The Commonwealth of Unrecognized States

UNRECOGNIZED

It is interesting that there are more countries or independent territories in the world than we ever would come to know. These states are unrecognized by the United Nations either because of processes of their formation or due to politics of exclusion.

Pajule Pader Chronicles brings you a list of these so-called unrecognized states;

1.     Nagorno-Karabakh Republic  

2.      Abkhazia

3.     South Ossetia 

4.     Transnistria

What do you know about these independent states?

Only at Pajule Pader Chronicles do you get these challenging and fascinating facts…

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Museveni is robbing the poor and lavishing the rich

 PRESIDENTIAL ROBBERY

For the last couple of months, President Museveni has been really generous. He has doled out millions of shillings in sacks to youth groups in Jinja; relinquished Buganda’s property [Ebyaffe] with 2b/= cash of the 20b/= arrears to accompany it, unconditionally; given hundreds of millions to veteran groups in Luwero and elsewhere; rewarded our golden boy, Stephen Kiprotich with a house, vehicle and all Moscow athletes with millions of shillings; motivated the Uganda Cranes with close to a billion of shillings for their world cup qualifiers against Senegal. Recently he donated about 80m/= to a church charity in western Uganda. The brown envelop appears to be dropping endlessly from Statehouse like manna from Heaven.

Unfortunately, these monies end up lining the pockets of the rich people who receive the money. In essence, the president is robbing the poor and lavishing the rich and powerful.

Two things come to mind; either the President is in a state of panic over the damning political mood in Uganda right now, or he is consciously accepting that things are not as he had always thought that they were. If the latter is true, then we have come to see a metamorphosis of a man who was once ensconced in the world of political ideologies to the world of reality - because his dream of steering Uganda to middle income country by 2017 was, in itself a symptom of an illusion, not a tenable vision.

But let’s forget his supposed transformation; let us focus on the seemingly strange act of altruism from the President. Many political analysts will agree that the act of lavishing out public money to various groups of people does not only serve to procure political favors, but it also serves to extend his patronage. The money that Mr. Museveni is donating to partisan groups is not his personal money. It is tax payer’s money which should be used for common good of all through state institutions.

When Mr. Museveni gives out cash rewards to Mr. Kiprotich, he does so on his account as the President, thereby expecting the people of Kiprotich to look up to him as the benevolent giver.  When the President doles out cash boost to the Cranes and charters private plane to fly fans to foreign lands, he does so in his individual capacity. In the same manner, when Mr. Museveni reaches out to youths, veterans, women or PWDs groups with money in the sac like a typical cowboy, he expects to fulfill personal political objectives.

One would not be bothered with who gets what kind of money from the President. But the trend is worrying for many reasons including an indication that government institutions responsible for such interest groups are literally dysfunctional.

The philosophical debate on whether altruism really exists for the sake of altruism has long dominated the worlds of psychology. In fact reading a 2010 New York Times opinion piece by Judith Lichtenberg enhanced my conviction that through an act seemingly altruistic, the President is really procuring political favors ahead of 2016 Presidential elections. Indeed, both Immanuel Kant and Freud questioned the nature of altruism because they both recognized that people’s motives are always hidden.

However, the prospects for future favors, the boost to reputation and enhancement of likability are some of the obvious reasons politicians like Mr. Museveni appear to be altruistic. In fact Mr. Museveni’s motives are palpable considering the timing and his known lifelong presidential ambitions.

It is very unfortunate that the President, who once had very clear programs and well articulated vision, has succumbed to this below pedigree approach. This blatant “Reverse Robinhood” effect - stealing from the poor and giving to the rich, are a testimony to the predicament of the many impoverished Ugandans.

When we examine the statistics of unemployment among youth, the figures are as gloomy as that of mortality rate for expectant mothers and children.  One would be duty bound to assert that the President is inadvertently admitting to his own guilt of failing Uganda by suffocating the institution of government that should distribute national resources equitably. This patronage seeking is the root of the endemic corruption in Uganda today.

The overall impression one gets is that, as long as the ordinary Ugandans continue to exert themselves, they will do so without the direct intervention of government. When they succeed, they will somehow get rewarded through the “altruistic’ gimmick of the President for publicity purposes. In essence, investing in public infrastructure, such as high altitude track and field, sports complex like Lugogo once boosted of; or putting in place scholarships in schools to support talented youths, are never a matter of ideological interest to the President. It is a pity that our own President robs us the poor to lavish the rich people!

