Kenya's efforts to promote safe sex and combat HIV/AIDS have apparently hit a snag, as religious leaders have accused the government of promoting infidelity instead. 

The controversy began when Kenyan health officials teamed up with USAID and a similar agency in the U.K. to sponsor a television advertisement showing two women shopping in the marketplace. One of the women reminds her friend to use a condom while having sex with her boyfriend when her frequently drunk husband is away. The boyfriend is shown in the background, selling shoes and flirting with another woman.

The commercial quickly came under attack from Christian and Muslim leaders who argue that it promotes immorality and infidelity. "The advert depicts this nation as a Sodom and Gomorrah and not one that values the institution of marriage and family," a leader of the Council of Imams and Preachers of Kenya, declared. One woman criticized the ad for using a mother as the main character. "The fact that a mother figure has been used makes it worse because mothers are the people who stand for families and the ones who teach children the good morals," she said. (Past condom ads in Kenya have been decidedly humorous, though they haven't exactly put public-health messages front and center.) The government has since withdrawn the ad.

In an interview with NTV, the head of Kenya's National Aids / STD Control Program (NASCOP), Dr. Peter Cherutich, defended the spot, arguing that Kenyans "cannot bury our heads in the sand." Sexual infidelity is a reality in the country, he explained, and NASCOP is doing its duty by promoting sexual health in light of this fact:  

The collaboration that we would like to have with the church is that they become our partners. They teach their congregants and they teach Kenyans how to protect themselves against HIV, by being faithful to their sexual partners. And for those that are not able to be faithful, then they need to use a condom.

"We know for a fact that a big proportion of both men and women have sex outside their regular partnerships," Cherutich told the BBC in another interview. "And so, unfaithfulness, as you would call it, is a reality that we need to address in this country." NASCOP says that it is also trying to fight the stereotype that only men are unfaithful, while emphasizing that the task of using condoms should not be left to men alone. 

It's an important conversation -- but one many Kenyans appear ambivalent about having as families gather around the television. 

News of a new "seal flu" has many fearing a repeat of the 2009 swine flu outbreak that infected more than 5.7 million in the United States before peaking as a level 5 on the WHO's 6-point pandemic alert. The H3N8 flu virus was discovered after the mysterious death of nearly 200 harbor seals off the United States' northeastern coast. Describing it as "a combination we haven't seen in disease before," researchers warned that the new strain of influenza A could have severe repercussions for human health.

The real shock of the story may be the public realization that such doe-eyed creatures could cause harm. While mosquitoes and ticks, those pesky harbingers of West Nile, dengue fever, cholera, Lyme disease, and Kyasanur fever (among other assorted viral, fungal, and bacterial pathogens) are universally hated, it's hard to believe the Earth's more cuddly creatures could breed evil. Here's another 13 to ruin your next trip to the petting zoo: 

Peacocks

Peacocks are dying in droves in Pakistan's Thar Desert region in an outbreak scientists believe is linked to Newcastle disease. Highly contagious in birds, the viral infection is currently rare in humans. Its unique replication properties make it a potential candidate for agroterrorism, but more positive headway been made in its use as a human cancer treatment.

Armadillos

Found primarily in Latin America, armadillos are better known for their unique defense mechanism than their role as a global disease vector. Beneath their shell, however, these mammals shield leprosy, a rare bacterial infection that attacks the skin and nervous system. Though associated more with the bible than modern medicine, the disease remains active throughout the world -- with armadillos responsible for more than a third of infections in the United States.

Whales

The world's largest mammal offers plenty of real estate for influenza A, a viral flu strain with the most potential for interspecies transmission. Luckily, the chances for accidental contact remain slim -- just another reason to skip the whale meat.

Monkeys and apes

Described by malaria researchers as a "reservoir for human disease," monkeys and apes are widely known for harboring emerging zoonotic diseases. The HIV virus originated in African monkeys and strains of malaria, Ebola, and monkeypox virus continue to be created or transmitted by monkey and ape populations -- not to mention the cases of measles, rabies, tuberculosis, salmonellosis, shigellosis, amebiasis, balatidiasis, herpes B, giardiasis and helminthes believed to have appeared first in man's closest relative.

