Winning a fight

Before anything else, I would like to congratulate Manny Pacquiao, again. And to Joshua Clottey: you can't win without fighting for it. I mean, really fighting.

Now here's an ongoing fight - on condoms, again. In her Inquirer column this weekend, Solita Monsod joins the fray.

The endless ‘condom dilemma’

Ma'm Monsod usually writes in her no-nonsense, hard-nosed, lets-get-the-facts-straight style that is very engaging and doubly difficult to contradict, but let me try to quibble a little bit.

She starts by exclaiming: "OH NO, HERE WE GO AGAIN, DEBATING ON an issue that has been medically resolved. I am of course talking about condoms.". The issue at hand in her own words, is on "how serious is the HIV/AIDS problem in the Philippines and what medical studies say about the effectiveness of condoms.".

On the seriousness of AIDS, Monsod writes:

And while our official data show that the total cumulative number of reported HIV/AIDS cases was 4,567, another set of estimates puts it at a much higher number. This alternative data set can be found in “The Epidemiological Fact Sheet on HIV and AIDS—Philippines, 2008 Update,” published by the World Health Organization, UNAIDS (UN Joint Program on HIV/AIDS). What are their estimates for the Philippines? Not 4,567, but an average of 8,300—with a low estimate of 6,000 and a high estimate of 11,000. And this was as of 2007, mind you, while our official estimates were for up to 2010. In other words, the Philippine official estimates are very conservative (or much more optimistic) than the international estimates.

On the effectiveness of condoms for AIDS, Monsod writes:

"Now let’s go to the condom effectiveness issue. Are they effective in preventing HIV/AIDS? The answer is “Yes,” if we listen to the WHO circa 2000 and the Johns Hopkins School of Public Health circa 1999...Johns Hopkins is more of the same (and probably one source of the WHO fact sheet): “Condoms provide highly effective protection against HIV infection when used correctly with every act of intercourse. All 10 cohort studies conducted through 1995 that evaluated condom use among heterosexual couples showed that consistent condom use protected against HIV."

It is hard to contest the figures and it's just as hard to contest the findings of a reputable research organization, although it surely must be a case of glass-half-empty, glass-half-full sort of thing. The facts may also give us something like the what-do-you-see-an-old-lady-or-young-lady sort of illusion (see picture at left). The thing is, the facts tell us something either way. Let us take for example the "high estimate" of 11,000 cases in a nation of 90M. The facts also say it is still a far, far cry from the end-2007 estimated 610,000 cases in Thailand with a population of 65M; or 240,000 in Burma with a population of 47.7M; or 290,000 in Vietnam with a population of 86M. In all three countries, condom usage is rising and its use is aggressively promoted. The particular case of Thailand, where the 100% condom program was launched way, way back in the early 90's, is deeply troubling. How come despite its massive condom funding for nearly two decades, its HIV cases are more than 550 times than that in the Philippines? So I see, condoms have been proven to be scientifically effective as protection against HIV? Depends on what they mean by 'effective', certainly they cannot mean 100%. Are we now supposed to mimic Thailand and spend $80M++ annually on condoms? On the other hand, isn't Thailand supposed to learn from us? Could the sudden spike in the Philippines HIV cases be attributable to low condom prevalence, or are there some other more significant factors at work? In the Philippines, does the statistics on the recent rise in HIV infections state what are the attributes of the rising cases? How about infections through intravenous drug abuse? Just assuming that the new cases stem largely from promiscuous sex, do we then give out free condoms because condoms are inaccessible and unaffordable to many of these existing cases who have been infected through promiscuous sex, including MSM? Which study says these people couldn't access nor afford condoms, which are legally and openly sold as it is? If we have been neglecting condoms for sooo long, why is our HIV statistics not in the 6-digit figure? Where does AIDS education come into the picture? Monsod's statistics and research references raise more questions than answers.

And indeed, Monsod concludes her article with a question:

"The question therefore is: Will the beneficial social, economic and health aspects outweigh the disadvantageous moral/religious aspects, or will it be vice versa?"

Even as the word 'beneficial' may be argued, the above question of course is only relevant to a secularist with a relativist worldview on what is right. Weigh things against each other, and the weightier side should prevail? But from whose viewpoint? The problem is again, there will be widespread disagreement on whether one sees an old lady or a young lady. But ask a bishop, and of course he will tell you that apart from disparate perspectives, you can't weigh things against moral absolutes: any intrinsic evil cannot be justified by a relative good that could supposedly come out of it. Thus from a Catholic viewpoint, there should be no dilemma in the first place, and you can't simply weigh things amorally to evaluate which is right. Finally, AIDS is not the worst consequence there is, for one thing, it only lasts a lifetime.

Back to Joshua Clottey: The bottom line is you tried to escape punishment with a good defensive tactic while employing a lousy fight plan. But first, you must understand what 'winning' means, and what it takes.
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