- Sarah Boseley in Kampala
Wyclif looked destined to become an Aids orphan. His mother Deborah was sick during her pregnancy and had to give up her job at a local school. She and her husband feared they would not live to bring up the new baby, who would then be dependent on the kindness and limited financial means of relatives, if he was lucky. Many Aids orphans, as those who have lost one or both parents are known, live a brutal life on the streets.
“I know my health status,” Deborah told the Guardian five years ago. “The time will come when Robert and I are not there for Wyclif or the other children. They will become orphans.”
Yet today, Wyclif Kukiriza is a bright-eyed, inquisitive little five-year-old, with a determined streak. Nobody else is going to show off his house but him.
He grips my hand firmly and tows me through mud and rubble tracks in the impoverished Baise suburb of Kampala to the dark, two-room, concrete bungalow with crumbling plastered walls that he shares with his parents and two elder siblings.
His vitality is great to see. Wyclif escaped infection because his mother received good medical care at Mulago hospital in Kampala and was given drugs and a caesarean section to reduce the chances of transmission. And five years on, Deborah and Robert no longer expect an early death.
Against all the odds, sub-Saharan Africa now has anti-retroviral drugs which keep people with HIV alive. A global campaign brought down the prices from $10,000 (£6,400) a year per person to less than $100 (£64). Aids treatment is free, thanks to western donor governments.
Wyclif’s good fortune is that Deborah and Robert live in Uganda’s capital city where HIV care is easily accessible and many local groups like Tusitukire Wamu (United We Stand), originally set up by eight women against domestic violence, offer HIV counselling and support.
That was where Deborah turned first for help. Both she and Robert are taking antiretroviral drugs every day and staying well. She no longer thinks HIV will kill her. “I am no longer worried,” she said.
What she probably does not know is that no expert working in HIV today would dare assume the drug supply is secure. Four million people worldwide, nearly three-quarters of them in sub-Saharan Africa, are now on ARVs and must take them every day for the rest of their life unless a cure is found, which looks highly unlikely any time soon. Over 5 million still need treatment.
The donor community, faced with recession at home, is cutting back and trying not to take on new commitments.
Ugandan doctors have been among the first to sound the alarm. Mulago hospital itself was having to turn away patients who were newly diagnosed for want of Aids drugs, the renowned Aids specialist Dr Peter Mugyenyi, who runs a research centre there, told the US Congress earlier this year.
He warned that they may run too short to be able to keep supplying those who have already started taking them.
So the Kukirizas’ future may be less certain than they know. It may be just as well they don’t, because they have enough other problems.
For the last few weeks, Robert has been out of work. He was a minibus driver, but the battered vehicle he drove finally collapsed and the owner has scrapped it. The hours were long and it wasn’t an incredibly lucrative job – if he didn’t get enough passengers and the takings were low, he had to pay the owner out of his own pocket – but it was steady.
Now he spends his days looking for another minibus to drive, while the couple’s friends subsidise them. But they have moved from the house where Wyclif first lived, where they couldn’t pay the rent a few times and the owner confiscated some of their possessions,and now live rent-free, looking after the house of a friend who works away from home as a truck driver. All three children are in school – the boy of 13 who wants to be a footballer and the girl of 11 who would like to be a businesswoman, as well as their baby brother– though they stop attending when money is tight. Even in government schools, there are uniforms, books and exams to pay for. Wyclif is in kindergarten, where he already has a report of the “could do better” variety. That may be something to do with the fact that he didn’t speak until he was four.
But Wyclif’s intelligence is unmistakable. Prompted by adults to talk about himself, he says nothing, looking at the mobile phone battery in his hand as they offer suggestions. Then, as the attention switches away from him, he says: “I want to drive an aeroplane.” His mother laughs in astonishment. He says he saw one in the sky. It would be nice to think that, against the odds, he could reach for the sky one day.
Under-fives mortality (per 1,000 births): 135
Population on under $2 (£1.28) a day: 75.6%
Debt per capita: $37.05 (£23.71)
Life expectancy: 52
% children in education (F/M): 55.2/57.1