U.S. Ambassador Natalie E. Brown’s Remarks at Y+ Beauty Pageant

U.S. Ambassador Natalie E. Brown’s Inspiring Speech at the Y+ Beauty Pageant Grand Finale

Serena Hotel Kampala | November 23, 2022 (As prepared for delivery)

Good evening, everyone! I am genuinely excited to join you for the eighth Y+ Beauty Pageant this evening. This marks my third pageant, a journey that began shortly after I arrived in Uganda in 2020. Each event has surpassed the previous one, showcasing the incredible talent and determination of the contestants. I would like to extend my heartfelt gratitude to the organizers for facilitating this remarkable partnership, which serves to empower young individuals to advocate for their own needs and create platforms for their voices to be heard.

I want to take a moment to recognize the Uganda Network of Young People Living with HIV/AIDS (UNYPA) for their impactful theme this year: “We Have Got the Voice; Pass Us the Mic.” Over the years, I have witnessed UNYPA’s exceptional advocacy efforts in creating safe spaces for young people living with HIV to share their experiences, tell their stories of resilience, and foster coalitions that combat stigma in their communities. Themes from previous years, such as “Changing the Narrative” and “Opening Opportunities,” have laid a solid foundation for this year’s significant message. My interactions with UNYPA and the Y+ ambassadors have truly illustrated how your organization continues to redefine narratives and provide vital opportunities for young individuals living with HIV across Uganda.

Since 2003, the United States government has partnered with the Government of Uganda and various Civil Society Organizations under the President’s Emergency Plan for AIDS Relief (PEPFAR) to enhance access to crucial HIV prevention, care, and treatment interventions. According to the most recent UNAIDS estimates, approximately 1.4 million individuals are living with HIV in Uganda. Thanks to improved access to essential health services, many individuals are now leading longer, healthier lives. PEPFAR’s initiatives extend to every district in Uganda, directly supporting over 1.3 million individuals receiving HIV treatment. The latest annual results from PEPFAR highlight that over 165,000 individuals initiated pre-exposure prophylaxis (PrEP) for HIV prevention, while more than 91,000 returned for periodic PrEP refills last year. This proactive approach has significantly contributed to protecting individuals at ongoing risk. Moreover, PEPFAR has aided nearly 610,000 orphans and vulnerable children, along with their families, by providing comprehensive family-centered services and interventions aimed at preventing HIV and violence. These statistics underscore the tireless efforts of the community, which are indeed making a profound impact. Notably, the Uganda Population-Based HIV Impact Assessment (UPHIA) released earlier this year reported a remarkable 39% decrease in new HIV infections and a 67% decrease in AIDS-related deaths from 2010 to 2021.

The robust health systems established through years of collaboration among the government, NGOs, and PEPFAR are also being effectively utilized to respond to other pressing public health threats, including COVID-19 and the ongoing Ebola outbreak. During these challenging times, PEPFAR partners and peer educators have risen to the occasion. Last year, I shared the story of Michael Ssenyonga, a former Mr. Y+, who founded the Kasese Network of Young People Living with HIV. During the peak of the pandemic, he ensured that food and essential medications reached over 700 young individuals living with HIV. His exemplary leadership inspired others, and now healthcare and community workers are actively following up with individuals who may have been in contact with Ebola patients and who are unable to reach clinics for their medication. These dedicated workers are tailoring their services to meet individual needs while providing crucial psychosocial support during this difficult period. Furthermore, despite the strain on the laboratory systems due to the Ebola outbreak, the established framework is efficiently managing the increased demand to ensure timely test results are delivered to those living with or tested for HIV.

