The policy — and moral — challenges of truly helping.
As Pope Benedict XVI continues his second trip to Africa as Holy Father, memories of Western media’s condom-focused coverage last time around are still fresh. What exactly does the Church teach, and what exactly do Africans need?
Matthew Hanley is co-author of Affirming Love, Avoiding AIDS: What Africa Can Teach the West, published by the National Catholic Bioethics Center, which was recently honored by the Catholic Press Association, and a new guide called The Catholic Church and the Global AIDS Crisis, published by the Catholic Truth Society in England. He talks about some of these issues in a conversation that might come in handy to have nearby as one reads some of the news reports about the Holy Father’s presence in Benin these next few days.
AIDS is affecting beautiful people who are full of life and dreams and plans, who love and are loved by those around them — unique people who are grandmothers, grandfathers, mothers, fathers, daughters, sons, relatives and friends. What does love and beauty and the Golden Rule have to do with combating AIDS?
Those suffering from AIDS often stand in need not just of medical care, but of internal healing and a compassionate human presence, particularly in the face of various forms of abandonment. But the same concepts and vocabulary we use to promote caregiving should not be applied selectively; they should extend to prevention as well.
For instance, if it’s a matter of justice (as we tend to hear from activists) to supply people with HIV medications in Africa, why would we ignore that justice also applies to the realm of interpersonal relationships? The misuse of sexuality and exploitation of others is an injustice, one that leaves painful though less measurable wounds lodged in the hearts of men and women, whether or not HIV is part of the picture.
But this is much more uncomfortable for us to admit. It hits closer to home, and it sounds judgmental to modern ears; this is the ultimate no-no. So, we have soft-pedaled the behavioral dynamics which fuel the pandemic and relied instead mainly on risk-reduction measures.
But by only trying to make everything “safer” through technical, supposedly judgment-free “solutions,” we abandon all regard for how we should treat one another (the Golden Rule). Here’s where John Paul II, I think, provides the best antidote for this mentality: “Only love can preclude the use of one person by another.” He wrote that back in 1960, but I can’t think of a sharper insight, or a more relevant remedy, for a whole host of ills today.
It’s in the Pope’s best interest, isn’t it, for you to shout from the rooftops that condom effectiveness is oversold?
I actually think that there is a broader point that should be of concern to everyone. The Pope, unlike public-health authorities, is not explicitly tasked with containing epidemics. In that sense, it’s alarming that he has a better read on the situation — and a much higher regard for human capacities — than trained authorities who are tasked with doing so. This suggests something is radically askew.
Our health-care leaders simply have not been able to bring themselves to clearly prioritize the behaviors (fidelity and abstinence) which enable people to avoid AIDS altogether: greater levels of which, incidentally, have always preceded drops in AIDS prevalence.
The fact of the matter is that the condom’s track record is rather poor. That goes for AIDS in Africa and a host of STDs here in the West.
Condoms may protect some people from some infections some of the time, but that is far from saying they are effective or constructive as public-health policy. HIV transmission rates have remained constant here for the past decade; even Dr. Anthony Fauci of the NIH (National Institutes of Health) took to the pages of The Washington Post recently to characterize, in unusually strong terms, our AIDS- prevention efforts as a failure — although he still dared not emphasize behavioral changes.
Your question got me thinking of, perhaps, another way to put it: One might fairly interpret the “Pope’s best interests” as something akin to the common good — since he is charged with safeguarding matters of faith and morals which are conducive to it — rather than the particular interests of Joseph Ratzinger, the individual man.
The pity is that we should be able to place trust in our public-health authorities to promote the common good as well.
As the Pope is in Africa, can the Western media manage to talk about anything but backward, cruel, Catholic social teaching on human sexuality and the use of condoms?
I suspect they will find a way to resurface the issue, even if he does not mention AIDS this time around; after all, HIV prevalence in Benin (1.2%) is relatively low compared to other African countries or, say, Washington, D.C. (about 3%).
He could have deflected the condom question last time and spared himself the frenzy that ensued. But he chose to present a vital, hope-filled alternative to the prevailing and despairing risk-reduction models which have failed us so miserably.
The media will doubtlessly have opportunities, should they wish to accept them, to grapple with similarly bold yet charitable statements — the kinds of which people just don’t make in this era of superficial multiculturalism. In the past month, for example, he has spoken clearly about the need to purify African religions of practices, such as witchcraft, which holds people in the grip of great fear and frequently leads to the taking of innocent life, that are “incompatible with following Christ,” noting that even many baptized Christians live with divided hearts.
This is a brilliant way to frame another sensitive issue. (I just returned from a part of Africa where these practices are pervasive, if little discussed). He identifies the need to uproot a specific regional problem in terms that have universal application: How many of our own hearts here in the West are divided? How many of our own practices, even those protected by law, are, pure and simple, incompatible with following Christ?
