Thursday, March 24, 2005

On HIV/AIDS and the Success of the ABC Strategy:
GE M 05:03:23a

On the Let's Talk programme, we sometimes let remarks stand without direct rebuttal; especially if the programme as a whole provides adequate balance. However, if such remarks are later sliced out of context and presented publicly as the bottom line on the topic, a few balancing words are then quite in order.

Regrettably, such a corrective is plainly now needed on the topic of the Church's morally based stance on the HIV/AIDS global epidemic and on the related success of Uganda's ABC campaign.

First, let us hear Moses on why biblical morality "works":

". . . what does the LORD your God ask of you but to fear the LORD your God, to walk in all his ways, to love him, to serve the LORD your God with all your heart and with all your soul, and to observe the LORD's commands and decrees that I am giving you today for your own good?" [Deut. 10:12 - 13]

So, Heb 13:4 -- "marriage should be honoured by all, and the marriage bed kept pure, for God will judge the adulterer and all the sexually immoral" -- should be seen in that light: our Creator's commands are meant to protect and bless us and our community, so ignoring them can have sadly devastating consequences for us, for our loved ones, and for the wider community.

But, equally, as Jesus pointed out: none of us is without sin, so instead of throwing stones at one another, each of us should ask God to help us take the planks out of our own eyes and reach out a helping or comforting hand. [Jn 7:53 - 8:11, Matt 7:1 - 5.]

Secondly, a recent (and unfortunately flawed) Columbia University study on Uganda may have led some to think that the A and B parts of the ABC strategy don't work in the real world. However, as the Harvard-based AIDS researcher Dr Edward Green observed just a few days ago:

"[condom use] went up in every country in Africa and in several countries condom user levels went higher than Uganda and [HIV/AIDS] infection rates didn't come down, they went up. We know the statement that condoms worked is not true. Then there's another claim: When people die off, prevalence goes down because of death. That's also not true because infection rates and levels of death, however you want to measure them, have gone up higher in other African countries and prevalence hasn't come down . . . . It went down uniformly throughout Uganda." [CT interview Mar 7 05, ]

That is, as Dr Green also noted, the best explanation for Uganda's success remains: "Most behavioral change [towards Abstinence and Fidelity] in Uganda was in the latter 1980s and early 1990s . . . . So the incidence rate started going down in the later 1980s and early 1990s and then it's the dynamics of epidemics that even if you don't really do anything after that, prevalence continues to go down for a number of years . . ."

In short, ABC did and does work. And, more specifically, while condoms are significantly (but not perfectly) effective as barriers to the passage of the HIV virus, the Uganda epidemiological evidence shows strongly that the A and B parts are the real keys to its success. So, let us heed the bottom-line lesson for the Caribbean: a balanced ABC strategy is both morally sound and epidemiologically sound. END

Saturday, March 12, 2005

PS: On Moving on beyond the "blame the churches" debate
GEM March 12, 2005

Regrettably, at the 2000, 2002 and 2004 International AIDS conferences, there was a tendency to blame the churches [and advocates of the ABC approach who stress the importance of morally-driven behaviour change as the key to the HIV crisis] for contributing to the spread of HIV AIDS, to the point where some seminars have deteriorated into mere religion-bashing. This sad and unnecessary development includes a now notorious presentation by Mr Martin Gunter of the Jamaica Red Cross (who was then a member of Jamaica's HIV Advisory Committee and Chairman of the Caribbean Regional AIDS Network, CARAN) at the 2000 Durban, South Africa XIIIth International AIDS Conference.

The resulting rebuttals by University of Technology Lecturer and Communications Consultant Mr Martin Henry and by church leaders are well worth reflecting on, as is Mr Gunter's unfortunately disingenuous response to these well-deserved rebukes.

Unfortunately, too, some of the acrimony of this regional and international debate has now come here; as was manifested by a regrettable ZJB news item presented on the evening of Fri March 11, 2005 which excerpted some rather sharp remarks by a Let's Talk guest panelist on March 2nd that echo Mr Gunter's perspectives. Even more unfortunately, these remarks were reported without reference to the broader context of the programme and the next session on March 9th as discussed above (and to which the station had prior access, including having print and audio copies of Rev. Seale's remarks at the CONECAR, as had been featured in the LT programme on Wed 9th -- one hardly needs to underscore the audience differences between a talk show and the Evening News!).

