Educating for survival not as sexy as condoms

Pope Benedict generated some headlines recently by commissioning a study on condom use and HIV/Aids. Will the Vatican eventually sanction the use of condoms in very restrictive circumstances such as in the case of faithful married couples where only one spouse is infected? I have no idea. All I know is that there are other important questions to be discussed.

According to the Global Campaign for Education, we could reduce the amount of new cases of HIV by an estimated 700,000 cases a year by ensuring that all children receive a primary education. Not sex education, or rather not only sex education, but by the reading, writing and arithmetic kind of education.

Education is particularly protective for girls. Women are twice as likely to contract HIV from men than vice versa. Young girls are particularly vulnerable. In the worst affected areas of sub-Saharan Africa, HIV infection rates among girls aged 15 to 19 are five to six times higher than in boys of the same age. It is not just because of biology. Poverty and lack of equality are major reasons.

Traditionally, African women have been socialised to be submissive rather than assertive. There can be a presumption that women do not have the right to say no. Also, part of the vicious spiral involved in this epidemic is that when parents become ill or die of Aids, the burdens of raising a family often fall on the girls.

Sometimes the only way to put food on the table, or to buy expensive drugs, is to sell sex. There is also a mythology in some parts of Africa that sex with a virgin can cure HIV. In South Africa, over 40 per cent of rapes involve girls aged 15 or younger.

Given that grim picture, why on earth focus on primary education? The International Centre for Research on Women conducted a 19 country study that showed the lower a woman's social status, the greater her risk of becoming infected. Education is inextricably linked to social status.

One Ugandan study in 2002 found that the chances of contracting HIV were reduced by 6.7 per cent for every year spent in education. Better-educated women are more assertive, and more likely to delay sexual activity, including marriage.

There have been recent reports from famine stricken areas that girls as young as 10 are being given in marriage in exchange for cattle. Delayed sexual activity leads to women having fewer and healthier children, in turn reducing the rate of mother-to-child infection.

Swaziland is one of the worst affected areas. It would cost approximately $20 million to eliminate school fees there. When Uganda used aid money to eliminate school fees, enrolment figures among the poorest girls doubled.

It is what was described by Make Poverty History as a "quick win". But you know what? It is not sexy. Not as sexy as condoms, anyway.

If you were to believe the propaganda, successive popes have brought death and destruction to Africa by refusing to sanction the use of condoms. Let's go back to Swaziland for a moment. It is one of the two worst-hit countries in the world, with rates over 38 per cent. Large numbers of Swazis are Zionist, an African belief system that is a blend of Christianity and ancestor worship.

Catholics are a minority. How likely is it that any pronouncement by any pope is going to be known or heeded? People are very fond of pointing out that the church is hopelessly out of date, and that its teaching on contraception is widely ignored. Yet, when it comes to Africa, apparently even people who are not Catholic are being condemned to death by pious adherence to church teaching.

Oddly, the same people allegedly browbeaten by the church into not using condoms have no problem ignoring the life-saving church teaching on not engaging in extra-marital sex.

It is much less simplistic, and much more disquieting to think that the spread of HIV/Aids has more to do with poverty and exploitation of women than with condoms.

Oddly enough, HIV is considered to have low transmissibility. Poverty, malnourishment, and poor health services for ordinary illnesses raise dramatically the possibility of becoming infected.

Women in developing countries who are absolutely faithful are still infected by husbands. There is probably an argument that could be made by Catholics that a spouse married to an infected person is not seeking to use condoms as contraception, but to prevent possible death - a kind of double-effect argument.

However, something else needs to be borne in mind. President Museveni of Uganda is a controversial figure in many ways, but he was right when he said: "In countries like ours, where a mother often has to walk 20 miles to find an aspirin for her sick child or five miles for a little water, the practical issues of ensuring a constant supply of condoms or using them properly might never be solved."

Uganda managed a huge reduction in HIV infection rates through a three-fold risk reduction strategy, called ABC, which stood for Abstain, Be Faithful, and Correct use of condoms. Given the failure in other African countries of campaigns based on condom distribution strategies alone, it is not unreasonable to suggest that changes in behaviour were the significant factors. However, it does not suit Western ideologues to think that behaviour change is even necessary, because that smacks of the ultimate crime of curtailing personal autonomy.

Not surprisingly, in the countries where the life-course of desperate little girls could be altered dramatically for the better by providing them with schooling, Africans are not so enamoured of the idea that condoms solve everything. Not to mention the fact that the Catholic Church is a front-line player in the prevention of Aids by being a major provider of education for girls, even in areas where it is a minority church. It also provides a quarter of all care for Aids sufferers worldwide, making it the largest institution providing such care.

Yet if Benedict decides that the Catholic teaching on condom use should remain the same, what are the chances of those two facts being to the forefront of commentary?