[lbo-talk] Europeans reject abstinence message in split with US on Aids

[Ira Glazer]

http://www.guardian.co.uk/christmasappeal2005/story/0,16796,1654865,00.html

* "Abstinence works if people can abstain, but I don't think people 
should die because they have sex" *

* "There is no doubt the condom crisis in Uganda is being driven by [US 
policies]," said Mr Lewis. "To impose a dogma-driven policy that is 
fundamentally flawed is doing damage to Africa." *

* "In reality, people have sex ... much as conservative evangelists in 
the US might prefer that they didn't," *



Sarah Boseley
Thursday December 1, 2005
The Guardian

Europe, led by the UK, last night signalled a major split with the 
United States over curbing the Aids pandemic in a statement that tacitly 
urged African governments not to heed the abstinence-focused agenda of 
the Bush administration.

The statement, released for World Aids Day today, emphasises the 
fundamental importance of condoms, sex education and access to 
reproductive health services. "We are profoundly concerned about the 
resurgence of partial or incomplete messages on HIV prevention which are 
not grounded in evidence and have limited effectiveness," it says.

While the US is not named, there is widespread anxiety over the effect 
of its pro-abstinence agenda in countries such as Uganda, where 
statements by Janet Museveni, the president's wife, and alleged problems 
with supply have led to a serious shortage of condoms.

The US has pledged $15bn (£8.6bn) over five years to fight the disease, 
most of which is channelled through the President's Emergency Plan for 
Aids Relief (Pepfar). Pepfar grants come with conditions, however - two 
thirds of the money has to go to pro-abstinence programmes, and it is 
not available to any organisations with clinics that offer abortion 
services or even counselling. The US is also opposed to the provision of 
needles and syringes to drug users on the grounds that it could be 
construed as encouraging their habit.

But the statement from 22 EU member states, released at a meeting under 
the UK presidency in London yesterday, calls on developing world 
governments to use every prevention tool, from condoms to clean needles 
to sexual health clinics, in a bid to slow down the spread of HIV. 
UNAids' latest figures show 40 million people are now infected, and the 
rate is rising as fast as ever.

"We, the European Union, firmly believe that, to be successful, HIV 
prevention must utilise all approaches known to be effective, not 
implementing one or a few selective actions in isolation," it says.

The international development secretary, Hilary Benn, told the Guardian 
that the evidence had shown what worked, from tackling stigma to 
supplying condoms and clean needles. "It is very important that those 
messages are heard loud and clear by everybody," he said.

Asked whether the UK disagreed with the US emphasis on abstinence, he 
said: "Abstinence works if people can abstain, but I don't think people 
should die because they have sex. We need to make sure people have all 
the means [of prevention] at their disposal - condoms and clean needles. 
It includes education and access to sexual and reproductive health 
services. We are very clear about that."

In August the UN secretary general's special envoy for HIV/Aids in 
Africa, Stephen Lewis, accused the* *US of "doing damage to Africa" by 
cutting funds for condoms in Uganda while promoting abstinence. "There 
is no doubt the condom crisis in Uganda is being driven by [US 
policies]," said Mr Lewis. "To impose a dogma-driven policy that is 
fundamentally flawed is doing damage to Africa."

Only 35m condoms were distributed in Uganda between October 2004, when 
the government said there was a problem with the quality of the stock, 
and August this year, compared with 120m in previous years.

Uganda has historically been cited as one of the HIV/Aids success 
stories and experts generally agree it was partly the availability of 
condoms that brought the infection rate down. But Mrs Museveni has said 
condom distribution pushes young people into sex and recently equated 
condom use with theft and murder in an interview with the BBC World 
Service. The shift in government thinking is being linked within Uganda 
to Pepfar.

Aids activists in the UK were pleased by the EU stance. "Activists have 
been warning for years that the US prevention policy is reckless and 
could cost lives," said Fiona Pettit of the UK Consortium on Aids and 
International Development. "The relentless promotion of abstinence only 
is already having an impact in countries like Uganda. Abstinence only is 
an unrealistic policy in many communities and a one-size-fits-all 
approach simply won't work."

"In reality, people have sex ... much as conservative evangelists in the 
US might prefer that they didn't," said Andrew George, the Liberal 
Democrat spokesman on international development.