Tuesday, October 31, 2006

The Condom Controversy: religious fundamentalism and the fight against AIDS in Zambia

It was my first time to visit rural Zambia. As our crowded SUV entered the dusty city limits of the fishing village Mwandi, we were greeted by a large black and white sign, reading: “Welcome to Mwandi, we are concerned about AIDS.” Below were listed the ABCs, “Abstain, Be faithful, Condomise,” and in red letters, “D – or you will die.” It was quite a sobering welcome banner; but it was descriptive of the ideologies about how to fight AIDS which I discovered during my stay in Mwandi.
The incidence of AIDS in Zambia is staggering. According to the 2006 Global Report on the AIDS Epidemic, nearly twenty percent of the Zambian population has AIDS. It is a disease strongly associated with dire poverty, affecting more women than men across sub-Sahara Africa. Nearly half of the population in Zambia is less than fifteen years old, and there are an estimated 710,000 AIDS orphans, evidence of the crippling effects AIDS can have on a poor nation.
In Zambia, like most of sub-Sahara Africa, HIV is largely transmitted through unprotected heterosexual sex. Most non-sexually transmitted HIV results from mother-to-child transmission during child birth or breast-feeding.
Prevention of HIV is the single most effective weapon in the fight against AIDS. UNAIDS projects that treatment combined with prevention will avert 29 million new HIV infections worldwide by 2020, as opposed to only nine million with treatment alone. The UNAIDS protocol for HIV prevention calls for a combination of: abstinence, monogamy, reduction in the number of sexual partners, and correct and consistent condom use. The male condom is still a vital prevention strategy as it reduces the risk of HIV sexual transmission by eighty to ninety percent.
However, promotion of the condom as an AIDS prevention strategy has encountered resistance from some governments and religious groups. Traditionally, Christian fundamentalist groups focus on the abstinence and fidelity aspects of AIDS prevention but refuse to incorporate condoms. For example, in 2001 the Christian Council of Zambia was successful in removing condom advertisements from the radio, claiming they encouraged promiscuity. President Chilumba, who declared Zambia a Christian nation in 1991 and who said condoms were a sign of lax morals, supported the clergy in removing the condom ads as did the Minister of Education (AEGIS). Also, the Catholic Church widely rejects the use of contraception. In fact, at a 2005 meeting with African bishops, the Pope warned that “contraception was one of a host of trends contributing to a ‘breakdown in sexual morality’, and church teachings should not be ignored” (BBC news, 2005).
The condom controversy surfaces in areas where religious non-governmental organizations (NGOs) must create health policy due to lack of government involvement. Because most African countries do not have sufficient public health infrastructure, many nations rely on NGOs for health services, especially in rural areas. When religiously-funded organizations are charged with overseeing health policy, they may encounter a moral conflict. On one hand, they must comply with recommendations from the World Health Organization and UNAIDS to incorporate condoms in HIV prevention in order to save lives. On the other hand, they must appease the church by omitting condoms from HIV prevention strategies, which the statistics indicate will lead to more deaths from AIDS.
The condom controversy raises important questions as to the role of NGO involvement in health policy when NGOs are limited by their supporters of the religious right. Are they doing more harm than good in fighting the AIDS pandemic? Fortunately, condom distribution is now possible for some church-sponsored health clinics, which previously did not distribute condoms. For example, a July 2005 issue of Christian Century offers encouraging news about the condom controversy in Zambia. It claims that the Zambian Council of Churches “would promote the use of condoms only to prevent the further spread of disease.” The General Secretary and other bishops admitted, “If we don’t encourage this, we will be blamed for not saving lives” (Dart 2005).
Hopefully such tolerant attitudes will become prevalent among faith-based NGOs in the near future. If not, the consequences for the rural Zambian public could be devastating. Whereas there are many compounding factors in the solving the AIDS problem, adhering to the simple ABCs of AIDS prevention is certainly a good place to start.

Thanks for listening, I’m Wes Fiser

Dart, John. “The Council of Churches in Zambia is supporting the use of condoms in the fight against HIV/AIDS.” 26 July 2005. Christian Century 122(15):17.
“Pope Rejects Condoms for Africa.” 10 June 2005. BBC news. 21 October 2006. .
UNAIDS. Comprehensive HIV prevention. 2006 Report on the Global AIDS Epidemic. 2006. 14-50, 124-128.
“ZAMBIA-AIDS: Condom adverts deemed too explicit: ‘Condoms are one of the major ways of preventing the spread of AIDS.’” 12 January 2001.UN Integrated Regional Information Network. AEGIS. 22 October 2006. .


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