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Scrutinizing Bukenya's popularity in the North

PRESIDENTIAL AMBITIONS

The prospect of having Hon. Dr. Gilbert Bukenya contesting in the 2016 general elections as Presidential candidate has generated comical sentiments. My area Member of Parliament, Hon. Otto Odonga was the first to fire salvo in public regarding the seriousness of Hon Bukenya’s Presidential candidature in light of his purported popularity in Northern Uganda (NV, Aug 19, 2013).

I have read several commentaries and social media analyses of this subject and of utterances by Hon Bukenya in media statements. Since Hon. Bukenya has publicly declared that he is a contender against President Museveni, this becomes a matter of public interest. It is important to scrutinize and evaluate the candidate as he is – with the frame of reference to his purported popularity in the North.

I first had personal contact with Dr Bukenya, then as Vice President in 2000 at Serena Hotel. He had come to officiate at a closing ceremony of a two days’ workshop on Corporal Punishment in schools that was organized by Uganda Human Rights Commission. Then, I was secretary for National Affairs at Uganda National Students’ Association and founding President of Pan African students Union, which is now defunct.

Hon. Bukenya had picked me out from the crowd due to my eloquent advocacy against any forms of corporal punishments. When we spoke, he was interested in knowing which part of the country I came from and I obliged to volunteer that information. It happened that he knew my father, like most of the people who were adults during the 70s and the times of liberation struggles against Idd Amin Dada.

One thing Hon. Bukenya shared with me was about his participation in guinea worms eradication in Northern Uganda. As a young medic, one of his early assignments were to eradicate guinea worms in Kitgum district and according to him, he enjoyed his time there. Beyond that, Hon. Bukenya could not pronounce a name of any place in Northern Uganda with precision or confidence. But a long time had passed and the memory of Northern Uganda and in particular – Kitgum, where Bukenya spent his formative medical practice years had significantly changed. Was Bukenya still relevant to the region? Did he have roots there during his tenure as VP?

Well, I can tell three things about Bukenya; Hon. Bukenya is not an astute politician, he is an administrator; Hon. Bukenya lacks originality, he is an impersonator and; Hon. Bukenya lacks the edge in mobilization and therefore, a national appeal.

I could substantiate in details about all my assertions here about Hon. Gilbert Bukenya, but for space limitation. A brief overview of these points however, will do:

When I say that Hon. Bukenya is not the kind of astute politician President Museveni or Hon. Amama Mbabazi are, I really mean it in that sense of ruthlessness. Anyone vying against the two NRM honchos must reflect critically first on the intricate link between Museveni and Mbabazi; their historical intimacy, existing political networks, syndication, loyalty and symbiotic trends between the two politicians. It is ironic that Bukenya fails to see these linkages relative to his political location within the NRM fabrics. Bukenya knows that his tide changed course profoundly the moment he stood on the way of Mbabazi for secretary general of NRM. Mbabzi is politically located inside the lifeline vessel of the NRM and Bukenya is not close to the queue!

 The quick lessons learned therefore should be that people who jump into the NRM now or later, especially when picked for publicity and public relations purposes, should not forget so soon that they have been appointed to serve just that purpose and nothing other.

This also brings me to my second assertion that Hon. Bukenya lacks in originality and is merely an impersonator.  This view will dent his credibility and therefore his prospects. For the many years Hon. Bukenya served as VP, he underwent serious metamorphosis - transforming himself into a perfect “dummy” of Mr. Museveni. Video clips of Hon. Bukenya gradually changing his characters to speak, gesture, swagger and assume posture like his boss are all over the internet. I mean, one can admire and emulate his superiors, but to transform one’s entire being wholly from the original self to a “Museveni” was rather exhibiting a strange form of physical and psychological sycophancy unprecedented in Uganda’s politics.

In the eight years Bukenya served as VP, his only project that he can count on is the upland rice. Definitely for regions of Uganda where upland rice cannot grow, this project only exists in news. But most importantly, the revelation that Hon. Bukenya is famous in the north must be rebuffed and chided because statistics do not stand by him. As VP, Hon. Bukenya never stood by the people of Northern Uganda during the war or internment. But it is not only Hon. Bukenya, most Vice Presidents to Museveni have always undermined, neglected or perpetuated disregards for the people of Northern Uganda and their struggles. 

