The first HIV/AIDS case was identified in Uganda in 1982 along the shores of Lake Victoria . Superstitions and witchcraft characterized the initial response from communities amidst lack of clear government response to HIV/AIDS. Consequently, the epidemic progressed very fast to a national prevalence of 18.3% with some centers registering prevalence above 30% by the end of 1992. Spontaneous community responses and inevitable response from the health care facilities were reinforced in 1986 when the new National Resistance Movement (NRM) government established the first AIDS Control Program in the Ministry of Health.
As early as 1987, The Government of Uganda recognized that the magnitude and impact of the HIV/AIDS epidemic cut across all sectors of life. The Multi-sectoral Approach to the Control of AIDS (MACA) was developed and adopted in 1992 to ensure a concerted response. This policy and strategy called for the involvement of everyone, individually or collectively to fight the epidemic within their mandates and capacities at all levels.
The Uganda AIDS Commission (UAC) was established, by Statute of Parliament, in 1992 under the Office of the President, to ensure a focused and harmonized response. Uganda's response to the epidemic, spearheaded by H.E. President Museveni, has been marked with high political commitment at various levels, openness about HIV/AIDS that enhanced behavior change communication interventions, unprecedented support from international development partners, and action from sectors of government and civil society.
Uganda was among the first hard hit countries. The Ministry of Health Surveillance Unit estimates that there are 1,055,555 people living with HIV/AIDS by the end of December 2001, and over 940,000 HIV/AIDS related deaths have occurred since the onset of the epidemic in the country. At the end of 2002, the national HIV prevalence was estimated at an average of 6.2% of the total Uganda population, following a history of declining national prevalence average of 18% with about 30% in the worst hit areas of the country in the early 1990s. The Ministry of Health estimated new infections in 2002 alone at 70,170 cases, new AIDS cases at 73,830 and deaths at 75,290. These figures could however be an underestimate, due to constraints in AIDS reporting from the sentinel surveillance system.
Uganda is one of nine hardest hit African countries projected to loose agricultural workers. According to data from www.fao.org/FOCus/E/aids/aids6-e.htm AIDS is becoming a greater threat in rural areas than in cities of the developing world. Growing links between rural and urban areas through trade, migration and improved transportation networks have made HIV prevalence rates rise faster in rural areas.
AIDS is mostly a rural issue.
- More than two thirds of the population of the 25 most-affected African countries live in rural areas and Uganda is one of the twenty-five.
- Information and health services are less available in rural areas than in cities. Rural people are therefore less likely to know how to protect themselves from HIV and, if they fall ill, less likely to get care.
- The costs of HIV/AIDS are largely borne by rural communities as HIV-infected urban dwellers of rural origin often return to their communities when they fall ill.
- HIV/AIDS disproportionately affects economic sectors such as agriculture, transportation, and mining that have large numbers of mobile or migratory workers.
AIDS undermines agriculture because of its toll on the labor force.
AIDS has killed around 7 million agricultural workers since 1985 in the 25 hardest hit countries in Africa . It could kill 16 million more before 2020.
More than a third of the gross national product of the most-affected countries comes from agriculture.
In contrast to other diseases, AIDS mostly devastates the productive age group – people between 15 and 50 years.
Up to 25 percent of the agricultural labor force could be lost in countries of sub-Saharan Africa by 2020.
AIDS reduces productivity as people become ill and die and others spend time caring for the sick, mourning and attending funerals. The result is sever labor shortage for both farm and domestic work.
Labor-intensive farming systems with low level of mechanization and agricultural input are particularly vulnerable to AIDS.
AIDS affects women disproportionately.
- Women whose husbands are migrant workers are especially vulnerable to AIDS, as their spouses may have other sexual partners. The women themselves may engage in commercial sex in periods of economic stress.
- Some of the traditional mechanisms to ensure widow's access to land contribute to the spread of AIDS—for example, levirate, the custom that obliges a man to marry his brother's widow. Unfortunately, initiatives to stop these practices may leave widows without access to land and food.
- Biological and social factors make women more vulnerable to AIDS, especially in adolescence and youth. In many places HIV infection has been found to be three to five times higher in young women than in young men.
- In several countries, studies have found that rural women whose husbands have died of AIDS were forced to engage in commercial sex to survive because they have no legal rights to their husband's property.
- Women and girls also face the greatest burden of work—given their traditional responsibilities for growing much of the food and caring for the sick and dying. In many hard-hit communities, girls are being withdrawn from school to help lighten the family load.
The impact of AIDS on farming communities differs from village to village and country to country. But it is clear that the epidemic is undermining the progress made in the last 40 years of agricultural and rural development. This poses enormous challenges to governments, non-governmental organizations and the international community. The disease is no longer just a health problem—it has become a major development issues.