In search of a scapegoat

MICHAEL COOK

Was John Paul II responsible for the deaths of millions of African AIDS victims because he refused to sanction the use of condoms?

Only a month after the death of his predecessor, the new Pope, Benedict XVI, announced that he had launched the process which culminates in Catholic sainthood. The Vatican normally moves at a glacial pace in such things, so the unprecedented speed confirms what most people feel about John Paul II — that he was an extraordinarily good chap.

However, before the faithful get too wound up, something has to be tidied up: the little matter of whether Karol Wojtyla was, in fact, the greatest mass murderer of the 20th century. If he was, canonisation might not be such a good idea.

Here's what the devil's advocates have had to say.

Nicholas Kristof, of the New York Times, says that the Vatican's ban on condoms has cost hundreds of thousands of lives, making it one of "its most tragic mistakes in the first two millennia of its history"1. The influential New Statesman, in London, ran a cover story shortly after the Pope's death claiming that he "probably contributed more to the continental spread of the disease than the trucking industry and prostitution combined"2.

Rosemary Neill, of the Australian, in Sydney, opined that the intransigent Vatican "will eventually be accused of crimes against humanity"3. Polly Toynbee, of the UK's Guardian newspaper, who clearly had something quite vile for breakfast that morning, compared JP2 to Lenin: "they both put extreme ideology before human life and happiness, at unimaginable human cost"4. Even doctors chimed in. The world's leading medical journal, The Lancet, accused an ignorant and rigid Pope of presenting "insuperable obstacles to the prevention of disease"5.

I'm not aware of whether any of these writers have visited AIDS hospices and embraced AIDS patients, as John Paul II did, or worked as hard John Paul II did to get international funding for AIDS treatment. By and large, they seem to be the same crowd who put the boot into everything else he did. But they have made their claim and it deserves a hearing. Does it stand up?

  

Terrifying statistics

There's no doubt that AIDS in Africa is terrifying. The latest survey of AIDS prevalence in Swaziland, a tiny kingdom of 2 million people surrounded by South Africa, has reached 42.6 per cent, the highest in the world. And climbing. Three years ago, in 2002, it was 38.6 per cent. "Swaziland will be wiped out," said one AIDS activist despairingly6. Figures for other countries in southern Africa are almost as grim.

According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), two-thirds of people with HIV/AIDS live in sub-Saharan Africa. At the end of 2004, 25.4 million people there were infected, with about 3 million infected during the year. Life expectancy at birth has dropped below 40 in nine countries: Botswana, Central African Republic, Lesotho, Malawi, Mozambique, Rwanda, Swaziland, Zambia and Zimbabwe. In Zimbabwe, life expectancy at birth was 52 years in 1990, and only 34 in 20037.

Awful. Unbelievably, heart-rendingly awful.

But there is something absurdly medieval about making the Pope a scapegoat, as if the clouds would break and the sun shine if we thrust enough pins through a JP2 voodoo doll. Pinning the blame for the tragedy of African AIDS on one man is one of those ideas that are, in the words of George Orwell, "so stupid that only intellectuals could believe them."

  

The role of Catholicism

Two such ideas run through all these criticisms. The first is basically this: African Catholics are so devout that if they have sex outside of marriage, dally with prostitutes or take a third wife, they will piously refrain from using condoms because the Great White Father told them not to. Ms Toynbee darkly invokes "the Vatican's deeper power... its personal authority over 1.3 billion worshippers, which is strongest over the poorest, most helpless devotees."


Superimposing maps of prevalence of AIDS on prevalence of Catholicism is enough to sink the link between the Catholic Church and AIDS. In the hospice which is Swaziland nowadays, only about 5 per cent of the population is Catholic. In Botswana, where 37 per cent of the adult population is HIV infected, only 4 per cent of the population is Catholic.


But she can't have it both ways: these benighted dark-skinned Catholics can't be both too goody-two-shoes to use condoms and too wicked to resist temptation. Journalist Brendan O'Neill — who describes himself as an ex-Catholic who has jettisoned Catholic teaching on sexual morality — sums up this patronising argument in the on-line journal Spiked: "The only reason you could believe the fantastically simplistic idea that Vatican edict = AIDS in Africa is if you consider Africans to be little more than automatons... who do as they are told"8.

Superimposing maps of prevalence of AIDS on prevalence of Catholicism is enough to sink the link between the Catholic Church and AIDS. In the hospice which is Swaziland nowadays, only about 5 per cent of the population is Catholic. In Botswana, where 37 per cent of the adult population is HIV infected, only 4 per cent of the population is Catholic. In South Africa, 22 per cent of the population is HIV infected, and only 6 per cent is Catholic. But in Uganda, with 43 per cent of the population Catholic, the proportion of HIV infected adults is 4 per cent9.

