Uganda's Zero Condom Policy
PROTEST AUGUST 30th, 2005
AIDS ACTIVIST PROTEST UGANDA'S CONDOM SHORTAGE: CALLS FOR GOVERNMENT TO UNLOCK THE CONDOMS AND REJECT ABSTINENCE ONLY APPROACHES
AIDS activists protest at Ugandan Mission to the United Nations as Uganda's much-lauded HIV prevention program erodes into U.S. financed abstinence-until-marriage approaches.
(Manhattan) A coalition of AIDS activists held a demonstration in midtown Manhattan outside of the Ugandan Permanent Mission to the United Nations today to bring attention to that nation's severe condom shortage which is putting people at dangerous risk of HIV infection. The crisis has developed over the past ten months as the government of Uganda has stopped its robust program of public sector condom distribution. These condoms previously accounted for 80% of condoms available in the country.
50 activists delivered a giant key to Mission officials labeled: "Unlock the condoms. Unlock the truth: Condoms Work. Responding to media reports yesterday, the Ministry of Health denied the condom shortage exists.
Since May 2004, new shipments--some 30 million quality-approved condoms--have been sitting in government warehouses. Activists are demanding to know why, nearly a year into the shortage, health clinics are still unsupplied and the government is refusing to state when or how they will distribute the condoms. "This crisis could have been averted by the government long ago. The condoms are there, but what is in woeful shortage is the political will of Ugandan leaders to distribute them and promote condom use," said Sharonann Lynch of Health GAP.
"This apparent 'Zero Condom Policy' of Uganda marks another alarming shift away from the government's established HIV prevention approaches which have been at work since the early 1980's," said Aaron Boyle of Health GAP. Uganda was able to achieve a significant drop in HIV prevalence from 15% to 6% over the past two decades, which many experts attribute to comprehensive prevention efforts, including social promotion of condoms. Now activists in Uganda say the program has been overtaken by abstinence-until-marriage approaches as President Yoweri Museveni and First Lady Janet Museveni are aligning Uganda's policies with the ideology touted--and financed--by the United States government.
Uganda is a country receiving funds from the President Bush's Emergency Plan for AIDS Relief (PEPFAR). The program requires a minimum of 33% of its prevention funds to be used for abstinence-only-until-marriage programs, and limits the distribution of condoms to specific high-risk groups. "The strident prevention politics tied to the Bush administration's AIDS funding are undermining sound prevention in the name of abstinence-only approaches. Scientific studies have shown the inadequacy of such methods, and President Museveni is neglecting the public health of Ugandans by bowing to Bush's pressure." said Eustacia Smith of ACT UP.
Today's protesters, including members of ACT UP New York, African Services Committee, the Bondala group of Harlem United, Health GAP, are demanding the release of condoms and a return to condoms as an integral and effective prevention strategy in Uganda's HIV/AIDS program.
ACT UP New York | African Services Committee | Health GAP (Global Access Project)
For more information, including fact sheet, timeline, and useful
contact information, go to: http://www.genderhealth.org/uganda.php
DOWNLOAD REPORT (PDF)
Note for editors:
For a transcript from an international teleconference for journalists about the Uganda condom shortage held Monday, August 29 with Beatrice Were of ActionAid Uganda and Health Rights Action Group, Zackie Achmat of Treatment Action Campaign, UN Special Envoy on AIDS in Africa Stephen Lewis, and Jodi Jacobson of the Center for Health and Gender Equity, contact Sharonann Lynch at email@example.com
Photographs from todays protest will be made available at http://www.genderhealth.org/uganda.php
In late 2004, the Government recalled Engabu brand condoms, causing an immediate crisis in condom supplies. This crisis has deepened as the Government of Uganda has failed to replenish condom stocks and as attacks on the Engabu brand have eroded public confidence in the brand and in condoms generally. For additional background information see Fighting to close the condom gap in Uganda, The Lancet, Vol 365 March 26, 2005.1127. Available at: http://www.genderhealth.org/pubs/Lancet0305.pdf
10 MONTHS AND COUNTING:
THE CONDOM CRISIS IN UGANDA
AFRICAN ACTIVISTS CALL FOR END TO ARTIFICIAL CONDOM SHORTAGES AND ABSTINENCE-ONLY HIV PREVENTION STRATEGIES
BACKGROUND: U.S. and Ugandan government policies are exacerbating a dramatic condom shortage in Uganda, the African country best known for its successful HIV prevention efforts. Some 32 million quality-approved condoms remain impounded in government warehouses while the U.S. government ramps up financing for abstinence-only approaches to HIV prevention. Religious groups are undermining confidence in condoms throughout the country and contributing to misinformation about their effectiveness. According to Ugandan AIDS activists, the governments actions will undermine community efforts to reduce HIV prevalence and HIV transmission. These trends away from scientifically sound, evidence-based prevention strategies are occurring in Uganda and in other countries hard-hit by the AIDS epidemic, such as Nigeria, South Africa, and Zambia.
