10. Telegram From the Embassy in Uganda to the Department of State1

3301. Subject: AIDS Epidemic in Uganda.

1. Action request paragraph 5.

2. Following is a summary of recent conversations with Dr. Rick Goodgame (US citizen missionary internist) and Dr. H. Wilson Carswell (UK citizen contract surgeon). They and five Uganda medical doctors at Mulago Hospital (Uganda’s largest hospital, located in Kampala) have formed a committee to investigate the spread of acquired immunodeficiency syndrome (AIDS) in Uganda.

3. AIDS is becoming a major health problem in Uganda. 10–20 percent of general medical admissions at Mulago have the disease. It presents in two forms. One is enteropathic with severe wasting, diarrhea, and unusual organisms infecting the GI tract, i.e., cryptosporidiosis, isospora belli, candida albican. The second is atypical aggressive Kaposi’s sarcoma. Active research is underway by members of the staff at Makerere University Medical School and Mulago Hospital. Preliminary results have been published (Lancet, February 16, 1985; October 19, 1985).2 The unusual and distressing features of this epidemic are the equal distribution in both sexes, the high prevalence of HTLV III viruses in the population (about ten percent of the general population), and the apparent transmission by heterosexual contacts. [Page 31]The at-risk population is enormously high, including both Ugandans (from all strata of society) and expatriates (no cases identified thus far).

4. Serious investigations are already underway in the following areas:

—Cause of diarrhea

—Sexual behaviours of patients versus general population

—Sero-epidemiology

—Post-mortem studies

—Immunologic studies

All of these have been initiated locally with little or no financial support from abroad.

5. Action request: Doctors here have identified two kinds of needs:

—Immediate short-term: Funds to send from one to six Ugandan doctors to November 21–22 AIDS in Africa Conference in Brussels so they may present posters on AIDS in Uganda and develop international contacts.3 Estimated cost would be USdols 2,000–10,000 depending on the number of participants. (Funding from other governments and organizations thus far has not been forthcoming.)

—Seven-doctor committee on AIDS at Mulago Hospital want to establish an ongoing comprehensive research program with NIH, CDC, or some American medical school to be able to carry out and extend the above-mentioned projects. Small amounts of funding (USdol 1,000–10,000) would go far locally for procurement of equipment, reagents, materials, and office supplies. Doctors wish to establish a linkage with a US institution which would help supervise and direct research. (N.B. while visits from US medical authorities would be welcomed, given present political-security situation obtaining, travel to Uganda would not be necessary for programs to go forward.)

Preliminary inquiries have been made to Drs. Robert Bigger and Karl Western at NIH; serious proposals have not been discussed, however.

6. Comment: Embassy understands that research on AIDS in Africa is expanding rapidly. While the medical infrastructure in Uganda has been badly damaged over the past fifteen years, there remains a cadre of accomplished medical practicioners who could carry out high quality research for a modicum of financial input.

[Page 32]

7. RMO Rollins/New Delhi knows Dr. Goodgame well and may wish to comment on impressions gained while visiting medical establishment in Kampala during 1980–84 tour as RMO in Nairobi.

Bennett
  1. Source: Department of State, Central Foreign Policy File, D850787–0689. Unclassified; Priority. Sent for information to Nairobi, Kigali, Dar es Salaam, Kinshasa, Bujumbura, Khartoum, and New Delhi.
  2. A.C. Bayley, R. Chiengsong-Popov, A.G. Dalgleish, R.G. Downing, R.S. Tedder, R.A. Weiss, “HTLV–III Serology Distinguishes Atypical and Endemic Kaposi’s Sarcoma in Africa,” The Lancet, vol. 325, no. 8425, February 16, 1985, pp. 359–414.
  3. In telegram 352051 to Kampala, November 16, the Department informed the Embassy: “Very sorry to report am unable to obtain funding from AID for Ugandan doctors to attend AIDS conference in Brussels. AID/S and T/HEALTH and AID/AFR declined to support travel, and use of post funds was judged not to be legal.” (Department of State, Central Foreign Policy File, D850822–0470)