIDACTION - FRANCE
Giota Touloumi - Athens University Medical School, Greece
Tim Thomas - International Council of AIDS Service Organizations, New York
Patrick Friel - Reproductive Health HIV/AIDS Consultancy, LLC, New York
Alex Pius Margery -Tanzania National Network of People with HIV/AIDS (TANEPHA),
Renate Baehr - Deutsche Stiftung Weltbevoelkerung (DSW), Germany
Donna M. Guenther - Unites States of America
Yassine Fall - Africa Women's Millennium Initiative on Poverty and Human Rights, Senegal
Rosemary Gravenor - WOSA - We are Church, Durban South Africa
Sharene E McKenzie - Civil Society Specialist, Kingston 10

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