Net working workshop for NACWOLA members,staff and partners

16 Days of Activism Against GBV-Walk in Masaka town

Gender Based Violence (GBV) is still an emerging and developing concept, which has come to be synonymous with violence against women. Originally it was used mostly to replace the term ‘(male) violence against women.’ The United Nations Declaration on the Elimination of Violence against Women (1993) defines it as "any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life". It is perceived as a function of gender inequality, and an abuse of male power and privilege.

Society has always labelled women as the victims, and men as the perpetuators of GBV. However, evidence shows that men too experience GBV. However in this article therefore; i look at gender based violence as an umbrella term for any harmful act committed against a man’s or woman’s will as a result of gender inequalities.

The overall framework for GBV prevention and response in Uganda, among others, includes the Uganda Constitution and the Domestic Violence Act. Article 2 of the Constitution of Uganda provides for the fact that men and women are of equal status before and under the law in all spheres of political, economic, social and cultural life. The constitution protects the right to life (Article 22), provides for freedom from torture, cruel, inhuman and degrading treatment (Article 24) and prohibits laws, cultures, customs and traditions which are against the dignity, welfare or interest of women (Article 32). On the other hand, the Uganda Domestic Violence Act (2010) provides for protection and relief of victims of domestic violence; punishment of perpetrators of domestic violence; procedure and guidelines to be followed by the court in relation to protection and compensation of victims; jurisdiction of courts; and handling of domestic violence cases by the Family and Children’s Court. Despite the fact that such a preventive and responsive framework exists, GBV in Uganda is widespread and is mainly committed against women. The Uganda Demographic Health Survey (2006) shows that on average over 50% of the women in Uganda have experienced physical violence since the age of 15 and in certain areas like Eastern Uganda, the figure goes up to over 70%.

According to the Uganda Demographic Health Survey (2006) GBV committed against women happens in various physical forms which include slapping (40%), pushing (25%), kicking and beating (23%). On the other hand, the common forms of emotional violence in Uganda are insults (42%), humiliation (24%), physical threats (22%), verbal assaults, death threats and denial of custody of children (UWONET, 2009).

National statistics (UDHS 2006) reveal that violence is mainly committed in intimate partner relationships. 52% of ever married women report physical violence by their husbands or former husbands in the last 12 months while 23% of married men report that they had experienced violence from their partners in the same period of time.

In discussing the prevalence of intimate partner violence, the Uganda Women’s Network (2009) points out that this type of violence is ‘normalised’ in Uganda as, it is viewed as an acceptable part of life. Research (UWONET, 2009) shows that many people in Uganda (46%) are of the view that domestic abuse is a private matter that should not be reported outside of the family. Six in ten men (60%) and seven in ten women (70%) agree that reasons such as burning food, going out without informing the partner or refusal to have sex are legitimate justifications for violence. In a case study, the report further illustrates that 70% of men and 90% of women in Rakai district view beating of the female partner as justifiable in cases of disobeying the husband, neglect of household chores and refusal to have sex. Women are often dependant on their husbands and are afraid of how the community will judge them if they left their husbands. They, therefore, choose to live in violent relationships.

The Uganda Law Reform Commission (2000) also recognises the role culture plays in enhancing gender based violence. According to the Commission, the law, custom and religion all stress the right, particularly of the husband to sexual intercourse within marriage and consequently promoting marital sexual assault. The Uganda Law Reform Commission (2000) further recognises that cultures such as circumcision and witchcraft promote violence. For example, in Mbale circumcision enhances rape and defilement. During the pre-circumcision ceremony people are allowed to have sex indiscriminately as a cleansing act. Similarly, witchcraft, which is reported to be pronounced in Uganda, also promotes sexual gender based violence where traditional healers prescribe defilement as a cleansing process for their clients; barren women are encouraged to have sex with the witchdoctors in order to conceive; and sex with virgin girls is believed to work for those that are pursuing riches.

“Violence against women and girls continues unabated in every continent, country and culture. It takes a devastating toll on women’s lives, on their families, and on society as a whole. Most societies prohibit such violence – yet the reality is that too often, it is covered up or tacitly condoned.” UN Secretary General Ban Ki-Moon (8 March 2007)

As the UN Secretary General observed, gender based violence continues even when various studies have shown that it has significant negative effects on world economies. For example, the World Bank (2009) estimated that nine million Disability-Adjusted Years (DALYs) are lost annually due to Intimate Partner Violence. The disability-adjusted life year (DALY) is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death. It was developed by Harvard University for the World Bank in 1990 and adopted by the World Health Organisation in 2000. Based on the World Bank DALY estimate, it is noted that domestic violence and rape rank higher than cancer, motor vehicles accidents, war and malaria in the global estimates of selected risk factors for increased morbidity, disability and mortality, hence accounting for 5 to 16 percent of healthy economically

Lively hood is the way to go for NACWOL Amembers

NACWOLA   Members in Amuru  District inspect thier G.nuts gardens funded by UNwomen

No drugs no vote

The Stride to take this year

Dear NACWOLA staff, members, partners, donors and stakeholders,


I'd like to start by wishing you a very Happy New Year!

As this year begins, I hope with renewed vigor and more clear focus, the sky will be the limit for NACWOLA.

Our relevancy to respond to HIV/AIDS from a gender perspective stems from the fact that by the end of last year 124000 new infections occurred and read this 73,000 of these were women and 25000 children! It could have been worse if we did not act and remain active as NACWOLA but also it is a challenge for us now to bring down this rate through our responses.

HIV/AIDS Stigma and Discrimination in Uganda

A group comming up with astigma compaign strategy

HIV/AIDS-related stigma and discrimination has been identified as one of the key social cultural drivers of the HIV/AIDS epidemic. The National strategic plan 2007 /08 – 2011/12 cites stigma as a key driver and barrier to accessing HIV prevention, treatment and care and social services. Stigma is the holding unpleasant social attitudes or beliefs and display of unfriendly behaviour against a person or group of people. HIV/AIDS stigma and discrimination is a state and process of devaluing a person or group on the basis of their HIV status or that of people they are related to.