I commend the healthcare workers who responded valiantly to COVID-19—remember to get your jab as cases continue to rise—and who are now actively supporting the response to Ebola. Their interventions have been vital in ensuring the survival of many individuals and in mitigating the further spread of this disease. However, it is essential for us to remain vigilant and to educate our communities about the ongoing risks associated with the Ebola Virus Disease (EVD), especially as we approach the festive season and people begin to consider travel. Anyone who has been in contact with someone exhibiting EVD symptoms should diligently follow the Ministry of Health guidelines for early screening to protect themselves and others. Timely treatment is crucial for better health outcomes. While we frequently discuss the stigma associated with HIV/AIDS, we must also acknowledge the significant impact of health-related stigma and discrimination. It is crucial that we welcome survivors of this severe illness—79 to date—back into our communities and ensure they receive the support they need.

Despite the encouraging trends of declining new infections and AIDS-related deaths that I have mentioned, it is not yet time for celebration. The epidemic remains a pressing issue, affecting individuals across all age groups and genders, but the impact is felt differently among various populations. Young people aged 10-24 are particularly vulnerable to HIV infection, with 43% of new HIV infections occurring within this age group. Out of the 1.4 million individuals currently living with HIV, 50,000 are young men and 120,000 are young women aged 15-24. Alarmingly, there were 20,000 new HIV infections reported within this same age group in 2021, with 15,000 among adolescent girls and young women and 5,000 among boys and young men. Additionally, 6,000 new infections were reported among children aged 0-14 years. These statistics highlight the critical need for UNYPA’s initiatives, particularly as we navigate an environment where adolescent girls and young women remain at high risk for early pregnancies, gender-based violence, HIV infection, and treatment failures.

It is important to recognize that all these numbers represent real individuals—our family members, friends, and neighbors. I have been privileged to hear directly from young people about their experiences with HIV. In February, I had a heartfelt visit from UNYPA ambassadors on Valentine’s Day, where I listened to the remarkable life stories of several young individuals present here today. During my visit to Oyam District, I learned about the daily struggles and small victories from a group of dedicated young peer leaders committed to reducing stigma and encouraging HIV treatment initiation within their community. Most recently, I attended the National HIV and AIDS Symposium, where I was thoroughly impressed by Ruth Awori’s MC skills and had the opportunity to engage with passionate civil society advocates who stressed the importance of providing accessible services for all, including individuals with disabilities. The ongoing disparities in HIV testing, infections, care, and treatment emphasize the urgent need to focus efforts on eliminating inequalities between young people and adults.

Ending AIDS by 2030 is an achievable goal. Over four decades, Uganda has made groundbreaking scientific advancements and gained invaluable program experience, equipping us with the knowledge needed to reach this target. By applying a person-centered service delivery framework, combined with strong governance, strategic investments, and the passionate advocacy of young people for needs-based service delivery, we can mobilize policymakers, development partners, civil society, and communities towards effective solutions that will significantly reduce the incidence of new HIV infections and AIDS-related deaths. PEPFAR is currently reimagining its strategic direction to not only end the HIV pandemic but also to sustainably enhance public health systems. Our strategic approach will be closely coordinated with the newly released “Global AIDS Strategy 2021-2026: Ending Inequalities, Ending AIDS,” which has been embraced by all PEPFAR countries.

As we focus today on amplifying the voices of young people advocating for their needs, I want to reaffirm that PEPFAR is deeply committed to ensuring all ages, genders, and populations at risk for HIV infection receive equitable, data-driven, and evidence-based prevention and treatment services. It is essential to recognize that pandemics do not impact all individuals uniformly, as highlighted by the significant equity gaps that persist for adolescent girls, young women (AGYW), and children. We will intensify our efforts to prioritize these groups, aiming to effectively achieve durable viral load suppression and reduce incidence rates.

Recognizing that youth are the most technologically connected demographic, with 71% of the global youth population online compared to only 48% of the total population, we must leverage these technological advancements in our treatment adherence activities and differentiated service delivery models. This includes creating new opportunities to harness technology and innovation for youth engagement. Digital approaches, such as UNYPA’s app for peer support groups, can enhance communication between young individuals living with HIV and medical providers, while also identifying local youth-friendly services. I commend youth-led organizations like UNYPA, which have pioneered digital and community interventions to combat stigma and discrimination.

