US stance on condoms slammed
May 30 2004
By Caroline Hooper-Box
Source: Sunday Tribune
American President George Bush's administration has been accused of using "pseudoscience" to dispute the efficacy of condoms in preventing the spread of Aids.
And while the United States has pledged $15-billion (about R100-billion) to fight Aids in Africa, it has insisted that a third of the money be used for sexual abstinence and monogamy programmes.
The moves have been criticised as being the result of the US administration bowing to pressure from right-wing religious movements. A group of more than 60 top US scientists, including 20 Nobel laureates, accused the Bush administration of manipulating and distorting science for political purposes. (Scientists Say Administration Distorts Facts, New York Times, Ndr)
'Statistics show condoms really have not been very effective'
In a 46-page report and open letter, the scientists cited several examples, charging the Bush administration with bending science and technology to policy.
During Bush's term in office the US federal health agency Centres for Disease Control and Prevention's fact sheet on proper condom use has been replaced with a warning emphasising condom failure rates.
At the centre of the row is US Global Aids Co-ordinator Randall Tobias, former head of pharmaceutical giant Eli Lilly, who said "statistics show condoms really have not been very effective".
Speaking in Berlin at a Global Business Coalition on HIV and Aids 2004 awards function in April, Tobias said condoms had been "the principal prevention device for the last 20 years, and I think one needs only to look at what's happening with the infection rates in the world to recognise that has not been working", Agence France-Presse reported.
A New York Times editorial last week said this showed the Bush administration was following the "tragic example of putting ideology above medical science", set by president Thabo Mbeki in the dispute over HIV and Aids.
'Tobias is wrong, and not just about the science'
Mbeki "finally acknowledged reality", the editorial read.
"The Bush administration should do so too and stop risking millions of new Aids infections and hundreds of thousands of lives."
Tobias, testifying in the House of Representatives in March, cited a supposed study by the London School of Hygiene and Tropical Medicine, showing condoms did not help slow the spread of HIV.
The New York Times said: "Tobias is wrong, and not just about the science. The dean of the London School wrote him to say that the school never produced any such report, and that a steady stream of its research supports the idea that condoms do work."
The newspaper said the Bush administration was "using pseudoscience to explain its choices".
However, in a letter in response published on Tuesday, Tobias defended the President's Emergency Plan for Aids Relief, writing that "reliance on condoms alone, in the face of the data, would be a tragic error".
The prestigious medical journal The Lancet has described US policy on Aids as "perhaps one of the best examples of ideology impeding sound public-health policy".
Speaking to The Sunday Independent, Helen Rees, executive director of the Reproductive Health Research Unit (RHRU), said: "We do know from overwhelming global evidence that condoms are effective against HIV, gonorrhoea, and pregnancy."
Condom distribution forms a large part of the South African government's strategy to combat HIV and Aids. The public sector made 270 million male condoms available for distribution in 2003/4, and is aiming to up this number to 400 million.
In addition, South Africa has "extraordinarily high standards of checking the quality of condoms", Rees said.
South African health department spokesperson Jo-Anne Collinge said: "In certain age groups, it is appropriate to promote a later start to sexual activity.
"In other groups it is a matter of your own personal choice. We have to take account of the fact that youth are not a homogeneous block."
Condoms, properly and consistently used, provide the best protection that we have at present. It's not perfect, but it is significant protection," said Collinge.
Many experts argue that increasing infection rates are not the result of condom promotion, but inadequate resources. The Bill and Melinda Gates Foundation has reported that only 25 percent of the need for condoms was met internationally in 2002.
• This article was originally published on page 2 of The Sunday Tribune on May 30, 2004