Opinions: The Pope and condoms; fighting HIV/AIDS in South Africa; malaria eradication or control; health care workers; foreign aid in Haiti

Nov 24 2010

Religion, Public Health Need To Respect Role Played By Other

Reflecting on Pope Benedict XVI's recent statements regarding the use of condoms to prevent the transmission of HIV, Michael Gerson writes in a Washington Post column: "No effective AIDS prevention strategy can ignore the role of condoms - or the role of behavior change that is often related to religion. Both are necessary because human beings are neither angels nor beasts, as Christian theology would attest."

"Religion deals with ideals of human behavior. Public health deals with likely human behavior - a very different category. Both should respect the role played by the other," Gerson continues. "The best AIDS prevention programs are idealistic about human potential and realistic about human nature. This seems to be where the pope is heading. Given his unquestioned standing as a theological conservative, perhaps only he could make the trip" (11/23).

Pope's Statements On Condoms Should Kick Start Conversation In Church On Stopping Disease Spread

Pope Benedict XVI's remarks on condoms "should begin a discussion within the church focused more on humane ways to limit the spread of diseases like AIDS and less on an instrument - the condom - that the church has in the past vilified," argues a Boston Globe editorial.

The pope's shift from one year ago where he "said condoms not only did not help in reducing the spread of AIDS but actually worsened the problem … will encourage some church leaders, including a cardinal from Ghana, who have said the church should consider approving the condom use by married couples in which one partner is infected with the AIDS virus and the other is not," the editorial states. "Benedict's acknowledgement that an across-the-board rejection of condoms could make the church a barrier to effective disease-fighting strategies is a welcome sign that the Vatican is not deaf to appeals from both inside and outside its walls," the piece concludes (11/23).

To Prevail In Fight Against HIV/AIDS, 'Every Country Must Take The Leadership Role'

In a Times Live opinion piece, U.S. Ambassador to South Africa Donald Gips, reflects on the impact PEPFAR has had in South Africa, including connecting patients with antiretrovirals and support services for children made orphans by HIV/AIDS. He also outlines PEPFAR's strategy in the country: "In this phase of PEPFAR, the U.S. will support the prevention of new HIV infections in more than 12 million people, provide ongoing HIV treatment for more than four million people with HIV/AIDS, and care for more than 12 million people, including five million children and orphans. Besides doubling the number of babies born HIV-free, through U.S. investments in the Global Fund to Fight Aids, Tuberculosis and Malaria, millions more people will benefit from prevention, care and treatment," Gips writes.

"We are using our money wisely for greater impact," Gips writes, pointing to efforts to increase the availability of low-cost antiretrovirals and the program's success at driving down the cost to ship medicines. He also references President Obama's Global Health Initiative, the importance of prevention efforts to stemming the spread of HIV/AIDS and the future of HIV/AIDS care, before concluding: "If we are to prevail in this fight, all must come together and contribute their unique strengths. Every country must take the leadership role, including providing resources to the extent of its ability. ... We must, together, remain dedicated to building on our recent successes to save even more lives. I am optimistic that South Africa will turn the tide, due in large part to the commitment of the South African government and the vibrant civil society" (11/21).

The Past, Present, Future Of Malaria Control Efforts

In a Wall Street Journal book review, W.F. Bynum, professor emeritus of the history of medicine at University College London, reflects on the history of malaria control efforts and the challenges associated with trying to eradicate malaria, as detailed in Sonia Shah's "The Fever" and Bill Shore's "The Imaginations of Unreasonable Men."

Bynum notes that though the two authors "sit at opposite ends of the international malaria problem - the vertical visionary and the horizontal historian," both acknowledge the role the Bill & Melinda Gates Foundation is playing in fighting malaria after having put "eradication back on the agenda." He writes, "The danger of the latest eradication attempt is that, with even the best will in the world, private philanthropy may not have staying power. The slog will be long and hard and the results slow in developing. We must not be paralyzed by the past. Nevertheless, the international health industry needs to set attainable goals - or risk repeating the failures of the initial malaria eradication program, which stopped when the money ran dry" (11/20).

Listen To Health Workers On The Ground To Strengthen Health Systems

In light of last week's health systems research meeting in a SciDev.Net opinion piece, journalist Priya Shetty calls for researchers and policymakers to pay greater attention to the experiences of health workers to inform ways to strengthen health systems. Shetty writes, "Their recommendations and feedback on the shortfalls in health systems is the practical input that is desperately needed, yet not often sought."

"Health professionals are the backbone of any health system, but a major reason for crumbling health systems in developing nations is a shortage of workers," Shetty writes. "Insight that needs to come directly from health workers includes issues such as why they emigrate - as this exacerbates the severe shortage of personnel - and what incentives might make them stay." She concludes, "if academics and policymakers hope to improve health systems, they also need the input of local doctors and nurses" (11/19).

Foreign Aid Is Reinforcing 'Low Expectations In Haitian People'

"Foreign aid is reinforcing a tyranny of low expectations in the Haitian people," Andress Appolon, a former officer with the USAID in Haiti, writes in a Christian Science Monitor opinion piece where she reflects on the how the flood of foreign aid into the country that followed the Jan. 12 earthquake has impacted local development.

"Of course, it was our moral obligation to come to Haiti's rescue in the immediate aftermath of the earthquake. However, as the months wear on, we have to think more critically about how our aid money affects local development," Appolon writes. "By most estimates, Haiti has the most development NGOs of any country per capita; as a result, the management of the country's vital social services has been ceded to domestic or foreign NGOs. So, although after the earthquake, Haiti should have been able to leverage our dollars to establish more sustainable post-disaster assistance programs, our dollars largely bypassed Haitian institutions - governmental and otherwise." Appolon points to the Nov. 28 election in Haiti as an opportunity for Haitians "to break this cycle of dependency. … [H]opefully, this time, we will listen too and finally begin directing our aid money towards reinforcing local - and not imported - capacity" (11/17).