NB: THIS TRANSCRIPT WAS TYPED FROM A TRANSCRIPTION UNIT RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT: BECAUSE OF THE POSSIBILITY OF MIS- HEARING AND THE DIFFICULTY, IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE BBC CANNOT VOUCH FOR ITS ACCURACY. ........................................................................ PANORAMA CAN CONDOMS KILL? RECORDED FROM TRANSMISSION: BBC-1 DATE: 27:06:04 ........................................................................ STEVE BRADSHAW: For two decades condoms have been a major weapon in the fight against AIDS, about 40 million people are thought to be living with AIDS virus. It's been called mankind's biggest health disaster. But last year a leading cardinal in the Vatican insisted on Panorama that condoms can have holes in them that leak the deadly virus. His claims provoke controversy across the world. POUL NIELSEN: They are hurting and bringing into great danger the lives of millions. BRADSHAW: Now the Vatican has produced evidence for its claims, and it says condoms may even be fuelling the pandemic. RAFAEL LLANO CIFUENTES: Using a condom to stop AIDS is like trying to put out a fire with petrol. BRADSHAW: Tonight Panorama investigates the scientific evidence, can condoms really help the world defeat the AIDS virus, or could they be making the AIDS pandemic worse? Rio de Janeiro, Brazil BRADSHAW: It sounds like carnival, and it looks like carnival, but this year - the danger of sex. Dancers dressing as the HIV virus that causes AIDS, and as the device millions trust for protection – condoms, inflated to nightmarish proportions. In the street they're giving them away. This year's carnival – an opportunity to protest the teaching of the Catholic Church. GABRIELA LEITA [distributing condoms]: In spite of what the church says, we must always use condoms BRADSHAW: And what's made the row over condoms in this year's Brazilian carnival so acrimonious? The words of a leading cardinal on Panorama broadcast worldwide. Is it the position of the Vatican that the virus, the HIV virus, can pass through the condom? Cardinal ALFONSO LOPEZ TRUJILLO President Pontifical Council for the Family Panorama interview in 2003 Yes, yes, because this is something which the scientific community accept. Doctors know what we are saying. You cannot talk about safe sex. BRADSHAW: Condoms not working because they have holes in them? The Vatican's claim caused an outcry, especially in the country with Latin America's highest AIDS rate. GABRIELA LEITA Executive Director, DAVIDA It's not easy to persuade people to use condoms, but when Cardinal Trujillo goes on Panorama on BBC and says there is no point using condoms because they have holes and fail, it's very serious. In this time of AIDS it's essential to use condoms. BRADSHAW: AIDS activists know the Cardinal as one of the Church's most powerful conservatives. They launched a counter attack which made headline news. 'Fantastico' Globo News Programme BRADSHAW: The story – the activists have produced a campaigning TV advert. It was designed to shock. The ad accused the Church of an historic error in opposing condoms. DAVIDA TV Advert The CATHOLIC CHURCH took centuries to seek pardon for the INQUISITION FLAVIO LENZ Assistant Director, DAVIDA We wanted to alert people about Church saying wrong things and being responsible for the death of millions and millions of people. [Ad continues] How long with the CATHOLIC CHURCH take to seek pardon for the AIDS victims? BRADSHAW: Their charge – committing a crime against humanity. RAFAEL LLANO CIFUENTES Auxiliary Bishop, Rio de Janeiro Why do they accuse us of a crime against humanity? Do they think the Church is spreading AIDS, or that the condom is in some way a solution to the problem of AIDS. I would say that using a condom to stop AIDS is like trying to put out a fire with petrol, because it encourages the fire. So I believe something more profound is needed. BRADSHAW: But many Brazilians believe the Bishop is wrong to say condoms wont help, and they're making their voices heard. Rio Grande, Rio's leading samba school celebrating condoms. It's their theme for this year's carnival. "Satisfy your crazy desire" they sing "but wear a condom my love and protect yourself." And it's not only AIDS activists and samba schools. In this largely Catholic country the government itself is also taking the Church on. Over Ipanema Beach it's answer to