With over 1.2 million people living with HIV (PLHIV) in Uganda and an annual incidence of 135,000 (UAC 2006), a supportive environment for people infected and affected with HIV continues to be of critical importance. The 2004 – 2005 Sero Behavioral Survey however indicates that as few as 19% of women and 28% of men in Uganda express accepting attitudes towards people living with HIV and AIDS. This calls for interventions that will contribute to reducing stigmatizing attitudes towards those infected and affected by HIV and AIDS. It is against this background that Uganda AIDS Commission, with support from USAID through Health Communication Partnership (HCP) worked with other partners to develop a national campaign strategy to reduce HIV/AIDS stigma and discrimination in Uganda.


In the 2004 – 2005 Sero Behavioural Survey, men and women who had heard of AIDS were asked four questions related to their attitudes towards people infected with HIV. They were asked if they would be willing to care for a relative who is sick with AIDS in their own households and if they would be wiling to buy sugar, fresh vegetables or other food from a market vendor who had AIDS. They were also asked if they thought an HIV+ female teacher who has HIV but is not sick should be allowed to continue teaching. A more personal question asked whether they preferred that a member of their family who is infected with HIV should remain a secret.

The HCP/YEAH survey (2009) conducted in 14 districts of Uganda shows that only 23% of the respondents had knowledge HIV/AIDS stigma and discrimination, whereby only 19% of women and 28% of men expressed positive attitudes on all four indicators. In the same study, urban women and men were more likely than rural respondents to express accepting attitudes on all four measures. Respondents who were more educated had more accepting attitudes than those less educated; and wealthier men and women were more likely to have accepting attitudes. Yet only 4% of males and 7% of females expressed positive values by rejecting all misconceptions about PLHIV.
By the end of 2007, approximately 70,000 people in Uganda were receiving ART from different outlets. While this exceeded the target set by the Ministry of Health for this period, it only represented a half of the total number of people who need ARVs in Uganda.

According to available research, there is lack of knowledge about stigma, how it manifests itself and its impact on individuals, communities and the nation (ACCORD 2004). A sizeable minority of people practice stigma and discrimination unconsciously without recognizing that their words, behaviour and practices create prejudice against the stigmatised. There is need therefore for a communication campaign to raise the consciousness of the Ugandan public about HIV/AIDS stigma and discrimination and its impact on individuals and society, as well as what to do to overcome the problem. Increased awareness and effort against HIV/AIDS related stigma and discrimination is an essential component in the overall response to the HIV/AIDS pandemic.

Presidential Candidates to Debate Healthcare Plans

ASK YOU’RE QUESTIONS ON:

Health Financing, 15% Abuja Commitment

Maternal and Child Health

Scaling up HIV prevention,

Treatment, care & support

Access to Medicines

Human Resources for Health

Family Planning and more!!!

.Every minute, 8 children die from easily preventable or treatable conditions

“It is estimated that 12,000 children die every day in Africa .Every minute, 8 children die from easily preventable or treatable conditions, 2 of them newborns.” African Union’s social affairs department representative; Byaruhanga said as she presented, the overview of the theme of the 15th AU Summit, Kampala ,19-27 July 2010 `Maternal, infant and child health and development in Africa, to the participants of AU-CSO Pre- summit meeting.
She went on to say that, a woman in Africa has a 1 in 16 chances of dying in pregnancy or childbirth. Almost 90% of all child deaths are attributable to just six conditions: neonatal causes, pneumonia, diarrhea, malaria, measles, and HIV/AIDS. Malnutrition contributes to more than 35 per cent of child deaths. Malaria threatens a disproportionately high percentage of the population in Africa, with about 350 million episodes annually.
“The GDP loss in Africa due to HIV/AIDS is estimated to be between 0.5% and 2.6% annually. In countries with a high prevalence of tuberculosis, economic loss is estimated at between 4% and 7% of GDP annually. Due to the high prevalence of malaria in the past 30 years, Africa’s GDP lost as much as USD 100 billion. More than 90% of the 430,000 human immunodeficiency virus type 1 (HIV-1) infections in children each year occur in Africa, where HIV-1 acquisition through breast milk accounts for more than 40% of infections.” She said
Byaruhanga said that the above situation is caused by,weak health systems ,delays at different levels in accessing health services ,lack of emergency neonatal and obstetric care ,inadequate Family planning services ,complication of unsafe abortions ,inadequate skilled human resources, socio-cultural barriers to accessing health care, inadequate investment in health and social development compounded by over dependency on external funding, inadequate food security and malnutrition, HIV/AIDS, tuberculosis, malaria, other communicable diseases, non communicable diseases and neglected tropical diseases.
Global efforts have to be appreciated Byaruhanga reminded the participants as she mentioned some of these efforts like MDGs, 8 September 2000, at the Millennium Summit Commitment: We will spare no effort to free our fellow men, women and children from the abject and dehumanizing conditions of extreme poverty, to which more than a billion of them are currently subjected. We are committed to making the right to development a reality for everyone and to freeing the entire human race from want then linked nature of MDGs, the ICPD (1994 ) BEIJING PLATFORM (1995) COPENHAGEN WSSD (1995)
Africa’s efforts like Current summit theme choice, Position paper to the G20 Canada recently, adoption of policy instruments, Continental efforts (policy instruments), Health Strategy (2007-2015) which serves as an overarching framework to enable coherence between countries, civil society and the international community and is aimed at strengthening health systems for equity and development. It sets out a clear vision for health- An integrated and prosperous Africa free of its heavy burden of disease, disability and premature death and a mission call for Accelerated Action on Africa Fit for Children which highlighted the issue of child survival and development. The AU Commission has completed a report on the State of the African Child which will serve as a useful reference tool for enriching the work of the African Committee of Experts.