Hon. Bukenya’s predecessor was even worse; she once opined that the people murdered in Atyak Massacre were serving the purpose of forming manure, which is good for the soil. So, it is categorically a false perception that Hon. Bukenya is famous in the North. We are taking account of all politicians who stand by us during our moments of need and at such an appropriate moment, we can reflect on their values to us!

I contended that Hon. Bukenya is a weak mobiliser whose influence does not transcend the Busiro/Buganda stretch. His organizational skills and resources cannot match that of the establishment especially if he plans on running against President Museveni in 2016 for nomination or as NRM candidate on false perception of self worth and popularity.  Wishing him all the very best!

END.

The Closure of MUK is a shame to our conscience

Makerere University Closure

The joy of witnessing Uganda’s prodigy, Steven Kiprotich win a gold medal in Moscow was malingering in my heart when a friend called me from Edmonton. I had anticipated a more animated pre-victory discussion of Kiprotich’s sweet triumph, but in fact we were lured into discussing Makerere University closure.

People who are educated at Makerere University have very strong emotional attachment to this institution. Not that it is the oldest University in the region as such, but as an alma mater and an intellectual repository - an instrument of civilization whose centrality in spurring our economy is incontestable. We agreed that the closure of Makerere University is indeed a shame to the nation’s conscience, and to Africa as a whole.

There are three insights emerging out of this Makerere University closure debate: the attitude attributed to the state operators; the poor grasp of the role of University academic staff and; the centrality of a University like Makerere, in advancing human civilization. I will discuss each separately;

Attitude of the state operators

To fully contextualize the current problem dogging Makerere University, we ought to understand the origins of the problem – pay. Ever since the implementation of the liberalization of the economy in the 90s, Makerere University has increasingly become commercialized,  enabling it to generate revenues from private students schemes and other ventures. Paradoxically, the University has never become financially independent and yet every year, tuition costs, number of students and faculties are increasing. Further, when the University teaching staff decided to go on strike, they did so not in an overnight, but through years of seeking audience with the authorities from the Prof. Tanga Odoi’s era.

The attitude of the state operators towards the MUK Dons is one which has been persistent indifference. This partly because most of the staffs are regime’s apologists so whoever advances critical issues such as "pay increment", is considered anti-establishment. For many years, MUK was expected to infatuate with the regime and to embed the NRM ideology as part of the correct-lines in the curriculae - a practice that was accomplished. Through many political appointments, the University employees and staffs have become complacent to the regime with the hope of following in the footsteps of Prof. Apollo Nsibambi and others.

When President Museveni stated that the striking Professors should go and rear goats, he knew that Makerere University no longer matter in the grand scheme of things at this stage in his political career. MUK is too independent minded and yet there are other Universities which professes the NRM ideology as expected. Ofondo Opondo, the Media Centre director actually contextualized the attitude of his regime towards MUK very succinctly when he said that the closure of Makerere University would not bring down the skies.

Role of Professors

For many years now, Makerere University’s ranking in Africa and in the world has been dismal despite its historical contribution to academia, the economy and to the region. The Academic Ranking of World Universities (ARWU) compiled by Shanghai Jiao Tong University which is now maintained by Shanghai Ranking Consultants, has been ranking world Universities since 2003, making it the earliest ranking system (Wikipedia, 2013). According to this system, the criteria for ranking world Universities are numerous and based on indicators of academic or research performance, including alumni and staff winning Nobel Prizes and Fields Medals, highly cited researchers, papers published in top academic journals such as Nature and Science, papers indexed in major citation indices, and the per capita academic performance of an institution. MUK measures very dismally globally on all these!

There are other Universities ranking systems such as the QS Ranking Systems etc. The point here is that University lecturers are not supposed to be rearing goats or participating in some shoddy business transactions and investing time on schemes as SACCOs to earn a descent living. Those are enterprises for the ordinary people and peasants.  This is a total misunderstanding of the role of Professors and teachers in Uganda. Professors are supposed to profess, or produce knowledge precisely through research undertakings and other innovative ways and to convey the knowledge universally. I need not recite Socrates’ dialectics in the Republic or Aristotle’s teleology to reinforce the issue of specialization here. There is merit in the argument that University teaching jobs should be one of the most lucrative in terms of remunerations and the agitation for 100% pay rise is appropriate. This extends to all teachers and civil servants; they should not be impoverished and under paid or distracted with callous schemes like SACCOS for offering their services to the nation!