Cardinal Trujillo's claims about holes in condoms is written in the sky. Is that one of your planes? CAMPOS: Yes. BRADSHAW: What does it say? CAMPOS: Nothing gets through condoms. Use it and trust it. BRADSHAW: Does the Brazilian AIDS Commission believe that the virus can pass through condoms because they've got holes in them? ROBERTO BRANT CAMPOS Deputy Director National HIV / AIDS Programme No, the AIDS Brazilian Commission don’t believe that. We have scientific works that show that it's impossible for HIV virus pass through condoms. BRADSHAW: The Government on the attack handing out free condoms to help control AIDS. It also publicly questioned whether the Church might be committing a crime against humanity. CAMPOS: We are trying to shock now, we are trying to provoke debate because we are trying to say please, condoms are the unique weapon we have against AIDS. Please, don’t discredit.. don’t discredit them amongst people. BRADSHAW: You were raising the question of whether discrediting condoms could be a crime against humanity. CAMPOS: Yes. BRADSHAW: This year's girl from Ipanema wears a condom round her neck… GIRL: Respect the people of Brazil – use a condom. BRADSHAW: …and so does the playboy. MAN: This is Rio de Janeiro. A man has to have at least 15 to 20 women. You have to use a condom. BRADSHAW: "Wear a condom my love" they want the message to reach across the world. But on the other side of town a very different kind of carnival. The Catholic Church insists condoms are the wrong way to tackle AIDS. CIFUENTES: [preaching to congregation] We must show that we have our own Carnival , a Carnival full of happiness. Happiness belongs to us, not to those parading in the carnival stadium BRADSHAW: There's no explicit mention of condoms in the scriptures, but the Church says they offend the natural law which everyone, not just Catholics, should obey. CIFUENTES: The Church is against condom use. Sexual relations between a man and a woman have to be natural. I've never seen a little dog using a condom during sexual intercourse with another dog. Animals have natural sex. Man likes the pleasure but not the consequences. [to congregation]: Dearest brothers and sisters, love does not grow from a casual encounter, at the beach or the carnival, for which they say – it is necessary to use a condom. Is this how we love? Yes or no? CONGREGATION: No! BRADSHAW: It's a time hallowed argument. What's causing the row, the Church is calling science to its help. Bishop Cifuentes has released 100,000 copies of a pamphlet backing Cardinal Trujillo's claims. So Cardinal Trujillo was right, AIDS can pass through the condom? CIFUENTES: Yes. Yes, in a percentage. Not absolutely, but in a percentage. It varies – 5%, 10, 15, 20, 25, up to 30% - and so what you can't say is safe sex, and the people are being deceived. The Church is like a mother. What mother would allow her son to go on a plane if she knew there was a 15% chance it would crash? For more information on condoms and AIDS visit our website bbc.co.uk/panorama STEVE BRADSHAW So what's the truth? Are there holes in condoms and, if so, do they present a health risk? After our last programme the Vatican published an important document in which Cardinal Trujillo defends his controversial claims about condoms. It's a detailed and passionately argued defence that the Church's position on condoms called "Family values versus safe sex" and it goes as far as to suggest: "condoms may even be one of the main reasons for the spread of HIV AIDS." The document claims: "So-called safe sex using condoms is Russian roulette, and leading people to think they are fully protected is to lead many to their death." It's shocking and serious stuff, and if it's true we're going to have to rethink our whole approach to preventing AIDS. Our first stop, New Mexico. We've come to discover if Cardinal Trujillo's scientific claims stand up to scrutiny. The Cardinal, for example, reports a claim that: "Condoms have a 10-15 percent inefficacy or failure rate because minute AIDS viruses are much more able to pass through condoms than the sperm" and he says: "there could be millions of leaking condoms". Cardinal ALFONSO LOPEZ TRUJILLO President, Pontifical Council for the Family Panorama interview in 2003 The AIDS virus is roughly 450 times smaller than the sperm. And so, scientists realise that there is a degree of uncertainty. It might be 15%, 18% or 20%. BRADSHAW: