The English Guardian may face something of a dilemma when covering the WHO's failure to give clear advice to African women who have been persuaded to use Depo Provera and similar injectable hormonal contraceptives, which appear to be associated with a doubling of HIV transmission from females to males and from males to females; birth control is close to the heart of he who would control population, Bill Gates, whose Foundation sponsors the paper's Global Development section. Not that the article appears in the Gates sponsored section; perhaps there is no such dilemma.
But Sarah Boseley sticks pretty close to the WHO's press release and says that women who use injectables such as Depo Provera should also use condoms. As with the 'advice' from WHO, Boseley notes the use of 'dual protection' against pregnancy, on the one hand, and infection with sexually transmitted infections on the other. For Boseley and WHO, this means using condoms along with Depo Provera. But what neither seem willing to point out is that condoms on their own provide such dual protection.
So why would anyone want to use these expensive and possibly dangerous hormonal injections if condoms on their own give dual protection? Well, according to WHO and other 'experts' in reproductive health (often just a useful term for 'birth control'), condoms are not 'female controlled'; many people don't use condoms if they can help it. So rather than recommending that people who wish to avoid both pregnancy and sexually transmitted infections should use condoms, they recommend that people use Depo Provera, despite knowing that many people who opt for injectable hormonal contraceptives (and various other methods) cease to use condoms?
The oral versions of Depo Provera and similar contraceptives are said to be unsuitable because women need to take them daily and they may forget, or their husbands may object, etc. Injectable versions are said to be women controlled and only need to be taken every three months. In reality, they are to a large extent controlled by those who supply them, often NGOs and other institutions who believe strongly in the population control paradigm of development. Whatever synonyms are used, the concept of control is always detectable.
Boseley claims that women 'choose' Depo Provera and similar products but these pharmaceuticals are aggressively marketed by some of the biggest NGOs working in population control. Use of injectables has increased considerably over recent years but it's difficult to work out whether that's a matter of availability or genuine choice. Given the political and financial clout that NGOs and institutions such as the Gates Foundation have over the lives of people in developing countries, it seems unlikely that birth control is as high on the agenda of people in African countries as it is for the various non-African parties on the bandwaggon. One might even wonder if anyone gives a damn what Africans think about such matters.
It's astonishing just how uncritical Boseley is, in fact. She parrots bits about the WHO's 'expert group', but it was not concluded that hormonal contraception is safe ("Current evidence is not strong enough to prove or disprove an increased risk of HIV from hormonal contraception"). Rather, it has clearly been decided that it is safe enough for Africans and other poor people; it is not much used by white, middle-class Westerners. These products have not been shown to be safe, far from it. But the most important consideration for the WHO is that their goal of population control is not compromised by worries about safety issues, which they have been aware of for decades.
The logical conclusion to be drawn from the WHO's findings is that, if people want to avoid unplanned pregnancy and sexually transmitted infections, they should use condoms. The WHO statement is not based on a logical conclusion; it is a political declaration designed to protect the interests of Big Pharma, big NGOs and big private institutions with a population reduction agenda, and of course, the interests of the WHO itself. As for UNAIDS, they have taken a back seat; HIV prevention has never been their strong point.
Boseley finishes with a few non sequiturs and then supplies a version of the population control enthusiasts' mantra: "About 25% of the 128 million married or cohabiting women in sub-Saharan Africa aged 15 to 49 want but cannot obtain contraception." This self-serving statement doesn't tell us who was asked the questions, who was asking them, what questions were being asked and who chose those questions; a far higher percentage of women (and men and children) face numerous life-threatening issues on a day to day basis. It is likely that some of those issues would carry a higher priority, such as lack of clean water and sanitation, accessible and secure food supply, adequate living conditions, and many others.
When you know how you will get through the next few years, you can plan the next few decades. Family planning is not the panacea depicted by WHO when you are faced with low survival rates for your children and life expectancy for yourself. Population control in the form of birth control and family planning can be dressed up to look like an obvious choice for people in developing countries. But large scale population control exercises are not, neither in intention nor in practice, matters of choice for their putative beneficiaries. Population control is the prerogative of those who also control vital resources and the like, and who wish to limit access to these for people who are at the bottom of the heap.
Consider the role of eugenicist and neo-eugenicist doctrine in developing countries over a period of many decades; population has risen rapidly, regardless. Far from people being given choices over matters such as family planning, self-determination has been systematically denied. But Western maneuverings have failed to control population growth; they have only brought developing countries to their knees, creating new problems and exacerbating existing ones. When the rich and powerful talk piously about choice, it's always worth remembering that they consider their choice to be the only viable one.
Saturday, February 18, 2012
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I just came across this article in the English Guardian by Jonathan Freedland:
He and Boseley should read each other's articles.
I posted a comment on the interesting connections between Freedland's and Boseley's articles but it was removed from Freedland's comment section. Must have touched a raw nerve.
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