Europe, led by the UK, has 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 Thursday for World AIDS Day 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 Presidents wife, and alleged problems with supply have led to a serious shortage of condoms.
The US has pledged 15 billion US dollar over five years to fight the virus, most of which is channelled through the Presidents Emergency Plan for AIDS Relief (PEPFAR).
However, PEPFAR grants come with conditions: two thirds of the money has to go to pro-abstinence programmes, and it is not available to any organizations 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.
The statement from 22 European Union member states, released at a meeting under the UK Presidency in London 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.
“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 UK International Development Secretary, Hilary Benn, said that evidence had shown what worked, from tackling stigma to supplying condoms and clean needles. Asked whether the UK disagreed with the US emphasis on abstinence, he said:
– Abstinence works if people can abstain, but I do not 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 Generals 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). To impose a dogma-driven policy that is fundamentally flawed is doing damage to Africa, Mr. Lewis said.
Only 35 million 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 120 million 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 will not work, added she.
Kilde: The Push Journal
