Despite boost in numbers, shortages seen
By John Donnelly, Globe Staff | September 8, 2005
JOHANNESBURG -- The US government has purchased more than 1 billion
condoms in the past two years to help prevent HIV infections in
the developing world, a significant increase from previous years,
amid criticism from activists that the Bush administration isn't
doing enough to make condoms more widely available.
By the end of December, US officials project that they will have
shipped more than 612 million condoms this year to Africa, Asia,
and Latin America, the greatest annual figure since 1991, according
to the Office of the US Global AIDS Coordinator in Washington. In
2004, the United States purchased 442 million condoms.
Despite the increase, more than 60 countries around the world report
condom shortages, according to the United Nations. Last week, activists,
including a United Nations AIDS representative and two prominent
AIDS activists in Africa, blamed US policies as playing a role in
a shortage of condoms in Uganda.
The United States now is emphasizing that the two best prevention
methods against contracting HIV are abstinence and being faithful
to one partner. If either is not possible, officials recommend consistent
condom use. Activists suggested that Uganda's president, Yoweri
Museveni, who has disparaged condoms as only an ''improvisation"
tool in preventing AIDS, has not been aggressive in addressing a
condom shortage out of deference to US pro-abstinence policies.
But Dr. Mark Dybul, US deputy global AIDS coordinator, calls such
thinking ''bizarre."
''We are still, by far, the largest supplier of condoms in the
world," Dybul said by telephone last week from London. ''During
the last two years, the only difference is that we recognize a condoms-only
policy to prevent the spread of HIV in a generalized epidemic just
won't work."
A generalized epidemic is one that has spread throughout society
and is not limited to specific populations. More than 25 million
people in sub-Saharan Africa are estimated to have the virus that
causes AIDS. That number amounts to roughly seven of every 10 people
living with the virus globally.
Dybul and several US officials working in AIDS programs in Africa
said the administration's AIDS-prevention policy has shifted significantly
over the last two years, broadening to put more emphasis on promoting
abstinence and faithfulness within marriage. US legislation now
requires that one-third of AIDS-prevention funding be spent to promote
abstinence, a condition strongly supported by US religious groups
but criticized by many world health authorities as unnecessarily
rigid.
The distribution of US-purchased condoms, Dybul said, is now more
tightly aimed at such ''high-risk activity" areas as bars,
border crossings, brothels, and military bases, but does not preclude
giving them to other groups at risk. He said that promoting condom
use to all segments of society would send the wrong message to people
who are trying to abstain from sex or stay faithful to one partner.
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