SOLIDARITY ACTION :
A campaign launched by Ugandan activists, 10 months and counting: Ugandas zero condom policy, protesting the condom crisis and resisting the abstinence-only agenda supported by the Government of Uganda and the Bush Administration.
The rise of anti-condom rhetoric in sub-Saharan Africa, the critical shortage of condoms in Uganda, and the influence of U.S. President George W. Bushs global AIDS policies on programs to prevent HIV.
Calls by the Pan-African Treatment Access Movement (PATAM) for African governments to resist U.S. pressure and ensure that condoms and safer sex messages are supported in HIV-prevention programs.
For more information, including fact sheet, timeline, and useful
contact information, go to: http://www.genderhealth.org/uganda.php
Text of flyer:
10 MONTHS & COUNTING:
Uganda's Zero Condom Policy
PROTEST: 1PM TUESDAY, AUGUST 30th, 2005
Join us in Manhattan for a rally outside at UGANDA's permanent mission
to the United Nations: Uganda House, 336 East, 45th Street between 1st
and 2nd Avenue in Manhattan at 1 PM on Tuesday, August 30
"Release the Condoms" Campaign
The government of Uganda is putting thousands of people at risk of infection of HIV EVERY DAY by failing to make condoms available to all those who need them. In October 2004, the Government of Uganda removed the brand of condoms-previously provided free through government health clinics-following complaints of an unpleasant smell. Since the recall, free condoms have all but disappeared from public facilities. The government-distributed condoms constituted 80% of the estimated 100 million condoms available in the country each year. Today, new condom supplies-certified under the government's own process-remain locked in national drug store warehouses. 32 million condoms of assured quality brought into the country after the recall continue to sit in national drug stores/warehouses.The government refuses to state when or how they will release the condoms.
Condoms in Preventing HIV in Uganda
Uganda's prevention program was a showcase to the world because of reducing its national level of HIV infection from 15% to 6% since the late 1980s.The policies put in place since the first case of HIV was identified in the country in1982 are now being overtaken by programs that reflect abstinence-only approaches, with heavy financing from the US government, and aggravated by the artificial condom shortage. Abstinenceonly campaigns-funded by the Bush Administration for ideological reasons-have expanded at the same time the condom shortage has worsened, and the Ugandan government has failed to take steps to restore public confidence in condom use as a major tool in prevention of HIV and other sexually transmitted diseases.
The U.S. Government Putting Lives at Risk
The U.S. government requires at least one-third of its global President's Emergency Plan for AIDS Relief (PEPFAR) prevention funds to be used for abstinence-until-marriage programs, even though there is no evidence of the effectiveness of programs that promote abstinence to the exclusion of safer sex and condom messages. Evidence supports comprehensive sex education is more effective than abstinence-only approaches in reducing behavioral risks related to the transmission of HIV and other STIs among young people. By not providing important safer sex information and limiting the availability of condoms to what it defines as "highrisk" groups (e.g. sex workers and people living with HIV/AIDS), the U.S. government jeopardizes the health and well-being of an entire generation of youth and others around the world.
Global Day of Solidarity
In Uganda, a coalition of AIDS activists is organizing a peaceful demonstration on August 30, 2005 to challenge the government's prevention policies.The coalition has issued a call to action for a Global Day of Solidarity asking for people to bring voices of support for comprehensive prevention policies to Ugandan government officials by organizing demonstrations at Ugandan consulates and embassies on August, 30 2005.
