August 29, 2005

US abstinence drive hurts AIDS fight – UN official

By Andrew Quinn

JOHANNESBURG (Reuters) - The U.S. government's emphasis on abstinence-only programs to prevent AIDS is hobbling Africa's battle against the pandemic by downplaying the role of condoms, a senior U.N. official said on Monday.

Stephen Lewis, the U.N. secretary general's special envoy for HIV/AIDS in Africa, said fundamentalist Christian ideology was driving Washington's AIDS assistance program known as PEPFAR with disastrous results, including condom shortages in Uganda.

The Bush administration favors prevention programs that focus on abstinence rather than condom use and has more than doubled funding for U.S. abstinence-only programmes over the past five years.

As part of President George W. Bush's global AIDS plan, the U.S. government has already budgeted about $8 million this year for abstinence-only projects in Uganda, human rights groups say.

Activists in both Uganda and the United States say the country is now in the grip of condom shortage so severe that men are using plastic garbage bags in an effort to protect themselves.

"There is no question in my mind that the condom crisis in Uganda is being driven and exacerbated by PEPFAR and by the extreme policies that the administration in the U.S. is now pursuing in the emphasis on abstinence," Lewis told journalists on a teleconference.

"That distortion of the preventive apparatus ... is resulting in great damage and undoubtedly will cause significant numbers of infections which should never have occurred."

Many health experts say condoms are the most effective bulwark against AIDS.

The Office of the U.S. Global AIDS Coordinator which administers PEPFAR did not immediately return calls seeking comment. It has rejected criticism over condom policy in the past, saying it maintains a balanced approach to prevention.

Uganda had been praised for cutting HIV infection rates to around 6 percent today from 30 percent in the early 1990s, a rare success story in Africa's battle against the disease.

But President Yoweri Museveni's government has come under criticism for sidelining its condom policy, a move activists tie to pressure from Washington through its PEPFAR program.


The Ugandan government, which in 2004 recalled free condoms over quality fears, has failed to provide alternatives -- pushing the price of store-bought condoms up threefold, Ugandan activist Beatrice Were told the teleconference.

"From this you can see where Uganda is going ... people are desperate for condoms," she said.

Uganda's State Minister for Health Mike Makula told the Monitor newspaper on Monday there was no condom shortage, saying the country had 65 million in stock and had ordered another 80 million for delivery soon.

"That there is a condom shortage in the country is just a rumor by people who want to spoil the image of this country," the newspaper quoted Makula as saying.

But Jodi Jacobson of the U.S.-based Center for Health and Gender Equity said the about-turn in Uganda's previous policy to promote condoms was having a real impact -- reducing availability of condoms and cutting consumer confidence in them.

"They are kow-towing to the (U.S.) fundamentalist right on this issue," Jacobson said.

The U.N.'s Lewis said the effects of Washington's "obsessive emphasis on abstinence" were most profound in Uganda, where it resonated with strong local religious traditions.

But he said the U.S. drive for abstinence was being felt more widely across Africa and threatened to derail or divert more AIDS-fighting programs

"What PEPFAR has done is to have made it possible for a number of Pentacostal and more fundamentalist churches to pursue the abstinence agenda," he said.

"I think the administration and PEPFAR have to come to their senses ... to impose dogmatic policies is doing great damage to Africa.."