Laura Bush on AIDS Funding in Africa: Gender, Abstinence and a story from Guinea

Did anyone catch the interview with Laura Bush on NPR yesterday? An excerpt of a conversation between Bush and NPR’s Michele Norris about funding for HIV/AIDS prevention and treatment in Africa was broadcast on “All Things Considered” yesterday evening.

Here’s the link if you’d like to listen to it and/or read the transcript:

http://www.npr.org/templates/story/story.php?storyId=11291671

Here’s some background and my own take on the interview:

Laura Bush will be traveling to Africa (I’m not sure where) on Monday to check out the progress of the administration’s emergency AIDS plan (PEPFAR). The plan itself, initiated in 2003, is quite impressive. Bush pledged $15 Billion over five years for AIDS relief (mostly in Africa). Now he’s asking Congress for $30 billion to continue the plan through 2013. This is, according to NPR, “…the largest amount any country has spent fighting a disease outside its borders.” No doubt this is how George W. Bush got his face on one of the Vanity Fair covers. While Bush supporters and critics alike laud his efforts to fight and treat AIDS abroad, some question the way the money being sent to Africa is being spent. In other words, the debate about abstinence education versus education about using protection rages on. This is a debate that the U.S. can’t seem to resolve within its own borders much less outside of them. According to the current AIDS relief package that the administration exports mostly to Africa, one-third of the funding, (that’s one-third of $15 billion!), must go toward abstinence education. This is legislated by congress.

Basically, most African states have adopted a plan for HIV/AIDS prevention known as “The A-B-C strategy.” A is for “abstinence”, B is for “be faithful,” and C is for “condoms.” The U.S. supports the African A-B-C plan for prevention and the use of anti-viral medication for treatment. Clearly though, in terms of education, there is a lot of wiggle room. Abstinence AND condoms are part of the plan. So why has the U.S. chosen to focus much of its money for AIDS education on “A” and “B?” What happened to “C?!” In her interview with Laura Bush, this is what Michelle Norris asked, though more tactfully of course. Bush’s answer completely confused me. Completely. Since hearing the interview yesterday evening I’ve tried to understand the logic of her answer but I just can’t. It doesn’t seem to make any sense to me. Before posting Bush’s response though, let me just say this: It’s clear that I don’t agree with legislating the type of AIDS education people will get in other parts of the world, parts of the world where upwards of 30% of the population are HIV positive. BUT, despite my personal opinion on this matter I was ready to hear what Bush had to say, ready to at least *see* where she was coming from on this issue. And, unfortunately, I got stuck on the logic (or lack thereof) of what she said.
Here it is:

BUSH: “In countries where there are gender issues and where girls feel like they have to comply with the wishes of men, I think abstinence [and abstinence education] become even more important. We need to get the message to girls everywhere, not just in Africa, that they have a choice, that they can be abstinent and make choices for themselves that keep themselves safe.”

Hmmm…So if there are “gender issue” in these countries and girls don’t have much of a say and must “comply with the wishes of men,” then how on earth is abstinence on the part of the girl or woman going to work?! How can one say, in the same response, that women don’t have a voice and that they should make the decision to abstain from sex? It is also unclear how women can encourage their husbands to be faithful if they must “comply with the wishes of men.” So this is what I’m stuck on, this is where I’m trying to figure out her logic. It seems clear from what she said about gender issues that educating men is probably the best route to take. And since the reality is that sex and rape happen (between men and their wives, between men and their multiple wives, between men and their girlfriends, between men and prostitutes, between men and the women who don’t wish to have sex with them) it seems like HIV testing, condom education, and discussions on faithfulness might be good places to start.

I’m going to end this with a quick story from Guinea. While I was in Guinea I worked with a man at the high school who was probably in his 40s. He had a wife and several children. One day he invited me to his wedding. He was to marry a second wife, a girl (not woman) from a very small village a few hours away. I went to the wedding not sure what to expect and curious about what a traditional Guinean wedding would be. As soon as I arrived I was ushered into a small room full of older women. The women were crowded around the bed shouting to someone in their language (Mandingo). A French speaker told me that they were giving advice to the bride. I craned my neck to see a girl of no more than 14 years sitting on the bed looking petrified. On that day she was to become the second wife of a man who was old enough to be her father. She would also become a second mother to several children who were a few years younger than she was. They asked me to say a few words to her. I had no idea what to say. Since she didn’t speak French I sputtered out a few blessings in Mandingo and politely excused myself. The wedding itself was a colorful, festive event. Women danced in the moonlight, an animal was slaughtered and everyone was sent home with uncooked meat and a bag of sweet cassava bread.

But I kept thinking about that young girl. Thinking back to that day in terms of what Laura Bush proposes as one way to stop the spread of HIV/AIDS in Africa I can only sigh. I don’t know when my colleague planned to consummate his new marriage but I can say that whether his new bride was to be exposed to HIV was probably all up to him. Her father expected her to marry this man, and that man would expect her to consummate the marriage eventually. As far as I can tell (keeping in mind that as an outsider I cannot pretend to know too much) keeping her safe would be about educating her husband on the benefits of being tested for HIV and of being faithful. It would also be helpful to stress to him the importance of using protection when and if he were to seek “companionship” outside of his home. While there is a time and a place for abstinence education, in this case (and I can only imagine in many more cases throughout the world, including in the U.S) abstinence education (for women as well as for men) seems like throwing money into the wind.