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Last Updated: Tuesday, 22 July, 2003, 16:11 GMT 17:11 UK
Can abstinence end the spread of Aids?
Zambian children orphaned by Aids
Nelson Mandela has told an Aids convention in Paris that Europe needs to match US funding to fight the disease.

Mr Mandela was speaking at a four day meeting, organised by the International Aids Society to mark the 20th anniversary of the discovery of the HIV virus.

His comments came after the former Brazilian President Fernando Cardoso criticised the US for using the wrong strategy to fight Aids by promoting abstinence and fidelity.

Brazil has halved the Aids death rate by setting up education campaigns, expanding basic health care and providing all those infected with anti-retroviral drugs.

Should Europe match US funding to fight Aids? Would Brazil's approach to Aids health care work everywhere else? Will America's promotion of abstinence cut Aids cases? How else could the epidemic be tackled?

A selection of your e-mails will be broadcast on BBC World Service's Focus on Africa programme during the 1705 edition on Saturday.

This debate is now closed. Read your comments below.

Your reaction:

The following comments reflect the balance of views we have received:

Abstinence cannot curb the HIV/Aids virus
Sam Casey, USA
No abstinence cannot curb the HIV/Aids virus. What I'm seeing is that people are forgetting that this virus is not only spread through sexual contact, but also through IV Drug use, and other bodily fluid contacts. Sure abstinence could help, but be realistic, how many people are going to give up sex? Not many. Education, proper health care, and realization that this is going to be a long battle with the potential to do serious damage to the worlds population are the keys to victory over the HIV/Aids virus.
Sam Casey, USA

With anti-retroviral drugs and abstinence I'm sure we could curb Aids. I agree with Brazil.
Moira Eyre, South Africa

Abstinence isn't required. The spread of HIV/AIDS would be arrested by fidelity. You have to visit sub-saharan Africa to understand the extent of the promiscuity that is normal behaviour there. It's not PC, of course, to suggest that the spread of the disease in those countries is in any way attributable to the behaviour of their people. But as I say, the real issue is one of limiting the number of partners you have. Of course we should spend more money on treatment and drugs - it's our human obligation to do what we can. But don't believe its not avoidable - most Africans are richer than the 600m "lower caste" people of India, but there's nothing like the same HIV/AIDS problem.
Ian, UK

Abstinence must be taught to our children
Paul Winwright, UK
People should be wholly responsible for their actions. With sex there is a risk, condom or no condom. Humans throughout history have not taken this necessary responsibility, to a greater extent now than ever before because we live in an age of infidelity, promiscuity and the world youth are nothing short of loose! Abstinence must be taught to our children. We must inject our youth with the ideals of dignity, correctness grace of which they presently have none!
Paul Winwright, UK

Aids, like every disease, is best addressed through health education and appropriate care. That's the cheapest and surest way to reduce the rate of infection.
Obiba Afrikani, USA

In the West we have managed to control Aids without reverting to absolute monogamy or abstinence - so why would we now assume that this is the solution for other countries?
Robert Webster, Australia

Aids is a scientific disease that ought to be tackled scientifically rather than relying on outdated traditional methods of abstinence. With so much emphasis on the African traditional value of 'procreation', do you think abstinence has a chance?
Cecil Nsambila Mbolela, USA/Zambia

The final responsibility is with the individual
Anthony, Germany (UK)
Yes, fidelity and abstinence can make a difference; and yes, condoms can make a difference too. Previous generations were killed in huge numbers by Syphilis and other STDs. They had no access to penicillin and other drugs. Those who can't abstain or stick to one partner should use condoms but there are still people who wouldn't use them. You can't blame governments for everything. The final responsibility is with the individual!
Anthony, Germany (UK)

The best way to fight HIV/AIDS in Africa is for the International Monetary Fund and World Bank to drop all of Africa' debt. How can a continent that spends more per annum on debt than education and health care adequately address education and health issues? The bottom line is drop the debt and countries within Africa will have more resources to address HIV/AIDS and would not be as dependent on the North for aide.
Megan Kuhn, USA

Abstinence only seems to work with people who are not sexually active
Dalene, Zimbabwe
Yes I agree that Europe should match the US funding. The Brazilian approach is the best way to tackle HIV/AIDS. There are people I work with who are not as informed as I am about HIV/AIDS and they really believe it won't affect them. People have to stop viewing this as a disease; I think HIV/AIDS is a condition. Abstinence only seems to work with people who are not sexually active.
Dalene, Zimbabwe

Abstinence is a good first step, but cannot realistically be the only approach. Raising awareness and dispelling myths is paramount. How many people still think having sex with virgins will cure them? Finally, provide doctors, clinics, and access to medications.
Kristine, USA

Forget the American Christian-right recommendation of abstinence and get on with education which should include safe sex measures.
Jas, Canada

I believe that God wanted us to be in a committed relationship for life, not because He wanted to spoil our "fun", but because He knew the consequences. If people really wanted to eradicate AIDS, they would promote all possible ways which includes a strong preventative emphasis on abstinence and fidelity as well as all methods of healing.

