Waste of money

Catholic strategy for the prevention of HIV infection can be summed up in 4 words, "Do not have sex".  Yet, the Philippine government via the Philippine Charity Sweepstakes Office gave a church based organization, AIDS-Free Philippines, 500,000 to 1.5 million pesos per year from the time of former President Estrada until 2009 to precisely promote this.

Which would have been bad in itself, promoting only the AB (Abstinence and Be Monogamous) without the C option (use Condom) for those who cannot do the AB is counter productive.  The catholic church has been trying to teach AB since before I was born and Filipinos are still begetting children before getting married and having sex outside of marriage.  So only promoting the first 2 options promotes the spread of HIV through ignorance.

But it's worse than that,  the AIDS-Free Philippines organization actively opposes the use of condoms, 

"In 2004, Dr. Rene Josef Bullecer, Director of AIDS-Free Philippines and Executive Director of Human Life International (HLI) Visayas-Mindanao, observed that:

“The discrepancy in the infection rates between the two countries, Thailand with severe condom- oriented programs and the Philippines without, has continued and only grown wider. As of August 2003 there were 899,000 HIV/AIDS cases documented in Thailand and approximately 125,000 deaths attributed to the disease. These numbers are many times those projected by the WHO (60,000-80,000 cases) in 1991. These numbers contrast sharply with those of the Philippines where, as of September 30, 2003, there were 1,946 AIDS cases resulting in 260 deaths. This is only a mere fraction of the number of cases (80,000-90,000) that the WHO projected would be reached by 2000.”31

The huge discrepancy continues, with Thailand having 610,000 [low estimate: 410 000; high estimate: 880,000] people living with HIV and death according to the UNAIDS/WHO. In contrast, the Philippines has only 8,300 [low: 6,000; high: 11,000] persons living with HIV. The numbers are even
more striking considering that the Philippines has a much larger population than Thailand.32
There is also more evidence from other countries that questions the effectiveness of condoms in the fight against HIV/AIDS. A study in Uganda by Kajubi et al. (2005) concluded that condoms were not effective at lowering HIV infections: “In this study, gains in condom use seem to have been offset by increases in the number of sex partners. Prevention interventions in generalized epidemics need to promote all aspects of sexual risk reduction to slow HIV transmission.”33
Dr Edward Green of the Harvard AIDS Prevention Research Project, in his book Rethinking AIDS Prevention: Learning from Successes in Developing Countries, contested the efficacy of condoms and HIV counseling and testing, the preferred prevention strategies of Western donor nations and the U.N.
Green said:

“The largely medical solutions funded by major donors have had little impact in Africa, the continent hardest hit by AIDS. Instead, relatively simple, low-cost behavioral change programs–stressing increased monogamy and delayed sexual activity for young people–have made the greatest headway in fighting or preventing the disease’s spread. Ugandans pioneered these simple, sustainable interventions and achieved significant results.”34

Tim Allen and Suzette Heald, in a comparison of AIDS policy in Uganda and Botswana, also noted:

“Promotion of condoms at an early stage proved to be counter-productive in Botswana, whereas the lack of condom promotion during the 1980s and early 1990s contributed to the relative
success of behaviour change strategies in Uganda.”35

Their opposition to condom use for the prevention of HIV infection boils down to, people do not use them correctly, therefore they are ineffective.  If used correctly, condoms provide up to 98% protection against HIV infection.  They argue that, behavioral change is more effective in preventing the spread of HIV,  we are not  disputing that, but correct and consistent use of condoms is also behavioral, what is the difference then? Then, there is the problem of what to do with people who are already infected with HIV,  are they barred from having sex the rest of their lives?  Condom use is the only way HIV infected people can have sex with their partners without overly worrying about infecting them.

So we have here an organization, that was funded by the Philippine government, supposedly dedicated to the prevention of HIV infection among Filipinos actually promoting the spread of HIV among Filipinos, now that is a waste of money.

Clarifying the Pope

Last week, the Pope pronounced that it is ok to use condoms in certain cases. Those in the Philippines who support the passage of the Reproductive Health bill saw this as a sign that the catholic church is about to change it's position of contraceptives while those who oppose the bill tried to do damage control and assert that the fundamental stance of the church remains the same.

