In spite of all that the program has accomplished, however, a persistent problem remains: the promotion of homophobia by African governments receiving American aid money. In no nation is this problem more acute than in Uganda, one of 15 PEPFAR “focus” countries that collectively account for half of the world’s HIV infections. Homosexuality is considered a taboo in most of Africa, yet few governments have gone to the lengths of Uganda’s in punishing it. The consequences are devastating not only for the people directly affected by these adverse policies but for the fight against AIDS in general.

Uganda’s campaign against homosexuality took a disturbing turn last month when a member of parliament in the nation’s governing majority introduced legislation that would stiffen penalties for actual or perceived homosexual activity, which is already illegal under Ugandan law. According to the proposed law, “repeat offenders” could be sentenced to death, as would anyone engaging in a same-sex relationship in which one of the members is under the age of 18 or HIV-positive. Gay-rights advocacy would be illegal, and citizens would be compelled to report suspected homosexuals or those “promoting” homosexuality to police; if they failed to do so within 24 hours, they could also be punished.