Europe, led by the U.K., Wednesday night signaled 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 for World AIDS Day Thursday, emphasizes 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 United States 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 president's wife, and alleged problems with supply have led to a serious shortage of condoms.
The U.S. has pledged $15 billion over five years to fight the disease, most of which is channeled through the President's Emergency Plan for AIDS Relief. PEPFAR grants come with conditions, however -- two-thirds of the money has to go to pro-abstinence programs, and it is not available to any organizations with clinics that offer abortion services or even counseling. The U.S. 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.
But the statement from 22 European Union member states, released at a meeting under the U.K. presidency in London Wednesday, 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. UNAIDS' latest figures show 40 million people are now infected, and the rate is rising as fast as ever.
"We, the European Union, firmly believe that, to be successful, HIV prevention must utilize all approaches known to be effective, not implementing one or a few selective actions in isolation," the statement says.
The international development secretary, Hilary Benn, told the Guardian that the evidence had shown what worked, from tackling stigma to supplying condoms and clean needles. "It is very important that those messages are heard loud and clear by everybody," he said.
Asked whether the U.K. disagreed with the U.S. emphasis on abstinence, he said: "Abstinence works if people can abstain, but I don't 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 U.N. secretary general's special envoy for HIV/AIDS in Africa, Stephen Lewis, accused the United States 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" U.S. policies, said Lewis. "To impose a dogma-driven policy that is fundamentally flawed is doing damage to Africa."
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 of 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 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 U.K. are pleased by the E.U. stance. "Activists have been warning for years that the U.S. prevention policy is reckless and could cost lives," said Fiona Pettit of the U.K. 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 won't work."
"In reality, people have sex ... much as conservative evangelists in the U.S. might prefer that they didn't," said Andrew George, the Liberal Democrats' spokesman on international development.
This article has been provided by the Guardian through a special arrangement with Salon. ) Guardian Newspapers Limited 2005. Visit the Guardian's Web site at http://www.guardian.co.uk.