AIDS: Ideology and disease

St. Louis Post-Dispatch: By 1991, 15 percent of Uganda's population was carrying the virus that causes AIDS. Few people outside of sub-Saharan Africa seemed to notice or care.
A decade later, the country's HIV infection rate had been cut to 5 percent. No other nation had recorded such success in the dismal struggle against AIDS. Suddenly, all eyes were on Uganda. The government's campaign -- known as ABC, which stands for "abstain, be faithful, or use a condom" -- became a model for beating back the seemingly inexorable epidemic.
Something very much like that campaign is about to get a huge funding boost. Last week, the U.S. House of Representatives approved a $15 billion program to fight AIDS in Africa. That's an enormous achievement. President George W. Bush, who envisioned the massive new program and Rep. Henry Hyde, R-Ill., who wrote the bill, deserve great credit.
But the American-funded program and the Ugandan model program won't be exactly alike. There will be no "c" for condom in the American version. The bill provides money for prevention efforts. A last-minute amendment, which Bush strongly backed, sets aside one-third of that prevention money for abstinence-only programs. Another allows religious groups to reject proven strategies, like condom distribution, that they consider objectionable. Those changes transform what had been a giant public health campaign into what House Majority Leader Tom DeLay, R-Tex., called "a moral crusade."
Excise the ideology
The goal of a moral crusade is to save souls, by imposing one's beliefs and values on others. The goal of a public health intervention is to save lives by stopping the spread of disease. Confusing those two risks wasting billions of dollars and condemning millions of people to an agonizing death from AIDS. The Senate must excise the ideology to save the AIDS bill.
For years, many conservatives in Congress voted against foreign-aid programs, saying there was no evidence that they worked. Now many of those same conservatives are backing the abstinence-only provision. Yet there's no solid evidence that abstinence-only education works.
The ABC approach, when coupled with frank and open discussion about sex, has been proven effective. Its success doesn't come from any one part. Condoms are no more or less important than stressing abstinence or mutually faithful relationships. But for those thousands of people who will not abstain or are not monogamous, death need not be the consequence.
Success will be difficult enough to achieve. Why make the job harder by discounting what works in favor of what passes an ideological litmus test?