US Envoy, Janet Bolster Fight Against HIV in Karamoja


tadalafil geneva; font-size: small; line-height: 200%;”>Good afternoon.

I am honored to be here today in Karamoja as one of Uganda’s committed partners in the Option B+ campaign for the elimination of mother-to-child transmission of HIV. Together, we have already changed the lives of thousands of mothers, the children they will bear, and the fathers, and family members who love them.

We are striking another blow against the scourge of HIV, reducing the rate of new infections and moving another step closer to an AIDS-free generation. However, there is still much to do, and many have yet to receive care. To that end, we now are launching Option B+ in Karamoja, a beautiful region inhabited by a proud, courageous people.

At the outset, I would like to extend my sincere appreciation to First Lady and Minister of Karamoja Affairs, Mrs. Janet Museveni. Your strong and determined leadership as the Champion of Elimination of Mother-to-Child-Transmission in Uganda is inspiring to us all.

Thanks to your unrelenting efforts, as well as the hard work and dedication of the Ministry of Health, many children in Karamoja who might have been born infected with HIV are living healthy, HIV-free lives. I sincerely believe, Madame First Lady, that with programs in place such as Option B+, we will eliminate mother-to-child transmission of HIV, and you will see your dream of an AIDS-free generation become a reality.

And I want all here today to know that the Government of the United States shares that dream. President Obama has been clear about his commitment to see the virtual elimination of mother-to-child transmission of HIV by 2015. This ambitious, but achievable objective is fully within our grasp, if we work together in partnership.

The Option B+ program is critical to achieving this goal, because, quite simply, it works. The healthy children among us today, born of HIV positive mothers, are all the proof we need. Literally millions of children all over the world are alive today thanks to this critical intervention.

HIV has threatened the fabric of Ugandan society since Slim Disease, as it was first called, began to take the lives of people here in 1982. Many can remember how it threatened to destroy the nation, with one out of every five Ugandans condemned to die from a disease for which there was, and still is, no cure.

And you will remember that the President, Mama Janet, and other senior leaders were the ones to raise their voices insisting that behaviors had to change to save the nation. And they were successful.

Sadly, HIV continues to threaten the lives of many, and there is still no cure. Karamoja is no exception. The most recent AIDS Indicator Survey from 2011 shows that HIV prevalence in the Karamoja region stands at 5.3 percent – nearly double what was in 2006.

Though HIV affects everyone, it hits some especially hard. For example, we know that HIV is the leading cause of death among women of reproductive age. We also know that roughly one third of children born with HIV will die by their first birthday, and 50 percent by the age of two – without access to necessary care. And even more troubling is the fact that in Karamoja, the mortality rate for children under five from all causes including HIV is more than twice that of Kampala and the highest in the country.

These are unacceptable statistics by any measure, but even more so when we have the knowledge and the resources to reverse them. Thirteen years ago, Uganda was the first sub-Saharan country to demonstrate that the use of anti-retrovirals was effective in the prevention of mother-to-child transmission. Science tells us that there is no reason why a child born to an HIV-positive woman should acquire HIV. But while science can tell us what must be done, it is up to us to actually do it.

The question is, are we committed to ensuring that half of the babies born HIV positive will not die before they see their second birthday? Are we determined to ensure that this stops now…that next year and the year after that and the year after that, we will not see this sad cycle continue here in Karamoja or anywhere in the country?

Your leaders are determined to change the picture. Mama Janet, the President, the Minister of Health, and our many outstanding colleagues from the Ministry of Health are determined. I am determined. But we need every person here today to share this commitment. Each of you has a part to play. The AIDS free generation starts with you.

Together we need to improve the manpower gap in health centers and improve access to health services and health education. According to the most recent AIDS indicator survey, knowledge on HIV prevention in Karamoja is very low when compared to the rest of the country, and we need to continue to educate both men and women in Karamoja to truly grasp that HIV can be prevented.

We need to devote our resources and use modern technology to ensure all women of reproductive age have access to the health services they need, including HIV testing and counseling, and family planning services. In Karamoja less than five percent of women use family planning services.

That is the lowest in the country and it must change. This region also registers the lowest proportion of women in all of Uganda who are willing to make their desire for safer sexual relations known to their partners.