In fact, without the Catholic Church the situation might be much worse. The AIDS disaster in Africa weighed heavily on the Pope. Ten years ago he appealed to "the world's scientists and political leaders, moved by the love and respect due to every human person, to use every means available in order to put an end to this scourge"10. And Catholics have responded.

About 27 per cent of health care for HIV/AIDS victims is provided by Church organisations and Catholic NGOs, as even The Lancet has acknowledged11. They form a vast network of clinics which reach the poorest, most remote and most neglected people in Africa.

These statistics suggest that the true story may be quite the opposite to the tune sung by the media: that Catholic observance may, in fact, be the best prophylactic.

  

How effective are condoms anyway?

The second assumption is that condoms are essential for preventing AIDS in Africa. In the words of researchers at the London School of Hygiene and Tropical Medicine, "The condom is a life-saving device: it is highly effective in preventing HIV transmission if used correctly and consistently, and is the best current method of HIV prevention for those who are sexually active and at risk"12.

However, notice that this dogma is limited by two significant qualifications: "if used correctly and consistently". How often can we expect this to happen in southern Africa? If the experts haven't been able to end AIDS in San Francisco and Sydney by promoting condoms, what makes them think that they will succeed in Africa?

Amazingly, despite the dogmatic insistence that distributing condoms is the only way to stop AIDS in its tracks, there are very few studies to prove it. An article in the Bulletin of the World Health Organization last year admitted that very little research has been done on the impact of condom-promotion program on the actual incidence of HIV infection13.

Furthermore, even if condoms are "efficacious" — that is, they don't break and don't leak — Murphy's Law says that they will often fail. According to Family Health International, an American group which supports reproductive health initiatives and vigorously promotes condoms, "condoms have to be used correctly and consistently to work"; "correct use is more complicated than it may seem because there are lots of ways to get it wrong"; and "some users will have difficulty using condoms successfully and will experience more than their share of breaks"14.

In the chaotic social environment of many African countries, where poverty is endemic, women are regularly abused and polygamy is widespread, men are unlikely to use condoms consistently. As President Museveni of Uganda has observed, "In countries like ours, where a mother often has to walk 20 miles to get an aspirin for her sick child or five miles to get any water at all, the question of getting a constant supply of condoms may never be resolved"15.

A recent study of condom use in the developing world in the journal Studies in Family Planning summed up the situation with these damning words: "no clear examples have emerged yet of a country that has turned back a generalised epidemic primarily by means of condom promotion"16. This is most clearly seen in southern Africa. High HIV transmission rates have continued despite high rates of condom use. In Botswana, says Professor Norman Hearst, of the University of California at San Francisco, condom sales rose from one million in 1993 to 3 million in 2001 while HIV prevalence amongst urban pregnant women rose from 27 per cent to 45 percent. In Cameroon condom sales rose from 6 million to 15 million while HIV prevalence rose from 3 per cent to 9 per cent.

  

The example of Uganda


...the history of AIDS in Uganda supports the Church's belief that abstinence and fidelity within marriage are actually the best ways to fight AIDS. In 1991, the infection rate in Uganda was 21 per cent. Now, after years of a simple, low-cost program called ABC, it has dropped to about 6 per cent.


In fact, the history of AIDS in Uganda supports the Church's belief that abstinence and fidelity within marriage are actually the best ways to fight AIDS. In 1991, the infection rate in Uganda was 21 per cent. Now, after years of a simple, low-cost program called ABC, it has dropped to about 6 per cent.

ABC stands for Abstain, Be faithful, or use Condoms if A and B are not practiced. Ugandan President Yoweri Museveni preaches the ABC of AIDS with the fervour of an evangelist. "I am not in favour of condoms in primary and even secondary schools... Let condoms be a last resort," he said recently at an international AIDS conference in his capital, Kampala. "I have grown-up children and my policy was to frighten them out of undisciplined sex. I started talking to them from the age of 13, telling them to concentrate on their studies, that the time would come for sex"17.

Ms Toynbee contended in her diatribe in the Guardian that "abstinence and celibacy are not the human condition". But Museveni — no innocent about the human condition — thinks that they are. "We made it our highest priority to convince our people to return to their traditional values of chastity and faithfulness or, failing that, to use condoms," he told American pharmaceutical executives a couple of years ago. "The alternative was decimation"18.

  

Behind the campaign

The campaign to blacken the name of John Paul II with African deaths is so blazingly and bewilderingly brainless that it amounts to conclusive proof of Orwell's maxim. What could possibly be behind it?

