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HIV spreads under Bush Africa policy

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By ROBYN E. BLUMNER, Times Perspective Columnist
Published October 12, 2003

Visiting a neighborhood bar or shebeen in Soweto, South Africa a few years back, I noticed a basket of condoms propped on the floor of the tiny restroom. The prophylactics were free, available for the taking - a tangible reminder of safety first.

I often wondered just how many lives that small public service had saved in a country where more than 20 percent of the population is HIV-positive. Hundreds? Thousands?

There is nothing magical about the way to stop a sexually transmitted killer. If a population is not going to abstain from sex - and even many Catholic priests can't seem to accomplish that feat - then protection against transmission is the best defense. But sub-Saharan Africa, home to 30-million of the world's 40-million HIV/AIDS sufferers, is suddenly facing a condom shortage. Family planning clinics from Ethiopia to Swaziland have had their American-donated supplies sharply reduced or cut off; and we can thank our president and his religious right politics for this.

President Bush reinstated the Mexico City Policy, also known as the global gag rule, as one of his first official acts. It was also one of his meanest. The policy bars organizations that receive U.S. international family planning funds from having anything to do with abortion; even uttering the word in counseling is verboten.

Ronald Reagan gets the credit for this political stroke, announced at the 1984 Mexico City Conference on Population. It was a way to spread an antiabortion agenda around the world - delighting the religious right - without doing much political damage at home. Americans notoriously have little interest in what our government does relative to the developing world.

Bill Clinton retracted the policy and Bush resurrected it. Think of it as our culture wars exported.

So how has Bush's Mexico City policy been impacting women in Africa? A new report titled "Access Denied," put out by Population Action International and a few other sponsoring organizations, lays out the harms.

In Kenya, five established clinics have closed; some were the only affordable reproductive health services in the area. One was located in Kisumu, a town with the highest HIV prevalance rates in the country. In Lesotho, where one in every four women suffers from HIV/AIDS, the Lesotho Planned Parenthood Association no longer receives any donated condoms from USAID, the U.S. government agency that doles out family planning money and supplies. During the years 1998 to 2000, the Lesotho group had received 426,000 donated condoms.

In short, thanks to the closure of medical clinics and reductions in supplies wrought by the policy, more Africans will contract HIV, more mothers will transmit it to their babies and more of the population will die. Those tend to be the calculations in places like Lesotho when a lifeline gets snatched back.

USAID is the single largest donor of condoms in the developing world, providing $75-million worth annually, or about a third of all donations. Yet, according to the PAI report, 16 poor countries in Africa, Asia and the Middle East have been cut off from USAID condom shipments because their family planning groups are associated with the International Planned Parenthood Federation, which refuses to sign the antiabortion pledge.

In another 13 countries, including Ethiopia and Zambia, the nations' leading providers of reproductive health services also no longer receive USAID condom supplies.

"This (gag rule) is an antiabortion policy - why is it affecting family planning supplies?" asks Wendy Turnbull, legislative policy analyst with Population Action International and an author of the report. "(Condoms) can't be used to promote abortion, they're trying to help women avoid abortion."

That is the sad twist in all this. Bush claims to care about stemming the AIDS pandemic in Africa. He was in Africa this summer, eyes welling as AIDS orphans sang America the Beautiful, pledging billions in assistance. And he is certainly antiabortion. This is the man who held back the most promising area of medical science with his nutty stem cell skittishness.

But stopping the supply of condoms to organizations that counsel clients on all legal reproductive health options is leading inexorably to HIV's spread and a rise in unwanted pregnancies and abortions.

Hillary Fyfe, chair of the Family Life Movement of Zambia, which counsels young people on abstinence, reproductive issues and HIV prevention in nine provinces, says the funding cuts have been devastating. There is not a donated condom to be had in the region,"completely nothing," she says, and "when the (young women) fall pregnant they have no place to go. They take a knitting needle and push it down or they go in the bush and dig up a poisonous root and push it down. Half the time they die."

These are the real-life consequences in Bush's war of ideology. The PAI report puts Bush on notice; if changes aren't made we must presume that he cares more about gaining a political edge than African lives.

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