Shock, horror! The Pope says that condoms are not the answer to Aids in Africa, and may make matters worse. It would seem that virtually every news source, together with France, Germany, the European Union and other authorities, trumpet and condemn his words. He is out of touch, biased by doctrine and potentially responsible for many future deaths.
Yes, there is a scandal. And it’s a scandal of media behaviour and sad ignorance. First, what did the Pope actually say? “This problem of Aids can’t be overcome only with publicity slogans. If there is not the soul, if the Africans are not helped, the scourge can’t be resolved with the distribution of condoms: on the contrary, there is a risk of increasing the problem. The solution can only be found in a double commitment: first, a humanisation of sexuality, that is, a spiritual and human renewal that brings with it a new way of behaving with one another; and second, a true friendship, also and above all for those who suffer, the willingness — even with sacrifice and self-denial — to be with the suffering. And these are the factors that help and that lead to visible progress.”
A rather more nuanced picture, I think you would agree. But is the Pope talking though his mitre? On the contrary, he is bang up to date, and by up to date I mean March 2009.
Many will recall the paper published by Cafod in 2004 (Ann Smith et al) whose analysis showed the interconnections between different factors and the various elements which play a part both in the spread and the control of the disease. There was no one answer. Because it was evidence-based, and not a polemic, it accepted that condoms could play some part in the mix. It caused a stir, although Cafod does not fund agencies for whom condoms are central to their programmes. But it must be emphasised, because it appears to be little known, that the Church’s teaching on contraception applies only to marriage. It has made no ruling on its use outside marriage, and I would certainly argue that unprotected sexual contact outside marriage compounds the sin.
In 2007 I interviewed a non-Catholic journalist (Rhidian Brook) who had spent three months living in, mainly African, local communities in Aids-ridden areas. He said: “Condoms are about as important to controlling Aids as recycling your green bottles is to global warming. They are just a plaster. Poverty has far more to do with Aids than condoms.”
An important paper on the subject was published in Studies of Family Planning (March 2009) by Edward C Green et al, under the auspices of the Harvard Centre for Population and Development Studies. It is an academic paper, replete with supporting references to relevant studies. But you could almost believe that the Pope was reading it as he flew to Africa. You can study it for yourself.
We tend to look at outbreaks of Aids through western eyes. They occur in high-risk groups, and so are limited. In sub-Saharan Africa they are national epidemics and need to be treated as such. Reviewing this paper together with an interview given to The National Review Online, I find Green firmly saying: “We have found no consistent associations between condom use and lower HIV-infection rates, which, 25 years into the pandemic, we should be seeing if this intervention was working.”
The strategy of ABC (Abstinence, Be faithful, use Condoms), which is consistent with Cafod’s study, has proved effective in several countries when it has been energetically promoted and supported at national level.
Green tells us that even the Demographic Health Surveys, which are funded by the US, show that greater availability and use of condoms leads to higher, rather than lower, HIV rates. This may be the result of people taking greater risks, and perhaps doing so in the light of drug treatments effective in keeping HIV at bay. We might recall here our own lamentable rates of teenage pregnancy despite the emphasis on condom education in our schools.
“The best and latest empirical evidence,” Green claims, “shows that reduction in multiple and concurrent sexual partners is the most important single behaviour change associated with reduction in HIV-infection rates (the other major factor is male circumcision).” Studies in Uganda, Kenya and Zimbabwe have shown that such a reduction in multiple relationships has led, shortly after, to a substantial reduction in HIV rates.
This is the “Be faithful” component in the strategy, but the “Abstinence” component is also important, although the evidence is not as complete. Nor should we forget that condoms (despite Cardinal Trujillo’s gross misinformation on the subject) are a highly effective, if not infallible, prophylactic. For instance, Green tells us, consistent use of condoms by couples, one of whom is infected, reduces the rate of transmission by 80 to 90 per cent. We are still awaiting Rome’s response on this last issue, following several senior prelates questioning the standing prohibition. The delay is doing damage. Condoms can also play a useful role in the commercial sex market.
So the Pope was right. His deep and important message is that we cannot solve the problems caused through the misuse of sexuality merely by throwing slogans, money and artificial remedies at them. It cannot be done without the proper use of the sexual faculty, that is – if I may use an unfashionable word – chastity. Nor is this pie in the sky. We now know that this works in sub-Saharan Africa, as indeed it could work within our own sick society.
But was the Pope prudent to make this response in these particular circumstances? Given the voracious and venal media which watches every phrase for a scandal, I think not. It has overshadowed many other important messages of no interest to the headline-hungry. He would have done better to have sidestepped the question at the time, and then given a measured and factual statement on the subject, if that were needed.
Napoleon said that he wanted generals who were lucky. But Pope Benedict is unlucky. He is a holy man of the highest intelligence, yet he has shown a knack for proffering hostages to fortune. I don’t want a “street wise” pope, with a continual eye for the jackals. I am proud of what he said. But experience must teach him how to proclaim the truth so that it is the truth and not the media flak which the world comes to hear.
So what do you think? Do you agree with Pope Benedict in his statement? Do you think he could have handled the situation better? Or is he right simply to tell the truth when he is asked? You may like to look at the documents concerned.
You will find the Pope’s interview here.
My thanks to James H, who frequently contributes to this Blog, for his lead to the Edward Green Paper.
The National Review interview with Green
Cafod’s approach to HIV prevention.