Abstinence and AIDS

Edward Green, a medical anthropopligist and senior research scientist at the Harvard Center for Polulation and Development Studies, says (in a subscription-only Weekly Standard artile) that AIDS prevention programs in Africa have been subverted by American AIDS bureaucrats:

For many years, there was an open secret in the battle against AIDS in Africa. A few of us knew about, and earnestly sought to publicize, crucial findings indicating the most effective approach to AIDS prevention. Yet the "experts" in the field didn't want to hear. Our secret was that the country that had best succeeded in curbing the spread of HIV--Uganda--had achieved this result without following the formula the experts had been pushing for over 20 years, namely, condoms, drugs, and testing. Instead, Uganda had achieved its unparalleled decline in the prevalence of HIV with a home-grown, low-cost program built around something offensive to conventional experts: promotion of sexual abstinence and fidelity, with condoms promoted only quietly, to high-risk groups and those already infected.

The figures are startling. Through a public-information campaign backed by local medical personnel, pastors, and imams and reinforced in schools, Uganda reduced its HIV rate from 15 percent to 4 percent between 1991 and 2004, according to a U.N. calculation.

Not surprisingly, information about what was actually working in Uganda was unpopular. Condoms have been regarded as the first line of defense for everyone, everywhere, and anyone who disagrees with this orthodoxy has been dismissed as a religious fanatic with "an agenda." Hundreds of millions of dollars have been spent on condom social marketing (a field I myself worked in for several years) and on related medical-pharmaceutical solutions. How infuriating that an approach not funded by the big donors and scoffed at by foreign experts should prove to be the very thing that worked best.

Let's keep politics out of disease prevention. If possible.