Inter Press Service - November 25, 1999
Marwaan Macan-Markar

Opposition to promoting the use of condoms has undermined the efforts to curb an alarming increase in the number of victims of the acquired immune deficiency syndrome (AIDS) and the associated HIV virus.

"Action is needed as soon as possible, but some religious groups are against the idea of promoting the use of condoms," says Jose Enrique Zelaya, the inter-country programme advisor for the Joint United Nations Programme on HIV/AIDS (UNAIDS).

The alarming situation in the Caribbean and Central America has led the governing body of UNAIDS to consider these areas as "priority regions," Olavi Elo, a UNAIDS director, told a recent conference on AIDS held in Honduras.

At the end of 1997, this region had 1.3 million adults and children infected with HIV/AIDS, the third highest after sub- Saharan Africa and South and South-East Asia. Today, studies by the World Bank and UNAIDS pointed to a "marked increase" in these numbers.

The problems health workers like Zalaya have encountered with religious opposition to the distribution of condoms also has been experienced in other regions.

The situation in the South-Asian state of Bangladesh is a case in point. There, orthodox imams have come out strongly against the move in an environment health workers describe as having "all the elements for a wildfire epidemic."

Less than 20 percent of Bangladesh`s sexually active people use condoms and there is a 60 percent of active commercial sex workers suffer from sexually transmitted diseases.

"We had meetings with religious leaders on the use of condoms but some of them accused us of promoting promiscuity and others were arrogant," complained Professor Nazrul Islam, head of virology at the Bangabandhu Medical University in Dhaka, the Bangladeshi capital.

In the east-African state of Uganda, on the other hand, this issue has been met with relative success by health workers.

The Islamic Medical Association (IMA) was instrumental in convincing the country's Muslim theologians about the importance of condoms to combat the spread of the epidemic.

They agreed that religious leaders would continue to advocate abstinence and fidelity but they would not stop people from purchasing condoms, given its importance to stem the tide of fatalities due to HIV/AIDS.

"The imams know of the reality and they recognised that something needed to be done, but they are not legitimising its use," explained Dr. Magid Kagimu, the chairman of IMA.

Previously, the imams and the leaders of the Roman Catholic Church in Uganda had regarded the use of condoms as something "against religion." Not only did they refuse to talk about it, they mounted aggressive campaigns to ban condom advertisements.

Some South-East Asia health workers hoped to draw on the Ugandan model for such countries as Malaysia, given its predominant Muslim population. A few months ago, a seminar featuring Ugandan representatives in the Malaysian capital, Kuala Lumpur, drew a significant number of Islamic theologians who had previously avoided such gatherings.

One public health official considered such a turnout a sign that their religious leaders were willing to take on "a more active role in combating the HIV epidemic."

He hopes the government will heed such a development - launching messages about combating HIV/AIDS, including the use of condoms for preventing infection. According to the Malaysian AIDS Council, between 300 to 400 cases of HIV/AIDS have been reported every month in the last few years. Furthermore, between the years 1986 to 1998 close to 73 percent of those with HIV and 55 percent of those with AIDS were from the Muslim majority.

Today, AIDS has moved up to the fourth place among world killers, a dramatic rise from its position last year, where it was ranked as the seventh highest cause of death worldwide.

In its annual report this year , the World Health Organisation (WHO) describes it as "the primary cause of disease burden in developing countries." Furthermore, the impact of AIDS has been deemed catastrophic because of who it targets, young adults, unlike the other three that top it - heart disease, strokes and acute lower respiratory infections, which are typical causes of death in old age.

"The burden of AIDS will continue to be severely felt. This is only the tip of the iceberg," warned Peter Piot, executive director of UNAIDS.

And the way to combat the disease, says Piot is to increase awareness among those who could be felled by it. Promotion of safe sex campaigns was one form he had in mind.

Zelaya's outlook is similar for the countries he monitors.

"Central America has double the numbers when compared with the figures five years ago. The worst affected countries are Honduras, Belize and Guatemala," he says.

And this situation, he admits, can only be combated if more condom use is encouraged. Governments in the region need to advocate its significance - encouraging safe sex, thereby controlling the spread of this disease. Denial, will only help the spread of AIDS, Zelaya says. (END/IPS/mmm/mk/99)
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