Uganda has only a fraction of the 150 million condoms it needs to manage its AIDS crisis.

The US government's emphasis on abstinence may have precipitated Uganda's condom crisis. Credit: China Photos

Refuting allegations by activists, an official of Uganda's health ministry says the country is not in the throes of a condom shortage.

Health campaigners charge that condoms have been alarmingly scarce for more than ten months, a situation they say is undermining one of the most successful HIV-prevention programs in Africa. Under US pressure, they say, the Ugandan government is increasingly promoting abstinence and monogamy as anti-HIV tactics, rather than all three parts of its 'Abstinence, Being faithful and Condoms' (ABC) strategy.

If this is not a crisis, I don't know what is. Jodi Jacobson,, Center for Health and Gender Equity

Just days after the condom dispute erupted, the Global Fund to Fight AIDS, Tuberculosis and Malaria also announced the temporary suspension of $201 million in committed grants to Uganda, on grounds of “serious mismanagement” by the health ministry.

Still, Elizabeth Madraa, who manages the Ugandan Ministry of Health's AIDS and STD program, says 20 million condoms have been distributed in the country since August. “Currently we are not having condom shortages,” she says, adding that another 60 million condoms are in warehouses awaiting distribution or testing. The Global Fund is expected—despite its recent action—to ship in 55 million more by the end of September.

But the 20 million condoms now in distribution arrived as an emergency shipment from Europe in April and sat in storage for a full three months before reaching the public, notes Jodi Jacobson, executive director of the Center for Health and Gender Equity. What's more, she adds, only an additional 10 million condoms from the government and nonprofit groups are currently in circulation. And those supplies are nowhere near enough.

“Estimates are that at least 120 to 150 million condoms are needed in Uganda each year for HIV prevention alone,” says Jacobson. “If this is not a crisis, I don't know what is.”

Uganda has recently begun requiring that pretested international condoms go through another round of quality testing upon arriving in the country. Due to a new import fee, the price of condoms in shops has also spiked from $0.16 to $0.54 for a package of three. District hospitals and government clinics, which previously dispensed condoms for free, are drained of supplies, says Beatrice Were of ActionAid in Uganda.

Uganda's First Lady Janet Museveni, a conservative evangelical Christian, is meanwhile vigorously promoting the abstinence message, prescribing 'virginity pledges' and reversing pro-condom billboard statements, Were adds.

Jacobson says about $20 million under President Bush's emergency plan for AIDS relief has already gone this year to Ugandan HIV prevention efforts. Based on grant agreements and internal state documents, she says, at least 56% of that money has been targeted at abstinence-only initiatives.

Mark Dybul, the deputy US Global AIDS Coordinator, dismissed suggestions that the Ugandan condom shortage was motivated by either the Bush administration or the Ugandan government's stance on abstinence. Rather, he says, it arose due to a nationwide condom recall in October 2004 after overseas testing authorities found a faulty Ugandan batch. The recall “is the only way to rebuild confidence in the product, and it is exactly what any other government, including in Europe or North America, would do when faced with similar circumstances,” Dybul says.