US abstinence programmes hurting AIDS fight

JOHANNESBURG - The US government's emphasis on abstinence-only programs to prevent AIDS is hobbling Africa's battle against the pandemic by playing down the role of condoms, a senior UN official said on Monday.

Stephen Lewis, the UN secretary-general's special envoy for HIV/AIDS in Africa, said Christian ideology was driving Washington's AIDS assistance program known as PEPFAR with disastrous results such as a shortage of condoms in Uganda.

Washington rejected the criticism.

"There is no question in my mind that the condom crisis in Uganda is being driven and exacerbated by PEPFAR and by the extreme policies that the administration in the US is now pursuing in the emphasis on abstinence," Lewis told journalists on a teleconference.

Uganda had been praised for cutting HIV infection rates to around 6 per cent today from 30 per cent in the early 1990s, a rare success story in Africa's battle against the disease.

But President Yoweri Museveni's government has been criticized for what activists say is a reduction in the number of free condoms available due to pressure from Washington through the PEPFAR program.

A top US official rejected Lewis's criticism and that it had forced Uganda to reduce the condoms available, saying the Bush administration supported condom use as part of a balanced program that included prevention.

"The statements that I have heard are completely untrue and completely mischaracterize effective prevention programs," Mark Dybul, deputy US global AIDS coordinator and chief medical officer, told Reuters by telephone.

As part of President George W. Bush's global AIDS plan, the US government has already budgeted about $8 million this year for abstinence-only projects in Uganda, human rights groups say.

Activists there and the United States say the country is in the grip of a condom shortage so severe that men are using garbage bags in an effort to protect themselves.

"That distortion of the preventive apparatus ... is resulting in great damage and undoubtedly will cause significant numbers of infections which should never have occurred," Lewis added.

Many health experts say condoms are the most effective bulwark against AIDS. Dybul and a Ugandan minister said there was no shortage in the country.

RELIGION

Lewis said the effects of Washington's "obsessive emphasis on abstinence" were most profound in Uganda, where it resonated with strong local religious traditions.

But he said the drive for abstinence was being felt more widely across Africa and threatened to derail or divert more AIDS-fighting programs

"What PEPFAR has done is to have made it possible for a number of Pentacostal and more fundamentalist churches to pursue the abstinence agenda," he said.

Dybul said around 20 per cent of the US government partners in fighting AIDS were "faith-based" groups, many of which were in remote locations ignored by other organizations and providing key support for communities.

The Ugandan government recalled free condoms in 2004 over quality fears and activists say it failed to provide alternatives, pushing up the price of them in the shops.

But Uganda's State Minister for Health Mike Makula told the Monitor newspaper there was no shortage, saying the country had 65 million in stock and had ordered another 80 million.

"That there is a condom shortage in the country is just a rumor by people who want to spoil the image of this country," the newspaper quoted Makula as saying.

Dybul said 15-20 million condoms bought with support from the US government were in a warehouse in Uganda awaiting testing following Uganda's rejection of the flawed condoms.

He said the Bush administration supported the so-called "ABC" program -- abstain, be faithful or use a condom -- developed by the Ugandan government.

"The ABC has been a long-standing program which was developed by the Ugandans and is employed throughout the world because of its effectiveness, but to tell the Ugandans how to run their programs is highly paternalistic," Dybul said.

- REUTERS