They are less likely than any other women in the country to insist their partner use a condom, and the men of this region are much less likely to agree to a woman’s desire to use a condom than those living in other regions. Why? Why would anyone endanger another person’s life by exposing them to the HIV virus?

To the HIV positive women and men who are with us today, you must understand that through your actions and choices you will decide whether your child will have the chance to be born without the burden of HIV. What will you choose?

Mothers can make a difference simply by having an HIV test early during pregnancy to learn whether they need anti-retroviral drugs. And if you need them, you must take them faithfully to protect yourself and your baby.

Men of Karamoja, show the courage the Karamojong are so famous for. Be strong enough to protect your partners by using condoms. Get tested with your wife or your partner. If your wife or partner becomes pregnant, encourage her to seek regular antenatal care from a skilled health care worker and support her in taking her anti-retroviral drugs regularly and as prescribed.

Option B+ will ensure a healthy future for all of Uganda’s children, make the nation stronger and more prosperous, and bring us closer to our dream of an entire generation born HIV free. But we need to work together.

I call on all the elders, cultural, political and religious leaders to join hands with our health care workers to ensure that practices that promoting safe sexual behaviors and reducing the risk of HIV transmission are respected.

Rally behind the First Lady’s efforts to expand EMTCT! We have the necessary tools and knowledge and, if we act now, over 90 percent of pediatric HIV infections can be averted annually. Imagine the impact that this would have in terms of healthy families and communities, educated societies, productivity, and most importantly, the children of this country.

The United States, through the President’s Emergency Program for AIDS Relief, or PEPFAR, is committed to improving the health of men, women and children in Uganda. This financial year alone, the United States has invested $40 million towards the acceleration of EMTCT services in Uganda and over $340 million in total to the fight against HIV. We will continue this partnership until NO child in Uganda is at risk.

I would add, however, that as we expand the number of women and men on treatment, costs increase as well. We cannot let this deter us from providing life-saving treatment, but we must find a way to address the programming, funding, and operational challenges of expanding treatment regimens.

I urge the government of Uganda to explore options, such as the HIV/AIDS levy that Parliament is exploring, to ensure adequate resources to meet the challenges of fighting this disease.


However, no matter how much the government improves systems and offers better medical support, ultimately every man and woman in this country must recognize that you too have a responsibility to yourself, to each other, and to your nation.

The ABCs, are not just a slogan. They must be part of your way of life. Responsible sexual behavior is essential to protecting yourself and those that you love. Too many young people seem to think that the threat of AIDS has diminished because now there are drugs. You’re wrong. AIDS is not a cold. It is not influenza. It does not get treated and go away.

Make no mistake –drugs will not cure you. They will keep you alive but your life will be harder, filled with greater challenges, and likely shorter than the lives of those who live life HIV-free. You must recognize that you will live with HIV for the rest of your life, you will have to take drugs for the rest of your life, and you will regret the choices that led to your infection for the rest of your life as well.

ABC. Abstinence, being faithful, and condom use if you insist on engaging in risky behaviors. These, coupled with circumcision, Option B+, and early and effective treatment for those who contract HIV, can make the difference for the nation.

We are making great strides. This year, for the first time, there will be more people put on treatment in Uganda than there will be new infections. This means that those on treatment, and who stay on their treatment, ultimately reduce the level of the virus in their body to the point where they cannot transmit it to others. This is critical.

And more men are being circumcised than ever before. Although this does not make them immune to HIV, it reduces their risk of contracting the disease tremendously.

The EMTCT campaign marks a new wave of energy and momentum, led by Mama Janet. We must use all the lessons we have learned thus far to move forward. With the government’s leadership and in a true spirit of partnership we can reach our ultimate goal of a healthy, prosperous, peaceful and productive Uganda. And Karamoja must play its part.

Karamoja is considered by many a “hard to stay” and “hard to reach” place and so with even more reason I applaud the health workers who have the compassion to commit themselves to working in this under-served region. I urge the Government of Uganda to do everything it can to ensure that these front-line workers are motivated to remain serving the people of Karamoja.

And to the people of Karamoja, we are inspired by the warrior spirit and courage for which you are so rightly famous. Show us that courage as we fight this disease together. Show us that you have the determination to see this through to the end. An AIDS free generation starts with you. It starts with your partner. It starts with all of us. Let’s do it together, for God and your country.

Thank you.


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