Dogs and cats

While many a dog-lover cheered reports of a feline parasite's negative impact on human dopamine production, man's best friend carries its own risks. Though undulant fever is more commonly associated with other species, human cases of the leptospirosis bacteria, an infection whose effect ranges from flu-like symptoms to liver and kidney failure, encephalitis, and pulmonary involvement, have been reported to originate in dogs.

Prairie dogs

More commonly associated with rats, plague seems to have chosen prairie dogs as its modern rodent host. One leg of a complex threesome that includes mice and fleas, prairie dog coteries across North America have been struck by a mass outbreak of bubonic and sylvatic plague. In an effort to cull the epidemic, the U.S. Department of Agriculture has implemented a mass fumigation campaign.

Horses

While flying foxes are their natural reservoir, the Hendra and Nipah viruses have adapted to survive within horses where they take residence alongside anthrax. Worse, equine encephalitis virus, a pathogen listed as a global priority by the Global Early Warning System for Major Animal Diseases, Including Zoonoses, has spread globally. Transmitted by mosquitos, the virus can be fatal in both horses and humans.

Rabbits and hares

Elmer Fudd had a point. Beneath their long, soft ears, rabbits and hares carry a host of mites and ringworms and can breed tularemia, a bacterial infection listed as a potential bio-weapon.

Guinea pigs and hamsters

However popular with the preschool set, guinea pigs and hamsters are still rodents. Next time your kid asks to bring one home remember - these furry beasts are disease vectors of lymphocytic choriomeningitis, leptospirosis, yersiniosis and salmonellosis. Handle with gloves.

Just one week after the acquittal of fiery far-right politician Geert Wilders, the Dutch parliament struck another blow against multiculturalism in the Netherlands yesterday with the passage of a bill banning ritual animal slaughter. The bill requires that all animals be stunned before being slaughtered, a requirement that conflicts with halal and kosher stipulations that animals be fully conscious.

The bill was initially proposed by the Party of the Animals, which holds two seats in the 146-seat Dutch parliament and maintains that ritual methods of slaughter are inhumane. It gained support from centrists on similar grounds, but Wilders's Freedom Party has also been a longtime proponent. In fact, it was Wilders who first raised the issue in 2007 when he objected to halal meat being served at a public school in Amsterdam.

The ban has provoked a furious reaction from Jewish and Muslim leaders in the Netherlands and Europe. From Reuters:

"The very fact that there is a discussion about this is very painful for the Jewish community," Netherlands Chief Rabbi Binyomin Jacobs told Reuters. "Those who survived the (second world) war remember the very first law made by the Germans in Holland was the banning of schechita or the Jewish way of slaughtering animals."

It should be noted that a last-minute amendment attached to the bill states that halal and kosher slaughterhouses will be able to apply for special permits if they can show that their methods do not cause more pain than non-ritual methods. But some are skeptical of the permit process's efficacy, and the European Jewish Congress is already considering challenging the law in court.

The bill awaits confirmation in the parliament's upper house, though it passed easily in the lower house and enjoys widespread public support. If passed, it will put the Netherlands in the company of a handful of countries that have outlawed ritual animal slaughter. Revisions to New Zealand's animal welfare code made kosher slaughter illegal as of this May, while bans in a number of Scandinavian and Baltic countries date back to anti-Semitic measures passed before World War II.

The New York office director of UNAIDS, Bertil Lindblad, is worried about the one region of the world where HIV infections are increasing, even as rates in the rest of the world level off. It's not in Africa or Asia, or even Latin America. It's Eastern Europe -- countries like Russia and Ukraine -- where a recent UNICEF report notes that increases in infection rates of as high as 700 percent have been seen since 2006.

"There is an urgent need for the whole Eastern European and Central Asian region to act quickly," Lindblad said this morning. "This is really quite scary given the fact that there is denial, and so much stigma and homophobia [in that region.] This could really create huge problems if HIV continues to spread from smaller groups in the population to wider."

It's HIV/AIDS's silent crisis, one that has been underway for the last decade. The region is home to a quarter of all injection drug users in the world (3.7 million), and this is where the epidemic is believed to have begun. These users are young -- most of them teenagers. But from there, HIV spread to sex workers (the majority of whom are also under 30), and now has fully moved into the everday lives of men and women in the region, married and unmarried. A mark of the epidemics progression -- from specific populations into the majority -- is the new incidence of HIV among women, who account for 40 percent of all new infections (that's up from only 24 percent at the turn of the century.)