Africa Regional Nutrition Strategy (2005-2015) whose main purpose is to advocate and sensitize African leaders about the essential role of nutrition and food security in socio-economic development. The African Task Force on Food and Nutrition Development (ATFFND) has been established to serve as the advisory arm of the African Union in supporting Member States to implement the strategy.Abuja Call for Accelerated Action towards Universal Access to HIV/AIDS, Tuberculosis and Malaria Services by the AU Heads of State and Government in 2006, significant progress has been made by Member States. This has been revealed in the 5-Year Review of the Abuja Call for Accelerated Action towards Universal Access to HIV/AIDS, Tuberculosis and Malaria Services that was conducted in 2010 in pursuance of the mandate of the AU Heads of State and Government [Assembly/AU/Dec.115 (VII)].
Continental Policy Framework on SRHR and the Maputo Plan of Action (MPoA for its implementation, adopted by the policy/decision-making organs of the AU in 2006 and 2007-designed as Africa’s contribution to the implementation of the Programmes of Action of the International Conference on Population and Development (ICPD), aimed at accelerating action on the implementation of the MDGs, particularly those related to health, including MDGs 4, 5 and 6.
AU CARMMA (May 2009)-advocacy strategy aimed at accelerating the availability and use of universally accessible quality health services which are critical for the reduction of maternal mortality. The focus is to ensure accountability, coordination and effective implementation of existing plans and strategies. 17 countries have launched since May 2009 to date

“The key messages as we start off pre-activities for the AU summit are, let us deliberate on cost-effective measures with high impact that will accelerate the reduction of maternal and newborn and child mortality. The sharing of experiences amongst the Heads of State and Government on successful practices and what works in their countries will take us a long way.CARMMA can continue to be used to accelerate reduction of maternal and child mortality through national ownership. Challenges faced in reducing maternal, newborn and child mortality rate in Africa with a particular focus, among others on: delivery of quality, comprehensive, integrated and affordable primary health care services in order to assure continuum of care, promote safe motherhood, child survival, and women, newborn and child health. The impact of nutrition, food, and sanitation on maternal, newborn and child health; of Mother to Child (PMTC) transmission of HIV/AIDS. Byaruhanga ended.
The AU CSO pre-meeting at Imperial Royale Hotel Kampala Uganda was yesterday officially opened by Major General (Rtd) Hon Kahinda Otafire, Minister for trade and tourism. In his key note address the minister said that a platform such as this one where CSOs engage African governments on important issues like maternal, infant, child health and development in Africa has been long over due…..” He also regretted to say that “Although African government committed themselves to allocate a 15%increase in their respective budgets towards health issues in 2001 most of the governments are still wanting on this promise” He once agin wished the participants good deliberations and he concluded his address with the panafrican movment mmotto “Don’t agonize, Organize! One struggle, Many fronts”

Strengthening TB and HIV&AIDS Responses

The NATIONAL COMMUNITY OF WOMEN LIVING WITH HIV/AIDS NACWOLA is one of the organizations through which strengthening TB and HIV&AIDS Responses in East Central Uganda (STAR-EC) is done. The program aims to increase access to, coverage of, and utilization of quality and comprehensive HIV&AIDS and TB prevention, care and treatment services within district health facilities and their respective communities.

STAR-EC’s implementation strategy is built on three key pillars: systems strengthening; quality improvement; and demand creation.

The program covers six districts in East Central Uganda that include Bugiri, Iganga, Kaliro, Kamuli, Mayuge and Namutumba and serves a population of approximately 2.7 million people in this region (approximately 9% of Uganda’s total population) with significant populations living at fish landing sites, hard-to-reach areas and islands especially in and around Lake Victoria and Lake Kyoga.

In order to increase the uptake of comprehensive HIV&AIDS and TB services, STAR-EC will expand access to these services, strengthen systems for service delivery, build linkages and networks for coordination and collaboration between HIV&AIDS and TB services, improve service quality and create demand for these services at all levels.
STAR-EC is supporting CSOs and Health facilities to offer services; Antiretroviral Therapy Tuberculosis screening and treatment, Male Medical Circumcision and Condom distribution to the people of East Central region.

The interventions are meant to utilize approaches that are best suited to address potential drivers of the HIV&AIDS epidemic in the region and outlines strategies to effectively reach vulnerable and most-at-risk populations that live in this socio-geographical context.

Child rights project in Lira and Soroti

NACWOLA Uganda in partnership with Healthlink Worldwide UK secured DFID Civil Society Challenge fund to implement an OVC/Child Rights Project in Lira and Soroti districts, operating in two sub counties in each district. The project is part of Healthlink Worldwide child rights intervention in East Africa and the goal is to reduce children's vulnerability and poverty relating to the HIV and AIDS epidemic in East Africa.

The project aims to reduce poverty of children affected by HIV and AIDS by strengthening the recognition and attainment of their legal rights. This will be achieved by ensuring that children’s legal and human rights to a secure future are recognized. By placing children’s needs at the center of the initiative, it also responds to a particularly vulnerable group in Uganda.

In February and March 2010 NACWOLA conducted a number of activities including a stakeholder meeting and a baseline study. The breakfast meeting for stakeholders was carried out concurrently in Lira and Soroti. The meeting was attended by different stakeholders from the district local government, political leaders, NACWOLA executive members, media, and NGOs that promote child rights. The baseline study was successfully carried out in Lira Branch in the sub counties of Ogur, Amach and Lira, and in Soroti Branch in the sub counties of Arapai, Asuret and Gweri. Officials from the local government, the media, NGOs, community leaders at sub county level, members of the community and NACWOLA staff participated in the baseline study. Interviews were conducted with OVCs and other children as well as with community members and stakeholders from the respective sub counties (see picture).

Visit to Arua Branch, February 2010

In the year 2010, the NACWOLA branch in Arua is mainly focusing their activities on income-generating strategies, vocational training of OVCs and continuing counseling. Twice a week, members of NACWOLA meet in the office to discuss and exchange ideas and thoughts. What is particularly nice about the office in Arua, is that NACWOLA members can do some gardening and farming on the office compound which also provides them with food while meeting. So they can actually spend the entire day there. In order to generate some income, many women do handicrafts such as making grass mats or necklaces from 100% recycled paper (see picture).

