Quotes of the Day

Ugandans learned their ABCs before other Africans. That's ABC as in Abstinence, Being faithful and using a Condom. The east African nation was at the center of the aids pandemic when it began in the 1980s — and was the first African country to fight the disease seriously. The ABC approach has helped cut the hiv rate in adults from more than 15% in 1990 to just under 7% today.

Has the Ugandan government now forgotten its alphabet? A group of Ugandan and Western organizations and a senior U.N. aids expert claim that Uganda has over the last year allowed a condom shortage while promoting a message of abstinence based on religious dogma. "It's been a deliberate government policy to shift the emphasis from ABC to AB," Stephen Lewis, the U.N. Secretary-General's special envoy for hiv/aids in Africa, said last month. Ugandan aids campaigner Beatrice Were agrees: "There is a new wave of stigma … attached to the use of condoms. Those of us who promote condoms are looked at as immoral people."

The Ugandan government says that's nonsense. The Ministry of Health asserts the condom shortage resulted from the discovery last year of a bad batch of Engabu condoms from China; it's the brand the government gives away and accounts for around two-thirds of the 120 million used in the country each year. The recall last October means that since then, just under 30 million condoms, one-quarter the usual number, have been distributed for free. But the government says that some 150 million replacements are on their way, and also promises a new public education campaign stressing A, B and C.

Some activists remain unconvinced. Were and her colleagues point out that abstinence billboards now dot Uganda's capital Kampala where condom posters used to be. Uganda's First Lady Janet Museveni, a high-profile member of one of the country's fast-growing evangelical churches, has been spreading a message of abstinence and even advocates a "virginity census," though she's short on details about how to conduct it. President Yoweri Museveni last year attacked the widespread use of condoms in a speech to the U.N. aids Conference in Bangkok. With such powerful people on one side, Were thinks the official policy of a balanced approach is getting drowned out: "Evangelical churches are enjoying the crisis we are going through and taking advantage of it to promote abstinence-only programs," she says.

Some also link the shift in Kampala to the Bush Administration's President's Emergency Plan for aids Relief (pepfar), which, critics say, has shifted the emphasis toward abstinence only. "There is no question in my mind that the condom crisis is being driven and exacerbated by pepfar and by the extreme policies of the U.S.," said aids envoy Lewis. "You couldn't come up with a more bizarre conspiracy theory," counters Dr. Mark Dybul, deputy coordinator and chief medical officer at the State Department's Office of the U.S. Global aids Coordinator, which oversees pepfar. Dybul says it's the program's critics who are politicizing the issue because they are pushing a "condoms-only" agenda. To advocate a condoms-only approach, he says, "is really colonialistic and paternalistic." The U.S. is the biggest single donor for aids prevention in Uganda, and Ambassador Jimmy Kolker points out that U.S. funding for aids prevention has more than tripled in the past two years, from $45 million annually to $140 million. While pepfar stipulates that money for condoms should target only high-risk groups such as prostitutes and soldiers rather than the general population, "the truth is we're doing more of everything," says Kolker.

• SIMON ROBINSON / Kampala
• Some experts say Uganda is emphasizing abstinence — and religious dogma — over condoms in its fight against AIDS. Could the U.S. be to blame?