So what if there could be up to a 20% chance of condoms failing because of holes? What makes it so crucial to know the Vatican's claims are being repeated across the world as Panorama has discovered. Nicaragua CARDINAL OBANDO BRAVO: We were told that AIDS can be transmitted through the doctor's surgical glove which is less porous than a condom. Philippines ANNA DAHILIG: Because the condom they are made of rubber, so even the AIDS virus can pass through the pores of the condom. Kenya ARCHBISHOP OF NAIROBI: We shall be proved the only people who have been right in this matter in the long run. BRADSHAW: Cardinal Trujillo believes he's already amassed evidence that proves his fears are well founded. This 20 page document has 87 footnotes which include references to lots of scientific papers which he says back up his claims. We're in New Mexico to meet Dave Lytle whose work on whether condoms leak is widely considered the best and the latest. Cardinal Trujillo quotes one of his papers to make his case. Dr Lytle wishes he hadn't. What do you make of how Cardinal Trujillo used your work? DAVE LYTLE Senior Research Bio-physicist US Food & Drug Administration 1996-99 I think that it's misleading. He didn't pay attention to the paper, he took a number out of it and basically misused it. BRADSHAW: Lytle was a US Government scientist when condoms were first being promoted as a way of preventing AIDS. The story that's not been told is that the US Government once shared the same fears as Cardinal Trujillo does. LYTLE: Well one day our Centre Director came in to the office of a colleague of mine, I was there, and he asked the question: "Can condoms stop viruses?" and we didn't know. It was clear that we needed to do some quick experiments to find out what.. where truth lie. BRADSHAW: Lytle's most conclusive work was conducted with actual viruses but not HIV, that was too dangerous. His team tested 470 condoms and found 12 of them allowed "some virus penetration". In his document Cardinal Trujillo uses this to endorse his case that HIV can pass through condoms. But Lytle points to important differences between his laboratory test and real life. The viruses he used were a fifth of the size of HIV. Lytle used water, not less fluid semen. The pressures were higher, and he tested whole condom service, any hole might have been in a different place to the semen. He concluded that only 1 condom out of all those he tested might conceivably leak any infectious HIV. Give me an idea of the worst one, how much liquid actually leaked from it? LYTLE: If we translate that into real life circumstances, the amount that went through the condom would be just barely visible if it were on a white surface, just barely visible. BRADSHAW: Barely visible dot. LYTLE: Yes, yes, just a dot. BRADSHAW: So how could anything pass through a condom? Michael says his worst case condom was a so-called water leaker. These are condoms with tiny flaws, allowed to pass through manufacturers tests at the rate of one in four hundred, though manufacturers we spoke to said they do much better. But in Lytle's judgment, even taking water leakers into account there is no risk to worry about. LYTLE: Latex condom is a very effective barrier. A few may allow minimal exposure to virus, and if I were to give my children or grandchildren advice about whether to use condoms, I would say absolutely. BRADSHAW: But is Dr Lytle right to be so relaxed? He concluded that ordinary intact condoms are essentially impermeable to HIV. But what is the chance of being infected by a condom like the water leaker Lytle found? Now just because you're exposed to semen that carries the virus, doesn't necessarily mean you're going to get infected. It's a question of risk, and there's a whole variety of things that affect what that risk is. For months we've been corresponding with HIV specialists. The main factors, they say, that influence whether you get HIV include viral dose, how many viruses you're exposed to, the infectivity of each virus, genital lesions, or particular risky sexual practices which could make you more susceptible to the virus. So what's the risk of coming across a condom like the water leaker Lytle found, the condom leaking HIV and the virus infecting you, assuming your partner is HIV positive. We asked a world expert on HIV infectivity. Dr PIETRO VERNAZZA Head of Infectious Diseases St. Gallen Hospital, Switzerland We're talking