Follow-up on Solar Lanterns in Aloi Sub County

In December 2008, NACWOLA Lira with support from NACWOLA Uganda received 100 solar lanterns from German Technical Cooperation (GTZ). 20 of these lanterns were distributed in Aloi sub county to help NACWOLA women improve on their lightening system. In January 2010, three members of NACWOLA Lira visited these women in Aloi. The idea was to find out about the benefits and challenges of these lanterns.

Some of the benefits were:

• it is not necessary anymore to buy parafin and matches – hence it saves costs within the entire household
• useful for taking drugs during night
• if family members get sick, there is light to help them
• in case of sickness, you can carry the lamp with you and you can find your way to the hospital
• it limits the danger of houses getting burnt, parafin lamps easily burnt the grassroot houses
• it is very useful when babies are born or very small
• with the lamps, life came back to the house, many had the feeling that there is electricity in their homes
• lamps helped to educate children in the evening hours – made reading possible
• lamps provided for HIV+ women reduced stigma and discrimination
• lamps strenghtened their positive thinking
• it helped the community, since many lanterns were shared
• because HIV+ women were provided with lanterns, other women were encouraged to go for testing
• knowledge transfer which was provided at the training by GTZ was appreciated since even non-educated women now knew how to use these lanterns

Some of the problems/challenges:

• three of 20 lanterns were broken, one right at the beginning and two after 10 months of using
• the lanterns can often only be used for couple of hours
• most lanterns were working for the first 10 months, after this time, they became weak
• some mechanical problems
• suggestion: two of the 20 women should be trained on how to repair and clean the lanterns

NACWOLA Award Winer-HBC 2009!!!

Cordaid HIV and AIDS Award 2009 Recipients
Award recipients Join us in congratulating the Award Recipients and the finalists! The Review Panel was positively surprised by the large number of nominations received for the 2009 Cordaid HIV and AIDS Award on Home Based Care (HBC) for people living with HIV (PLHIV)! Nominations Cordaid received more than 200 nominations from over 30 countries, for the two categories: best organisation and best individual. The majority of the nominations came from Africa (55%), with 27% from (Eur) Asian countries and 18% from Latin America. 11% of the nominations received were submitted in French or Spanish.
This is a reflection of how relevant home based care is globally. Review reportRead the Review Panel Report and find out more about the winners’ work and trends around home based care! Recipients Congratulations to the two Award recipients!-

National Community of Women Living with HIV/AIDS in Uganda (NACWOLA) for the category organisation

Ms. Moira Catherine Boshoff; Care Ministry, South Africa for the category individual

Congratualtions also to the 12 finalists!The two prizes (€15.000 and €5.000 respectively) were handed out on World Aids Day (1 December 2009) during the Nationaal Congres Soa*Hiv*Seks - Versterking gezocht by the new Aids Ambassadeur, Marijke Wijnroks. To get an impression please see the pictures taken.

Children & Mothers are the most affectd by HIV/AIDS

Partnership meeting Malawi

Mothers With out Children impossible!

The young mothers at NACWOLA head office with a volunteer from VSO teaching the various skills

National partnership platform initiative in Uganda.

KCs during the monthly meeting at the Allience

Over 20 directors of various civil society organization spent of the day on the 25th of August at KatiKati hotel in Kampala planning for a better direction to take the national partnership platform initiative in Uganda.Agnes Apea the executive director NACWOLA was among the directors

How Uganda's food shortage is affecting ART and TB treatment’

Food shortage may lead to death and drug resistance for PLWA in Teso sub-region
HIV-positive patients in drought-hit eastern Uganda are abandoning their anti-retroviral regimens in droves, and leaders fear that unless more food becomes available, they will soon be dealing with drug resistance and death.
"If the government doesn't address the food crisis, many of us who are on ARVs are going to die," said Stella, a NACWOLA member at Katakwi district.
A total of 17 districts in northwestern, northeastern and eastern Uganda have been listed as worst-hit by a nationwide drought, and another 31 districts are experiencing “acute food shortages” while four districts have been evaluated as “moderately affected.” A prolonged dry spell has withered the region's traditional crops, leaving hundreds of thousands of people hungry, many surviving on a diet of bought maize meal rather than a balanced diet.
Those most affected are PLWA on ARVs. This famine has destructed antiretroviral therapy (ART) trends in the country. An estimated 180,000 individuals are currently on ART, which is only a fraction of the estimated 360,000 people in need of ARVs.
In an assessment by National Community of Women Living with HIV/AIDS (NACWOLA) in Teso a sub-region in eastern Uganda, it was found that HIV/AIDS patients in the region take their ARV drugs on the understanding of food being available. In the absence of food, many stop taking their ARVs, putting their lives at risk. TB drugs and ARVs are very strong; if taken without food, they cause dizziness and general body weakness.
“When you take these drugs without eating, they make you weak and reduce your strength - you feel like vomiting," said,Jemina NACWOLA Soroti Chairperson District.
The government has spent an estimated US$10 million on food for the Teso sub-region, however not all needs have been met.
“The food being given to our people is just a drop in the ocean," said Patrick Amuriat, chairman of Teso Parliamentary Group. "What can one cup of beans and two of posho [maize flour] do? It's just for one meal."
The National community of women living with HIV/AIDS in Uganda NACWOLA calls upon Government to provide sufficient food to the people to reduce some side-effects of ARVs and promote adherence to drug regimens. The government to do all that it takes to increase the supply of food in this region and more so to the HIV/AIDS people. To set a criteria for giving out food in the region giving special attention and priority to people living with HIV/AIDS and more so those on either ARVs or TB treatment.

