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This paper provides an insight into the experience of GTZ in supporting the fight against HIV/AIDS in Kabarole, Uganda, and highlights ways of measuring success. It reviews the different projects implemented in Kabarole since the late 1980s, and shows the results of the different monitoring initiatives undertaken.

The paper concludes that the experience of HIV/AIDS control in Kabarole district provides clear evidence that it is possible to make a significant impact on the HIV epidemic in Sub-Saharan Africa, particularly amongst the young population. However, the success cannot be seen in isolation but must rather be considered within the specific historical, epidemiological and societal situation in Uganda. This implies that it may not be transferable to other countries or regions in Africa.

Lessons learned include:

• HIV/AIDS control can only be successful if the country’s leadership shows strong political commitment
• success in HIV prevention will be first observable in the young and educated population groups
• in generalised HIV epidemics such as in Uganda, the core of the problem will shift to the rural poor who have little education and often very limited options for decision-taking
• sufficient emphasis must be placed on monitoring and evaluating programme impacts
• HIV/AIDS programmes should be integrated into more general support to health system development and service delivery as a necessary element of successful HIV/AIDS control.

[adapted from author]

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