about such miniscule risk that in general in our regular life is a zero risk. See, it's an addition of several unlikely events, the unlikely event that the condom will have a tiny hole, the very unlikely event that a virus will pass through that hole, and then even after that it's very unlikely that a virus that has passed, actually causes transmission. This is very unlikely. It happens as rarely as my plane crashes when I'm on my vacation.. going on vacation. Of course we take into account that a plane could crash but we still go on vacation. BRADSHAW: Of course the Cardinal might say look, that's just the view of two or three individual scientists. Where's the evidence the scientific establishment agrees? The World Health Organisation describes any risk from intact condoms or water leakers as negligible, and it's not alone. Penny Hitchcock lives in New Mexico. Four years ago she chaired a conference of America's top scientists on condoms. Their report the most authoritative to date. PENNY HITCHCOCK Chair US Condom Effectiveness Task Force In the report we looked at data from the laboratory and from clinical studies. The data are consistent, there are no holes in condoms that present a risk of infection. BRADSHAW: No risk of infection at all. HITCHCOCK: Not that is significant. Theoretically - of course, but not in actually practice. No one should not use a condom because they think it's going to leak. I don’t care whether they're in the United States or in Africa. They should be using condoms with confidence, that if they use them correctly, they'll prevent HIV infection, for the church to not support the use of condoms to prevent infections is very detrimental to our controlling the epidemic. BRADSHAW: But that's not the end of the story because, as public health experts recognise, condoms can fail. We're still in the American South West on our way to a place where they understand these issues, the place quoted in the scientific literature about condoms and HIV. Our rationale, this is a real life laboratory. Brothels like Sheri's Ranch are legal in some counties in Nevada. The law says condoms must be used. Whether it's for vaginal, oral or manual sex, at Sheri's they use over 15,000 a year. But there is a risk for girls like Kayla, it's the risk condoms may slip off, or tear, because they're not properly used. Jewellery or rough sex for example can cause problems. Still, that's not something that concerns the sex workers here. KAYLA It's safe because we use condoms here. I've been in the business a few years on and off and I've used a lot, thousands, it just.. it varies. There could be a week I use hundreds. BRADSHAW: And do you know your HIV status? KAYLA: Do I know it? I don’t have HIV (laugh) LARAINE HARPER [giving Steve a tour of premises]: We are in the old brothel right now. BRADSHAW: The Madame has to make sure the girls have regular health checks. That too is the law. The girls are tested for HIV when they start work and after more than five days off. How many age HIV positive cases have you had, if any? LARAINE HARPER Madame, Sheri's Ranch We've never had any. They've done over 66,000 tests on ladies that work in our brothel. There's never been one reported or documented case ever. BRADSHAW: And it's not just Sheri's. 16 years ago Nevada started mandatory HIV tests for all legal sex workers. There is no long-term follow up but according to state records, no prostitute working in a legal Nevada brothel has ever tested positive for HIV. So from your point of view, condoms are 100% protection. HARPER: Absolutely. BRADSHAW: Against HIG? HARPER: Yes. BRADSHAW: So for professionals like Kayla, condoms do work against HIV, but then they are professionals. The danger for everyone else is that the basic techniques of condom use are forgotten in the heat of the moment, or have never been learnt. Cardinal Trujillo says in his document: "The risks of slips and tears for ordinary people is relatively high when dealing with a potentially mortal disease such as AIDS." And he says that: "Like cigarettes, perhaps condoms should also be required to carry warning labels stating that they are not safe. Here in Nevada the precautions they take against slips and tears are rigorous. Have you ever had one slip off? LARA No, I keep a good grip on it. (laugh) BRADSHAW: You do what? LARA: You keep a good grip on it. You should actually, at all times, you know.. during