ACT UP NY, African Services Committee, Bondala Department at Harlem United,
Health GAP. For more info, call: (646) 645-5225, or email: firstname.lastname@example.org
CONDOM CRISIS DEEPENS IN UGANDA
SHORTAGES SPREAD TO OTHER COUNTRIES
US POLICIES UNDERMINE HIV PREVENTION PROGRAMS
A condom crisis in Uganda is now in its 10th month, and shows no signs of being resolved, reported the Center for Health and Gender Equity (CHANGE), endangering Uganda's previously successful prevention efforts.
Condoms have become difficult to find in cities, even for a price, and are unavailable in many rural areas. Reports indicate that in some areas, including those with large numbers of internally displaced persons, people desperate to prevent HIV infection have begun using garbage bags as condom substitutes. Similar condoms shortages and abstinence-only campaigns -- including those funded by the Bush Administration -- are reducing access to and undermining public confidence in condoms as a tool for prevention of both HIV and unintended pregnancy in other countries as well.
|RELATIVITY: CENTRAL AMERICA
Its interesting that in Central America with all the USAID money floating around and directly supporting a regional NGO called PASMO, which distributes condoms that the same problem is not occurring. PASMO's staff have told me that they must refer to abstinence in their printed materials as well as their workshops etc, but they are notprohibited from distributing condoms. They are distributing more condoms, paid for with US dollars, than previously, but with the conditions mentioned above.
Uganda's Aids programme faces crisis
Activists urge leaders to make more condoms available
Sarah Boseley, health editor
Monday August 29, 2005
Uganda's pioneering Aids programme, which showed the world that the epidemic could be turned around in Africa, appears to be in crisis as the government stands accused of obstructing the distribution of millions of condoms while preaching that no sex is the best prevention policy for single people.
Leading Aids activists and the UN special envoy for HIV/Aids in Africa, Stephen Lewis, will today urge Uganda to make more condoms available.
They will argue that the abstinence-only policies being promoted by the first lady, Janet Museveni, and financed by the US government are not, on their own, going to stop the spread of the disease.
The battle over prevention tactics appears to be coming to a head just days after questions have been asked about the financial management of Uganda's flagship Aids programmes.
Last week the Global Fund for Aids, TB and Malaria pulled all its funding from Uganda's programmes.
After a review by accountants PricewaterhouseCoopers of the handling of Aids funding, the Global Fund suspended five grants worth $201m (£112m) over two years and demanded that the unit within the Ugandan ministry of health that manages them should be disbanded.
The phenomenal success of Uganda's fight against Aids is largely credited to its president, Yoweri Museveni, who took the bold decision to speak out publicly about what was considered a shameful disease and tell people how to combat it. Prevention strategies, including the promotion of condoms, were central.
But in the last couple of years, the Ugandan and US governments have shown increasing interest in promoting abstinence and fidelity in marriage, with condoms given out only to those who cannot manage either.
New billboards have appeared in Uganda, signed by the office of the first lady and bearing the logo of USAid - the US development agency. One has a picture of a glamourous, smiling young woman, saying "She's saving herself for marriage - how about you?"
Activists argue that while abstinence until marriage and fidelity inside marriage are admirable concepts, human weakness, prostitution, the subservience of women in African society and the difficulty of changing behaviour dictate that condom use must be at least as well promoted, and condoms must be easily available.
But the condom supply has dried up, say campaigners. According to the US pressure group the Centre for Health and Gender Equity (Change), condoms are difficult to find in the cities, and are unavailable in many rural areas. Change says that the same pattern is beginning to occur in other parts of Africa.
"The crisis in Uganda has been created by the actions - and inaction - of the government of Uganda and the Bush administration, the primary donor for HIV/AIDS programmes in Uganda, and a major force in undermining effective HIV prevention programmes throughout sub-Saharan Africa and central America," said Jodi Jacobson, executive director of Change.
The condom crisis began in October last year, when the president ordered a nationwide recall of the condoms distributed free in government health clinics under the brand name Engabu. It was alleged they were of poor quality.
The government carried out a quality testing programme and all condoms were impounded. Public confidence in the Engabu brand plummeted after negative stories in the press and comments by the first lady about the effectiveness of condoms. New taxes pushed the price up.
The government claims that the original Engabu condoms are now too discredited to be distributed, even though tests have cleared them. They have obtained an emergency grant from the UK's Department for International Development for 20m new, unbranded condoms. When those are finished, they will distribute a new batch of 80m of the Engabu brand, they say.
