Vatican flinches on condom use in fight against HIV/AIDS

According to the Washington Post (Tuesday), the Vatican has commissioned a study on whether "condoms can be condoned" in the effort to slow the spread of HIV/AIDS:

Cardinal Javier Lozano Barragan, who heads the Vatican office for health care, was quoted over the weekend in La Repubblica daily as saying his office was preparing a document on the question of condoms and AIDS, and that it would be released soon.

But on Tuesday, he clarified that his office was merely studying the issue at the request of Pope Benedict XVI as part of a broader "dialogue" with other Vatican departments.

...

While the Vatican has no specific policy concerning condoms and AIDS, the Roman Catholic Church opposes the use of condoms as part of its overall teaching against contraception. It advocates sexual abstinence as the best way to combat the spread of HIV, the virus that causes AIDS.

The issue was reignited last week when a one-time papal contender, retired Milan Cardinal Carlo Maria Martini, said in comments published in the news weekly L'Espresso that condoms were the "lesser evil" in combatting AIDS. [emphasis mine]

I can't speak to the theological question, but I can point the Pope to lessons learned in Uganda. After initiating a comprehensive "ABC" (Abstinence / Being Faithful / Condoms) HIV/AIDS prevention program in 1990, Uganda saw a massive drop in the HIV prevalence rate from nearly 31% in 1990 to just over 5% in 2004 (although a report by the NGO National Guidance and Empowerment Networt estimated the prevalence rate that year to be closer to 17%, showing just how difficult it can be assess prevalence in developing countries where not everyone has access to health care facilities). [Source Avert.org]

Whatever the actual rate, frustration is growing in Uganda over the insistence in Bush's PEPFAR program that 1/3 of its HIV/AIDS prevention budget go to abstinence-programs. According to Avert.org:

In 2004 the Ugandan government issued a nationwide recall of the condoms distributed free in health clinics, due to concerns about their quality. Although tests showed there was nothing at all wrong with the condoms, the government said that public confidence in the brand had been badly dented, so they would not redistribute them. By mid-2005 there was said to be a severe scarcity of condoms in Uganda, made worse by new taxes which made the remaining stocks too expensive for many people to afford.

Some have said the US is largely to blame for the shortages. According to Stephen Lewis, the UN Special Envoy for HIV/AIDS in Africa, "there is no question that the condom crisis in Uganda is being driven and exacerbated by PEPFAR and by the extreme policies that the administration in the United States is now pursuing".

Mr Lewis has also said that PEPFAR's emphasis on abstinence above condom distribution is a "distortion of the preventive apparatus and is resulting in great damage and undoubtedly will cause significant numbers of infections which should never have occurred".

However, speaking in August 2005, Uganda's coordinator of condom procurement at the Ministry of Health denied there was any shortage of condoms, and said that new stocks would be distributed soon. She also said the government was committed to promoting all three parts of the "ABC" strategy: Abstinence, Faithfulness and Condoms.

Lest you take what the Ministry of Health says at face value, consider that abstinence-only programs are growing in strengh in Uganda (Avert.org):

Uganda receives significant amounts of funding from America, and much of the PEPFAR money is being channelled through pro-abstinence and even anti-condom organisations which are faith-based, and which would like sexual abstinence to be the central pillar of the fight against HIV. This money is making a difference - some Ugandan teachers report being instructed by US contractors not to discuss condoms in schools because the new policy is "abstinence only".

Small community-based organisations are increasingly shifting the emphasis of their prevention programmes to comply with the agenda of PEPFAR's favoured donors. This change is also being encouraged by evangelical churches within Uganda, and by the First Lady, Janet Museveni. Around the country dozens of billboards have sprung up promoting only abstinence to prevent HIV infection, with no mention of condoms.

I'll leave it here, but if you want to read more, I suggest checking out Human Rights Watch's 2005 report on abstinence-only programs in Uganda, Planned Parenthood's short 2004 article on those programs, Avert.org's summary of the HIV/AIDS epidemic in the US, and Population Action International's fact sheet on the ABCs of HIV/AIDS prevention.