In Praise of Zero Grazing
The Terri Schiavo case painfully demonstrated how bioethics has become a flashpoint for culture wars between conservatives and liberals. But more excruciating still is how these culture wars are increasingly being exported abroad. As Helen Epstein describes in “God and the Fight Against AIDS" in last week’s New York Review of Books , unseemly conflicts between secular and evangelical Christian AIDS organizations over US government contracts to tackle HIV prevention in the developing world threaten to fuel the pandemic.
As Epstein observes, up to 2000, evangelical Christian groups went out of their way to stigmatize persons living with HIV/AIDS. After a fellow evangelical took office in the White House, however, religious groups began to see spiritual prospects (and large sums of money) in HIV/AIDS patients where they once saw only the workings of Satan. As Franklin Graham (son of Billy) put it, “AIDS has created an evangelical opportunity for the body of Christ unlike any in history.”
Speaking of which: $1 billion of the $15 billion to be devoted to AIDS treatment and care in developing countries by the US government is earmarked for HIV prevention through abstinence-only-until-marriage programs. Sensitive to the accusation that such programs are based on religious moralizing rather than scientifically proven effectiveness, evangelical groups typically cite the case of Uganda, where a dramatic drop in HIV prevalence rates during the 1990’s is claimed to have been due to abstinence policies and programs. If nothing else, these claims are music to the ears of the First Lady of Uganda, Janet Museveni, herself an evangelical Christian. However, almost on a monthly basis, hefty reports emerge that claim abstinence was not the cause of the decline in HIV prevalence in Uganda, and that current abstinence-only HIV prevention programs in Uganda or elsewhere will be a public health disaster. Last month, it was Human Rights Watch’s turn.
Epstein has an interesting take on the debate. In her view, what drove the decline of HIV in Uganda in the 1990’s was not abstinence or the increased use of condoms, but the then-established HIV prevention policy of ‘Zero Grazing.’ Many persons in Uganda, especially in rural areas, practice polygamy. Men may have many wives as they can economically support. The basic message of Zero Grazing was: those in polygamous relationships should be faithful to their (many) lifelong partners, and not engage in casual sex. If all men sleep only with their different wives, and the women only sleep with their husbands, HIV would not spread. This policy did not involve the promotion of abstinence or condom use: it promoted faithfulness, albeit faithfulness within a network of polygamous relationships. And according to Epstein, it was a culturally responsive policy seemed to work in 1990’s Uganda.
What are the chances of reviving ‘zero grazing’? Not great: certainly the present US administration would be loath to support any policy premised on an acceptance of polygamy. And as Epstein notes, while abstinence and condom programs are supported by multimillion dollar bureaucracies, zero grazing has no backers. So the ignorant armies will continue to clash at night for the foreseeable future.