Civil society organization are called upon to carry out sensitization and encouraging clients on ARVs to continue taking the drugs because if they default, this will build resistance to drugs which can be another difficult condition to deal with in the future? It’s a choice of life or death that our members have to take.
For PLWA are called upon to continue taking the ARVs/TB drugs and seek medical advice before discontinuing medication.

ARVs CRISIS IN UGANDA

Uganda is one of the very few countries around the world that is recorded to have brought a generalized epidemic under control. From a prevalence rate of 18% among the adult population in 1992, today the prevalence rate is ranging between 6.3 and 6.7%.
It is estimated that 180,000 individuals are currently on antiretroviral therapy (ART) in the country. However, this is only a fraction of the estimated 360,000 people in need of ARVs. It is now generally believed that new infections are re-emerging and the number of people being infected annually is more than the number of people put on ART in the same period

Women,Children with HIV/AIDS and Economic Crisis

“Global financial crisis” Is a very common word these days to explain a lot of situations that have got something to do with money in Uganda.

Yesterday I wanted to get a tax man to take me to one of the hotels at the city centre; he told me a price, which I thought, was not realistic. When I challenged him he said “Credit Crunch” and I asked him “what about it well?” He could not explain; but he said “e bintu birinye” Meaning prices have gone high.

He reduced the price, and as he drove me to the hotel I contemplated on what he actually meant by saying prices have gone up.

This morning I visited a number of women living with HIV/AIDS I asked them what their experiences are about the Credit Crunch.



Am a teacher, I have not been paid for two months; the pupils have not paid the fees; so I cannot get my salary yet; until the money is colleted. The parents are saying they cannot pay in time because they do not have the money to pay and they are blaming this to the credit crunch which has affected what they do. This means I cannot also buy all that I need in time so am really affected by the credit crutch. Well it is hard to tell if this is the effect, but that is what I am told. Nakanyike Stephan.

My name is Sarah Ndagire, yes I have been affected we used to get food from NACWOLA but we no longer get food. They told us that, World Food no longer gives food due to the economic crisis; they have also stopped some projects that used to help us with income generating activities they told us that the donors have cut the amount of money they give; that has had a challenge with my life. Am on treatment, my body is weak, I do not know how am going to survive. I have children to pay fees for; the sponsors have stopped the payment of the fees. It is painful for me to see my children not going to school.

Female Condom (FC)

The female condom (FC) is the only female initiated method to prevent HIV/STIs whose efficacy and acceptability with specific groups has been well documented. It was first marketed in Uganda in 1998 by Marie Stopes International following a successful acceptability study, but registered little success. The Ministry of Health (MOH) now intends to develop a strategy to relaunch the FC in Uganda.

This was reveled at the advocacy workshop workshop for female condom access organized by centre for health and gender equity and Global Campaign for micobicides at Imperial Royale Hotel Kampala Uganda from the 23thed to the 25th June 2009.

The objective of the workshop was to form a coalition of civil society organization to work hand in hand to advocate for the female condom access in Uganda.

Proposed Female Condom Program

Goal
To develop a comprehensive and integrated 5-year national female condom program

Program Objectives
1. Increase availability and access to female condoms for sexually active men and women in Uganda
2. Increase demand and utilization of female condoms for prevention of HIV/STI and unwanted pregnancies
3. Strengthen coordination, management and logistical support systems to ensure timely and consistent supply and distribution of female condoms

2.9 Million Women won't recieve PMTC Services

The President and U.S Congress need to hear world voices, especially voices from Africa, about the devastating impact of the President’s broken campaign promises.” Dr. Paul Zeitz, GAA Executive Director.Washington, DC (Tuesday, May 12, 2009) – In an email sent to more than 12,000 Health Advocates and organizations around the world, Global AIDS Alliance (GAA) Executive Director Dr. Paul Zeitz called for a worldwide response to fix the funding gap in President Barak Obama’s fiscal year 2010 budget request submitted to the U.S. Congress last week.When President Obama released his US $ 3.6 trillion budget on May 7, he broke two campaign promises and created a total shortfall of US $ 3.3 billion in U.S. support for global AIDS funding through U.S. bilateral AIDS programs, including PEPFAR, and for the Global Fund to Fight AIDS, Tuberculosis and Malaria. (Broken Promises fact sheet linked below.)“The time has come for the global health community to speak out and tell President Obama that he MUST meet his promises for fiscal year 2010,” said Zeitz. “The President’s budget request sets his Administration on a path to breaking many of his campaign promises to the people of Africa and to falling short on its commitments to reassert U.S. moral leadership around the world, with devastating health consequences.”GAA estimates that as a consequence of President Obama’s broken promises on U.S. bilateral AIDS programs:• One million people around the world won’t receive treatment for AIDS.• 2.9 million women won’t receive services to prevent mother-to-child transmission of HIV.• 27 million people won’t access sexual disease transmission prevention programs.• 1.9 million orphans and other children affected by or vulnerable to HIV/AIDS won’t receive care and support services.Please contact in-country representatives of the U.S government, including American Embassies, PEPFAR and USAID Regional Offices, and local offices of the American Chambers of Commerce. Ask them to support full funding of PEPFAR and the Global Fund.“The President and U.S. Congress need to hear world voices, especially voices from Africa, about the devastating impact of the President’s broken campaign promises,” said Zeitz. “The President needs to know that people will die needlessly without full funding of PEPFAR and the Global Fund. And he needs to know that the world is watching and waiting for him to make good on his promises.”

Capacity building

The National Community of women Living ith HIV/AIDS NACWOLA Uganda is a member of MeTA; an approach designed to support country efforts to increase access to medicines
Improve information and increase transparency on price, quality, availability and promotion. A multi-stakeholder approach to support stronger governance and more accountability. International & national – peer pressure, share learning and work at both ends of supply chain. The picure above was taken at the workshop organised by MeTA and tow staff from NACWOLA attended the workshop.

Counterfeit Bill 2008 and HIV/AIDS IN UGANDA

Critical Issues in the Uganda Counterfeit Bill 2008
What legislating on Counterfeits she’d consider.

