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Originally published Friday, June 17, 2005 at 12:00 AM

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The ABCs of fighting the spread of AIDS in Africa

Elton John is furious at Bob Geldof for inviting the pope to one of the upcoming Live 8 concerts, organized to raise money for sick and...

Elton John is furious at Bob Geldof for inviting the pope to one of the upcoming Live 8 concerts, organized to raise money for sick and starving Africans. What's the Rocket Man's problem with the pontiff attending the party? Condoms.

Elton is peeved about the Vatican's longstanding position against artificial birth control, including condoms, considering it a slap in the face for those working to stem the spread of AIDS in Africa.

In his estimation, "Banning Condoms Kills," as the abortion-advocacy group Catholics for a Free Choice stated in an ad campaign. And so the Catholic Church, according to the chattering class, is a major accomplice in the pandemic senselessly killing off African adults and orphaning their children.

In a story published right after Pope John Paul II died earlier this year, the British New Statesman proclaimed that he "did more to spread AIDS in Africa than prostitution and the trucking industry combined." FYI, John Paul said: "Fidelity within marriage and abstinence outside are the only sure ways to limit the further spread of AIDS infection."

Excuse my simplemindedness, but that seems like exactly the pill Africa needs. And you don't have to take the Vatican's word for it. Throwing condoms at the problem has simply not worked in Africa. Fidelity and abstinence, where they have been tried — most notably in Uganda — seem to give people a fighting chance, as they logically would.

Edward Green, senior research scientist at the Harvard Center for Population and Developmental Studies, is an expert on the "ABC" approach to AIDS prevention: "Abstain; Be Faithful; Use Condoms."

Don't have sex if you're not married; be true to your spouse if you are married; use a condom as a last resort, as Green explains in his book "Rethinking AIDS Prevention, Learning from Successes in the Developing World."

Uganda has embraced this approach and the standout results present a model for attacking the African pandemic. Between 1991 and 2001, HIV infection rates went from about 15 percent to 5 percent. In Kampala, the country's capital, HIV among pregnant women dropped from 30 percent to 10 percent.

How? Uganda's president blanketing the country in ABC education. Premarital sex rates went down, for one — something Western elites rarely consider possible, here or abroad.

You mean education and behavior change might go further than Bill Gates airlifting condoms into Africa? Teach a man to respect himself and the women around him, and you might just be en route to putting a dent into a pandemic. And you don't have to be pope to realize that.

Unfortunately, the ABC approach may not spread and flourish, even in Uganda. Because of "conventional wisdom of the world," major donors to Africa do not favor the A and the B of it. According to Green, "If you look at the current national Strategic Framework for HIV/AIDS, which is a blueprint for all the activities supported in Uganda to combat AIDS, you will see that there are virtually no A or B elements there. The document is all about condoms, STDs, future vaccines, future microbicides and testing."

This approach reflects the attitudes the major donors like. In fact, the word abstinence appears only twice in the body of this 77-page document, but only as part of a general approach — there are no specific objectives or impact measures associated with A or B interventions. That remarkable turnaround in Uganda is reversing course due to Western ways. But despite the successful evidence, some Westerners are wedded to their tried-and-failing ways, putting that remarkable turnaround in danger and holding the rest of Africa (among others) back.

Large donors and popular voices like Elton John seem to think you must give the Third World inhabitants condoms because you can't keep them from promiscuity. That insulting attitude does Africans a deadly disservice. People deserve to know they have alternatives in life to risky sex.

Not only do the numbers show that the approach isn't ending the scourge of AIDS, but a whole host of other, associated problems. Donna M. Hughes, a women's studies professor at the University of Rhode Island who's an advocate for victims of sex slavery, has noted: "If men more often chose to 'keep it in their pants' ... there would be less demand for women and girls for prostitution. If men more often choose to be faithful, they would not contract HIV and transmit it to their monogamous wives, who are frequently identified as one of the fastest-growing HIV-positive subgroups."

Hughes, once a buyer into the condom conventional wisdom, now believes "that the ABC approach is good for women and girls." And it ain't too shabby for men, either, obviously.

Feminists — who are normally averse to the "abstinence" word, associating it with (heaven forbid) George W. Bush (who favors ABC) and the Catholic "patriarchy," ought to hold their noses and give it some consideration. They could lead a revolution and save a continent!

"If it turns out that the findings from Uganda and other countries are confirmed, and we have failed to promote the right messages, then it is not too far-fetched to say that millions of lives could have been saved and yet were not," notes Green.

Is proving the pope wrong really worth taking that kind of chance? Even the Rocket Man can see there's no bloody point in that.

Kathryn Lopez is the editor of National Review Online ( She can be contacted at

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