Aids 'wars' in Africa distorted by libertarians


Criticism of the pope’s attitude to condoms reveals a fault line in western propaganda, writes JOHN WATERS

DRIVING AROUND Uganda in recent years, you could hardly help noticing the government-sponsored advertising hoardings along the highway. One had a picture of a smiling man in his 60s with the slogan, “Say No to Sugar Daddies”. Another showed a slightly younger man, and the slogan, “Would you want this man sleeping with your daughter? So why are you sleeping with his?” The billboards were part of Uganda’s long, successful battle against Aids, these posters being directed at creating a sexual firebreak between generations.

In the 1980s, Uganda was at the epicentre of the African Aids catastrophe, but managed to reverse the spread of the disease through an emphasis on cultural adaptation – abstinence, fidelity and some education about condom use. In Europe and America, however, whenever the subject of Aids and Africa is mentioned, there is an assumption that condoms are incontrovertibly the sole option.

No sooner had Pope Benedict XVI stepped off the aircraft in Cameroon this week than the western media was again pumping out its partisan propaganda. The pope was reported saying Aids could not be overcome through the distribution of condoms, “which even aggravates the problems”. As usual, voices asserted that the battle against Aids in Africa was all about condoms, with the Catholic position treated as dangerous obscurantism. Benedict, we were told, was “refusing to yield”. Spokesmen and women for European governments claimed the use of condoms was the vital element in the fight against Aids. We were told that “even” some priests and nuns working against Aids believe the pope is wrong.

But for every such voice, there are hundreds of priests, nuns and other anti-Aids activists in Africa saying the western obsession with condoms is a distraction. What works is action to change sexual behaviour, and the Catholic Church has long been to the fore in pushing such initiatives.

At the core of the kick-the- pope argument is a gross absurdity. Aids was spread in Africa mainly by truck drivers using prostitutes along the arterial highways that string together an otherwise disorderly continent. The pope, as well as opposing condoms, is also hostile to prostitution and extra-marital sex, and yet it is implied that those who have been spreading HIV/Aids through promiscuous behaviour would wear condoms if the pope told them to do so. But Pope Benedict is neither a lawmaker nor a policeman. He has the power simply to speak the truth as he has received it and then allow everyone the freedom to decide for themselves.

Whether the libertarian West likes it or not, much of the evidence in Africa indicates that emphasis on monogamy and sexual continence is what delivers on Aids. Uganda many years ago identified the problem as a cultural one relating to sexual promiscuity, with condoms a minor and ambiguous sidebar. The Government promoted the standard “ABC” approach (abstain, be faithful, use condoms), but condoms did not play a significant part in the early battle against the disease, largely because President Yoweri Museveni believed they offered false hope that the disease could be curbed without a change in sexual behaviour. Later, under assault from the West, the Ugandan health ministry began giving out about 80 million free condoms a year. But after some batches were found to be defective, the government now distributes far fewer condoms.

In the 25 years since Aids was first reported in Uganda, broad-based partnerships and effective public education campaigns have contributed to a spectacular decline in the number of people contracting HIV and Aids. State-sponsored programmes reduced Aids prevalence from over 30 per cent to about 6 per cent. Fidelity to a single partner was the dominant message of early HIV prevention campaigns. Uganda’s first lady Janet Museveni has been a vocal proponent of abstinence approaches, and has been widely criticised by the same people who regularly attack the pope.

In recent years, there has been a slight disimprovement in Uganda’s Aids situation. External critics, predictably, have blamed abstinence policies, but the facts are not so clear-cut. Although western propaganda seeks to fudge this, there is some evidence that condom availability may have diluted the earlier message, causing a shift back to old habits.

Ideally, one might think, abstinence programmes and safe sex strategies should complement each other. But in practice the approaches are mutually incompatible. Once you advocate condom use, you are accepting that abstinence is no longer a persuasive option. And if you argue, as the Catholic Church does, that promiscuity promotes HIV/Aids, it would be ludicrous to recommend measures that, implicitly, suggest that this position can be relativised.

This is a complex issue, which certainly cannot be reduced to a simple questions of condoms. What the world needs is a full and truthful discussion, not bigoted, libertarian propaganda masquerading as reportage.