Aid workers and foreign activists say Uganda is moving away from the highly successful "ABC" formula that won the country international recognition as Africa's leader in the fight against AIDS.

The pioneering formula -- which stands for "abstain, be faithful or use a condom" -- helped the government reduce the infection rate in Uganda from 18 percent to 6 percent in a decade.

But the infection rate remained at 6 percent in recent years and rose to 7 percent in the most recent Health Ministry survey. Critics say this is because the government -- influenced by evangelical Christians -- has de-emphasized condom use, focusing exclusively on abstinence and marital fidelity.

In fact, even the "6%" figure itself has been subject to debate. The setback was also addressed by The Guardian:

New billboards have appeared in Uganda, signed by the office of the first lady and bearing the logo of USAid - the US development agency. One has a picture of a glamourous, smiling young woman, saying "She's saving herself for marriage - how about you?"

A local condom brand, Engabu, was erroneously declared to be of poor quality and recalled, creating a condom shortage. A subsequent letter to the newspaper added graphic details:

The lack of condoms in Uganda has led people to desperate measures, including the use of plastic bags...

Political and religious ideologies driven from Washington and the Vatican are having an immense impact. Over 50% of all US HIV/Aids funding to Uganda is currently being spent on abstinence programmes. Many Ugandans are Catholics, and the antipathy of the church towards condom use creates huge tensions. To limit access to condoms is to condemn many people to the dangers of HIV; to focus on abstinence is to ignore the limited scope many women have to refuse sex. Such refusal can often lead to sexual coercion and violence, including rape. And now, even if a Ugandan woman can negotiate safe sex, it is increasingly unlikely that she and her partner will be able to get hold of condoms.

Janet Gruber
Cambridge

These newspaper reports echo studies from Human Rights Watch and the Alan Guttmacher Institute.

True Love Waits is not the only American abstinence organisation working in Africa; among others, there is also Sub-Saharan Africa Family Enrichment (SAFE), which has campaigned in Malawi under the slogan, "Why Wait?" SAFE is run by Professor Dick Day, and Museveni has again been involved. ASSIST Ministries profiled Day in August 2005:

Day happened to be in Malawi on a one-year teaching sabbatical in 1990 when he and his wife Charlotte observed the magnitude of the African crisis firsthand. Horrified, they knew the "Why Wait" message was desperately needed there and decided to remain in Malawi to address the problem.

Word about their Christian-based approach stressing abstinence and faithfulness spread to leaders in surrounding countries. President and Mrs. Museveni of Uganda had particularly receptive ears for the message. Museveni already was bucking the prevailing tide of world opinion by refusing to embrace condoms as the solution to his country's woes. "I don't support the idea of condoms myself," he told the VII International AIDS Conference in 1991.

...In 1992, Mrs. Museveni of Uganda invited Day to be the principal speaker at a newly organized youth forum in Kampala. His "Why Wait" message seemed to resonate. "The response from the parents and youth was so positive we did a national one the following year," Day says. The Uganda Youth Forum became a national event attended by thousands of young people each year.

Day explains his approach further in another document:

"WHY WAIT? Africa" was initially presented in 1992 at the first annual week-long Uganda Youth Conference, hosted by First Lady Janet Museveni. In 1993, the Malawi Ministry of Education requested Sub-Saharan Africa Family Enrichment (SAFE) to develop an African-oriented curriculum addressing sexual abstinence, life skills and character development that could be used in schools to help address the HIV/AIDS pandemic. The first draft of the WHY WAIT?/Family Enrichment curriculum was drafted by University of Malawi Professor Moira Chimombo. In 1994, the first teacher training and training of trainers (TOTs) workshops were conducted. The WHY WAIT? programme was launched nationally at a convocation of 3,000 students and 500 teachers hosted by State President Bakili Muluzi at Sanjika Palace in 1995.

Meanwhile, a report from Rob and Patricia Williams describes the involvement of Campus Crusade for Christ in what appears to be a complementary program (link added):

In the country of Malawi in Africa in the late 1980's, Dick Day and Josh McDowell (authors of "Why Wait") were touring and ministering on the topic of abstinence while presenting the Gospel. The Minister of Education in Malawi approached Dick Day and asked if curriculum could be created based on this message to be taught in the schools. Campus Crusade responded and the ministry CrossRoads was born.

CrossRoads exists to equip national leaders to connect with their target audiences to share the gospel through this AIDS-based curriculum. But its uniqueness is that it involves parent-student involvement, peer involvement, school-community outreach, and teacher-student connection.

CrossRoads exists to equip national leaders to connect with their target audiences to share the gospel through this AIDS-based curriculum. But its uniqueness is that it involves parent-student involvement, peer involvement, school-community outreach, and teacher-student connection.

Day also (not surprisingly, given his association with creationist Josh McDowell) appears to link his anti-AIDS campaign to anti-evolutionism. Back to ASSIST:

"Your world view determines your values, which determines your behavior," Day notes. "We're engaged in ideological warfare," he says. "Are we evolving animals? Or is there a God-given dignity that can be expressed in our sexuality?"

The implementation of Day's educational curriculum in these countries faces some obstacles. "IF we can keep kids in school we have 10 years to build a biblical world view," he says.