The stigma attached to the disease -- and more importantly, to the groups of people percieved to be the majority infected with it -- is the biggest obstacle to doing anything about the disease. "Those living with HIV have been silenced and excluded, and risky behaviours borne of futility and hopelessness have been sanctioned or repressed," the UNICEF report notes. Government officials are said to be resistant to admitting the scale of the problem, and today that country remains a difficult places for AIDS advocacy, says Lindblad, who formerly worked in the UNAIDS office in Moscow.

But where there is challenge such as this, there is also often opportunity. Russia, I would think, should have a very serious interest in addressing this crisis. For starters, because AIDS threatens to exacerbate its larger demographic problem -- that of a fast-shrinking population. But the other point might be even more convincing: The injection drug users are using heroin. And that heroin comes from Afghan poppies. For Russia, tackling the illegal drug market in Afghanistan -- one which fuels the insurgency -- is a serious national security issue.

Of course, good old fashioned peer pressure might help edge them along as well. And when the U.N. General Assembly meets later this month, one of the side conversations, according to Lindblad, will be a discussion on HIV/AIDS "co-hosted by the government of China, the government of Nigeria, and UNAIDS," specifically, the Chinese premier and the Nigerian president (South Africa's President Jacob Zuma was also supposed to come, but had to cancel.) "That could influence other big countries such as Russia, for example, to turn around."

For those of you who don't subscribe to the bimonthly print edition of Foreign Policy, you're missing a great feature: the FP Quiz. It has eight intriguing questions about how the world works.

The question I'd like to highlight this week is:

Which of these three countries has the highest annual death rate?

a) Germany    b) Iraq    c) Kenya

(The photo above is of half-buried headstones at Arlington National Cemetery during last month's D.C.-area "snowpocalypse.")

Answer after the jump ...

It seems like Uganda is taking two steps forward and one step backward this week in terms of securing human rights for its citizens. Amid growing debate regarding the national Anti-Homosexuality Bill, the Ugandan parliament unanimously passed a law which not only outlaws the practice of female genital mutilation, but imposes a strict punishments of ten year to life-long sentences for convicted perpetrators.

Not a single parliamentary member spoke against the bill, and Francis Epetait, Uganda's shadow health minister explained the reasoning:

"This practice has left so many women in misery. So we are saying no. We cannot allow women to be dehumanised."

So as gender activists celebrate in Uganda, national rights advocates still cringe as the likelihood of the passage of the Anti-Homosexuality Bill looms nearer. The Ugandan Civil Society Coalition on Human Rights and Constitutional Law released a statement yesterday to mark International Human Rights day in which they call the pending bill an "unprecedented threat to Ugandan's human rights:

“Uganda today stands at a crossroads. We can either turn further towards an agenda of divisionism and discrimination, and pay the costs in terms of internal suppression of our own citizens coupled with international isolation and marginalization, or we can embrace diversity, human rights and constitutionalism.”

SHAUN CURRY/AFP/Getty Images

 

Research published in the British Medical Journal says there is no public evidence that Tamiflu reduces complications associated with influenza. Researchers attempting to review data about the Roche produced drug -- dubbed "our best line of defence" against swine flu by the British health secretary -- found the Swiss laboratory wouldn't permit public access to the studies on the drugs.

Tamiflu might shorten influenza suffering by a day or so they said, based on information in the public domain, but it's not clear that chances of serious complications, like pneumonia, would be affected by Tamiflu. Such meager results mean it might not be worth confronting the side-effects, which include: "insomnia, nausea, bad dreams, abdominal pain, headache and a rare neuropsychiatric disease that caused some users to attempt to harm themselves."

This is understandably a problem for the governments around the world who have stockpiled huge quantities of the drug to prescribe for H1N1, contributing to Roche's estimated $2.65 billion in revenues this year from Tamiflu. In a very entertaining, but not too enlightening analogy, a Brit scientist tried to explain the situation policy makers now find themselves in when deciding to use the drug:

But I suppose that once you've gone and bought lots of doses, then it's a bit like the situation with gun control in the US. If you have a gun in the house, it is much easier to use it. But it does not mean it's the right thing to do."