The New Vision of the 19th February 2009 published President Yoweri Museven;s call for a law that provides for harsh punishment for dealers in counterfeit goods. In his on wards published by the new vision the president said.
"The law must link punishment to the value of goods that have been counterfeited," he said. "Because they will not have this kind of money, they will go bankrupt or be locked up."
"Counterfeiters damage the economy, the image of this country, the livelihood and health of the people,"
He even referred to the firing squad that was used to push the man who sold sold milk that killed children in chain.

From the outset...I recognise that, there are numerous positive steps that have been suggested to fight counterfeits generally. However ... sight must not be lost of the balance that has to be in place between right holders and 3rd parties. Sight must also not be lost of the special nature and character of medicines.

Care must be taken :
Not to mislead the public that generics are counterfeits; and to ensure that the rights of generic manufacturers are preserved in the legislative process. To empower the commissioner for customs; to seize and detain suspected counterfeit goods. To empower inspectors to be appointed by the NBS to seize and detain suspected counterfeit goods.

Immerging Issues

Definition of Counterfeits
Without, authority of the owner of any intellectual property right subsisting in Uganda in respect of protected goods.

The manufacturing, producing, packaging, re-packaging, labelling or making, whether in Uganda or outside Uganda...

The manufacturing, producing or making, whether in Uganda or outside Uganda, the subject matter of that intellectual property,

The manufacturing, producing or making of copies, in Uganda or outside Uganda, in violation of the author’s rights or related rights

These clauses above do not recognize that there are instances when a third party may not require the authority of the holder of the intellectual property right (IPR) to exploit it.

Infringing on the powers of the National Drug Authority (NDA)

Under Sections 3 and 4 the authority the administering the anti-counterfeiting legislation is vested in the Uganda National Bureau of Standards (UNBS).

UNBS would ordinarily not have the requisite capacity to deal with counterfeit medicines and trying to establish the needed capability by the Bureau would be a duplication of effort.

This also means that the inspectors appointed under Section 6 should include some from the drug regulatory authority.

In section 20, the Commissioner of Customs is granted wide discretion in determining what a counterfeit product without giving room to expert regulatory agencies to participate in this determination.

Gaps in the Process

Limited consultation of the stakeholders, for example Ministry of Health, National Drug Authority (NDA), National Medical Stores (NMS) Civil Society Organisations (SCO) and the Private sector. Dangers of non consultation are, the l bill is only seen and taken from a trade perspective no major inputs from the health perspective and one wonders why?


Very Important !

These ambiguities if misinterpreted or abused would be detrimental to the ongoing local and international efforts to ensure access to essential medicines for all Ugandans. This is because the Bill greatly undermines access to low-cost generic medicines by branding them counterfeits.

Key Action Issues

Amending section 2, definitions of “counterfeiting” and “counterfeit goods.” The Bill should have a provision distinguishing generic medicines from other counterfeit goods, failure of which will lead to an absurdity of treating generics as counterfeits. Sections 4 and 1 should be amended to give NDA the responsibility to deal with counterfeit medicines.The Bill needs to be harmonized with the Patents Bill to recognize the TRIPS Flexibilities in regard to Public Health.

Creating more awareness about the Bill is very key,there are still opportunities for engagements with parliament
Ministry of Trade and Industry ,National Drug Authority and civil society organisations CSOs

By Ivan Kintu Evarist.

Communication and Advocacy Officer
For National community of women living with HIV/AIDS in Uganda.( NACWOLA)

Dozens of HIV patients have been placed at risk !

Dozens of HIV patients have been placed at risk after the Dutch authorities seized consignments of Indian-made medicines shipped via Schipol airport for distribution to clinics in Nigeria, a multilateral agency yesterday said.
Officials claimed the drugs were counterfeits and -violated patent rules but Unitaid, the Geneva-based agency which paid for the medicines, demanded their release and said the claims were “misleading”.
The action - the latest seizure of drugs shipped via the Netherlands to developing countries - has highlighted tensions between European Union legislation and special patent rules on medicines agreed by the World Trade Organisation, which yesterday offered to intervene in the dispute.
The latest confiscation is particularly embarrassing because the drugs were paid for by the international donor governments which support Unitaid - including several EU nations such as France and the UK - and were to be distributed in Nigeria by the Clinton Foundation established by the former US president.
Dutch officials insisted the seizure reflected “friction” between EU and WTO rules.
A 2003 European Council regulation requires the seizure and destruction of counterfeits or goods violating intellectual property rights from third countries, even if they were only being shipped via the EU.
James Love of Knowledge Ecology International, an advocacy group that has helped raise concerns about the seizures, said the EU position was “indefensible”.
In other documents that KEI has reviewed, this case involved a shipment of 29,880 units of Abacavir from India to the U.S. Embassy in Nigeria, via the Schipol airport. The company shipping the product was Aurobindo, a well known and major supplier of Indian generic AIDS drugs to PEPFAR, the Global Fund and UNITAID.
Abacavir is a relatively expensive second line AIDS treatment, and in Africa is normally provided to patients who have developed resistance to a less expensive first line regime. It would be useful to have better information about this case, but based upon what is known so far, the Dutch Seizures at a minimum provided a risk of an interrupted supply of the drug to the patients. If so, this can contribute to further problems of drug resistance, according to numerous scientific studies on the relationship between multi-drug resistance and poor compliance involving Abacavir.

Who we are, What we do, Whom we serve & How.

Care and treatment services next to you!

A new Infectious Disease Institute (IDI) centre has been launched at Kiswa Health Centre.The $ 25,000 (about sh50m) centre was funded by the US President's Emergency Plan for AIDS to strengthen the care and management capacity of KCC clinics.It will provide HIV prevention, care and treatment services."The institute at Mulago was congested and we need to reduce on the numbers by transferring the patients to their nearest health centres," said the IDI/KCC capacity building project manager, Dr Alex Muganzi.The institute has supported KCC to start services at about eight clinics, which include Kiswa, Kiruddu, Kisenyi, Kawaala, Kitebi and Komamboga.The clinic was equipped with HIV/AIDS diagnostic laboratory equipment including CD4 and humalyte count machines.