I have to agree with the US's stance on this; abstinence by those who are infected is one of the most effective ways to help stem the spread of this disease in places like Africa where the use of condoms is not widespread and at times frowned upon. Of course Europe should give more funding, but the governments of these developing countries should also take steps to get the spread of the disease under control by making it illegal for those who are infected to practice unsafe sex with one or more partners. It would also be a good idea to get the Catholic Church to promote the use of condoms.
Niki, UK

It's ridiculous to ignore those people for whom abstinence is not realistic
Scait, South Korea
Of course abstinence would greatly reduce the transmission of a number of diseases. Eating properly would go a long way to reducing disease burden in both rich and poor nations too. The simple fact is that in the same way that people don't or can't control their eating habits - whether too much or too little - many people can't or won't abstain from risky behaviour. It's ridiculous to ignore those people for whom abstinence is not realistic. Risk reduction methods like condoms or needle exchanges must be funded as they are more likely to have an impact on transmission rates than the promotion of abstinence.
Scait, South Korea

How come developing Muslim nations don't have this problem? For example, Indonesia, Pakistan, etc? Answer: Because it is part of Islamic morals to abstain. So abstinence should be encouraged.
Shipra, USA

I grew up with other Liberians who believed that Aids was a joke. And so they carried on with their lives without any precaution whatsoever. Perhaps similar behaviour is also true of people in other parts of Africa. What a sad legacy being a part of a group of people who seem to cause much of their own suffering.
Eddie Lee, Liberia

If what we're being told about HIV/Aids is anything to go by, then abstinence will reduce the rate of spread of the disease by not more than 70%. There are other suspected modes of the spread of the virus like sharing of needles and blades, blood transfusion etc, which have nothing to do with abstinence. So to end the spread of Aids, we must not only preach and practice abstinence, we also must not do the 'other things' that could spread the virus.
T. Adams, Ghana

The USA is more interested in preaching morals
Ken, USA
Education, health care and medicines are the best way to reduce Aids infection rates. Bush caters to his right-wing support. They still believe Aids is a homosexual disease. You've seen this before in the restrictions of medical support to countries that allow abortions. The USA is more interested in preaching morals.
Ken, USA

The answer is abstinence or one partner sex. Educational effort has been focused on Africa for years with absolutely no result. The situation is getting worse. The message is not getting through.
Richard, England

Fidelity and abstinence are brilliant ideas; they're free, available to everyone and will be 100% effective with no side effects. What more can you ask for? As for blaming the media for promiscuity; don't we have free will and the ability to make independent choices?
Cathy, UK

While the spread of Aids can be stopped by proper preventive methods, the cure will be possible only by giving free access of anti-retroviral drugs to the millions of people who are affected. One cannot forget how the multinational drug companies reacted to the efforts of Brazil and South Africa when they initiated such measures.
Srinivasan Toft, Denmark

Of course abstinence will help prevent the spread of Aids and other STDs. The problem is that abstinence is never going to happen. African culture promotes having several children to help on farms and to look after the parents in old and also because of the high death rate. The problem is that we are trying to change their culture, and that is not an easy thing to do in any country.

Promoting abstinence should be part of the overall education programme
K Lonsdale, UK
There are 42 million people worldwide living with HIV/Aids - transmitted through a number of routes, primarily through the practice of unsafe sex. Abstinence is a phase in the US and we would be naive to consider this latest fad is the answer to a global problem. The real issue is how to treat the millions who currently live with the infection, to educate people for the need to practice safer sex and more importantly for pharmaceutical giants to make their modern and effective treatments available to all people in all nations. Promoting abstinence should be part of the overall education programme offered globally - as one of the many options to prevent transmission of HIV.
K Lonsdale, UK

For once I would agree with America on the fidelity stance. It is purely logical that if we stop infidelity the infection rate must decline. Whether people do this is another matter, and whether focusing on this works is another matter. The issue is off the boil though - I know many people who think it's ok to have unprotected sex because they're willing to take a chance. The issue has subsided when it shouldn't have.
Nat, UK

