/ 10 December 2003

HIV: Morals vs safety

It wasn’t the president of Uganda’s most electrifying speech on HIV/Aids. Bits of it were confused; others, platitudinous.

But in the midst of his tired ramblings in honour of World Aids Day, President Yoweri Museveni managed to say something that infuriated half his audience and delighted the other half, and in doing so, summed up the biggest challenge to his country in the fight against the deadly disease.

”You people are confusing morals with safety,” he thundered, with a sideways glance at Uganda’s high-minded MPs.

Last week Uganda’s MPs passed a unanimous motion condemning the choice of Ugandan Big Brother Africa housemate Gaetano Kagwa — famous for seducing his fellow housemate, South African Abby Plaatjes, and having sex with her live on the show — as a figurehead for the youth to raise awareness of HIV/Aids.

To the distress of the moral majority, Kagwa and the 10 other Big Brother housemates were invited to help Uganda celebrate World Aids Day. Kagwa himself has also been touring the country with the United Nations Children’s Fund (Unicef), helping to promote awareness of HIV/Aids prevention.

How can a guy so promiscuous, who cheated on his girlfriend live on TV and may not even have used a condom, possibly be a role model for the youth, the moralists asked?

”What is important is not who has behaved rightly or wrongly,” Museveni replied in his Aids Day speech, ”but how can we best spread the message about how to protect yourself from the disease.”

His remarks echo those of Unicef programme officer for the event, Susan Kasedde, who told the Mail & Guardian that critics have missed the point: ”None of the Big Brother housemates have been invited as role models,” Kasedde said. ”The primary objective is to bring youths together to share their experiences about HIV/Aids and that’s what they are here to help us do.”

Uganda’s reputation as the continent’s sole success story in the fight against the spread of the HIV/Aids — turning the epidemic around at a time when many other African countries were lost in denial — has won it international acclaim and several international awards.

Even so, there remain differing opinions as to how Uganda’s successes were achieved. Conservatives say it was by preaching ”moral” behaviours to the young — telling them to abstain from sex before marriage, telling them it is wrong to have several partners or to cheat on your partner.

Liberals say it was achieved in a more progressive fashion — explaining the mechanics of the disease, how it is spread, and how it can be prevented, especially through condoms. Some of these liberals even fear that Uganda’s anti-Aids message is being hijacked by a backward Christian fundamentalist lobby in the United States (very influential in Uganda), which preaches abstinence before marriage at the expense of safe sex, and whose real agenda is controlling society, not controlling a disease.

But according to UNAids, neither side can claim to be the sole victor over the increase in prevalence rates.

”Anyone who says: ‘Uganda’s success is because of ‘a’ but not ‘b’ is bound to be missing something,” says Ruben del Prado, country coordinator for UNAids.

”The truth is that all these approaches have come together. The religious and moral leaders have had a lot of success in getting youths to delay sex and in reducing numbers of sexual partners. But they weren’t solely responsible. A big part was sensitisation about condoms.”

Prado thinks tying Aids education in with a ”moral” message may have enabled those with no access to condoms to protect themselves. ”If you drop the message to abstain or stick to one partner, a lot goes with it — a society at risk from HIV has to be ready for this permissiveness. Uganda might not be.”

Yet UNAids has also collected testimony from districts in Uganda that paint a very different picture of the influence church and other moral leaders are having. Young Sali Kiddu of Masaka district, wrote to the programme with a terrifying complaint: ”The ideas of the Church and those of the anti-Aids organisations are at loggerheads,” she lamented.

”The Catholics have scientific evidence that condoms are incapable of preventing Aids. They say that the pores in the condom allow the virus to pass through.”

Prado says such extreme misinformation is not the official policy of the Catholic Church, although the head of the Church in Uganda, Cardinal Emmanuel Wamala, did go on record in September to say that condoms should be rejected because they promote immorality.

Prado thinks church leaders must be confronted on this. ”We recognise they want to protect their morality. But they do not have to misinform people to achieve their spiritual goals.”

That just leaves what is perhaps the biggest risk in trying to tackle Aids by linking it to morality: the stigma. If ”moral” behaviour is what enables us to prevent Aids, then doesn’t it follow that people with Aids got it because of their ”immoral” behaviour?

”Many Ugandans claim that the Church perpetuates stigma,” says Prado. ”That is something which must be corrected.”