"There is no condom shortage in Uganda," Vastha Kibirige, coordinator of condom procurement at the ministry of health, told the Guardian.
"The strategy is to distribute the non-branded ones first, and when we are more sure of particular groups that will not mind whatever brand, so long as we give them condoms, we shall distribute the new Engabu.
"We also have to withdraw the old stocks before we provide the new ones."
She added that the government was committed to a three-pronged Aids prevention strategy, comprising abstinence, fidelity and condoms. "Abstinence and faithfulness will continue to be emphasised," she said.
US abstinence drive hurts AIDS fight - UN official
Aug 29, 2005
By Andrew Quinn Reuters
JOHANNESBURG (Reuters) - The U.S. government's emphasis on abstinence-only programs to prevent AIDS is hobbling Africa's battle against the pandemic by downplaying the role of condoms, a senior U.N. official said on Monday.
Stephen Lewis, the U.N. secretary general's special envoy for HIV/AIDS in Africa, said fundamentalist Christian ideology was driving Washington's AIDS assistance program known as PEPFAR with disastrous results, including condom shortages in Uganda.
The Bush administration favors prevention programs that focus on abstinence rather than condom use and has more than doubled funding for U.S. abstinence-only programmes over the past five years.
As part of President George W. Bush's global AIDS plan, the U.S. government has already budgeted about $8 million this year for abstinence-only projects in Uganda, human rights groups say.
Activists in both Uganda and the United States say the country is now in the grip of condom shortage so severe that men are using plastic garbage bags in an effort to protect themselves.
"There is no question in my mind that the condom crisis in Uganda is being driven and exacerbated by PEPFAR and by the extreme policies that the administration in the U.S. is now pursuing in the emphasis on abstinence," Lewis told journalists on a teleconference.
"That distortion of the preventive apparatus ... is resulting in great damage and undoubtedly will cause significant numbers of infections which should never have occurred."
Many health experts say condoms are the most effective bulwark against AIDS.
The Office of the U.S. Global AIDS Coordinator which administers PEPFAR did not immediately return calls seeking comment. It has rejected criticism over condom policy in the past, saying it maintains a balanced approach to prevention.
Uganda had been praised for cutting HIV infection rates to around 6 percent today from 30 percent in the early 1990s, a rare success story in Africa's battle against the disease.
But President Yoweri Museveni's government has come under criticism for sidelining its condom policy, a move activists tie to pressure from Washington through its PEPFAR program.
The Ugandan government, which in 2004 recalled free condoms over quality fears, has failed to provide alternatives -- pushing the price of store-bought condoms up threefold, Ugandan activist Beatrice Were told the teleconference.
"From this you can see where Uganda is going ... people are desperate for condoms," she said.
Uganda's State Minister for Health Mike Makula told the Monitor newspaper on Monday there was no condom shortage, saying the country had 65 million in stock and had ordered another 80 million for delivery soon.
"That there is a condom shortage in the country is just a rumor by people who want to spoil the image of this country," the newspaper quoted Makula as saying.
But Jodi Jacobson of the U.S.-based Center for Health and Gender Equity said the about-turn in Uganda's previous policy to promote condoms was having a real impact -- reducing availability of condoms and cutting consumer confidence in them.
"They are kow-towing to the (U.S.) fundamentalist right on this issue," Jacobson said.
The U.N.'s Lewis said the effects of Washington's "obsessive emphasis on abstinence" were most profound in Uganda, where it resonated with strong local religious traditions.
But he said the U.S. drive for abstinence was being felt more widely across Africa and threatened to derail or divert more AIDS-fighting programs
"What PEPFAR has done is to have made it possible for a number of Pentacostal and more fundamentalist churches to pursue the abstinence agenda," he said.
"I think the administration and PEPFAR have to come to their senses ... to impose dogmatic policies is doing great damage to Africa.."
What? Condoms Can Prevent AIDS? No Way!
By HELENE COOPER New York Times Editorial Published: August 26, 2005
Six years ago, former prostitutes in several Central American countries began going to brothels, beer halls, bars and discos from Tegucigalpa to Managua and Mexico City. Every night, these women walked out of their homes and into the red-light districts in the poorest parts of these very poor cities. They carried over their shoulders bags filled with their props for the night.
Their aim was simple: to teach their former colleagues about the dangers of H.I.V. and AIDS and how to protect themselves and others.
