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THE MISSING CONDOMS

The New York Times
MONDAY, SEPTEMBER 5, 2005

Uganda became Africa's leader in fighting AIDS by
waging an all-fronts war. In 1991, 15 percent of
Uganda's adults were infected with the virus. Ten
years later the figure was 5 percent. Ugandan
officials achieved this drop by bringing the disease
out into the open and encouraging people to protect
themselves. President Yoweri Museveni called the fight
"a patriotic duty." The government and a network of
citizens' groups promoted abstinence, faithfulness and
consistent condom use.

Now this balanced approach is tilting, and Ugandans
will die as a result. The country still prescribes
condoms for high-risk groups. But in the last few
years, pushed by Washington, it has begun to emphasize
abstinence only, for the general population.
Washington is moving away from condom advocacy in all
its overseas AIDS programs, but Uganda is the only
place that this policy has been so fully embraced by
the government. Last year at an international AIDS
conference, Museveni gave a blistering speech
attacking condoms. Meanwhile, his wife, Janet, has
been condemning condom use as immoral and has called
for a national census of virgins.

Billboards that promoted condom use have come down.
More than half of Washington's funds for preventing
sexual transmission of AIDS now go to groups promoting
abstinence only. Among Washington's grantees are
groups that argue incorrectly that the AIDS virus can
pass right through a condom. While free condoms used
to be widely available at clinics in Uganda, in the
last year they have virtually disappeared, and condoms
in stores have tripled in price.

The most important development of the past year is the
disappearance of free condoms. A year ago, Ugandans
began to complain that the Engabu brand made in
Germany and China and distributed free by Uganda's
health system smelled bad. Uganda sent a batch to
Sweden for testing and they were found to have holes.
Further widespread testing found that the condoms were
actually fine, but by that time the government had so
attacked the brand that people will not use them.
Thirty million Engabu condoms are sitting in
warehouses.

As result only eight million free condoms have been
available to Ugandans in the past year, while 80
million were needed. The government has no plan to
address the shortage. Instead, it has put a new fee on
condoms sold in stores, raising a shortage-inflated
price further. And it instituted a requirement that
condoms undergo new testing after they are received in
Uganda. Extra testing is fine, but Uganda has halted
all condom distribution for months while it sets up
the testing regime. An emergency supply received in
April is still sitting in warehouses.

Promoting abstinence and faithfulness has been crucial
to fighting AIDS in Uganda. But so have free condoms.
One of the highest-risk groups is young married women
infected by straying husbands. For them, abstinence is
not an option, and they are already faithful. They
need to be able to protect themselves. Abstinence-only
teaching does not work in the United States, and there
is no reason to think it will work in Uganda.

The policy shift in Uganda threatens to undermine the
country's success in bringing AIDS into the open.
Ugandans felt relatively free to talk about the risks
of catching the AIDS virus and to be open about living
with AIDS. If condom users are branded as immoral, it
will drive the epidemic back underground. No one knows
better than the Ugandans that lives are saved when
AIDS is treated as a public health challenge, not a
moral crusade.


http://www.iht.com
(c) 2005 The International Herald Tribune | www.iht.com



Aggo Akyea
http://www.tribalpages.com/tribes/akyea

"Instead of studying how to make it worth men's while to buy my baskets,
I studied rather how to avoid the necessity of selling them."
WALDEN by Henry David Thoreau – 1854

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