MUK as vehicle for civilization

There are fundamental contradictions in our public realms in regards to the product of Makerere University. I regret that it was not possible for me to illustrate statistically the academic achievements of Makerere University in the last five years alone in regards to publication in major journals, inventions, works cited, conference presentations, alumni field awards and recognition, and list of alumni contributing to global civilization. However, it is a general perspective that Makerere University graduates have been declining in quality, thus the increasing mediocrity in our society. They still take university education as qualification for job, not an empowering experience; most of them lack in innovation and therefore participate less in the economy in trades and commerce in the manner the uneducated are doing; they are not in research nor are inspiring innovation anywhere. Where are they? Most of them are job searching with NGOs that they have not created; some are outright jobless and drunkards in villages, while majority have fled the country. How do we explain these?

The answer to these paradoxes are embedded in this strike and the closure of the university. University teaching staff must be accorded the maximum environment to concentrate without any hindrances to the furtherance of the intellect of the students who enroll at Universities. Because of the lack of concentration, professors have been indulging in exchanging marks for sex, extortion, spending little time on students’ supervision for small extra businesses in Kikuubo or up-country and; splitting time between teaching and other consulting jobs. These must stop!

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The Public Order Management Bill is deterrent to Democracy

Unjust Laws

For many months, we waited for the Public Order Management Bill (POMB) to be passed into law. Considering the numerical strength of the NRM MPs, this event was long overdue. When Hon. Oulanya bulldozed the parliament to vote on it, many of us who have come to understand the inherent flaws within the NRM regime never dropped a jaw. Every sane Ugandan, including Hon. Oulanya himself knows that this POMB is a major deterrent to democracy. The passing of this bill illustrates that Uganda is no longer a democracy, rather, a country slipping into another painful episode of its political life.

There is a big problem with our leaders. The NRM people claimed that they have ushered in democracy and peace. But here, the Public Order Management Bill is yet another draconian law which strives to stifle the very democracy. It is a bill passed in total neglect of the Muwanga Kivumbi vs Attorney General of Uganda; it is a total violation of all human rights provisions – the right to associate, to assemble, to free speech and that of individual liberties – all, as enshrined in chapter 4 of the 1995 Constitution and international human rights charter.

POMB is intended to usurp the provision of Chapter 4(23)(6)a, b and c of the 1995 Constitution which enumerate bail eligibility among others. However, a look at POMB clauses six through eight attest to the point that the bill is insensitive to the rule of law. The basics of the Muwanga Kivumbi vs Attorney general were the recognition of the limitation of the powers of the police especially from interfering with civil liberties. This bill trashes that ruling and reinstates enormous powers for the dispensation of the militarized and politicized Police to trample upon rights of Ugandans.

But the real purpose of this bill is to limit dissent and yet it does not create alternative and credible options for the masses to get engaged politically. The culture of dialogue is alien to the country. Every group of people or individual now realizes that civil processes have been replaced by strikes and demonstrations. This is not because Ugandans do not want to negotiate and seek mediation through existing institutions for amicable resolution of their issues. It is precisely because of patronage of the state – and more so, unequal distribution of resources to the crooked political elite.

The ease with which President Museveni can release billions of shillings to bribe MPs to pass for him a repressive bill reveals how the President has become egocentric. But when it comes to teacher’s salary, the money can never be found. One would never see or hear that an MP, Minister or Statehouse employees have gone home without a salary for a month or missed an allowance in that case.

The passing of the POMB has hurt many people and has truly dented the public image of these MPs. Some of these people may think that they are in power forever and therefore, they are untouchable. One can only predict that one day; these very laws will turn to bite them. But most importantly, Ugandans are continuously getting disengaged from the political realms for the very same reason, that politics has become the dumping ground for mediocrity.

Reading the tempo on social media, one can gauge that many Ugandans are persistently aggrieved by the conduct of the MPs. They have truly denigrated the legislative branch of government by being complacent to self interests. What they are doing, is to place Uganda in the same path as Zimbabwe!

