Saturday, 20 November 2010

Quote of the day...

...was a close call.

I was tempted to give it to the leader of the Green coalition in Catalonia, Joan Herrera, who said it would be "very difficult to reach orgasm voting for any of the candidates, myself included," in reference to an advert which has caused a furore during the Spanish elections. However, I have nothing substantial to say on that matter.

Instead, we turn to Joseph Ratzinger on contraception;
There may be a basis in the case of some individuals, as perhaps when a male prostitute uses a condom, where this can be a first step in the direction of a moralization, a first assumption of responsibility.
The Pope made his comments in a book, Light of the World: The Pope, the Church and the Signs of the Times, due out on Tuesday. It comes from a series of interviews with journalist Peter Seewald, and claims to "tackle head-on some of the greatest issues facing the world of our time."

This particular issue, however, could hardly be seen as "great." In fact, it is only the intervention of religious beliefs - primarily those of Ratzinger and his predecessor Karol Wojtyła - which makes condoms or contraception in general at all "controversial" or "contentious." More than that, it has actively hindered efforts which save countless lives and address the problem of AIDs in places such as Africa.

Last month, Ben Goldacre made the point eloquently;
In May 2005, shortly after taking office, the pope made his first pronouncement on Aids, and came out against condoms. He was addressing bishops from South Africa, where somebody dies of Aids every two minutes; Botswana, where 23.9% of adults between 15 and 49 are HIV positive; Swaziland, where 26.1% of adults have HIV; Namibia (a trifling 15%); and Lesotho, 23%.

This is continuing. In March 2009, on his flight to Cameroon (where 540,000 people have HIV), Pope Benedict XVI explained that Aids is a tragedy "that cannot be overcome through the distribution of condoms, which even aggravates the problems". In May 2009, the Congolese bishops conference made a happy announcement: "In all truth, the pope's message which we received with joy has confirmed us in our fight against HIV/Aids. We say no to condoms!"

His stance has been supported, in the past year alone, by Cardinal George Pell of Sydney and Cardinal Cormac Murphy O'Connor, the Archbishop of Westminster. "It is quite ridiculous to go on about Aids in Africa and condoms, and the Catholic Church," says O'Connor.

"I talk to priests who say, 'My diocese is flooded with condoms and there is more Aids because of them.'"

Some have been more imaginative in their quest to spread the message against condoms. In 2007, Archbishop Francisco Chimoio of Mozambique announced that European condom manufacturers are deliberately infecting condoms with HIV to spread Aids in Africa. Out of every 8 people in Mozambique, one has HIV.

It was Cardinal Alfonso López Trujillo of Colombia who most famously claimed that the HIV virus can pass through tiny holes in the rubber of condoms. Again, he was not alone. "The condom is a cork," said Bishop Demetrio Fernandez of Spain, "and not always effective."

In 2005 Bishop Elio Sgreccia, president of the Pontifical Academy for Life, explained that scientific research has never proven that condoms "immunise against infection".

He's right, they don't. They stop the virus which kills you from being transmitted during sex.

How effective are they? It's wise not to overstate your case. The current systematic review of the literature on this question published by Cochrane found 14 observational studies (because it's unethical to do a randomised trial where you actively stop people using condoms, since you know that they work but just want to find out how well).

These studies generally looked at HIV transmission in stable couples where one partner had HIV.

Many of them looked at transfusion patients and haemophiliacs. Overall, rates of HIV infection were 80% lower in the partners who reported always using a condom, compared to those who said they never did. 80% is pretty good.

There is no single perfect solution to the problem of Aids: if things were that easy, it wouldn't be killing 2 million people every year.

ABC is a widely used prevention acronym in Africa: abstain, be [faithful], [use a] condom. Picking out one effective measure and actively campaigning against it is plainly destructive, just as telling people to abstain doesn't make everyone abstain, and telling people to use condoms won't make everyone use them. But Ratzinger has proclaimed: "The most effective presence on the front in the battle against HIV/Aids is the Catholic church and her institutions."

This is ludicrous. You, the Catholic church, is the only major influential international political organisation that actively tells people not to do something that works – on a huge scale. Your own figures show that your numbers are growing in Africa, even faster than the population does.

I'm happy for you to suggest abstention. But sabotaging an effective intervention which prevents a disease that kills 2 million people a year makes you a serious global public health problem.
As such, it would seem that this new message marks a welcome change in direction.

Even if he still maintains that abstinence and marital fidelity is the best way to beat HIV, he at least acknowledges that condoms could be justified "in the intention of reducing the risk of infection." Given the influence he holds over some of the most high risk areas for AIDS and HIV, it's a start.

The only problem is that he is only able to accept this as "a first step in a movement toward a different way, a more human way of living sexuality," in the case of male prostitutes. For everyone else, the "sheer fixation on the condom implies a banalisation of sexuality," and sexuality becomes "a sort of drug that people administer to themselves." Because, you know, preventing the spread of disease and infection is exactly the same as taking crack cocaine.

He then asks: "How many children are killed who might one day have been geniuses, who could have given humanity something new, who could have given us a new Mozart or some new technical discovery?"

This may be an appropriately emotive, if extremely flawed, argument in the debate on abortion. When talking about contraception, it is absurd. One might as well mourn the mass genocide that occurs every time a teenager masturbates in his bedroom. Sperm are not people and, frankly, that is a sentence I should never have had to write.

If Ratzinger and his church were going to end their active opposition to condoms, I would welcome it. They can hold whatever views they like on them morally, as long as they don't put lives at risk by deliberately obfuscating the facts. But I don't think this is the case.

"He's not going to [fundamentally alter Church policy] in an offhand remark to a journalist in an interview," according to William Portier, a Catholic theologian at the University of Dayton. Cardinal Elio Sgreccia, a Vatican official on bioethics and sexuality, confirmed that this comment was "in the realm of exceptionality" and this exception "must be verified [as] the only way to save life." If there is going to be significant reform, then its pace is far too slow.

We are long past the stage where altering the Vatican's line on this matter is anything other than futile. Those Catholics who are in favour of reform and want their Church to make a positive difference in the world - and their are many - must actively circumvent their leadership in order toforce the change on the ground where it matters.

Presently, those who disagree with the Church's stance appear only to be preaching to the converted or to those largely unaffected. Where it counts, where people are at the highest risk of HIV and AIDS, the Pope's influence is still overwhelmingly strong. And people are dying as a result.