Impacts
of the Disease
HIV puts economic stress onto the young and the old, as they
have to provide for the family if their relative who is of a working age is
infected with HIV. This is made worse by the fact that 58% of all jobs are in
the primary sector- using resources directly from the land- meaning that the
young and the old are physically strained by work which they are forced to do
in order to survive, which is not suitable for their body or their age. This
also means that instead of farming and then selling their produce for money, they
are forced into subsidence farming (providing for themselves alone), as they
need to survive. This decrease in agriculture is also producing a huge loss or
workforce across Uganda, which is directly impacting its GDP as a country. This,
therefore is undoing decades of economic progress made by Uganda, and is
hindering its economic development massively.
The financial costs of caring for patients with HIV/AIDS can
also be huge, relative to total household income. In the Rakai district,
households reported spending up to a third of their total annual income on
medical care for one month, or for a funeral. This then puts more strain on the
carers to make more income, putting huge amounts of economic and emotional
stress on the already-vulnerable age groups. This could lead to mental problems
such as depression and high levels of anxiety, which sometimes causes suicide,
especially prevalent amongst young people.
HIV affects Uganda’s healthcare in 2 ways: it increases the
number of people in need of services, and healthcare specifically for HIV is a
lot more expensive than for other infectious diseases. By 1993, 54% of the
admissions in Rubaga hospital (on the outskirts of Kampala), were HIV-positive
and mortality rate of these patients was 17.4%, as oppose to the mortality rate
for those not infected, which was 5.8%. Hospital occupancy rates has increased
due to the huge amount of people seeking help with their HIV, and so this is
putting a huge strain on the health sector in Uganda, which is already under
massive amounts of pressure, given the high number of people with other
infectious diseases such as malaria, TB and cholera, which require lots of
medical attention.
The transmission rate in Uganda is also extremely high from
lack of education about the disease, resulting in more cases, more poverty and
more strain on both private and public resources. This could also be due to the
fact that there is still a huge social stigma around HIV, and so high risk
groups aren’t aware that the person they are getting it from even has HIV.
Education in Uganda is also extremely low, with the only
53.3% of children finishing primary school in 2011. This is somewhat due to
children having to act as carers for sick relatives, or having to work to gain
income for the family. This results in families being trapped in the poverty
cycle because if people aren’t educated they can’t receive a high-paying
specialised job, resulting in a very low income and poverty.
Management
Strategies
The main approach to preventing HIV in Uganda is known as the
ABC system:
·
Sexual abstinence
·
Be faithful
to a single partner or reduce the number of partners
·
Always use a condom
This means that high risk groups are less likely to get/pass
on HIV, as the number of unsafe sex encounters are drastically reduced. This
initiative started when the government realised that the number of Ugandans who
reported using condoms at their last sexual experience was at 13.7
percent in 2011. People, however, tend to not follow this advice, or are forced
into having unsafe sex due to either domestic violence, rape culture or
prostitution. This campaign is a change from abstinence-based approaches to
prevention, which became dominant in previous years due to PEPFAR's
significant investment of money for these types of
programme. Delaying sex until marriage is hoped to reduce HIV infection
rates among young people, and billboards across various cities in Uganda widely
advertise this. However, ignoring the importance of condom use is contributing
to rising HIV rates, showing how important all three areas of the ABC
approach are.
A community-based organisation called The AIDS Support Organisation was set up in 1987 to help people
come to terms with their disease and try and reduce the taboo of HIV, and was
one of the first action groups in Uganda to help those with HIV.
Prevention of mother-to-child transmission (PMTCT): expectant
mothers are encouraged to know their HIV status in Uganda, as this seriously
affects the health of their baby. Around 94 percent of pregnant women who
attended antenatal clinics in Kampala received counselling and testing for HIV
in 2011, which suggests that knowledge about PMTCT is relatively high in the
capital, however, this is only true for the women who went to antenatal
clinics, which is around 68% of the city.
The World Bank has also significantly contributed to the HIV
healthcare of Uganda, as it has donated a total of over $100 million dollars on
HIV prevention and treatment over the last 50 years- drastically improving the
prevalence of the disease in the last decade.
Uganda’s government has also ‘mainstreamed’ HIV issues in its
Poverty Eradication Plan- raising
awareness of the disease, various prevention methods and the socio-economic
stress put on a large segment of the population.
Moroidin is the active chemical in the toxin of the plant, and is a bicyclic octapeptide. Its skeletal formula is shown on the adjacent diagram, and it has a molecular formula of C47H66N14O10. It is made of 9 different amino acids. 
