The Rev. Evatt Mugagura knows he's lucky to be alive. The 35-year-old Anglican priest grew up in Nyamifura, a western Ugandan village that has been ravaged by AIDS: "Most of the people my age, the ones I studied with, the ones I grew up with, have died." The devastation drove Mugagura to become what many derisively call a "condom priest." He reversed his stance against birth control and began distributing condoms in his parish, personally teaching villagers how to use them. "Losing so many close friends gave me the courage to continue talking," says Mugagura. "Because if I had had a way of reaching them with a condom, I would have them now--sinners as they may be."
Mugagura's views are controversial--and rare. In most of sub-Saharan Africa, Christian churches have stood quietly by as AIDS has decimated whole communities. "The disease has been so long associated with illicit sexual activity that there's been an overpowering silence on the issue," admits the Rev. Ted Karpf, HIV/AIDS missioner for the Anglican Communion in southern Africa. But now a growing number of Western NGOs and development agencies hope to persuade other African churches to follow Uganda's example. There, religious leaders like Mugagura have helped the government cut HIV infection rates from 14 percent in the early '90s to 8.3 percent in 2000 (and they're still falling.) "We've increasingly recognized how important religion is, not only in the care and support of people who are affected by AIDS, but also in our ability to prevent new infections," says Dr. Paul De Lay, acting director of the Office of HIV/AIDS at the United States Agency for International Development in Washington. De Lay says the church is key not only in shaping people's moral decisions, but in operating much of sub-Saharan Africa's infrastructure, where 40 percent of health care is provided by missionary hospitals. Last December his office unveiled a new program that offers grants to faith-based groups in developing countries for AIDS prevention and AIDS treatment programs.
The learning curve will be steep. When HIV prevalence rates were presented at a conference for African religious leaders in New York recently, the audience reacted with gasps of disbelief. "I didn't know it was that bad in Africa," said Msgr. John Aniagwu, a Roman Catholic priest from Nigeria, where one in 10 adults is HIV-positive. In some cases, the clergy's ignorance stemmed from blind faith. "We never preach about AIDS, because we think Christians cannot commit adultery or indulge in bad sexual behavior," says the Rev. Gabriel Kpokame, who leads a Pentecostal church in Cote d'Ivoire, which has the highest infection rate in West Africa.
But most ministers feel helpless to preach about prevention because of their opposition to birth control, including condoms. Pernessa Seele, founder of the Balm in Gilead--the U.S. nonprofit that organized the New York meeting--says her mission is not to reverse that position, but to remind leaders that AIDS is not only transmitted sexually. "The impact of AIDS is so great in these countries that if we get our religious communities to talk about getting tested, talk about the orphan problem, just talk about AIDS, period--dispelling the stigma--that is a great accomplishment."
That's not to say that African churches have done nothing. In some cases, they have spoken out more boldly than government leaders. In South Africa, for example, where President Thabo Mbeki has questioned whether HIV causes AIDS, religious leaders have campaigned for affordable AIDS drugs and challenged the Vatican's stance on condoms. In Namibia, Catholic leaders have endorsed the message "ABCD": Abstain, Be faithful, use Condoms, or face Death. And Karpf says leaders of the African indigenous church talk to their followers about "the beauty of wrapping gifts." "It's taboo to talk about body parts in polite society," he says. Some church groups operate clinics, provide counseling to AIDS patients and their families and support AIDS orphans.
But there's still a long way to go. Most of those who attended Seele's four-day conference left newly galvanized. Aniagwu, who had admitted to "not doing much" about AIDS previously, will now teach his 20,000 congregants how to prevent it. Mugagura, the Balm in Gilead's project director in Africa, says openness is key. "I preach AIDS in and out of season," he says. "Whoever I meet, I talk about AIDS. I am like a madman on AIDS." Of course, no one is forgetting the lack of money, infrastructure and basic medical care across sub-Saharan Africa. But here, too, religion has an important and practical role: averting panic. "If there was no faith in God, there would be total misery," says Mugagura. "Treatment with drugs is still expensive, and most people cannot afford it. But they can afford to believe in God."