THE INVISIBLE CURE

ZERO GRAZING: A TIMELINE

Uganda’s Zero Grazing AIDS campaign ran from 1987 until 1992. In its wake, Uganda’s HIV infection rate fell steeply throughout the country among men and women in all age groups. The campaign encouraged “partner reduction” and faithfulness. It tacitly acknowledged that polygamy was part of the culture, and that absolute monogamy was not always practicable.

After 1993, the Zero Grazing campaign was replaced by biomedical approaches to HIV prevention, including condom promotion, HIV testing and treatment for syphilis, gonorrhea and other sexually transmitted infections. These technical programs were supported by various donors and international agencies.

By the end of the 1990s, Uganda’s HIV rate had stopped declining and by the early 2000s it had even risen again, although only very slightly.

During the administration of George W. Bush, moral conservatives within the US and Ugandan governments reframed Zero Grazing as an "abstinence program". They called for its revival, because (they said) the condom programs had failed.

In fact, the original Zero Grazing campaign promoted not "abstinence" but partner reduction and was more pragmatic and less moralistic than the abstinence programs that flourished in Uganda in the mid-2000s. The Bush administration's support for abstinence helped bolster a number of Ugandan Christian pastors and others who were very outspoken about personal morality. While the most extreme members of this group received little direct funding from the US government, they did receive significant support from other conservative Christian groups in the US. With this backing, they have since launched a harsh campaign against the rights of homosexuals in Uganda.

The Ugandan government, perhaps keen to distract citizens from other issues in advance of elections in 2010, has allied itself with the anti-gay cause. A bill now before Parliament would--in its most extreme form-- criminalize discussion of homosexuality, and punish homosexual acts with death. Western human rights organizations are fighting back.

It’s worth noting that Uganda's HIV rate ceased falling soon after Zero Grazing was replaced by donor sponsored condom programs that down-played behavior change; then the US-inspired abstinence programs went too far in the other direction and also failed. If Uganda, or any country, is to have any success against the epidemic, it must reclaim its own policies, and cease to serve as a battleground for the culture wars of the West.

You may read more about this in my book, The Invisible Cure: Why we are Losing the Fight against AIDS in Africa (Picador/Penguin 2008)

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Contact Helen Epstein: helenepstein@yahoo.com