Edward C. Green - Broken Promises: How the AIDS Establishment Has Betrayed the Developing World

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BROKEN PROMISES

BROKEN PROMISES

How the AIDS Establishment Has Betrayed the Developing World

EDWARD C. GREEN

First published 2011 by PoliPoint Press, LLC

Published 2016 by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
711 Third Avenue, New York, NY 10017, USA

Routledge is an imprint of the Taylor & Francis Group, an informa business

Copyright 2011 by Edward C. Green

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

Notice:
Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.

Broken Promises: How the AIDS Establishment Has
Betrayed the Developing World
Production management: BookMatters
Book design: BookMatters
Cover design: Naylor Design, Inc.

Library of Congress Cataloging-in-Publication Data
Green, Edward C. (Edward Crocker), 1944
Broken promises: how the AIDS establishment has
betrayed the developing world / Edward C. Green.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-936227-00-6 (alk. paper)
1. AIDS (Disease)AfricaPrevention. I. Title.
[DNLM: 1. Developing CountriesAfrica.
2. HIV Infectionsprevention & controlAfrica.
3. HIV InfectionsepidemiologyAfrica.
4. Health Knowledge, Attitudes, PracticeAfrica.
5. International CooperationAfrica. WC 503.6]
RA643.86.A35G74 2011
362.1997920096dc22

2010044897

ISBN 13: 978-1-61132-112-8 (pbk)

Unanswered questions are far less dangerous than unquestioned answers.

UNKNOWN

Contents

It is the response to error that counts.

NIKKI GIOVANNI
Of Liberation

In the spring of 2009, Pope Benedict XVI was flying to Africa on Shepherd One. You may have ridden on it yourself, because the Vatican simply borrows whatever airliner Alitalia has available when the Pope goes abroad. His small staff, a security detail, and seventy-odd journalists were with him. Thirty thousand feet above Africa, a reporter asked about the AIDS epidemic devouring the continent. Standing in the aisle by the flight map, the Pope replied that money alone was not the answer. He added, If there is no human dimension, if Africans do not help by responsible behavior, the problem cannot be overcome by the distribution of prophylactics. On the contrary, they increase it.

World response was swift and caustic. The New York Times said he deserves no credence when he distorts scientific findings about the value of condoms in slowing the spread of the AIDS virus. The Washington Post declared: Pope Benedict XVI is wrong because the evidence says so. The top medical journal The Lancet, not given to hyperbole, called his comments outrageous and wildly inaccurate. And multinational organizations and entire governments throughout Europe passed consensus statements and even legislation vilifying the Pope.

Yet he was right about Africa. And soon I got the opportunity to jump into this bedlam by saying so. As director of the Harvard AIDS Prevention Research Project and senior research scientist at the Harvard School of Public Health, I received a call from a writer at a prominent national magazine who asked straight out about the ruckus. I hesitated at first. I knew that if I said the Pope had articulated the solution better than The Lancet, I would be inviting trouble. Condom distribution has helped in some places. It just hasnt worked in Africa, where two of every three AIDS victims live today. And the Pope opposes condom use period, while I support it as a backup and even as a primary prevention strategy in some countries.

On Shepherd One the Pope does not answer questions off-the-cuff, like a politician at a news conference. Instead, reporters submit queries in advance and he mulls them over before deciding which ones to answer and how. And he had said: condom distribution will worsen the problem. Not condoms, but condom distribution, as a program. And not just condom distribution, but condom distribution without responsible sexual behavior. He had summarized the best current research on AIDS prevention in Africa.

In 1988, I first advocated the inexpensive, commonsense strategies I have fought for ever since. Millions of men and women would still be alive in Africa if we had followed them. But what I call AIDS World took a different path, and the best and the brightest in medicine and public health have led us to a global disaster of epic proportions. In fact, we are now experiencing the greatest avoidable epidemic in history. HIV has infected some forty-six million people in Africa and about eighteen million have died. Thats equivalent to Hiroshima about ninety times over. Incidentally, the term AIDS World was inspired by journalist Maureen Dowds book about an alternate universe called Bushworld (Its their reality. We just live and die in it).

The results are visible in urban neighborhoods like Soweto, in Johannesburg. On weekends there, police struggle to keep funeral processions from causing gridlock. At the crammed cemeteries dirges from nearby services compete for mourners ears. Beyond the graveyards in Africa, twelve million AIDS orphans scramble to survive. Many have moved into tiny shacks with relatives who can hardly afford to feed them, or have become heads of their own threadbare households. Other orphans wander the streets homeless and malnourished. In some African countries AIDS patients fill half the hospital beds. In childrens AIDS wards there is the eerie hush of babies too weak to cry. The disease is honeycombing societies and impoverishing nations for decades to come. And weglobal AIDS programshave ignored the prevention methods that help while wasting billions on strategies that dont. In human terms this is the most important health story of our generation.

The Pope was essentially taking a moral stancethats what popes doand I knew I would be risking further career damage if I publicly agreed with him. I would be saying that The Lancet, major agencies, and highly respected newspapers understood the epidemiological bottom line less than this religious leader. I could expect harsh attacks, and as a result I might lose some credibility, weaken my future impact on AIDS discussions, and harm my efforts to stop the spread of AIDS itself. I had worked in this field long enough to know the game. There were other places to speak out. I didnt have to do it here, in support of the Pope.

Id noticed that the Pope hadnt used that great conversation stopper: abstinence. Rather, he had stressed faitthfulness. I realized that the platform of a national magazine could let me skewer enduring myths and force the worlds attention on the fact that AIDS is different in Africa. When I talk about African AIDS, Im referring to the worst epidemics on earth (sometimes called hyperepidemics), found in about a dozen African countries with prevalence rates of more than 5 percent. Condom use doesnt work here, for important reasons, yet most experts have yet to acknowledge this research and simply assume that noncondom programs lead to mass deaths. As a result, we have seen mass deaths in Africans, unnecessarily and for too long.

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