After seven years and $1.4 billion of American aid, Uganda is coming back to life following a near-death experience with HIV/AIDS.

But the battle is far from over. The U.S. government is spending on average $5 million a week ($280 million per year) to fight HIV in the East African country. About 100,000 Ugandans are newly infected each year, and about 25,000 are young children.

"We have a big gap to address in pediatric treatment and care," said Addy Kekitiinwa, executive director of Baylor College of Medicine Children's Foundation in Kampala. "It's a shame that most adult facilities cannot offer pediatric services."

Christianity Today visited Kampala's Mildmay clinic, which treats HIV-infected women and children. Inside, preschooler Elizabeth happily plays with Jackie, her 2-year-old sister. Both of them are too young to realize how narrowly they escaped becoming a statistic. Worldwide, 280,000 children died of AIDS in 2008.

Wearing a faded pink-and-white dress, Elizabeth is at the clinic for a check-up. For the past four years, clinics and hospitals have become her virtual second home. Born with HIV, Elizabeth came into the world weighing 4.4 pounds. Within eight months, she had contracted meningitis. She was continually coughing and vomiting and became malnourished. After six months of intensive care, she had a 75 percent weight gain and was discharged.

Winnie, Elizabeth and Jackie's mother, is among the 1.1 million Ugandans living with HIV. Before giving birth to Jackie, Winnie, 26, joined an HIV prevention program for expectant women, and so far Jackie has remained disease-free. Now pregnant, Winnie receives updated instruction at Mildmay on how to keep the virus from spreading to her third child.

Such programs are relatively new. In Uganda, programs for HIV-positive pregnant women started in 2000. Clinic nurse Vicky Nabuule told CT that treating pregnant women and children after HIV infection must be comprehensive to succeed long-term. "Women are encouraged to take their medication and to keep their appointments for good adherence," Nabuule said. Prevention reaches 30 percent of the women who are at risk of HIV infection. In Uganda, 150,000 children are living with HIV, but only half of them receive the drug treatment they need to survive.

The Mildmay center treats 22,000 Ugandans annually. The UK-based charity was begun in 1866 by evangelical clergyman William Pennefather to fight a cholera epidemic in London's East End. Mildmay ministers in five African nations. Its programs are designed to treat the whole person. Staff assess the physical, medical, and spiritual needs of each client, then design a treatment program to meet all of those needs. The World Health Organization has given Mildmay one of its best practices awards.

About 90 percent of Uganda's HIV programs rely on donor funding. Within the past year, many cash-strapped programs stopped providing antiretroviral drugs to new patients. This move prompted a worldwide outcry. The pepfar program, launched by the Bush administration in 2004, allowed an emergency supply of drugs worth $5.5 million to be given to the Uganda Ministry of Health. That put another 72,000 HIV-infected people, including 5,000 children, on drugs for the next two years.

"Elizabeth keeps asking me why she has to take the medicine when she is not sick. She does not know how lucky she is," said Winnie. A family friend, Namitala, is also pregnant and HIV-positive. She has lost two children.

Mildmay holds a non-sectarian worship service each morning for clients and staff. Norah Namono, Mildmay's public relations officer, told CT that the pastoral team offers follow-up counseling, because many people living with HIV blame God or witchcraft for their infection.

Dunstan Bukenya, the new Anglican bishop for the Mityana diocese, east of Kampala, said the scientists do the treating, but the healing is from God. "The missionaries knew that very well," Bukenya said. "That is why they built churches alongside hospitals."

Esther Nakkazi is a journalist in Kampala, Uganda.


Related Elsewhere:

In preparation for World AIDS Day on December 1, Christianity Today also posted "No Child Left to Die" and an op-ed from Michael Gerson on AIDS funding. CT also published a Bible study on "No Child Left to Die."

Previous HIV/AIDS coverage from Christianity Today includes:

Obama's AIDS Dilemma | White House funding priorities determine who will live and who will die. Collin Hansen | (May 17, 2010)
Talk and Walk | Getting our body in sync with our message. by Kay Warren | (June 6, 2008)
Killing a Pandemic | The church may be best equipped to deal HIV/AIDS a crippling blow. (November 18, 2002)

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