intercourse, keep your hand at the base of the penis holding the condom down and in that way can prevent that and it's just, as I said, proper use. BRADSHAW: Ever had a tear? LILLY No. BRADSHAW: Not one. LILLY: Not one. DENNAE I don’t let the gentlemen touch them. I put them on because I know the correct way. And when you put them on you hold the tip of it and roll it down to make sure there's no air in it. LILLY: We also do a doctor check, a DC, on the gentlemen. We'll grab a wipey, put on a glove, two gloves, wipe 'em down, check their hair area, make sure there's no… anything crawling around, and.. you know.. any sores, open wounds. BRADSHAW: You go through an extraordinary performance really.. I mean which would frankly put most people off, in order to make sure sex is safe. LARA: We are extra careful. I mean let's face it, you know.. a woman here, if she's very busy and successful in her business, could have sex with many, many, many different strangers in a day, in a week, in a month in her lifetime. If we can safely depend on it to protect us, I should think someone in the general public would feel extraordinarily safe using the same type of protection. BRADSHAW: But can and do ordinary people really achieve these levels of protection against HIV AIDS? Next stop – Milwaukee, home to Steve Pinkerton, for whom the Nevada brothel's success is one among many reasons for supporting the use of condoms against AIDS. STEVEN PINKERTON Professor of Behavioural Medicine Medical College of Wisconsin We don’t all have to be experts like the brothel workers in Nevada but there's no reason why people can't be educated and improve their condom use behaviours the same way that they learn to do other things. This isn't rocket science. BRADSHAW: The best science we have to show how well condoms protect against HIV in practice comes from research into people whose regular partner is infected with the virus. Pinkerton and other scientists have analysed studies of such people who say they are consistent condom users with their HIV positive partner. They show that at the end of a year of vaginal sexual intercourse about 99% remain uninfected. Pinkerton says they remaining risk can be blamed on slips, tears or people saying they use condoms when they don’t. Cardinal Trujillo says these studies show the condom does not seem to be the real answer. Would you therefore agree, having looked at all these studies, that condoms really are not the answer? PINKERTON: No, I wouldn't say that's true at all. Over the long-term condoms help reduce the size of the epidemic year after year after year and it's one of the best hopes we have of controlling the epidemic in the absence of a vaccine or a cure. San Francisco For more information visit our website bbc.co.uk/panorama BRADSHAW: So, where are we on the science? Well the evidence is clear. Cardinal Trujillo and others are wrong to say there is any significant risk of HIV infection from holes in condoms. But while condoms can slip or tear, the world's top AIDS experts say they have a vital place in the war against AIDS. Cardinal Trujillo declined our request for a further interview. But there's one other controversial point he makes that's still worth investigating. Condoms, he says, far from preventing the AIDS epidemic, have actually made it worse. He says that safe sex campaigns which promote condoms have increased sexual promiscuity and may have increased the number of AIDS cases too. As supporting evidence, Cardinal Trujillo points to a paper by San Francisco's Professor Norman Hearst who's studied AIDS across the world. So did you say that safe sex leads to increased promiscuity? HEARST: No, we did not say that. BRADSHAW: Is there any evidence that safe sex and condom promotion does lead to increased promiscuity? HEARST: I don’t think there is any conclusive evidence for that. BRADSHAW: In fact there's no academic consensus whether condoms do or don’t lead people to have more sex. But the Professor believes Cardinal Trujillo is right to question whether condoms are working against AIDS. In some parts of the world, he says, they are not fulfilling the hopes so many have placed in them. NORMAN HEARST Professor of Family Medicine University of California You can look at any number of countries in sub-Saharan Africa and see that while the number of condoms distributed has gone up, up, up, unfortunately the rates of HIV infection have gone up, up, up