There is a political answer. A slick campaign by disgruntled Catholics to discredit the Pope and the traditional teachings of their Church has been operational for several years. A pro-abortion group called Catholics for a Free Choice (CFC) launched an international PR drive in December 2001 to promote their view that "good Catholics use condoms". Advertisements in the US, Mexico, the Philippines, South Africa, Kenya, Chile and Zimbabwe marked "the first phase of an effort to change the Vatican's policy and challenge its aggressive lobbying against availability and access to condoms in areas of the world most at risk"19. Subsequent media coverage, at least in the UK, has reflected the major themes of CFC's ideology.

But on a deeper level, Catholic beliefs about sexuality clash with what John Paul II called a "pathology of the spirit". As an example of this, take Polly Toynbee's claim that "contraception is women's true saviour". The Pope looked to a different saviour. He knew that technology cannot repair the wounded human condition. It cannot inject self-restraint; it cannot infuse respect for others; it cannot manufacture a sense of responsibility. The only lasting salvation comes not from a pill or a latex tube but from a conversion of heart. A technical patch will leave Africa's acute problems of gender inequality, poverty, low education and social disruption unsolved. And without fixing these, the AIDS problem is sure to get worse.

But clearly a scapegoat for AIDS in Africa fulfils a primal need for a simple solution in the face of calamity. I have an idea which will fix everything up.

While British journalists are busy fulminating about appalling health care in Africa, the British government is colluding in making it worse. According to a recent issue of The Lancet, sub-Saharan health personnel are flocking to the UK, leaving their own countries' health care in a shocking state20. An estimated 60 per cent of doctors trained in Ghana in the 1980s, for instance, have left the country. Initiatives to tackle AIDS, such as the World Health Organisation's goal of providing lifelong anti-retroviral treatment, are being thwarted by a shortage of doctors. Unless doctors and nurses stay at home instead of chasing better salaries in the UK, many, many more HIV infected people will die.

One person can put a stop to this scandal: the British Prime Minister. Perhaps if Polly Toynbee sticks pins into a Tony Blair voodoo doll, the whole problem will go away. Silly? OK. But it makes a lot more sense than sticking them in the late Pope.

  

Endnotes:

  1. Nicholas D. Kristof. "The Pope and AIDS”. New York Times. 8 May 2005.
  2. Michela Wong. "Blood of innocents on his hands”. New Stateman. 11 April 2005.
  3. Rosemary Neill. "A Catholic culture of death”. Australian. 7 May 2005
  4. Polly Toynbee."Not in my name". Guardian. 8 April 2005.
  5. "The Pope's grievous errors". The Lancet. 12 March 2005.
  6. "Devastating setback in Africa"Globe and Mail (Toronto). 24 May 2005.
  7. UNAIDS. "AIDS epidemic update 2004."
  8. Brendan O'Neill. "Did the Pope spread AIDS in Africa?" Spiked. 8 April 2005.
  9. World Health Organization, Epidemiological Fact Sheets and The Hierarchy of the Catholic Church
  10. Ecclesia in Africa. 14 September 1995
  11. Javier Cardinal Lozano Barragán."Message for World AIDS Day". 1 December 2004 "The Pope's grievous errors". The Lancet. 12 March 2005.
  12. Anna Foss, Peter Vickerman, Charlotte Watts. "The Ban That Kills". Conscience. Spring 2005.
  13. King K. Holmes, Ruth Levine, Marcia Weaver. "Effectiveness of condoms in preventing sexually transmitted infections". Bulletin of the World Health Organization, June 2004, 82 (6).
  14. "The Latex Condom: Recent Advances, Future Direction". Family Health International .
  15. Cited in Norman Hearst and Sanny Chen. "Condom Promotion for AIDS Prevention in the Developing World: Is It Working?". Studies in Family Planning. March 2004.
  16. Norman Hearst and Sanny Chen. "Condom Promotion for AIDS Prevention in the Developing World: Is It Working?". Studies in Family Planning. March 2004.
  17. "Museveni Opposes Condoms in Schools". AllAfrica.com, 30 November 2004.
  18. Cited in Joseph Loconte, "The White House Initiative to Combat AIDS: Learning from Uganda". Heritage Foundation, Executive Summary #1692, 30 September 2003.
  19. www.condoms4life.org.
  20. "Loss of health professionals from sub-Saharan Africa: the pivotal role of the UK". The Lancet. 28 May 2005.

 

 



ACKNOWLEDGEMENT

Michael Cook. "In search of a scapegoat." MercatorNet (June, 2005).

This article reprinted with permission from the author, Michael Cook.

THE AUTHOR

Michael Cook is the editor of MercatorNet, a new web magazine. He also edits a newsletter on developments in bioethics and writes on bioethical issues for Australian and American newspapers and magazines. He lives in Melbourne.

Copyright © 2005 MercatorNet




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