Stigmamatisation and Discrimination

THE rate of stigmatisation and discrimination against persons living with HIV/AIDS is still high even among opinion leaders and media practitioners, health specialists have said.Venansio Ahabwe, the programme officer of HIV/AIDS Health Communication Partnership, said: "Stigma still remains the biggest challenge to fighting HIV/AIDS because the opinion leaders and media still have negative attitudes towards persons living with HIV/AIDS," he said.Ahabwe was speaking at a workshop organised by Uganda Health Communication Alliance for journalists and health related non-governmental organisations based in northern Uganda and West Nile.

As we celebrate TB day ...............................

UGANDA is facing a shortage of essential drugs in Government health facilities, according to the latest survey by Uganda Country Working Group. The study, conducted over the past four years, show that 32-50% of essential medicines to treat common diseases like malaria, pneumonia, diarrhoea, HIV/AIDS, TB, diabetes and hypertension are not readily available. Consequently, a consortium of Ugandan health civil society organizations NACWOLA inclusive on Thursday launched a nationwide campaign, code named Stop stock-outs.
“Stock outs have led to resistance among patients, most especially the TB patients. They start the course of the treatment and somewhere in the course of treatment, the drugs run out of stock causing resistance in the body.” A health worker in Soroti Local District Administration is quoted to have said to Human Rights and HIV/AIDS (AGHA) Uganda.

HOW MEDICINE GETS TO YOU
1-The Government forecastsl how many medicines will be needed to treat the population, based on the major public health challenges in the country. 2-Orders and tenders are then generated by the National Medical Stores. 3-Medicines are then purchased and stored centrally. 4-District stores and local health facilities decide what quantity of medicines they need and then place orders for these at the national medical stores. 5-National Medical Stores then delivers the drugs ordered and if they are out of stock, they issue a certificate of non-availability for the facilities to procure the drugs externally. Patients then receive the medicines from health facility pharmacies.

The most poor and abandoned

Many times we have to dare and bare those roads to find our beneficiaries; i mean the mothers and the vulnerable children.

Pictorial of Cives Mundi & NACWOLA

NACWOLA CELEBRATES WORLD AIDS DAY

Patricia is a volunteer with NACWOLA she took part in organizing world Aids day and below is what she wrote to her friends in UK about the day.

“On Worlds Aids Day we organized an event in partnership with VSO Uganda that just astounded me, and Richard.

NACWOLA has to move the Head Office to much smaller premises due to problems for a number of reasons. My view is that this will be a positive move as we will be based within a highly populated area. The current offices are a bit isolated, difficult for people to travel to and the rent is relatively expensive.

Last Sunday I visited the new site. NACWOLA owns this much smaller site, but they ran out of funds to complete the site some time ago. It is a good site but will take some time to complete. It will be an “interesting” New Year. At 2pm on Sunday it just looked like a building site. Piles of rubble, sand, bricks huge puddles everywhere. In a couple of hours big tents were arriving and needed erecting. Partitions were being put up internally, still 6 rooms to go, no windows no furniture, roof looks a bit suspect but the work goes on.

I then made some home visits to 5 Families, 4 of them Child Headed Families, taking some basic food supplies and soap as part of World Aids Day. The children heading these families have such a positive attitude, are very resilient and hopeful and amazingly competent at caring for their siblings and managing their homes.

Other Mothers in the community help and support these young people even though they themselves have very little.

We returned to the site on Monday to find the site cleared, tents up and 4 usable rooms. We then went on a 2 hr march led by the local school brass band, then the NACWOLA Drama Group and about 100 others. It was really good fun, children ran out from goodness knows where, it was like the Pied Piper, they sang and danced and a good time was had by all. Many more adults joined as we went along

We also offered volunteer counselling and testing for HIV. About 50-70 were expected. Well 153 turned up. I was doing pre-test counselling and then post-test counselling, giving results and making referrals. I was kissed, hugged, picked up and swung round in a way that left me feeling as if I had run a marathon. Speeches were made, dance and drama around prevention of AIDS took place then a very dramatic storm hit us, the tents blew over, a river developed in the middle of the site and everyone got very wet and muddy (while eating cake and drinking soda) but could not stop laughing.

So that was an excellent start for NACWOLA at Nsambya.

Then just as I had fallen asleep Sandra, who co-ordinated the event telephoned to say she had just seen me and Richard on the telly, with a report about our work, we had been oblivious to the fact that a TV crew there! Just as well.

Sorry about the essay, once I started writing I just could not stop.

As you can guess, we have settled into our jobs well, we seem to go from extremes of sadness to pure joy, but it is good. There is nothing we can do to change the past and working in a way that will positively influence the future means taking very small steps but then occasionally you take a giant leap and that’s just fantastic when it happens.

Best wishes to everyone; believe me when I say that the NHS really is second to none. We miss it, if only something similar could be developed here”

Positive Action Programe review Meeting

Members from Ethiopia Kenya, Malawi and Zimbabwe all came down to Uganda for the review meeting of the strategic grant from comic relief

NACWOLA drama group welcoming the Positive Action program members at NACWOLA field office where they had gone for an outreach.

NACWOLA, BBC and COMIC RELIFE spent the 11th and 12^th of this month visiting some of NACWOLA members. This picture depicts Michelle from comic relief and Sam Gibson from BBC talking Rose and the husband at Luwero.

Safe Water and Sanitation for all:A consumer's View

The chairperson of NACWOLA flanked by our staff fromLira waiting to recieve the minister at NACWOLA's stall.












The minister of state for water and enviroment Jeninifer Namuyangu at NACWOLA'S stall during Reverse Expo 2008

Only 10,000 out of 150,000 Children get ARVs

PRESIDENT Yoweri Museveni wants all pregnant women in Uganda to test for HIV and, if found positive, access treatment to save the lives of their unborn children.