at the same time. We have to, at some point, start saying wait a minute, this approach doesn't seem to be working. Maybe it's time to try something else. BRADSHAW: But where Professor Hearst and Cardinal Trujillo agree, that 'something else' involves changing people's sexual behaviour. Cardinal ALFONSO LOPEZ TRUJILLO President, Pontifical Council for the Family Panorama interview in 2003 The spread of AIDS can be combated and it is being reversed in some places by promoting family values, the virtue of fidelity and by encouraging young people to have a mature attitude towards sex. Kampala, Uganda BRADSHAW: In this African country they're already promoting family values as a weapon against AIDS. Cardinal Trujillo says it shows such values work and you don’t need condoms. Young people urged by the Church to delay sex until marriage. Formal pledges of abstinence from worshippers like Gift. GIFT NABUKEERA Because my religion teaches that people should remain pure and they should abstain until they are married, I thought if I took that pledge I would be more motivated to remain pure. Abstinence is a sure way of avoiding HIV. BRADSHAW: Better than a condom? GIFT: A condom is.. to some extent it's helpful, but of course abstinence is the best solution. BRADSHAW: The Catholic Church is not alone in saying it's working. The HIV infection rate in Uganda has actually fallen and there's evidence that Church and Government campaigns to cut back casual sex have helped, though the abstinence message here is a particularly demanding one. FATHER MASAALA SERMON: You know very well that when you're in the company of a certain person you are going to be aroused, you're going to be tempted, don’t go there. You know that by holding hands, some electricity is going to be flowing. Don’t even go there. You have to give up your girlfriend or boyfriend. There is no other way. BRADSHAW: Your message in there today was pretty tough. Do you believe that you will have helped to save people's lives by doing that? Father ANTHONY MASAALA Very much so. Very much so. BRADSHAW: You were asking them to stop holding hands. MASAALA: Exactly. BRADSHAW: Don't hold hands? MASAALA: Yes, I was saying that. BRADSHAW: Isn't this going a bit far? MASAALA: It may do but um…. BRADSHAW: Do you need to stop holding hands in order to be sure you wont get HIV AIDS? MASAALA: Yes, it may be the case. It may be the case. The Church is not preaching the message don’t use a condom, don’t use a condom, don’t use a condom. The Church is saying there's something better and that you don’t want to put your life… want to hand over your life to a piece of latex. MASAALA [Leads congregation in prayer]: Lord Jesus Christ I surrender my boyfriend, I surrender my girlfriend, I surrender that person to you right now. Thank you Jesus. Praise you Jesus. Thank you Jesus. Praise you Jesus. Thank you father, thank you Lord for what you have done, praise and magnify your holy name. For more information visit out website bbc.co.uk/panorama BRADSHAW: So, could the Church be right? Could the war on AIDS be won without condoms? LIFE GUARD: Ladies and gentlemen Life Guard is here this evening to bring you another programme on the proper use of condoms. BRADSHAW: AIDS activists think condoms are essential. They're handing them out free. At the last count there were only nine a year for every Ugandan male. But critics say they don’t always work so well in Africa. For example, they may be poorly stored, the wrong size, or don’t suit some sexual practices. Because of such problems some academics do share at least some of the Church's concern about condoms in Africa. RAND STONEBURNER Global Programme on AIDS World Health Organisation 1991-95 In Africa there's a much higher prevalence of HIV so you're probability of being exposed to someone who is infected is much greater. So if there is a risk of a failure of a condom, for whatever reason, it amplifies that possibility of being infected. In the past, the only took that was being advocated was condoms, and now we see from the lessons of Uganda that we need to do more to promote reduction in sexual partners and better understand how to bring that about. BRADSHAW: But there are those who say such views fail to take into account the realities of life in Africa. LIKICHO: [talks to class] Who's seen one of these before? BRADSHAW: Lillian Likicho is showing a class of young slum-dwellers how to use a