Monday, June 13, 2011
I had the extraordinary privilege of spending a few days with the Holy See's Delegation to the High Level Meeting on HIV/AIDS at the United Nations last week. (In the category of examples of the truth of the adage, "Men plan, God laughs": When I entered Columbia Law School decades ago, I had dreams of a career in international diplomacy, leading to some sort of work at the U.N. I certainly could never have imagined the convoluted career trajectory that started me off as a corporate lawyer lobbying for banks in D.C., to an academic career teaching Contracts and Sales in Minneapolis, and only then actually took me to the U.N. -- as an Advisor to the Holy See.)
Despite my official title, I was doing more observing than advising. One thing that I observed was the tremendous courage of H.E. Archbishop Francis Chullikatt, the Apostolic Nuncio, Permanent Observer Mission of the Holy See to the U.N., and his talented staff, and advisors like Jane Adolphe from Ave Maria School of Law. The constant criticism of the Catholic Church for its position on the use of condoms tends to obscure the fact that the Church provides 25% of the world's care of people living with HIV/AIDS. When you compare the breadth and scope of the Church's position on the needs of people living with HIV/AIDS with the more narrowly-focused, intensely political statements of most of the participants in the conference, the wisdom gained from that hands-on experience is clearly evident. But, still, statements like Archbishop Chullikatt's here, and other similar statements by Professor Adolphe, are often greeted with derision (and even boo's) in this "most civilized" forum for debate.
Here's a taste of some of the battles that the Holy See's delegation has to fight. The earliest drafts of the Political Declaration on HIV/AIDS that was being negotiated at this Meeting referred consistently to "evidence informed" approaches to addressing the HIV/AIDS crisis. The Holy See negotiators consistently recommended changing this to "evidence-based." What's the difference? Take a look at this explanation from UNAIDS' "Terminology Guidelines" (Jan. 2011):
"In the context of research, treatment, and prevention, evidence usually refers to
qualitative and/or quantitative results that have been published in a peer-reviewed
journal. The term ‘evidence-informed’ is preferred to ‘evidence-based’ in recognition of
the fact that several elements may play a role in decision-making, only one of which may
be scientific evidence. Other elements may include cultural appropriateness, concerns
about equity and human rights, feasibility, opportunity costs, etc."
What's at stake? Perhaps the fact that scientific evidence seems to be providing more and more validation of the effectiveness in HIV/AIDS prevention of programs stressing behaviorial changes such as abstinence and fidelity, and the ineffectiveness of prgrams stressing use of condoms? (See, e.g., the work of Edward C. Green, former director of the Harvard AIDS Prevention Project, here and here.)
As I flew home after a couple of days of observing this sort of debate, I felt I really ought to reread Nineteen Eighty-Four.