He said this would prevent the spread of HIV and save hundreds of babies infected by the virus through mother-to-child transmission.

Long before the Government initiated the Prevention of Mother-to-Child Transmission programme, research had indicated that 70% of the HIV-positive mothers deliver children who are free of the virus.

“Now the battle is to prevent the transmission of the 30%. It is possible to eliminate the chances of the mother transmitting HIV to the unborn child. We can completely clear this,” Museveni said.

He was yesterday commissioning the $2.5m Baylor Children’s Centre of Excellence at Mulago Hospital. The centre, that will provide treatment for children living with HIV/AIDS, was constructed with funding from John Damonti, the President of the American Bristol-Myers Squibb Foundation, the US Centre for Disease Control and the US-based Baylor College of Medicine.

Dr. Adeodata Kekitiinwa, the director of Baylor College of Medicine Children’s Foundation, said apart from treatment, the centre will also provide training for medical students as well as research in HIV/AIDS.

Care for the 150,000 children living with HIV/AIDS in Uganda continues to lag behind compared to the care provided for adults.

She said 133 health centres offer HIV treatment for adults, while only 32 centres care for children.

Museveni said when the NRM government came to power in 1986, it was a taboo to discuss HIV/AIDS and by 1990, Uganda’s HIV prevalence was among the highest in the world.

He said the Government’s sensitisation campaign reduced it to 6.4% by 2007.

He, however, noted that the Uganda AIDS Commission was no longer vigorous in its messages to warn the public against HIV/AIDS. He also criticised misleading messages.

“I was in Kabale and found a signpost that urged children to delay sex. But what does ‘delaying sex’ mean to a student? It could mean that instead of having sex at 9:00am, you have sex at 2:00pm. In the early days, it used to be: No to pre-marital sex. We need clear messages.”

He said HIV/AIDS remained a significant cause of ill-health and death in Uganda and that there was limited access to treatment.

Only 10,000 of the 150,000 children infected are getting anti-retroviral treatment, he said. He added that 40% of the children on anti-retroviral treatment are assisted by Baylor, mainly in urban areas. “We must ensure equity to life-saving interventions to cater for children,” Museveni said.

He hailed US President George Bush’s support to fight HIV/AIDS in Uganda and Africa.

He also praised Ugandan medical specialists who choose to serve their country under hardship and for low pay, instead of going abroad for greener pastures.

The President further said the Government would soon increase salaries for science-based professions.

TREATMENT ISSUES

NACWOLA being a member of the consortium of advocates for ART popularly known as (CAAT)

NACWOLA staff had a tour of the districts of Kamuli and Jinja and during the visit they went to Kamulu government hospital, Kamuli mission hospital Buwenge government hospital and Jinja government hospital.

Below are the issues our staff gathered as they interacted with the hospital staff, PLWAS, and district healthy officials.

1-Insufficient supply of ARVs

2- Receipt of drugs in wrong combination,

3-changing drugs with out proper usage education

4- in availability of drugs in public healthy facilities,

5-Absence of TB drugs and integration of TB services with aids

6-U necessary bureaucracy in procurement process

7-Lack of enough qualified healthy staff 1:100 ratio

PLWAS waiting to be attended to at Buwenge hospital

Sharing & Networking

NACWOLA believes in Sharing and networking, its one activity that NACWOLA engages in and it is done through exchange visits within and out side the country.

Above is a picture of our partners from Ethiopia they were learning from NACWOLA’s best practices in IGAs

Ivan Kintu

Why is there stigma related to HIV and AIDS?

NACWOLA makes three to five out-reaches to communities every month, addressing issues of stigma and discrimination, and in this work NACWOLA is not alone below are the pictures of a religious leader who mobilized his community and invited NACWOLA to share with them about stigma and discrimination.

Why is there stigma related to HIV and AIDS?

In many societies people living with HIV and AIDS are often seen as shameful. In some societies the infection is associated with minority groups or behaviors, for example, homosexuality, In some cases HIV/AIDS may be linked to 'perversion' and those infected will be punished. Also, in some societies HIV/AIDS is seen as the result of personal irresponsibility. Sometimes, HIV and AIDS are believed to bring shame upon the family or community. And whilst negative responses to HIV/AIDS unfortunately widely exist, they often feed upon and reinforce dominant ideas of good and bad with respect to sex and illness, and proper and improper behaviors.

Here are factors which contribute to HIV/AIDS-related stigma:

• HIV/AIDS is a life-threatening disease
• People are scared of contracting HIV
• The disease's is associated with behaviors (such as sex between men and injecting drug-use) that are already stigmatized in many societies
• People living with HIV/AIDS are often thought of as being responsible for becoming infected

Religious or moral beliefs lead some people to believe that having HIV/AIDS is the result of moral fault (such as promiscuity or 'deviant sex') that deserves to be By Ivan

Global TB Control Uganda Rank 15

As NACWOLA goes out to the communities to do its mandate, the shocking news is that, TB cases are on an increase! And blow is the snapshot of TB repot in Uganda.

GLOBAL TUBERCULOSIS CONTROL | WHO REPORT 2008 Uganda rank 15.

Rank based on estimated number of incident cases (all forms) in 2006

Two of the core components of DOTS (smear microscopy for diagnosis and direct observation of treatment) are still not routinely, performed in all districts of Uganda. Treatment outcomes were reported for almost all patients included in the 2004 and 2005 cohorts of new smear-positive cases.
However, in both years Uganda had the highest default rate of any high-burden country, despite the use of community-based TB care. Collaborative TB/HIV activities are expanding, but still in 2006 only one quarter of TB patients were tested for HIV. Although funding needs for 2007–2008 are higher than for previous years, the amount available is lower and limited funding is expected from central government for 2007–2008, resulting in increasing funding gaps. Even where funds are allocated, disbursement and absorption are problematic.

By Ivan