Two recent reviews of Uganda's celebrated "ABC" (abstinence, be faithful, condoms) approach to AIDS management have questioned the "A" and "B", and suggest (unfortunately) that we may need to add a "D".

First, researchers at Columbia's Mailman School of Public Health reported in February that abstinence and fidelity don't seem to have played a significant role in declining AIDS levels in Uganda's Rakai district compared to condom usage.

Second, Toronto's Globe and Mail reports on recent studies that suggest that much of Uganda's success in lower AIDS rates is due to deaths because of AIDS, a factor not previously given sufficient epidemiologic weight. It's tragic to think "ABC" may in fact need to be "ABCD".