HIV-FREE GENERATION
The debate about a prospective HIV-free generation given the advent
of WHO Option B+ attracts attention on the surface. A further probing of the
whole idea, however, may reveal a distant utopia. To have HIV-free generation,
our communities must come to a convergence on reducing new infections.
There is need for deliberate public health policy and unwavering fiscal commitment to this end. Unfortunately, our national spending priorities deprive the masses of critical social services needed to attain acceptable levels of health.
HIV/AIDS is a disease left to wreck havoc among the destitute of the world. The wealthy and educated are surviving the scourge longer. Their children are able to avoid contracting the disease when compared to the children from impoverished communities. This explains why the global burden of HIV/AIDS is most prevalent in underdeveloped countries like Uganda.
To think about a prospect of HIV-free generation, we have to see the big picture of the structure of governance, the quality of public policies and the distribution of critical resources necessary to secure prerequisites of health. These forbearing conditions also do shape how society places value on containing the HIV virus spread and caring for those living with the virus. The recently passed HIV and AIDS Prevention Bill (2008) is an example of required policy instruments, which must be accompanied with equal funding commitment
The Ugandan government has demonstrated inability to meet most of the MDG goals including reduction of HIV infections. Scientists now agree that at its current pace, Uganda may achieve some of the MDGs in critical areas such as reduction of new HIV infection, eliminating mother to child transmission of HIV, providing services to reduce child-maternal mortality by 2035.
Uganda is a signatory to the 2001 Abuja Declaration, which
committed governments to allocate at least 15% of its annual budget on health
services. Uganda has achieved barely 8% since 2007 while only Tanzania has
achieved this objective. The ratio of healthcare workers to patients remains
staggering and yet the WHO Option B+ remains the most promising opportunity to
the achievement of this goal.
It is impossible to effectively implement this HIV treatment regiment when government's per capita heath expenditure is far below minimum international threshold. An audit report in 2013 found that Uganda was spending only UShs 2, 500 (US $1) a month on healthcare, which means it's annual per capita health expenditure is about US$12. This is ridiculously below the 2001 Commission of Macroecomics and Health recommendation of US $ 34 per capita.
The HIV treatment has three parts to it: the biomedical aspect, which includes treatment; the psychosocial aspect, which entails the social needs of persons living positively with HIV; and health promotion, which entails preventive strategies. Each of these aspects is complimentary to each other and yet requires specialized skills, commitments, resources, and funding.
The HIV-free generation, health promotion in the context of maternal child health and HIV infection prevention are crucial. This is where our healthcare system is failing. The 380 people who contract HIV on the daily basis in Uganda are among some of the poorest and yet they endure insurmountable challenges in accessing health information and in economic production chains.
Opportunities for health promotion would mobilize distinctive and progressive cultural resources to enhance the quality, relevance, and efficacy of health promotion and the management of health to prevent new infections. Without bringing in relevant cultural resources, communities will shun important services such as family planning. Social and societal discrimination remains amplified and more so where resources are scarce.
Lastly and most importantly, is the understanding that to create HIV-free generation, we have to realize a reduction in new HIV infections. The WHO Option B+ is effective; however, certain cultural practices and beliefs are still retrogressive, oppressive, and predatory. These undermine opportunities for girls and women making them vulnerable to HIV infection. These conditions will continue to block progress towards achieving HIV-free generation.
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