U.S. Right Squeezes Lifesaving Aid to Africans

From a small building on the outskirts of this crowded West African capital, a new national organization for youth is taking shape. It’s called Young & Wise. One of the things it does is promote condom use to stop AIDS. It doesn’t distribute them willy-nilly. Its message is measured, its partners are churches and mosques, and its ABCs would be familiar to many conservative American Christians -- abstain, be faithful and use a condom when the time is finally right to engage in sex. On the walls are little stickers saying, “True love waits.”

The problem is that the supplier to Ghana of the best condoms, the United States Agency for International Development, can no longer give any to this project. Does this make any sense?

“It’s the ‘gag rule,’ ” explains Delah Banuelo, the organization’s program officer. He is referring to the Republican ban on giving aid to groups that counsel people on abortion, whether or not the groups actually perform abortions. The Bush administration is in effect punishing a promising effort in Ghana because Young & Wise is part of the Planned Parenthood Assn. of Ghana, which in turn belongs to the International Planned Parenthood Federation, an organization on the no-no list in the White House.

The gag rule has also harmed another funder of reproductive health programs in Ghana, the United Nations Population Fund. The U.S. has withdrawn all contributions to the fund because of unfounded reports, which the State Department has debunked, that it supports abortions in China.

In Ghana, the trickle-down effect of the gag rule has been widespread. And because Ghanaians -- Christian and Muslim -- are a religious people, the effect has been to undermine many programs that conservatives could support.

“In our part of the world, when the religious leader says yes, the congregation says yes,” explains Banuelo, who enlists pastors -- Anglican, Presbyterian, Methodist and others from an array of evangelical sects -- along with Muslim clerics to join or lead his program. The very nature of such teams makes it a conservative campaign.

At the Ahmadiya Muslim Mission in Accra, Hafiz Ahmad Saeed is in charge of another reproductive health program, one that has also felt the loss of American funds. Yet any Islamic program, he points out, must preach abstinence and no sex outside marriage.

Do conservative Christians in the United States, Catholic and Protestant, understand that they are doing in their fellow Christians and moderate Muslims? If they do, they don’t let that get in the way of their absolutist stand.

Anyone visiting Ghana would see the need for wide-ranging family planning programs. Only 19% of couples in Ghana use contraception. Large families are the norm; men tend to object to contraception; sex education is minimal and teen pregnancy is on the rise. Now health officials say they will have an $8-million shortfall by 2006 in funds to increase contraceptive use nationwide. In the meantime, maternity wards are crowded with exhausted, anemic women who could die in the next pregnancy, and HIV/AIDS is a pervasive threat.

Can American money alone help solve such problems? Yes. The Bill and Melinda Gates Foundation is picking up some of the slack to help Young & Wise, and more aid would only increase the effectiveness of organizations that have proved they can change behavior, cut birthrates and raise health standards. One slim sign of success: a small drop in new HIV infections among the young.

And nobody is asking for millions. At the Teen Center in the Ghanaian city of Kumasi, Christina Acquaah would love to have a simple delivery room to ensure that the pregnant girls she helps, most of them unmarried, will survive a birth and have a healthy child. And then there are those condoms Banuelo needs in Accra.

The message is clear: American conservatives should replace their blanket ban on family planning aid with real knowledge and nuance. One trip to Ghana would help them see the light.

Barbara Crossette, a former New York Times correspondent, is writing a report on family planning worldwide for groups that lobby for women’s reproductive health.