Experts attack Bush's stance in Aids battle
US promotes abstinence as global conference opens in Bangkok
Sunday July 11, 2004
The US faces condemnation this week from leaders of the worldwide struggle against Aids over the Bush administration's reliance on sexual abstinence as a response to the intensifying epidemic.
With a major international conference on Aids being opened by UN Secretary General Kofi Annan today in Bangkok, there are fears that lives are at risk in some of the world's poorest countries because of American objections to a 'safe sex' approach to combating Aids.
Hillary Benn, the UK's International Development Secretary, who spearheads Britain's fight against Aids overseas, told The Observer that an abstinence-only approach would not work. 'We need to have all the means at our disposal to fight the epidemic,' he said. 'People should have access to condoms.'
In Brussels, Poul Nielson, the EU's outspoken Commissioner for Development and Humanitarian Aid, criticised America for 'preaching one line only and denying people's rights by trying to push them into abstinence. It will weaken the battle against Aids, and the unfortunate reality is that it will directly endanger the lives of millions of women.'
Under the influence of the Christian right, Bush has adopted the so-called ABC approach to Aids prevention - A for abstinence, B for being faithful and C for condoms. But condoms are to be promoted only for use by 'high risk groups' such as prostitutes and drug abusers, with sexual abstinence the objective for all unmarried young people.
Unusually open criticism of US policy has also come from Unaids, the UN body responsible for co-ordinating the global response to Aids. Dr Peter Piot, executive director, said: 'We know condoms save lives. We are not in the business of morality. Condom promotion should be part of education about sexuality for young people.'
Bush's policy was laid down earlier this year in a 100-page document entitled 'The President's Emergency Plan for Aids Relief'. It is backed by a $15 billion commitment over five years and targets 15 countries, 12 in sub-Saharan Africa. References to condoms - for decades heavily promoted in the US drive for population control in the developing world - make clear that they are to play a marginal role. They can be distributed 'near areas where high-risk behaviour takes place' such as brothels, but they are not to be promoted for the general population, which should receive 'a clear message that the best means of preventing HIV/Aids is to avoid risk altogether'.
In Bangkok this week almost 20,000 delegates will review the faltering progress made in stemming the Aids tide since the last conference in Barcelona two years ago. The US interpretation of the ABC approach is to be challenged in a debate tomorrow by Steven Sinding, director-general of the London-based International Planned Parenthood Federation, which had official funding withdrawn for refusing to accept the US administration's views on abortion.
Later in the week the American campaign group Population Action International is running a session entitled 'Abstinence is Coming Your Way', designed 'to challenge the substitution of science with ideology in the policy-making process'.
Britain's Department for International Development last week pointedly announced an additional £80m funding over four years to the UN Population Fund, which has also had US funding withdrawn over the abortion issue. 'We are unashamedly a strong supporter of the UNFPA and the work they undertake,' said Benn. But he would not make any direct criticism of US policy. 'We speak up, we make our position clear and we have a different view.'
The EU has been fighting a rearguard action against US efforts to overturn key international commitments on sexual and reproductive rights. Europe has stepped in to fill what Nielson called 'the decency gap' by funding both the UN Population Fund and the International Planned Parenthood Federation after America withdrew financing.
A realistic approach had to be adopted, Nielson said. 'I think it was Groucho Marx who was asked his opinion on sex and said, "I think it's here to stay.' "
The US delegation to Bangkok will be led by Randall Tobias, former chief executive of the pharmaceutical giant Eli Lilley, who was appointed global Aids co-ordinator by George Bush last autumn. The number of US delegates has been cut back and there are signs that Tobias is adopting a mollifying, low-profile role in the run-up to November's US presidential election. But the administration will stick to its controversial stand. At a recent meeting in Washington, Tobias told sexual health experts: 'Whatever historians of the future write about President Bush's plan, they can never say it was the "same old, same old".'
The same meeting heard from Janet Museveni, wife of Ugandan President Yoweri Museveni, who initiated the ABC strategy which led to dramatic reductions in Uganda's Aids prevalence. She said: 'Giving young people condoms is tantamount to giving them a licence to be promiscuous; it leads to certain death.'
As the US steps up funding for Africa, Christian organisations are responding to its emphasis on the role of 'faith-based organisations'. One US Catholic pressure group has sent circulars to bishops throughout Africa, advising them how to secure funds for abstinence-only Aids projects. Government officials are supposed to be professional and courteous, says the circular. 'If this is not the case - if, for example, anti-Catholic or anti-abstinence sentiments are expressed or implied - please report this to us.'