Which Ugandan would like to be denied bail if I may ask you? We all know how trivial the police have become in regards to manufacturing political crimes and preventive arrests. This bill is precisely intended to narrow down political participation by restricting human movement; intellectual development and to greater extent, inculcating a sense of fear among the population in light of being critical to the establishment.

When Martin Luther King said that the hottest places in hell are reserved for people who, when in moral crisis, tend to keep their neutrality, he was not far off sending a warning shot to the elites of Uganda. But Malcolm X minced no words when he observed that “the moment someone lays a hand on you unjustly, make sure that he never gets the chance to touch another person”. This was a clarion call for us all to indulge in personal reflection to prepare for the brutality with which the police will implement this law.

As we come to 2016, the opposition groups must know clearly that the POMB has severe implications for them and their grassroot mobilizers. It is possible that during elections any candidate from the ruling party can revoke clauses of this law against organized opposition activities for agents of the opposition to get arrested and detained without bail thereby crippling opposition elections machinery.

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Recommend Mandatory HIV testing for Couples

HIV - PMTCT

The proposed HIV Prevention and Control Bill is before the public for consultation. One of the contentious issues in it is the mandatory HIV testing for pregnant women during uptake of ante-natal care (NV July 18th). This proposal has generated genuine concerns over ethical principles, notably; autonomy, confidentiality and informed choices. The civil society organizations have picked on these issues well. Our moral sense must be governed by categorical imperative not to harm the unborn fetus and the mother.

 The civil society organizations also highlighted several social-cultural imperatives that places the woman at a heighten risk of vices such as domestic violence, stigma, victimization, alienation from marital home and property; and getting punished unjustly physically and emotionally by the social system that views women as sole gateway to HIV infection.

Arguably, there is a moral to the perspectives of the civil society organizations, but there is also an imperative on the side of government to take bold measures to curb down the rising trends of HIV infections. No doubt, installation of mandatory testing requirements creates many barriers to using healthcare services; it is unethical and violates many international standards. But this is also the ethical dilemma that a need for such drastic measure may generate.

The underlying reason for the provision of mandatory testing during interface with the healthcare system is because Uganda has enrolled in the WHO option A of the Prevention of mother to child transmission of HIV. This option requires the measure of CD4 before a mother or anyone as such, can get enrolled for the Anti-Retroviral Treatment (ARTs).

Recognizably, there is pressure on most sub-Sahara Africa to put in place frameworks to reduce the transmission of HIV from mother to Child. Significant results have been recorded already in this area in Malawi and Botswana where there is an increased uptake of HIV testing by over 93% of pregnant women. Malawi now boost of 3% reduction of mother -to-child HIV infection through its bold implementation of WHO recommended ART B/B+ option treatments, despite having this measure in only limited number of districts.

HIV testing is a tough personal and intrusive process that plays out on the human emotions and generates fear. Laws requiring mandatory HIV testing become insensitive to the autonomous nature of humankind. It deprives one of pre-testing services and violates the principles of confidentiality.

Best practices world-over is such that everyone is accorded a just environment to make informed decision during such moments of vulnerability. Therefore this debate is indeed an ethical one which must be handled rationally and with an ethical decision making framework for its a buy-in and sustainability.

There is merit for every pregnant woman to know her health status and this includes her HIV status. This merit extends beyond the pregnant woman but to the general populace. When the pregnant woman comes to know her HIV status, she begins ante-retrovirus treatment (ART) early with a possibility of experiencing less stressful pregnancy. This also benefits the mother-child dyad by enhancing the prevention of transmission of the virus from mother to child.  

To add value to the proposed Bill, a national consensus has to be built around early detection of HIV and sexually transmitted diseases to reduce the rampant maternal-child mortality that has haunted our society. A regular, at least thrice a year complete medical examination including HIV status must be encouraged for a population that exists in precarious moral situations like it is in Uganda.

The Bill’s focus on HIV prevention must be rooted in social cultural realities that focuses on four players; the unborn fetus, the mother, the father and the community from which the couple belong.

The intricate complexities involving these players, ensures that HIV prevention is not merely a medical issue, but a social one as such. To provide effective HIV testing and prevention services, there is need to move the services to the communities because it is within these communities that issues of stigma and victimization takes place.

