DR IAN CLARKE: An appeal to President Biden

In a statement by President Joe Biden on the Enactment of Uganda’s Anti-Homosexuality Bill, he said, ‘I have directed my National Security Council to evaluate the implications of this law on all aspects of U.S. engagement with Uganda, including our ability to safely deliver services under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and other forms of assistance and investments. My Administration will also incorporate the impacts of the law into our review of Uganda’s eligibility for the African Growth and Opportunity Act (AGOA). And we are considering additional steps, including the application of sanctions and restriction of entry into the United States against anyone involved in serious human rights abuses or corruption.

I will not get involved in the debate on homosexuality, but I would like to comment on the implications of the above statement from President Joe Biden.

If rated by the number of wars he started, one of the worst presidents of the United States in recent history must be President George W Bush who went to war with both Afghanistan and Iraq, causing untold human suffering for millions of people. However, George W Bush will not just be remembered as a warmongering president, but as the man who started the largest aid programme in history in another war – the war against AIDS. The programme was known as the President’s Emergency Plan for AIDS Relief (PEPFAR) and has meant the difference between life and death for millions of Africans, including hundreds of thousands of Ugandans. President Bush was persuaded by a black woman – his Secretary of State, Condoleezza Rice – and an Irishman – Bono, the lead singer of U2 – to take this initiative, proving that no man is all bad or all good and most men have some humanity.

Many years ago, I sat in a meeting with Prof Alex Contino, the Executive Director of the Infectious Disease Institute, where we discussed the possibility of getting every person who was HIV positive on Antiretroviral Drugs. At the time these drugs were relatively expensive, and although some of my richer patients were receiving them, the vast majority of those who were HIV positive were not on treatment. I thought this was a pipedream at the time, but it has since happened – because of the programme initiated by George Bush and continued by every other president, including Donald Trump, until this present day. I well remember the experience of telling my patients they were HIV positive before the advent of ARVs because it was a diagnosis of hopelessness. Hope dawned with the advent of ARVs, but it was still hope only for the few. But for most Ugandans it was a death sentence due purely to an accident of birth – that of being born into a poor country.

This all changed with the advent of PEPFAR. Not only that, but the USA pioneered a programme to reduce the spread of HIV through treating everyone as soon as they were diagnosed. Previously those who were HIV positive were not treated until their CD4 count fell below 500, and such people continued to spread HIV. The new policy stopped transmission as soon as they had an undetectable viral load. The US also funded a safe male circumcision campaign in which men could get free circumcision, which significantly reduced their chances of becoming HIV positive. They also funded the programme to ensure expectant mothers were put on HIV treatment and thus prevent mother to child transmission. All these programmes have given back life and hope to ordinary Ugandans.

I believe that President Biden is a good man who is threatening to withdraw aid to Uganda on what he sees as a human rights issue (Gay people are also human beings who have rights). On the other hand, the vast majority of Ugandans see this as a cultural issue and feel they are being bullied by a strong western gay lobby.

My appeal to President Biden is not to abandon the wonderful work which the USA has done for ordinary Ugandans for decades. Two wrongs do not make a right, and how can it be the right response to punish poor Ugandans for an issue that is beyond their control? I see hypocrisy on all sides – the double standards of the Speaker of Parliament and other government Ministers who took iron sheets meant to go to the poor in Karamoja, but are very sanctimonious over the gay issue. However, it is no better for the US government to reflect their own judgement on Uganda by taking away ARVs from the poor.