What they are missing is that the Pope in this instance stopped focusing on the doctrine, but focused on the consequences of that doctrine. Less than a year ago, the Pope was too focused on the doctrine that in his visit to Africa

"The Pope had said the "cruel epidemic" should be tackled through abstinence and fidelity rather than condom use."

He was so focused on the doctrine that he dismissed those dying of AIDS and those at risk in contracting HIV in order to promote the doctrine. His recent pronouncement makes it seem that he has now focused on the people, that it is now more important to him to save the people rather than follow the doctrine blindly.

This is why we are hopeful that catholic doctrine will change, it may not be tomorrow, it may be years from now, but once you focus on the effects of the doctrine on people, you will notice other things. One of them as Congressman Lagman points out

"If condom use is the lesser evil than the spread of HIV/AIDS as clarified by Papal sources, then contraceptives are an infinitely lesser evil than maternal death and abortion,"

AltMed can lead to death

The quackometer has this story where a charlatan exploits South Africa's misinformation on HIV/AIDS to sell vitamin pills as cure, and people died. His conclusion is a harsh one for those who think alternative medicine is a harmless.

"Every supporter of alternative medicine in the UK has a little guilty role to play in this tragedy. By using the same arguments as Rath, such as the evils of drugs and the naturalness of vitamins, you are responsible for the deaths of real live people. Alternative medicine is not just the idle plaything of the middle classes from Islington. It matters. And when our Universities teach it as if it was science, and our hospitals offer it as if it was medicine, then charlatans are able to use this as justification for their own self-interest."

Church logic

A survey shows that 77% of Filipino Catholics found nothing wrong with using condoms, especially in preventing the spread of STDs. How will the Catholic Church leaders respond? By spewing stupidity. First there's the non sequitur of citing moral law.

“Surveys favoring contraceptives will not alter the Church’s position and insistence in teaching the objective moral laws regarding the dignity of human life and family,”

like moral law has ever stopped anyone determined to sin. Then they tried to poison the well.

"Msgr. Pedro Quitorio, the CBCP spokesperson, called the survey “deceptive,” saying that it was done to “fit their own agenda.”"

So what? As Senator Osmena answered when asked if he commissioned the Pulse Asia survey that labeled President Arroyo as the most corrupt President of the Philippines ever, "Yes. Any problem?" Or as the Executive Director of Pulse Asia responded "The results are independent of who commissioned it,". If there are any criticisms, it should be specific to the survey itself. Were the questions asked leading questions? Were the distribution of the respondents random? etc.

Then theres this bizarre quote position

"“Life begins in the womb. How can you become pro-life if you kill a baby?” said Quitorio."

I just don't know how to begin answering this statement. Should I point out that according to Catholic teachings, God forgives so that one may kill a baby and still be pro-life. Or that according to the bible, God has commanded many babies to be killed, which makes God pro-choice? There is also the problem of sin of omission and commission, if you can prevent the death of someone but did not act, that is still a sin, and a sin that according to Catholic doctrine is on par with abortion. Of course, according to my theology teacher in high school, just thinking about a sinful act is the same as committing the act itself. :)

But the worst part is the outright lie.

"Quitorio said condoms could not stop the spread of the human immunodeficiency virus which causes the Acquired Immune Deficiency Syndrome or AIDS.

He cited the case of Thailand, where the widespread use of condoms did not stop the spread of HIV/AIDS.

“Like in Thailand, they’re using it but AIDS is still proliferating,” said Quitorio."

Ok, let's be generous and say it was a misinformed statement. But he is the spokesperson for the largest religion in the Philippines, he should at least read something on the mater before pontificating on it. According to Avert.org

"There are very few developing countries in the world where public policy has been effective in preventing the spread of HIV/AIDS on a national scale, but Thailand is an exception. A massive programme to control HIV has reduced visits to commercial sex workers by half, raised condom usage, decreased the prevalence of STIs (Sexually Transmitted Infections) dramatically, and achieved substantial reductions in new HIV infections. 1

Thailand, though, is also a reminder that success can be relative. Its well funded, politically supported and comprehensive prevention programmes have saved millions of lives, reducing the number of new HIV infections from 143,000 in 1991 to 19,000 in 2003. 2 Nonetheless, more than one-in-100 adults in this country of 65 million people is infected with HIV, and AIDS has become a leading cause of death. 3

