EU advice for Africans - ignore Bush when it comes to AIDS

In what is seen as a major split with the United States over the AIDS pandemic, Europe, led by the UK, is tacitly urging African governments not to listen to the abstinence-focused agenda of the Bush administration.

In a statement released for World Aids Day the emphasis is on the importance of condoms, sex education and access to reproductive health services.

Profound concern has been expressed about the resurgence of partial or incomplete messages on HIV prevention which are not grounded in evidence and have limited effectiveness.

Although the U.S. is not directly mentioned, 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 $15bn (£8.6bn) over five years to fight the disease, most of which goes through the President's Emergency Plan for Aids Relief, Pepfar.

However such grants come with conditions, as two thirds of the money has to go to pro-abstinence programmes, and it is not available to any organisations with clinics that offer abortion services or even counselling.

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.

The statement from 22 EU member states, released at a meeting under the UK presidency in London 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.

The statement says that the European Union, firmly believes that, to be successful, HIV prevention must utilise all approaches known to be effective, not implementing one or a few selective actions in isolation.

According to the international development secretary, Hilary Benn, evidence has already shown what works, from tackling stigma, to supplying condoms and clean needles.

He says it is very important that those messages are heard loud and clear by everybody.

He also said that abstinence only works if people abstain, and people should not die because they have sex.

In August the UN secretary general's special envoy for HIV/AIDS in Africa, Stephen Lewis, accused the U.S. of "doing damage to Africa" by cutting funds for condoms in Uganda while promoting abstinence.

Mr Lewis says there is no doubt that the condom crisis in Uganda is being driven by U.S. policies, and the imposition of a dogma-driven policy that is fundamentally flawed is doing damage to Africa.

Apparently only 35m condoms were distributed in Uganda between October 2004, when the government said there was a problem with the quality of the stock, and August this year, compared with 120m in previous years.

In the past Uganda has been cited as one of the HIV/AIDS success stories and experts generally agree this was partly due to the availability of condoms that brought the infection rate down.

However negative comments by Mrs Museveni to the world media stating that condom distribution pushed young people into sex and encouraged theft and murder indicates a shift in government thinking in Uganda that could be linked to Pepfar.

Aids activists in the UK are very pleased by the EU's statement as they have been warning for years that the U.S. prevention policy is reckless and would cost lives.

Fiona Pettit of the UK Consortium on AIDS and International Development, says the relentless promotion of abstinence only is already having an impact in countries like Uganda and is an unrealistic policy in many communities.

Andrew George, the Liberal Democrat spokesman on international development, says much as conservative evangelists in the U.S. might prefer that they didn't, in reality, people have sex.


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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