To advance equity in HIV prevention, PEPFAR Uganda has continued to invest in the DREAMS program—an acronym for Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe. This program has expanded into more districts and increased service coverage within existing districts over the years. DREAMS focuses on comprehensive HIV prevention efforts among adolescent girls and young women in 24 high-incidence districts, reaching over 240,000 such individuals last year through gender-sensitive, evidence-informed prevention programs. These initiatives include curriculum-based behavioral change interventions, HIV testing services, PrEP expansion, educational subsidies, socio-economic strengthening programs, gender-based violence prevention, and post-violence care. Our efforts are deeply rooted in communities supported by robust partnerships with government and AGYW-focused organizations. During my visit to a DREAMS program in Wakiso in August, I was profoundly inspired by a young woman, a former DREAMS beneficiary, who utilized the skills she acquired from the program to prepare for university, which she started this year. She remains actively involved in DREAMS, now serving as a mentor to assist other girls in planning for their futures and finding their voices.

PEPFAR will persist in collaborating with the Government of Uganda and Ugandan civil society to keep girls in school while preventing teenage pregnancies and HIV infections. The rates of teenage pregnancies remain alarmingly high, with 25% of adolescent girls aged 15-19 having either given birth or are currently pregnant. Schools should serve as safe environments where children and adolescents can receive crucial information about HIV prevention. PEPFAR’s DREAMS and Orphans and Vulnerable Children (OVC) programs play vital roles in ensuring that children and adolescents remain in school by providing educational subsidies to those at risk of dropping out. Last year, PEPFAR was able to provide over 30,000 educational subsidies to counter the adverse effects of the COVID-19 lockdown.

The recently concluded National HIV and AIDS Symposium, themed “Ending Inequalities among Adolescent Girls and Young Women and Boys,” represented a significant step towards addressing the persistent treatment gaps that impact our progress. At this event, I witnessed the community’s passion for advocating on behalf of the most vulnerable populations. I engaged in discussions with prominent civil society leaders about the importance of recognizing the unique needs of individuals with disabilities and the necessity of providing equitable and stigma-free health services for all populations.

All initiatives aimed at rebuilding better for children and adolescents living with or at risk of HIV demand a united global community, including program participants, dedicated to achieving equitable access to treatment and essential resources. Without equal partnerships and a genuine willingness to listen to the experiences of all stakeholders—particularly the young people disproportionately affected—the HIV epidemic will continue to worsen amidst ongoing inequities. Rebuilding requires our commitment to collaboration with organizations and individuals willing to innovate, ensuring more resilient HIV programming that can sustain and catalyze necessary actions. PEPFAR will work alongside all partners, including young people, government entities, and communities to dismantle the social and structural barriers hindering progress in the global HIV response, particularly addressing equity for women and girls, sex workers, men who have sex with men, people who inject drugs, individuals in confined settings such as prisons, and LGBTQI+ persons globally.

As I wrap up my remarks, I want to focus on all of you present here, especially the soon-to-be-crowned Miss and Mister Y+ and the committed leaders and staff of UNYPA. You exemplify the creativity and innovation necessary to advance our fight against HIV. We are all invested in ensuring that Uganda achieves epidemic control. Your contributions to this important goal are invaluable. Tonight, as Americans prepare to celebrate Thanksgiving—a time to express gratitude for family, friends, and life’s many blessings—I want to extend my heartfelt thanks to you for carrying the torch for young Ugandans, for transforming narratives for those living with HIV/AIDS, and for creating new opportunities. We look forward to witnessing the incredible impact you will continue to make as we pass the mic to you.

By U.S. Mission Uganda | 24 November, 2022 | Topics: Ambassador, News, Sections & Offices, Speeches