Unless past efforts are sustained and new sources of infection are addressed, the striking achievements made in controlling the epidemic could now be put at risk. Factors such as an increase in risky sexual behaviour and a rising number of STI cases have led to concerns that Thailand could face a resurgence of HIV and AIDS in coming years. The government has decreased funding for AIDS prevention programmes significantly, and there are signs that public awareness is waning. Complacency - among both the government and the public – poses a real threat to the fight against AIDS in Thailand. 4"

So, condom use is not the problem why AIDS cases are again rising in Thailand, its complacency by the Government and the the people themselves. The anti-HIV program in Thailand has been so successful that people seem to have forgotten the lessons learned in the 1990's. This assessment is echoed by Time Magazine.

"Several factors have contributed to the worsening trends. "We have become complacent," says Mechai Viravaidya, (a.k.a. Mr. Condom), a senator and the principle architect of Thailand's successful anti-AIDS program of the 1990s. "People think because they can't see HIV anymore that we have it kicked, and they are taking risks again." Following the Asia-wide economic crash of 1997, successive Thai governments have slashed budgets for prevention programs to less than half their 1997 levels. Condom funding is down, education programs in schools have ended, and the media campaign has all but disappeared. Meanwhile, other avenues of infection—such as drug users sharing needles and men having sex with other men—have been largely ignored.

And in an understandable but no less ironic twist of fate, the advent of effective anti-HIV drugs has lulled folks at all levels of society into dropping their guard against HIV—just as it did in the U.S. and other countries. "This government has done a good job on treatment and care," says Dr. Praphan Phanupak of Chulalongkorn University in Thailand. "But they have to get back into prevention. There needs to be a balance [between treatment and prevention] if you want to contain this virus.""

HIV/AIDS has been largely contained. The new AIDS drugs can prolong the life of an infected person, we can also say the same thing for some cancers, but we still would not want people to be afflicted with them. Condom can prevent a young person from contracting AIDS, not approving it's use is a sin.

Tule laban sa HIV

The World Health Organization and UNAIDS said circumcision should be added to current interventions to reduce the spread of HIV. Three African trials have shown that circumcision halved the rate of HIV infection in heterosexual men.

The recommendations largely apply to countries where rates of heterosexual transmission is high.

Experts warned that greater use of circumcision would not replace the need for other prevention methods, such as condoms.

Which may be a reason why HIV infection rate in the Philippines is relatively low. I had a previous post on this.


read more | digg story

The Need for Sex Education

LiveScience.com - Social Pressure, Not Health Warnings Influence Sexual Behavior

"Young people often decide if they should use a condom by whether they perceive their sexual partners as “clean” or “unclean.” "

The problem of course is no one can really be sure.

Tule

Tule is the Filipino word for circumcision. It is a word filled with significance for every Filipino male. The process of becoming tule (circumcised) from being supot (uncircumcised) is the process of becoming a man from being merely a boy.

Evey year, thousands of Filipino young men undergo this ritual. The risk is after all slight (it is after all minor surgery), the benefits quite significant (to be seen as responsible and grown up by your family and peers), and the consequences of remaining "supot" quite dire (humiliation in front of everybody that knows).

I raise this point because of a news story I read from the Asian Wall Street Journal (subscription required) also reported in the San Francisco Chronicle, and MSNBC.

According to the Asian Wall Street Journal (July 6, 2005, page A7, column 1)

"French and South African Researchers have apparently found that male circumcision reduces by about 70% the risk that men will contract HIV through intercourse with infected women."

The study also suggests that

"women could benefit indirectly (from being infected with AIDS) because circumcision would reduce the chances their partners would be HIV-positive."

the study

"was conducted with more than 3,000 HIV-negative men ages 18-24 from a South African township...Half the men were randomly assigned to be circumcised and the other half to remain uncircumcised...after all the men have been followed for a year...the data showed the circumcised group fared much better. For every 10 uncircumcised men in the study who contracted HIV, only about three circumcised men did so"

But before Filipino men celebrate, it should be noted that

"the study's basic findings...haven't been published, so most experts haven't evaluated them."