condom. LIKICHO: [talks to class] The condom is designed for one single use. You cannot use it several times in one night. BRADSHAW: She was once convinced abstinence works and couldn't bring herself to mention the word 'condom'. LILIAN LIKICHO Naguru Teenage Information & Health Centre I was brought up in a Catholic home so both my parents were Catholic, not only Catholics but staunch Catholics. BRADSHAW: What did you think about condoms? LIKICHO: I didn't like them. I thought every young person could abstain. I thought people would be faithful to each other. I didn't see the need of condoms anyway. BRADSHAW: Lillian began to change her mind after realising the difficulties facing many poor women in a country where sexual relations are often dominated by men. But even though some Catholic priests do endorse condoms privately, she feared she was denying her faith. LIKICHO: I thought I was sinning because I wanted to be loyal to my Church. I no longer see it as a sin. Not everyone has sex because they want to. Some young people will go and have sex because of circumstances. Maybe some of them of course could be rape. Some of them could be that they do not have life skills. Some of them and most of them is because of economic reasons. I'm not saying condoms are the only way to fight HIV but let's give people all the options and let them make a decision out of it. BRADSHAW: So, does Uganda need condoms? Well Sam Okware should know. He's the Government scientist who's helped develop Uganda's policy of A, B and C – Abstinence, Be faithfully and Condoms. SAM OKWARE: If you have failed to abstain as the Bible says, if you have failed to be faithful as our culture says, then you have only one option left – that is condom. BRADSHAW: Isn't the distinguishing factor about Uganda's success behaviour change and abstinence? Dr SAM OKWARE Commissioner of Health Services No, I think it's a combination of everything. It's like saying when you have a car, which are more important the front wheels or the behind wheels, or the engine? All the three are quite equally important. The A – that's abstinence, the behaviour change as well as the condom. Without the condom I think I will still be having problems with this very sexually active age group, with a very high sexual drive. Those who continue to propagate the epidemic. BRADSHAW: Can't you persuade them to be abstinent? OKWARE: No, you can't. Sex is a complicated matter. All we can do at this moment is to make sex safer. BRADSHAW: So why is the Catholic Church so opposed to condoms when all the big AIDS control agencies say they are crucial to the fight against HIV? Cardinal Wamala is Uganda's senior Catholic and one of the men who'll elect the next Pope. When the present Pope's reign began, the AIDS pandemic hadn't broken out. When it did, the Pope continued to promote the Church's anti-condom's teaching. Cardinal Wamala has the responsibility of advocating it in Uganda. CARDINAL WAMALA: [Sermon] We must bring about the moral revolution in this country through behaviour change, abstinence, fidelity, not condoms. BRADSHAW: If somebody is going to have casual sex, can't stop themselves, do you believe it would be better then to use a condom, rather than take the risk of being exposed to HIV AIDS? Cardinal EMMANUEL WAMALA Archbishop of Kampala Well what does one mean by 'can't'? You mean that this person is sick, or what is it? Is he not normal or… what do you mean by 'can't'. You don’t encourage the weak people to become always.. or to remain weak. Just challenge them in order to overcome their weakness. BRADSHAW: So when people say the Church is making a terrible mistake here, it could be a crime against humanity, how do you react to that accusation? WAMALA: Well they may be right. They may be right because I mean these people who are saying it, they're not fools. They may be right. But they could also be wrong. BRADSHAW: But you would accept that the Church might be making an historical error? WAMALA: I mean the Church has made errors in the past, historical as you say. Indeed there is no guarantee that the Church will not make more historical errors. So it is possible. BRADSHAW: Does it trouble you that this might be the case? WAMALA: No, it doesn't, because it has to do with our moral beliefs. That's our understanding of the moral behaviour of a Christian. BRADSHAW: And you feel the message from the Holy Spirit is abstain, be faithful, but