Further, reports show that men tend to resist HIV screening, as a result, statistics show disproportional numbers of women to men, as living with HIV and yet it is more likely that a man uses multiple partners than a woman. There must be HIV family centre testing requirements that compels every couple to pre-test counseling and HIV testing irrespective of pregnancy. This approach may lessen the blame burden on the woman and provides her with the confidence to enjoy her reproductive rights without fear.

Case studies

Lessons from Malawi, Ghana, Kenya, Tanzania, Rwanda and Botswana can attest to these. In Malawi the controversy over mandatory testing was resolved by creating an alternative pathway service delivery in their PMTCT national guidelines. Each pathway is provided with pre-test counseling services for individual and family to attend clinics with their sexual partners. A pregnant mother is offered counseling before testing, if they consented to testing and found to have positive HIV results; they were put on WHO option B+ ART therapy and provided support by trained community agents through the pregnancy. The mother remained on ART for life.  

The Option B+ does not require CD4 count like it is for Option A that Kenya, Uganda, Tanzania and South Africa are adopting, and it is cheaper to administer. In the second pathway option, pre-counseling was provided to the pregnant women and family irrespective of level of literacy. If she or her family declines, she is processed through the system and provided counseling at every point of contact with the healthcare system while being reminded that they can decline to HIV tests. These services extend to the community.

According to UNICEF and UNAIDS 2013 reports, Malawi’s approach initially reduced the uptake of antenatal services, but after a short period, a surge was registered because of the benefits that some of these communities started seeing – that children are being born without HIV while the mothers on ART remained healthy to nurse and nurture their children. Over 90% of women are using HIV testing services and are getting enrolled and the Maternal-Child transmission has reduced to <5% in both Malawi and Botswana.

While there is a focus on ensuring that pregnant mother's get the treatment that they need, and that HIV transmission to the child is prevented, the law must propose a comprehensive family oriented approach. To ensure that women do not become victims of HIV testing, the law must encourage couples to undergo tests during visits to ante-natal clinics following counseling.

In places like Canada, once found to have any sexually transmitted disease, one is required to disclose recent sexual partners for follow-up by public health. This is largely because it is against the law to knowingly infect another person and is punishable by jail if found to have been negligent.

Uganda may not be bold enough to enact such a law, but under the current situations, there must be an integrated approach to HIV care which combines a number of fronts and yet very rational and ethical in all its vestiges.

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Ticker: Exploring Critical Issues on HIV/AIDS Fight in Uganda

HIV/AIDS

The cloud of gloom has yet transcended upon Uganda as global experts fear that the country is losing its gains in the fight against HIV/AIDS. Over the years, experts like Festus Mogae and Stephen Lewis have shown pessimism that Ugandans have become complicit to the advent of anti-retroviral medication that provides hope for a prolonged onset of AIDS. Further, the political will that previously elevation and sustained a high profile of HIV/AIDS among the population has been usurped by corruption and ideological disunity that threatens human rights.

This article intends to bring a critical perspective in the HIV/AIDS discourses and it intends to point out the critical gaps where current health service orientations have been unable to cover. There are fundamentally three areas that requires urgent attention if Uganda is to gain its stead to return to its glory path of curbing HIV. These areas are an investment in an integrated behavioural change approaches; adhering to strict and accurate data collection and management and; expanding existing healthcare systems to care for communities, rather than individuals.

Behaviour change

The Daily Monitor newspaper on May 18^th, 2013 quoted Mr. Musa Bungudu, UNAIDS country coordinator as casting fear on the rising prevalence rate of HIV in Uganda.  New cases of HIV infection show an increasing trend, from 124,000 in 2009 to 145,000 by 2011. On the average 353 Ugandans are infected daily and over 60,000 Ugandans die annually from HIV/Aids related ailments. Prevalence rates continue to vary from place to place, peaking at fish landing sites, conflict studded areas and urban centers. These are not small numbers, but they also don’t tell the entire truth due to many factors, but mostly that many Ugandans are still not testing their status.

Further, complacency to anti-retroviral medication treatment, sustained beliefs in mysticism and witchcraft as well as partaking in risky sexual expeditions are key domains of Uganda’s regular lifestyles. And yet it is empirically known fact that the most common route of HIV infection is through the sexual route and blood transfusion. Somehow, irrespective of unintended accidents, HIV can majorly gain entrance in the human body through the body fluid – blood.