This sad, and undesirable development underscores the point that it is high time for us to move on beyond the blame game and face what Mr Henry aptly called "[t]he cold truth":

"The cold truth which the AIDS industry, Marvin Gunter, and the rest of us must soberly confront is that, barring a scientific or divine miracle, this most dreadful pandemic is set to run its devastating epidemiological course, which has been already determined by past human choices. If not divine judgement, AIDS certainly is largely a consequence of anti-Christian sexual behaviour . . . . The surest protection for the uninfected individual is chastity and fidelity. Whatever else it may do by way of response to the crisis, the Church, in the teeth of antagonism sharpened by desperation, must preach this loudly and clearly without compromise but with the spirit of compassion and practical care for those already fallen ­ in the manner of Jesus her Head and Exemplar."

Let us heed this call to truth-based, morally sound, compassionate action in the spirit of Jn 7:53 - 8:11. END

Friday, March 11, 2005

The Rebuilding of Montserrat, 7:
Unsafe, SafER, SafEST
GEM 05:03:09a.1

Over the past few weeks, we have been discussing the HIV/AIDS crisis in Montserrat and the wider Caribbean, in light of a recent survey of students in the MSS. This survey reveals that the HIV/AIDS crisis has the potential to decimate a whole generation of our young people, if we continue with "business as usual."

For, it is clear that many of our young people -- and indeed many of our adult population, too -- indulge in very unsafe sexual habits: promiscuity, "unprotected sex"; even sex in exchange for money, favours, or even something as simple as a phone card. Such practices simply invite the spread of HIV/AIDS and the dozens of other devastating sexually transmissible diseases; some of which are almost as worrisome as AIDS -- e.g. Human Papilloma Virus [HPV], which is a leading, strongly suspected cause of cervical cancer. (According to available statistics, this cancer has killed more women in the USA than AIDS has. Moreover, while HPV is so contagious that it is reportedly the commonest STD in the USA, condoms provide little defense against it. HPV is thus very politically incorrect; so it is, by and large, a silent plague.)

Now, last week, Nurses Buffonge and Skerritt kindly helped us to look at the need for safER sexual practices: the use of latex condoms [Ed. note: and of dental dams], which act as barriers to the exchange of body fluids that can carry the HIV virus. We also saw that in Uganda, thanks to a strong intervention by the President and many leaders of that country through their ABC campaign -- Abstinence if single, Being Faithful to one's spouse, using Condoms if one insists on risky behaviour -- they were able to stem the tide of the AIDS epidemic there.

Thus, we can see from the implications of the silent HPV epidemic and the Uganda HIV/AIDS success story just how sound, practical and effective the 2,000 year old biblical principle of safEST sex is:

"Marriage should be honored by all, and the marriage bed kept pure, for God will judge the adulterer and all the sexually immoral." [Heb. 13:4; cf. Matt. 19:3 - 11, Eph. 4:17 - 24, Rom. 13:8 - 10, & Matt. 11:19b.]

So, as we continue to reflect on the HIV/AIDS and broader STD epidemics, we should recognise the direct relevance of an even older (and just as politically incorrect!) biblical principle:

"And now, O Israel, what does the LORD your God ask of you but to fear the LORD your God, to walk in all his ways, to love him, to serve the LORD your God with all your heart and with all your soul, and to observe the LORD's commands and decrees that I am giving you today for your own good?" [Deut. 10:12 - 13]

In short, our Creator has set moral limits on our behaviour for our own good, and the consequences of ignoring these limits can be devastating indeed. Thus, it is no surprise that the rapid spread of dozens of destructive STDs is due to the unhealthy implications of sexual immorality and associated promiscuity and perversion. Having said that, it is equally true that none of us is without guilt, so instead of casting the first stone, let us now consider how we can promote a return to wiser behaviour, and reach out with compassion to the victims of these diseases.

A good place to begin is with some recent remarks by the Rev. Gerry Seale of the Evangelical Association of the Caribbean, made at the Congress of Evangelicals in the Caribbean, which was held last month. In this presentation, Bro Gerry highlights AIDS as the number one emerging issue that the church in the region will have to confront, based on evidence that strongly suggests that sinful, unsafe sexual behaviour is rife across the region, within the churches as well as in the wider community-- so that there are already over half a million victims of HIV/AIDS in our region.

Such trends mean that we will increasingly have to deal with more and more victims of this disease, and will have to break out of the all-too-common sinful attitude of self-righteous condemnation. Instead, we should demonstrate the power of God to overcome bondage to sinful, unsafe sexual habits, and to enable us to reach out compassionately and effectively to our relatives, church members, friends and fellow citizens who have become victims of this latter-day plague.

Plainly, through the wisdom and power of God, we need to move on from unsafe, to safer or -- even better -- safest behaviour; and, we need to reach out in practical love and caring to those who will (or already have) become victims of these deadly diseases. So now, let's talk. AMEN