Why was Museveni able to succeed where so many other leaders have failed?
Some credit is due simply to President Museveni’s own charisma and personal capabilities (Putzel, 2004). As discussed above, credit is also due Museveni’s policy of creating space for NGOs and international donors to operate. However, the above explanation of Ugandan success in containing the AIDS epidemic has been challenged by those frustrated with failed attempts to replicate Ugandan results elsewhere in Africa.
There is less rosy explanation for the success of the Ugandan government in addressing the HIV/AIDS epidemic, involved the somewhat unique nature of political institutions. The early approach to the epidemic fundamentally involved fear and intimidation. The initial theme of many messages was “Beware of AIDS: AIDS kills”
(Kaleeba, Kadowe, Kalinaki, & Williams, 2000). Another important component of Museveni’s response to HIV was the use of local councils, remnants of the Resistance Councils from the civil war. These Resistance Councils initially operated parallel to the
civil service but were subsequently absorbed into it. They remain the bedrock of Museveni’s support. These bodies derived their authority directly from the President and were supported by the army. They allowed a decentralized system of representation built from the grassroots level, essential in a new country with weak state capacity.
However, while they supposedly served as advocates for people in their district and assisted in awareness and education campaigns, they also became active in promoting and even enforcing behavioral change, sometimes violently.
The local councils reasserted patriarchal interests, monitored the activity of people at dances, the movement of certain women, and mediated disputes involving bridewealth or the sexual activities of women. They forcibly stopped young women from moving from village to village and closed down discos and bars. They also became involved in hearing cases when a woman was accused of inyinya, or witchcraft
associated with poisoning, and on a number of occasions had the individual executed.
Once news about HIV/AIDS started to spread, such activities essentially received tacit approval from the administration. The term inyinya evolved to mean those women who might be infected with HIV, and the Resistance Councils became the primary source of such accusations (Allen & Heald, 2004). This grassroots approach to social control allowed Uganda to succeed in behavioral change where many other states have failed, but only at the cost of clear and substantive human rights violations.
The centralized character of the NRM regime was critical to ensuring the successful implementation of the AIDS Control Program. Museveni left little room for open political dissent once the NRM adopted any policy. The leaders of the central state acted first to rally the nation behind the fight against HIV/AIDS in order to preserve their own power. The centralist authority of the NRM, and the military organization upon which is was based, made dissemination of the messages about HIV rapid and thorough. It was Museveni’s military organization that in 1988 implemented the first national sero-survey to take place in Africa.
The army is Museveni’s power base, and as commander of the Ugandan People’s Defence Force - the successor to the NRA as the national army – Museveni personally oversees the lists of officers who receive ART. This is the ultimate form of patronage (De Waal, 2006). Museveni’s approach has long reflected his experience in the NRA: a single power center, which eventually would become the Presidency. This approach is
reflected in his approach to virtually all other institutions within the government.
Ugandan AIDS policy and apparent success have also become critical to
Museveni’s strategy for remaining in power. The political cachet of the apparent success of Uganda’s AIDS policies has been an essential boon to the Museveni regime. Museveni has been particularly adept at crafting his message to particular audiences. To
international donors and the urban population, he promotes a broad approach to HIV/AIDS including condoms, as well as minimal censorship and the proliferation of
NGOs. To rural and more conservative international constituencies, he promotes behavioral change and abstinence, often violently enforced by the local Resistance Council structure. Janet Museveni, the President’s wife, has long been popular in conservative circles in Washington DC, due partially to her opposition to condoms and prominence as a born-again Christian (De Waal, 2006).
Museveni’s politicization of HIV/AIDS has enabled him to cement his position both as President and as a world leader in the fight against the pandemic. Museveni has used his HIV/AIDS achievements to paper over cracks in his administration; his post-2000 emphasis on Ugandan HIV/AIDS policies coincided with increased pressure on him to counter allegations of his government’s economic mismanagement, corruption, and repression of opposition politicians. During the months leading up to Museveni’s reelection in 2001, there were numerous episodes of violence, kidnapping, and torture.
The vast majority of these offenses were carried out by Museveni supporters, including the Presidential Protection Unit against the most prominent challenger’s (Kizza Besigye) supporters (Epstein, 2001). The focus on AIDS has arguably reduced attention paid to a political situation that left over 1.6 million people living in IDP camps (Murphy et al., 2006). Museveni’s rise as a global AIDS authority also helped redirect attention from his controversial 1997 decision to send the Ugandan army into the DRC to help remove Joseph Mobutu from power, a decision that resulted in regional instability, the deaths of thousands of Congolese, and international condemnation of the Ugandan regime.
Particularly post-2000, Museveni’s faith-based approach won him both praise and criticism in equal measure. His increased emphasis on the merits of abstinence and fidelity over condom use caused considerable concern amongst those pressing for an increase in condom usage, particularly for teenagers. Critics dismissed his perspective as an attempt to curry favor with the Bush administration in the interest of securing
funding and personal recognition (Flint, 2011). It certainly is the case that recent political and religious influences, including PEPFAR, have led the country to tout its ABC
campaign to international audiences (Murphy et al., 2006).
Shoring up support via his policies on AIDS has been crucial to the longevity of the Museveni regime. Museveni took power in Uganda and established legitimacy by bringing peace, stability, and relative prosperity. However, during his second decade in power he has involved Uganda in meddlesome foreign wars, and his administration is beset by extreme corruption. Museveni has pursued an increasingly despotic style of government, including keeping a single-party system, and changing the constitution to allow him to continue in office indefinitely. While Western governments would
normally be reluctant to cooperate with such a regime today, his record in dealing with AIDS has become his greatest asset (De Waal, 2006). The international community needs Uganda’s success, Museveni is aware of this, and he knows how to use this to stave off criticism of his regime.