In the early 90s, it was excusable for anyone to conduct themselves dangerously as to have unprotected sex with an excuse that they didn't know how to access and use condoms. Many did not have explicit access to HIV screening or testing services. These arguments should be stale in the current epoch because condoms have been with us for the last 30 years and with the advances in media coverage and telecommunication system in Uganda, not using condoms or testing for HIV and other preventable diseases is no longer justifiable.

Therefore, a behaviour change effort must be made through a combination of policies and a deliberate reflexivity from cultural standpoints if we are to tackle the HIV scourge.

Further, Ugandan society is still largely patriarchal along its social and cultural landscapes. What this means is that age and gender remains major factors of subordination. Males are still repressive of the females and older individuals are still suppressive of the younger ones. In essence, women and young people – both boys and girls- continue to internalize their position in society as that of being submissive to the older and more so when they are men, making them easy prey. This fact also corresponds to high prevalence rates among this group (15-19 at 7.3% and women at 8.3%). Further, the people on retroviral treatment appear to be healthy and yet, their health also becomes the resource for their silence that leads to the spread of the virus – most especially when they are “loaded” or acting as sugar-mommies.

Research have found that it is the men who are more reluctant to seek HIV testing and even when they know that they are infected, they still blame it on their sexual victims who happen to be women or younger individuals than them.

This brings me to the issue of HIV prevalence and incident rates. These are epidemiological terms meaning “new” and “existing” cases of HIV among a population of 1000 people. In Uganda, the estimated national prevalence rate is about 7% and the total estimated number of people considered to be HIV carriers are 2.2 millions as of 2012.

These figures are contestable irrespective of whether they are World Health Organization's estimates or from Ministry of Health in Uganda. My contentions are as follows; most of Ugandans who seek HIV screening are Urbanites and often they chance on the results upon seeking treatment for other symptoms.

 In as long as Ugandans are asymptomatic, they would endure all sorts of silent killer diseases, like hypertension, diabetes and HIV infection, without seeking care. It is during this time that they will also distribute the virus indiscriminately. Therefore, most HIV statistics are taken at focal points when it is too late and yet it is very difficult to draw inferences for deaths outside the hospital where rural autopsy would consign it as witchcraft, poisoning or suicide. Therefore, a conservative estimate would say that the national prevalence rate is about 13% and the total number of incidences of HIV at about 5 million people!

Healthcare system’s deficit

Further, the failures of our healthcare system to succinctly capture, record and follow children who are born with the virus adds weight to the numbers dilemma. In the early 90s when Rakai was symbolic of the HIV/AIDS debacle, we were shown so many orphans whose parents had died due to HIV/AIDS. Most of these children were born with the infection. Today, they have become of age and some of them are pretty humbled by their modest upbringing under churches and orphanages. Many of them are virgins while a host o f them are the ones jumping helter skelter on the street with mind blowing minis and stilettos.

Unfortunately, the state cannot account for these and yet they are occasionally adding to the increasing number of HIV prevalence in Uganda.

The fight against HIV/AIDS is failing, not because of a single factor, but a multiplicity. This also means that the solution to the HIV problem should be an integrated approach that focuses on behavioural change at all levels of society. Ugandans must become bold to reclaim their moral aptitude and begin to conduct themselves with some sense of purpose beyond hedonism.

The Uganda of today is as tense as and worse off than Biblical Soddom and Gomorrah with promiscuity. Literally every married couple is a cheat and every person in authority is corrupt. In essence, Uganda is a country where both the cat and the mouse fight to swallow each other, such that each has become fearful of the other. The elders who should reinforce morals are themselves so devoid of such authority and yet the young people, in whose hands our futures should behold, are running amok with a life so precariously!

Integrated systems

Finally, the healthcare system requires restructuring to ensure that it is expanded outwardly to treat the community more than the individual. A combination of community based medical model which integrates social behavioural and biomedical sciences can help mediate between individuals and their precarious cultures. This model offers a formidable fruitful venture in healthcare investment, at public and private sector levels. This will also imply that we stop treating symptoms, but we treat the disease, the people and community all at once and it comes at a lower cost to the public purse.

END