don’t use a condom. WAMALA: Yes. Brussels BRADSHAW: But the Church is not united in its teaching on condoms. Some Catholics, including a Cardinal who's been spoken of as the next Pope, argue they can be used if the purpose is to save lives rather than to control conception. Cardinal GODFRIEND DANNEELS Archbishop of Mechelen-Brussels If someone is HIV positive and his partner says: "I want to have sexual relations with you" basically he should not do so. But if he does, then he must use a condom, otherwise he risks breaking the fifth Commandment. After all, the condom is preventive, it protects other people from catching disease and from death. There is no other moral or sane way in which to judge this. The condom cannot just be seen as a birth control measure. BRADSHAW: And in Brussels there is another powerful voice lined up against Vatican teaching on condoms, the European Union which helps fund the fight against AIDS in Africa, including the use of condoms. Nothing diplomatic about its forthright condemnation. POUL NIELSEN: European Commissioner Development & Humanitarian Aid The harshness, the aggressivity and the insensitivity, the lack of love for human beings and the unwillingness to take their situation seriously, I find that extreme. They are hurting and bringing into great danger the lives of millions out there, and this is where bigotry gets into big discussion. BRADSHAW: How do you mean? NIELSEN: The denial of the fact that very many people in this world do have a sex life, and they have to face a terrible choice of abstinence or lose the blessing of the church. BRADSHAW: In the villages of Uganda you can see just what that choice can mean for some devout Catholics in practice. Harriet Nakabugo decided not to use condoms with her husband Isaac whom she knew had AIDS. Now she fears she has AIDS too. It's been suggested that women like Harriet could be regarded as martyrs. HARRIET NAKABUGO Condoms have always been unholy. As Catholics we are not allowed to use them. We wont go to heaven if we use condoms. They were designed for prostitutes. I would miss all of God's blessings and my reward would definitely be hell. BRADSHAW: Is it fair to persuade somebody that they face a choice between losing the chance of going to heaven and using a condom? Cardinal EMMANUELWAMALA Archbishop of Kampala Well if it is wrong to use the condom, then her choice is the right one. BRADSHAW: You believe she would have made the right choice. WAMALA: If she really believes that that is wrong, then she has made the right choice. BRADSHAW: Even if it costs her life? WAMALA: Yes. Maybe that is why you get martyrs. BRADSHAW: So to give up your life for a principle could be the right thing to do. WAMALA: If it's the right principle. BRADSHAW: And not wanting to use a condom could be that right principle? WAMALA: Could be, yes. BRADSHAW: You're really saying that it could be better to die than to use a condom if that's your belief? WAMALA: If that's one's belief, yes, it's better. BRADSHAW: That's a harsh doctrine, isn't it? WAMALA: Well, Christ's teaching has never been easy, has it. BRADSHAW: The overwhelming view among those who lead the fight against AIDS is it's not condoms that kill, it's the failure to use them. The dilemma for the Vatican is whether to go on opposing condoms when so many of those fighting the pandemic believe that condoms can save lives. If you want to comment on this programme or find out more about the scientific evidence on the effectiveness of condoms, or about abstinence and behaviour change, visit our website: www.bbc.co.uk/panorama _________ CREDITS Reporter STEVE BRADSHAW Camera STEVE GRAY JOE VITAGLIANO JONATHAN YOUNG PETER GEORGE NEIL HIGGINSON Sound JASON BLACKBURN VALERIA FERRO DAVID MITCHELL VT Editor GARETH WILLIAMS Colourist GEOFF HOCKNEY Dubbing Mixer JEFF RICHARDSON Production Co-ordinator KAREN SADLER Web Producer ADAM FLINTER Research KATHLYN POSNER Film Research KATE REDMAN Graphic Design Liquid TV Post Production Co-ordinator LIBBY HAND Production Manager GINNY WILLIAMS Production Executive EMANUELE PASQUALE Film Editor JOHN MISTER Assistant Producers MUKUL DEVICHAND BARBARA ARVANITIDI SHABNAM GREWAL Producer TONY STARK ANDREW BELL Editor Mike Robinson 9 _____________________________________________________________________________________________ Transcribed by 1-Stop Express, 3 Southwick Mews, London W2 1JG, email: panorama@bbc.co.uk