Exciting new bioethics research topic: the Pope

Former South African president Thabo Mbeki and his fellow ideological travellers in the South African Ministry of Health encountered much domestic and international criticism for their positions on HIV/AIDS. Mbeki once claimed that he 'knew no one who died of AIDS' (it was poverty that did them in) and was cosy for awhile with a fringe group of researchers who deny that HIV exists, or if it exists, that it causes AIDS. The former president was soon clever enough to realize that these positions were very unpopular in a country with a raging HIV/AIDS epidemic, and so left it to various health authorities in the country to express similar beliefs. The former Minister of Health, Manto Tshabalala-Msimang, famously suggested that HIV virus could be treated with lemons and garlic, and that anti-retrovirals were poison, and only benefitted the pharmaceutical companies that produced them. But these were only the most flamboyant characters in the tale. The less-known story is how this absence of leadership, or just plain obstructionism, immobilized the South African health system in regard to HIV prevention and treatment for years, or what the true cost of that paralysis really was in terms of human morbidity and mortality.

Recently, however, two studies have put numbers where there was only speculation and accusation. A mathematical modelling study at Harvard University estimates that Mbeki and company's stance was responsible for the deaths of 330,000 people. A paper by Nicoli Nattrass at the University of Cape Town comes to roughly the same figures: 343,000 lives would have been saved over 9 years if the South African government was not engaged in 'genocide by sloth.'

Which brings us to ... the Pope. The Pope is visiting Africa this week, where he has declared that the use of condoms is not the answer in the fight against HIV/AIDS, and the answer is abstinence. Of course, Pope Benedict is not the first Pope to talk to Africans about how to have (or not have) sex, or the first to say that the distribution of condoms 'can even increase the problem.' As usual, these statements will infuriate many in the HIV prevention community who regard abstinence as a largely failed approach and regular condom use as a crucially important element in the struggle against HIV/AIDS.

But instead of getting angry, researchers should do with the Pope what was done with Mbeki: devise rigorous studies to quantify the number of deaths and new HIV infections that have resulted from the Vatican's position. How many new HIV infections and AIDS-related deaths might have been averted due to the Papal condemnation of condom use, particularly in Christianized African communities? And how does the resultant carnage of preventable deaths square with Christian values? It is not enough to complain: we must study the Pope and his effects, just as we would any other global health hazard.