Two African countries, Uganda and South Africa, face an overwhelming burden caused by the spread of HIV infection. Yet both have instituted programmes to help curb the disease and these efforts are slowly bearing fruit.
The HIV and AIDS statistics for the two countries make grim reading. Estimates suggest that one in 10 South Africans is HIV positive today. Anonymous surveys of women attending public health clinics there showed that 22.4 per cent were HIV positive at the end of 1999 and 16.5 per cent of 15-19 year olds were infected.
In Uganda figures for 1999 showed that an estimated 8.3 per cent of adults had the virus and that country's Ministry for Health says that 1.44 million people were living with HIV.
The disease has taken 800,000 lives in Uganda since 1982 when the first case was detected, and by 1999 1.77 million children had been orphaned by HIV/AIDS. However, a sustained government programme is bearing fruit - Uganda's current 8.3 per cent rate of adult prevalance of HIV is down from 14 per cent.
South Africa was somewhat slower to respond to the threat. In part this was due to a lack of resources but the South African president, Thabo Mbeki also caused consternation only a few years ago by suggesting that HIV was not proven as the cause of AIDS.
A cohesive anti-HIV programme is now in place in both states however and there are some encouraging signs that these programmes are having an impact on HIV and AIDS statistics.
South Africa appointed its first advisory group on AIDS in 1985 but a specific programme with resources only came into being in 1991.
A national coordinating committee was formed in 1992 and a National AIDS Plan was adopted in 1994.
It waged a Beyond Awareness Campaign for two years from 1998, a multimedia, multiactivity communications campaign meant to develop amongst the public an understanding of the disease and how to prevent its spread. The government also launched the "Partnership Against AIDS", which seeks to mobilise all South Africans to commit to working against the disease.
While these have had only limited effect so far, there may be some degree of disease stabilisation taking place.
The infection rate amongst the 15-19 year old category in South Africa fell from 21 per cent in 1998 to 16.5 per cent a year later. Over this same period there as a 0.4 per cent fall in the infection rate among women involved in the public health clinic study.
A similar picture is emerging in Uganda and its success has been held up as an example by consultants working with the South African government.
Uganda saw its first AIDS cases in 1982 in the Rakai District on the shores of Lake Victoria. By 1988 the average prevalence rates amongst adults stood at nine per cent. These rates peaked in 1992 according to government statistics and a gradual decline was clearly underway by 1993.
The Ministry of Health established its first AIDS control programme in 1986, but very quickly the government recognised that the disease extended beyond this single ministry's scope and represented both a social and economic threat. A multisectoral approach was put together and launched by the president, Yoweri Kaguta Museveni, in 1992.
It has involved a fight against stigmatisation of those with the disease, prevention through behavioural change, and increased condom use through social marketing.
The government has instituted extensive voluntary counselling and testing services and premarital counselling with tests to help prevent marriage when individuals are already infected. Great effort has also gone into educating young people to help them deal with the risks posed by the disease.
Both states accept that there is much more to be done but the achievements by these governments also provide hope that the march of the disease can at least be slowed and perhaps even checked given time.