Because so many of the prostitutes are illiterate, each shoulder bag of props contained materials for a game called Lotería (lottery). The game is like bingo; the prostitutes sit around a table and receive game cards, each with three rows and three columns: nine squares in all. Each square has a picture, like a palm tree, a doctor or a couple. The teacher holds up a pictograph card and calls out the name of what is pictured.
For instance, holding up a picture of a palm tree, the H.I.V. educator says, "La palmera," and then explains how condoms help people avoid H.I.V. and AIDS, just as palm trees help them avoid sunburn. Or, holding up a picture of la pareja (the couple), the teacher may mention the need to talk about condoms with a client or a partner.
If a game participant finds the pictograph on her Lotería card, she places a chip on that image. The first player to cover all nine images on her card wins a small prize.
Simple and straightforward, right? Well, not to Senator Tom Coburn, the Oklahoma Republican who recently wrote to President Bush to demand that the United States stop financing this preventive program, run by Population Services International, a nonprofit group.
"The project which has been funding these prostitute parties is up for renewal, and P.S.I. has applied for tens of millions more to continue the project," Mr. Coburn wrote. "There is something seriously askew at USAid when the agency's response to a dehumanizing and abusive practice that exploits women and young girls is parties and games."
Mr. Coburn also complained about the Noches Vives program: noches means nights, and Vives is a brand of condoms. Because most prostitutes in poor countries don't show up at local clinics to ask for condoms, P.S.I. sponsors Noches Vives, which has aid workers go to bars, brothels and other places where prostitutes congregate. They go from table to table, asking prostitutes and their clients for 5 or 10 minutes of their time. They hand out condoms and, sometimes using bananas as props, show people how to use them.
"It's a simple activity for largely illiterate people," said Michael Holscher, the regional executive director for P.S.I. "We can't just stand up in a bar and say, 'AIDS will kill you.' With an interactive activity, we can hold their attentions, sometimes for as long as an hour."
Apparently one hour of AIDS prevention in a Guatemala bar is one hour too long for the senator from Oklahoma's delicate sensibilities. He called Noches Vives a "misuse of funds to organize and sponsor parties and dance contests to exploit victims of the sex trade."
Shortly after Mr. Coburn's letter went out, Population Services International received word from the United States Agency for International Development that it was cutting off money for the program.
Many of Mr. Coburn's fellow Republican senators disagree with him. Larry Craig of Idaho, Orrin Hatch of Utah and Gordon Smith of Oregon have asked USAid's administrator, Andrew Natsios, to reconsider.
"Controlling infectious diseases abroad is domestic policy as much as foreign," Mr. Craig said. "Ignoring the problem by hamstringing proven programs is a disservice to U.S. citizens who are impacted by the wave of immigrants from these countries."
No kidding. It is also an absurd approach to curtailing AIDS. Mr. Coburn, a doctor, has apparently forgotten everything they taught him in medical school. Any doctor with sense knows that while abstinence may be a surefire way to prevent AIDS, teaching condom usage to prostitutes isn't far behind.
Let's hope the folks at USAid come to their senses soon.
from SCIENCE DAILY
U.S. accused of undoing Uganda AIDS gains
KAMPALA, Uganda, Aug. 30, 2005 (UPI) -- A U.N. official has accused the United States of undermining Uganda's success in fighting AIDS by pushing Kampala to de-emphasize the use of condoms.
Stephen Lewis, the United Nations' special envoy on fighting AIDS in Africa, said that Uganda -- under pressure from Washington -- was emphasizing abstinence instead of condoms, the BBC reported Tuesday.
He said condoms were now in short supply in Uganda and had tripled in price.
"Over the last eight to 10 months, there's been a very significant decline in the use of condoms, significantly orchestrated by the policies of government," Lewis told the BBC.
Ugandan Health Minister Mike Mikula denied any change in policy.
"The weight of the ABC (Abstinence, Be faithful and Condoms strategy) is all equal in that abstinence has been one of the critical strengths of Uganda's ability to reduce the prevalence (of HIV/AIDS infection) in the country.
"And obviously, being faithful, which is the B, has equally done very well. But condoms and the distribution of condoms continues unabated."
Uganda is often held up as a model of how to fight HIV/AIDS, with infection rates falling from 15 percent to 5 percent.
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