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  • Print publication year: 2017
  • Online publication date: October 2019

13 - Recovery?


METAPHORICALLY, 1995 WAS THE YEAR WHEN THE RAINS CAME. HOPES of containing the AIDS epidemic emerged. Economic growth returned. External debt and levels of poverty began to decline. New methods of combating disease and impoverishment were pioneered. Not all was hopeful, however. The sustainability of economic recovery was uncertain. Youthful anomie still festered. Civil wars continued. Competition for land and local power escalated. Islam was in turmoil. The peak of demographic transition was past but its future course remained uncertain. Yet the entire continent was now free, hope had returned, and independent Africa had its second chance.


Hope of checking the spread of HIV came from the most unlikely source, heavily infected southern Uganda, where reports in 1995 suggested that prevalence among pregnant women in Kampala had fallen between 1989 and 1993 from 28 to 16 per cent.1 The reports met scepticism. Some thought the figures unreliable or politically distorted. Specialists suggested that the epidemic might be slowing because the virus had killed most highrisk people, because it was losing its pristine virulence, or because mortality had increased to overtake new infections. Optimists replied that reduction in prevalence had been greatest among people aged 15–19. Whether new infections had really fallen – the crucial indication of a declining epidemic – required elaborate research. One team triumphantly confirmed it in 2002; another denied it in 2005. By then, however, evidence was accumulating that young Ugandans were changing their sexual behaviour in response to the suffering around them and intensive propaganda urging them to ‘Abstain, Be faithful, or use Condoms’. Researchers claimed that between 1989 and 2001 the average age of sexual debut had risen from 14 to 16 years, that in 2000–1 some 78 per cent of youths aged 15–19 denied having had sex during the previous twelve months, and that between 1989 and 1995 the proportion of men and women admitting casual sex had fallen by more than 60 per cent. All their findings were contested. Uganda's policies weakened early in the new century, behavioural change faltered, and overall adult HIV prevalence stabilised at between 5 and 8 per cent.