Of course abstinence would cut Aids and STDs dramatically. Problem is, no-one is going to abstain from having sex, and rightly so. Next idea please.
John, UK

Aids is spread at a higher rate in conservative societies
Albert P'Rayan, Rwanda/India
Creating awareness is very important to fight the disease. Aids is spread at a higher rate in conservative societies like India, where HIV positive and Aids victims are looked down upon by people. As a result, those who have the disease don't even reveal it to their partners. In many poor countries in the African and Asian continents those who are suffering from Aids do not have access to proper medical care and it is the moral responsibility of rich countries to generously help poor countries to fight Aids. Education leads to eradication.
Albert P'Rayan, Rwanda/India

Aids can be spread in other ways too, so it's not a whole solution, but abstinence will help a great deal. It will also combat other nasties like other STDs, unwanted pregnancy and cervical cancer. Of course it's not so much fun but there are cultural attitudes to be aware of surrounding Aids and sex, on both sides. There are always accusations of prudes/Bible bashers forcing their views onto others but that isn't fair - if you don't have sex, you don't get STDs because of it!
Stephanie, England

Who will abstain? It would be very blue-eyed indeed to try to alter or control the strongest instinct of a man. Better to require an HIV-free certificate before being allowed to marry or form a partnership that has legal consequences. At least that may protect some to remain HIV/Aids-free.
Ksenon Luminescu, Romania

Abstinence would have no effect on those who catch HIV by other means such as drug taking. Since abstinence cannot be relied on to reduce the rate of infection, the Brazilian approach should be employed as well (the two approaches do not need to be mutually exclusive). There has been a recent increase in Aids in Britain as a result of people forgetting the messages that were broadcast in the late 1980s and early 1990s.
John Wallace, UK

One of the reasons why Aids is spreading is because of globalisation/ease of travelling and having multiple sexual partners. Although abstinence is worth a try it would be better to encourage people to limit their sexual partners so as to contain the disease.
Patrick Leahy, UK

Telling others to behave differently from ourselves is condescending
John, England
Abstinence and fidelity are hardly traits that I recognise when considering the sexual habits of the typical American or Western European - telling others to behave differently from ourselves is hypocritical and condescending. Brazil on the other hand, despite being a very "friendly" country, is having good results based on its education-driven campaign. We need to be pragmatic and go with a proven programme, rather than expect people to behave like saints.
John, England

On one hand, the US' simplistic approach has led to an impractical solution. If everyone practised abstinence, the human race would be extinct within a century! On the other hand, a key element of Brazil's strategy (providing anti-retroviral drugs) merely disguises the problem, and by prolonging the lives of those carrying HIV it might even serve to make things worse in the longer term. There's no easy answer. A reliable immunisation drug, early identification of symptoms, and a cure, are the only way this illness will be beaten.
C. Hunter, England

I completely disagree with this! Sex is part of our everyday life! Movies, books and other TV programmes place a great importance on sex, we live with it so an idea of abstinence is false! Adolescents are taught from young to see sex as a way of acquiring power and the way they came into this world!
Claudia, Mozambique

One method will not work universally. But America is certainly not "wrong" in promoting abstinence and fidelity. These are the simplest of methods and values to decrease the Aids rate. But what I find most annoying is that Africa thinks that rich countries OWE them in providing money and services to fight Aids. We do have certain obligations and sense of responsibility as rich countries, but when we are criticised for not doing enough when in fact we are trying very hard to do so is discouraging.
Amy, USA

When has humankind ever practised abstinence?
H Huber, Netherlands
When has humankind ever practised abstinence? Even the Catholic church cannot control its priests given the recent sex scandals within. Abstinence is a fundamentalist-inspired strategy which might make the religious right feel good but does nothing to stop the spread of Aids or any other sexual activity. It only makes me more scared about other policies of the US.
H Huber, Netherlands

America's strategy of abstinence is logical, but not easy to implement. The entertainment industry in the US already bombards the minds of young people with suggestive images of sex, so it's pointless to promote abstinence when the media has too much of an influence in this manner. If America wants to promote abstinence, there should be regulations regarding what is put on the airwaves.
Anthony, Chicago, IL, USA

Well... obviously it's a little late for the world to decide to go for the whole abstinence plan! But if more and more privileged countries really worked hard at helping Africa and other such countries maybe Aids wouldn't be such a problem. One country at a time seems to be the best plan... those few who know the details of their Aids should try to remain abstinent and get treated.
Jessica, US of A

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