And even if further analysis and research does validate the findings

"circumcision doesn't make a person immune to infection. Indeed if men abandon safer sex practices because they think the surgery completely protects them, then HIV transmission could rise."

Not to mention the fact that there are other STD's that can infect you aside from HIV.

Update 3/29/2007:

The World Health Organization and UNAIDS said circumcision should be added to current interventions to reduce the spread of HIV. Three African trials have shown that circumcision halved the rate of HIV infection in heterosexual men. Story here.


Random Notes:

Yesterday, Mr. Allan Paguia admitted that he released the Gloriagate tape to the public disregarding the expressed instruction of his client, former Senator Francisco Tatad, not to do so. And he wonders why his license to practice law was suspended by the Supreme Court.

Also yesterday, after avowing that he is not interested in regaining the presidency, former President Estrada remarked that he will not reject the office if it was offered to him.

Virgin Coconut Oil and AIDS

I read this story yesterday from the Philippine Daily Inquirer. The story is posted on their website (now archived) here. The article tells the story of Tom (no last name given), who contracted AIDS when he was gang raped in the middle east while working as an overseas contract worker.

He returned to the Philippines in 2002 where he found out that conventional medicine "could not help alleviate at least his pains" so according to the story "Given up for dying, Tom knew he had to look elsewhere-beyond drugs-to win his battle."

He turned, to virgin coconut oil as prescribed by Dr. Conrado Dayrit, the father of the recently resigned Health Secretary of the Philippines. Through, the application of virgin coconut oil in his skin twice a day and ingestion of 6 tablespoonfuls daily, Tom, in nine months, was able to have "restored enough (life energy) to become an eloquent testimony to how something so natural as virgin coconut oil had halted his free fall (from AIDS). His sores are now just scars and,

"Each time Tom went to have his periodic hospital tests, his viral load decreased progressively. Tom said that when he told hospital doctors what he was taking, they could not believe that an inexpensive natural food oil was killing the viruses better than all the expensive drugs science could churn out."

The rest of the story tells of what Filipino and some foreign researchers are doing to research and promote the curative power of the coconut.

This story of Tom disturbs me because it is long on personal details, how Tom got AIDS from being gangraped, but short on medicinal details. Some questions that springs to mind are:

One, was Tom, using conventional AIDS medicine at the same time that he was using virgin coconut oil? If he was, maybe some of the credit should be given to them.

Two, if Tom was not using conventional AIDS medicine simultaneously with virgin coconut oil, is he then the only one who has gone through this regimen? As the article states, virgin coconut oil is relatively inexpensive, surely the researchers could afford to give virgin coconut oil to at least 9 other HIV/AIDS positive Filipinos to test their hypothesis. If there are others, what has happened to them?

Three, if Tom was the only one who has gone through this regimen, then what is the medicinal value of his testimony? Conventional medicines are approved only after clinical trials. They test the curative properties of the medicine on more than one person to be sure that it's curative powers was not due to chance.

Fourth, can there be other explanation to why his sores healed and his viral load decreased progressively? Like maybe a healthier lifestyle?

This story bothers me because the Philippines has been relatively unscathed from the AIDS epidemic. But we are in a precarious situation, according to this inquirer story , "majority of Filipinos are still at a loss on how the deadly disease (HIV/AIDS) is acquired". Furthermore "The Department of Health (DoH) has described the AIDS cases in the country as "hidden and growing" in terms of number."

Other relevant statistics from the story are "at least 23 percent of Filipinos aged between 15 and 24 believe they are "invincible" against the virus." and "About 60 percent more believe there's now a cure for HIV/AIDS so they have somehow become complacent in their sexual activities"

The story warns that "What we're seeing for AIDs is an ebb tide before the tsunami where the tide recedes and people are complacent, just looking at the coastline, playing, unmindful of the danger,"

A story about how wonderful are the healing powers of virgin coconut oil, while pleasing to Filipino pride and the manufacturers of virgin coconut oil is dangerous to Filipino's health, especally since the healing powers remains unproven.

I can readily envision Filipinos opting out of conventional treatment to try virgin coconut oil. I can also readily imagine that more people will become more complacent in their sexual acivities and practices because of this story.

The Philippines is teetering on the edge of a full blown HIV/AIDS epidemic, this story is just irresponsible.