BUSH ACCUSED OF AIDS DAMAGE TO AFRICA

Jeevan Vasagar and agencies in Nairobi and Julian Borger in Washington
Tuesday August 30, 2005
_The Guardian_ (http://www.guardian.co.uk/)

A senior United Nations official has accused President George Bush
of "doing damage to Africa" by cutting funding for condoms, a move
which may jeopardise the successful fight against HIV/Aids in Uganda.
Stephen Lewis, the UN secretary general's special envoy for HIV/Aids
in Africa, said US cuts in funding for condoms and an emphasis on
promoting abstinence had contributed to a shortage of condoms in
Uganda, one of the few African countries which has succeeded in
reducing its infection rate.

"There is no doubt in my mind that the condom crisis in Uganda is
being driven by [US policies]," Mr Lewis said yesterday. "To impose a
dogma-driven policy that is fundamentally flawed is doing damage to
Africa." The condom shortage has developed because both the Ugandan
government and the US, which is the main donor for HIV/Aids prevention,
have allowed supplies to dwindle, according to an American pressure
group, the Centre for Health and Gender Equity (Change). In 2003,
President Bush declared he would spend $15bn on his emergency plan
for Aids relief, but receiving aid under the programme has moral
strings attached. Recipient countries have to emphasise abstinence
over condoms, and - under a congressional amendment - they must
condemn prostitution. Brazil announced last month that it would
refuse to accept $40m (£22m) in American aid rather than stigmatise
prostitutes who Brazilian health workers said were essential to their
anti-Aids strategy. Senegal was also cut off from US aid because
prostitution is legal there. Campaigners accuse Uganda's first lady,
Janet Museveni, of being instrumental in the switch towards a policy
of abstinence. Ugandan government officials say that her religious
beliefs, stemming from being a born-again Christian, are central to her
promotion of the message of abstinence. In one poster campaign, signed
by the office of the first lady, the slogan alongside the picture of
a smiling young woman says: "She's saving herself for marriage - how
about you?" While Uganda needs between 120m and 150m condoms a year,
only 32m have been distributed since last October, Change said in a
report published yesterday. Meanwhile, religious groups that oppose
condom use are receiving an increased share of funding, the pressure
group says. "Religious fundamentalists, some financially supported by
the US government and the office of the first lady, Janet Museveni,
have become prominent in attacking condoms and those who distribute
them," Change's report said. Officially, Uganda remains committed
to the threefold "ABC" policy. The initials stand for "Abstinence,
Be faithful, use a Condom". The Ugandan government denied yesterday
that there is a scarcity of condoms or a policy change. The health
minister, Jim Muhwezi, said: "It is not true that there is a condom
shortage. There seems to be a coordinated smear campaign by those
who do not want to use any other alternative simultaneously with
condoms against Aids." The minister insisted that condoms remain an
important part of their HIV prevention strategy, but said the first
lady could not be expected to promote the use of contraceptives. "Her
role is to tell the young people to abstain. She cannot tell young
people to use condoms, she is a mother," he said. Uganda has had
extraordinary success in reducing adult infection rates from 30%
in the early 1990s to below 6% last year. This success is largely
credited to its president, Yoweri Museveni, who spoke out about what
was considered a shameful disease and told people how to combat
it. The row over Uganda's HIV/Aids strategy comes at a time when
the financial management of the country's Aids programmes is under
the spotlight. Last week the Global Fund for Aids, TB and Malaria
pulled all its funding from Uganda's programmes. After an inquiry by
accountants PricewaterhouseCoopers, the Global Fund suspended five
grants worth $201m over two years and demanded that the unit within
the Ugandan ministry of health that manages them should be disbanded.
An American Aids official last night denied that the US had forced
Uganda to reduce the condoms available, saying the Bush administration
supported condom use as part of a balanced programme that included
prevention. "The statements that I have heard are completely untrue
and completely mischaracterise effective prevention programmes," Mark
Dybul, deputy US global Aids coordinator and chief medical officer,
told Reuters by telephone.