4. Cost–Effective Strategies for the Excess Burden of Disease in Developing Countries

Like many countries in Sub-Saharan Africa, Uganda experienced a rapid increase in HIV incidence and a generalization of the epidemic in the late 1980s and early 1990s. By 1991, overall HIV prevalence was 21 percent (Low-Beer and Stoneburner 2003); however, the trajectory of Uganda's epidemic has differed markedly from that of its neighbors. By 2001, overall HIV prevalence had fallen to 5 percent, with dramatic decreases in incidence among key populations, such as soldiers, pregnant women, and young women (USAID 2002). Critical components of Uganda's HIV prevention program include the following:

• strong political support, especially from President Yoweri Museveni

• interventions to empower women and girls

• a strong focus on youths

• active efforts to fight stigma and discrimination

• emphasis on open communication about HIV/AIDS

• engagement of the religious leadership and faith-based organizations

• creation of Africa's first confidential VCT interventions

• emphasis on STI control and prevention.

Source: DCP2, chapter 18, box 18.5.