UNAIDS and UNFPA Want More of the Same for Asia

Steven Mosher
by Joseph A. D'Agostino
PRI Weekly Briefing
28 July 2005
Vol. 7 / No. 29
Reproduced with Permission

For 20 years, a huge amount of resources has been marshaled to combat the AIDS epidemic worldwide. Condoms, sex education, and gender equality re-education have been massively deployed in developed and undeveloped countries alike. The result has been an equally massive explosion in the spread of HIV and AIDS. But a curious effect of Original Sin is to make people's minds immune to reality -- and sometimes more prone to self-interested arguments than to the truth -- so what do the United Nations Population Fund (UNFPA), other international agencies, and USAID propose as the solution? More of the same.

It's just like the recent G8 summit: After 30 years and $50 billion in aid to corrupt African governments, the situation in most sub-Saharan African countries is worse than before, so the answer is: More of the same.

This month, UN agencies including the anti-HIV umbrella group UNAIDS decried the continuing spread of HIV and promised to fight it with more of the same proven techniques -- techniques proven ineffective. Reported UNFPA on July 6, "The number of people living with HIV has risen in every region [of the world]. UNAIDS chief Dr. Peter Piot said the deaths and infections were a testament to the world's failure to get prevention and treatment to those who need it."

Massive AIDS epidemics used to be confined to extremely poor, extremely chaotic sub-Saharan Africa. Now, big epidemics are developing in more affluent, better organized parts of the world. "AIDS is truly a disease of our globalized world," Piot said. "Whereas until recently AIDS was largely a problem for sub-Saharan Africa, one out of every four new infections is occurring in Asia today, and the fastest growing epidemic is happening in Eastern Europe. The virus is running faster than all of us."

Uganda, with its strong emphasis on abstinence and marital fidelity led by President Yoweri Museveni and his wife, is the only Third World country to have greatly reduced its HIV infection rate, from 18% in 1992 to 5-7% today. The Philippines has had great success in keeping her HIV infection rate down: Though the first AIDS case in the Philippines was reported in 1984, the same year the first one appeared in Thailand, the adult HIV infection rate in the Philippines in 2003 was less than 0.1%, one of the lowest in the world, according to the CIA World Factbook. Even the United States, with all her massive health care infrastructure and gargantuan anti-AIDS efforts, has an adult HIV infection rate of 0.6% -- six times that of the Philippines.

In neighboring Thailand, which took the sex ed and condom route, the adult HIV infection rate was 1.5% in 2003, or at least 15 times higher that the Philippines despite Thailand's recent and likely temporary success in reducing her rate. In Cambodia, it was 2.6%. The Asian AIDS epidemic has reached critical mass and may soon explode.

Though the Philippine example is right there in the Asian region for international AIDS potentates to see, the Seventh International Congress on AIDS in Asia and the Pacific -- at which Piot spoke -- chose to point to Thailand and Cambodia as models instead, to judge from UNFPA reportage on the conference. "An estimated 8.2 million people in Asia and the Pacific -- including 5.1 million in India -- are living with HIV," said UNFPA July 6. An astonishingly high proportion of those, 1.2 million people, were infected just last year. "Epidemics, often driven by drug use and paid sex, are growing fastest in Indonesia, Nepal, Viet Nam and China," said UNFPA. "Cambodia has joined Thailand in reducing HIV prevalence." UNFPA didn't mention the Philippines, perhaps because of the low incidence of HIV infection combined with the emphasis that a traditional Catholic culture puts on chastity. Even UNFPA admits that Filipinos have a very low rate of condom use. What else can explain HIV's failure to spread there but abstinence, marital fidelity, and low rates of immoral , dangerous behavior?

It's clear what's causing HIV rates to increase among Thai young people. Sex education and the "relaxed" attitudes towards sexual activity promoted by it and by contemporary popular culture are killing more and more Thai youth. Says a July 12 UNFPA report about Thailand, "In the past while open discussions about sex were taboo, it has been introduced in the school curricula in 1978, 1981 and more recently has been revised in 2001 within the broader context of reproductive health and sexuality, HIV/AIDS, safe sex, contraceptive use, pregnancy and parenthood. . . . When compared with preceding generations, younger people tend to be more permissive in their outlook towards sex. It is not uncommon that they have more than one sexual partner either before or after marriage. There is also a clear trend towards the first sexual encounter occurring at an earlier age (approximately 14-18 years). . . . Premarital sexual activity, gender-based violence and alcohol and drug abuse among adolescents have led to increases in unplanned pregnancies, HIV infection and abortions in this group."

The authors of the report do not suggest a return to traditional morality to combat these upward trends in AIDS, illegitimacy, and abortion among Thai youth. Instead, they recommend more sex ed and condom promotion -- the same things that helped generate these phenomena.

For the record, condoms, even when used by adults, offer little protection against the HIV virus over time. They offer even less protection in the hands of teenagers. For pregnancy, their failure rate is 15% per year of sexual activity. Those aren't good odds when you're trying to avoid a disease that is 100% fatal.

The United Nations lives in an Orwellian alternate reality in which "everyone" is at risk of HIV. But how about celibates or faithful married couples who don't use drugs? These are risk-free categories into which a lot of people fall.

The UN is also opposed to exerting the kind of social pressure that encourages safe behavior and promotes stable family life. For example, the December 2003 UNAIDS/World Health Organization AIDS Epidemic Update asserts, "Stigma devalues and discredits people, generating shame and insecurity. In the context of AIDS, it can fuel the urge to scapegoat, blame and punish certain people (or groups) in order to detract from the fact that everyone is at risk. . . . It stems from the association of HIV/AIDS with sex, disease and death, and with behaviours that may be illegal, forbidden or taboo, such as pre- and extramarital sex, sex work, sex between men, and injecting drug use. Stigma is harmful, both in itself (since it can lead to feelings of shame, guilt and isolation of people living with HIV), and because it prompts people to act in ways that directly harm others and deny them services or entitlements -- actions that take the form of HIV-related discrimination."

But isn't HIV/AIDS associated with sex, disease, and death? Aren't pre- and extramarital sex, prostitution, sodomy, and IV drug use the behaviors almost entirely responsible for the spread of HIV? Apparently, reality doesn't matter. If thieves and racists can be stigmatized for the harm they do to society, then why not prostitutes, sodomites and drug addicts?

UNFPA has a plan for the Philippines. This year, it committed $26 million in family planning money through 2009 to the Catholic nation. Part of this money will be used to de-stigmatize those dangerous behaviors listed above, the very stigmatization that has protected the country's population. Moreover, prominent Filipino politicians are pushing HB 3773 in the Filipino parliament, a bill which would greatly increase sex education, family planning, and coercive population control efforts by the national government. That's the plan: Replace a successful model with a failed one.

Then when an HIV/AIDS epidemic erupts in the Philippines, the UNFPA can prescribe more of the same.