This issue might not generate quite the same level of indignation — it’s not about sex. But it is, he says, a duty for us to say these things. Imagine if no one did say them.
How can lay Catholics in the West help make it a real educational opportunity about how we can truly help Africa on a whole host of fronts?
We might, as individuals, be limited in what we can do in faraway lands. But we can begin by taking seriously what Benedict XVI has repeatedly stressed: that the key to all human development is respect for life, for our own delicate human ecology (the broad issues of life, sexuality, marriage, the family, social relations, natural death), which is seriously threatened by “the moral tenor of society” today.
Some Catholics, perhaps, might feel embarrassed by such talk. These are, after all, issues that put them squarely at odds with the ambient culture — and with the leadership apparatus of entire professions. That’s never quite comfortable. And so can it really be that these issues, which some might wish to be marginal, optional, subject to conscience, etc., are, in fact, nothing short of indispensible to integral human development?
We severely botched our responses to the problems of malaria, AIDS, maternal mortality in Africa precisely because we failed to place human ecology decisively above destructive ideological substitutes. By that I mean to say that tens of millions of lives took second place to inhumane means of attempting to tend to the environment and to sexual and reproductive health. So we are dealing first and foremost with failures of ideas, not so much with a lack of know-how or resources.
Perhaps, then, we might consider the ways in which we too readily accommodate our culture — its notions of freedom, progress and development — and how reticent we generally are to defend sometimes unpopular moral and ethical positions. Only by doing so can we truly be in a position to offer authentic solidarity, charity and technical assistance to other peoples.
Development is not a passive process or a one-way street. (No country has climbed out of poverty as a result of foreign-aid schemes). John Paul II felt that “the world must learn to receive from the people of Africa. It is not just material and technical aid that the latter need. They need also to give: their heart, their wisdom, their culture, their sense of man, their sense of God, which are keener than in many others.” The South Africans I met in September really liked that.
Some of the poorest countries in Africa have the lowest AIDS rates, while some of the wealthiest countries have some of the highest AIDS rates. How is that so?
This might seem counterintuitive — at first. After all, many diseases, such as cholera or tuberculosis, are clearly diseases of poverty. But it’s really not all that puzzling, considering that the AIDS epidemic is fueled by multiple sexual partnerships. Without “disposable income,” people are less equipped to afford or sustain those partnerships. Relative wealth, or access to the three Cs — cash, car and cell phones — as locals began to put it, amounted to a risk factor.
Zimbabwe cut its very high AIDS prevalence nearly in half, a truly dramatic decline attributable to behavior change — not condoms by the way; this coincided with their catastrophic economic implosion over the past decade. Many were sympathetic to depicting AIDS as a disease of poverty, though, since it takes the focus away from the need to limit sexual behavior.
In that sense, it blended seamlessly with the whole risk-reduction approach in which everything, from condoms to testing to treatment, is emphasized over behavior change.
Can the human person be liberated by “truth” without divine intervention, without faith, without a Catholic worldview?
That’s a really deep question. If we were having a strictly theological discussion, I’d answer that in a certain, and different, way. But here, I would say, that there are certain truths we can all come to recognize, as they are accessible to reason. As we point out in the book, the great pre-Christian philosophers such as Plato and Aristotle recognized that sexual promiscuity damages the wholeness and well-being of a person. So did many other writers of antiquity and from the Jewish tradition.
This is worth stressing because we are told that today’s predominant view of a “liberated” human sexuality is based definitively on reason and, consequently, that opposing views must simply originate in an unreasoned faith. Non-Catholics can certainly, thus, take a page out of the ancient Greek playbook in refuting the hedonistic pragmatism of our own day.
Many traditional African cultures themselves prized virginity and held marriage, faithfulness, family life and the like in high regard. Catholic leaders in Africa have noted that its core teachings on sexuality are neither impossible not incompatible with its own traditions. So believers and nonbelievers alike can recognize that chastity, far from being an arbitrary external constraint, helps a person lead a well-integrated life and is essential for human fulfillment. Without it, discord and turmoil proliferate.
How did you get involved in all this?
Writing a book on this subject was the furthest thing from my mind when I went to work for Catholic Relief Services. As I mentioned, I was originally focused on the care-related imperatives of the epidemic, not the thorny issues of prevention. I’d never really been keen on talking about these matters and don’t exactly relish conflicts of this nature; I certainly don’t seek them out.
But as I dug into the matter, assisted by several gracious colleagues (non-Catholics) at other institutions, it became plain that there was so much more to the issue than we are conditioned to believe: so much falsehood; such a great need for the truth.
We felt that, armed with the evidence and the arguments, Catholics and others working in any related field might not feel the need to be on the defensive in the face of the zeitgeist, and be better equipped to offer positive contributions to human development. And the National Catholic Bioethics Center came along at just the right time to publish this work.