Cheat-Seeking Missles

Wednesday, November 29, 2006

Is Abstinence Really To Blame For Uganda's Jump In AIDS Cases?

Those critical of emphasizing abstinence in the battle against AIDS/HIV -- and they are legion -- could be accused of having a gleeful reaction to news that Uganda's incidence of AIDS cases and HIV infections was increasing. After all, the increase showed that Uganda's emphasis on abstinence, and the support for that position extended by the Bush administration and American evangelicals, was killing people.

How great is that?

Am I being too severe? Here's Esther Kaplan of American Prospect writing last summer:
Even in an administration famous for its contempt for science, President Bush's tortured case for abstinence stands out. He committed $1 billion to abstinence-only programs abroad without a shred of scientific evidence that they prevent disease. Casting about for justification, he and the virginity advocates who surround him latched on to one of the developing world's rare success stories: Uganda.

In their fertile imaginations, the East African nation was a fairy-tale place where Christian morality had turned the epidemic around. But their castle in the sky came crashing down in May, on the eve of a United Nations meeting on AIDS, when Uganda's AIDS commissioner announced that after years of decline, new HIV infections had almost doubled from 70,000 in 2003 to 130,000 in 2005. Devastating news.
It seems like she tacked on the last two words because she realized she had a broad grin across her face as she typed up these paragraphs.

But Kaplan and those like her, who refuse to accept abstinence for little reason other than their own personal sexual experience and their twisted feminist ideals that link promiscuity to liberation, is doing a cover-up.

First, her piece makes no reference whatsoever to the fact that the Global Fund, which allocates UN AIDS, tuberculosis and malaria funds, cut off all funding to Uganda in Aug., 2005. (Here are some C-SM posts on that cut: here, here, here, here.) Of course, that's too late to have had much if any impact on the increase in cases reported, but because the Global Fund swears it made the cut due to corruption in the Ugandan health ministry, you have to wonder how efficiently it was working to get the funds out to the field in the preceding years.

I personally think the UN's action was tied in part to Uganda's suppoprt for abstinence, but they've circled the information wagons, and if it was, we'll not find any smoking guns.

Second, there was this little problem with condoms in Uganda during this period. As in, they were defective and had to be recalled. That recall and subsequent mismanagement of the re-introduction of new condoms to the Ugandan market was not a Christian campaign; it was poor manufacturing and government incompetence in handling the crisis. Yet Kaplan does not attribute blame to the lack of condoms in Uganda. In fact, it's just the opposite:
The Lancet, a British medical journal, recently attributed Uganda's surge in new infections to the condom shortage and the ... campaign to remove the "C" from ABC [abstinence, being faithful, condoms). "There is no question in my mind," said Stephen Lewis, the U.N.'s Africa envoy, 10 months into the shortage, "that the condom crisis in Uganda is being driven and exacerbated by the extreme policies that the administration in the United States is now pursuing in the emphasis on abstinence."
There ought to be a lot of doubt in his mind. The condom crisis was page-one news throughout sub-Saharan Africa and a great embarassment to the Ugandan government. Senior officials lost their jobs, and not a word about abstinence was raised as an excuse. It was corruption and incompetence that botched the Ugandan condoms, not the Christians.

Kaplan and the anti-abstinence crusaders also ignore two irrefutable facts: First, the significance of the fact that the infection rate among Uganda's teenagers --those most receptive to the abstinence argument -- is dropping. I frankly don't know if abstinence is the reason for the drop, but I sure would like to before I go off placing any of the blame for this tragedy on Bush and Dobson.

And second, the most important point of all, they are focusing on the increase, not the comparable infection rate. Uganda remains a hallmark for AIDS/HIV success in sub-Saharan Africa. The top 12 infection rates are found in sub-Saharan nations, ranging from Botswana's rate of 213.4 per thousand to Kenya's 35.6. All these nations bought into the UN program of emphasizing the "C" in ABC.

In sharp contrast, Uganda, the only one of these nations that emphasized the "A," is not in the top 15 or 20 or 25 nations. It has the 29th highest infection rate, about half that of #12 Kenya -- 18.8 cases per thousand -- not far from the weighted global average of 14.4 per thousand.

So tell me again, why is pushing abstinence such a bad idea?

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