ANTONIO SCORZA/AFP/Getty Images

Over a million people die unnecessarily from malaria in Africa, according to a survey by ACTWatch. The group released a study of seven countries in Africa today, it found that most people in these countries are obtaining ineffective anti-malarials in the private market, due to the low availability and high prices of the far more successful Artemisinin combination therapy (ACT). ACT costs 20 times more than the older medications to which malaria has developed resistance. At about $11 it's 65 times more than the average daily wage in many of these countries.

Malaria needs to be treated with speed, explained Dr. Desmond Chavasse, speaking from the Pan-African Malaria conference being held in Nairobi. Children must receive medication within 48 hours of displaying malarial symptoms if they are to survive. This is why ACTs must get "out through the marketplace, so they are available at the end of the supply chain, in small shops, at affordable prices."

The study, funded by the Bill and Melinda Gates foundation, is intended to provide baseline information for a program that will subsidize ACT medication.

TONY KARUMBA/AFP/Getty Images

The city council of Nairobi passed a series of by-laws yesterday outlining new illegal activities for the streets of Kenya's capital. Newly outlawed activities include blowing one's nose in public without using a hankercheif and spitting into trash cans. Another of the laws criminalizes loud noise.

This particular ordinance may have the biggest impact on the economy of Nairobi, in which street hawkers, cab drivers and store owners rely on verbally cajoling customers into their services. One resident argued the city is just trying to make money, either from imposed fines or bribes, and directly ignoring the needs of its citizens:

"We get our daily bread here,We are not making noise. The council must know that we are self-employed."

The city maintains that the purpose of the news laws is to make the city more habitable and reduce general nuisance. 

AFP/Stringer

Even as it has become clear that the swine flu pandemic (at least in its current mutation) isn't much more serious or deadly than normal flu, stories of prominent people getting infected with it continue to be covered as if they had contracted bubonic plague.

Probably the best way to put swine flu stories in perspective is to just remove the words "swine" or "H1N1" from before the words "flu" and "virus." For instance:

Colombian President Alvaro Uribe has contracted the [...] flu virus and is being treated by doctors while continuing to work from his residence, government spokesman Cesar Velasquez said on Sunday. 

That doesn't sound so bad, now does it?

I'm sorry for sounding flip. H1N1 is a legitimate public health concern that continues to claim lives around the globe. But still, when I see headlines like "Bangladesh reports first H1N1 flu death," I have to wonder how many how many people in that country have died of normal flu (or any number of other diseases) this year without it warranting international media attention.

Chip Somodevilla/Getty Images

Iraq's cabinet has announced that it plans to ban smoking in all public places, the first such law in the Middle East:

The stance is particularly aggressive — and perhaps unenforceable — especially in a nation where cigarettes sell for as little as 40 cents a pack and smoking in public areas and workplaces is widespread. But it coincides with the government’s attempts to improve living conditions here, like Prime Minister Nuri Kamal al-Maliki’s order on Wednesday to remove blast walls from most of Baghdad within 40 days.

Given what else is on their plate, I would hope that Iraqi police won't be devoting a whole of their time to enforcing this. 

Some innovative thinking from India's Minister of Health and Family Welfare, who presents a new argument for rural electrification:

“If there is electricity in every village, then people will watch TV till late at night and then fall asleep. They won’t get a chance to produce children,” Mr Azad said. “When there is no electricity there is nothing else to do but produce babies.” 

He added: “Don’t think that I am saying this in a lighter vein. I am serious. TV will have a great impact. It’s a great medium to tackle the problem . . . 80 per cent of population growth can be reduced through TV.” 

I suspect Azad is pulling that number out of thin air, but in general, he may have a point. People need to pass their evenings somehow.

Hat tip: Marginal Revolution

Photo: meggieg22

Anne Applebaum has an interesting piece over at Slate arguing that while the reaction to swine flu may have been overblown, we should ultimately be grateful for it:

Before "that panic was ridiculous" becomes the conventional wisdom, let's be frank about it: Where infectious diseases are concerned, panic is good. Panic is what we want. Without panic, nothing happens. Up to 500 million people will get malaria this year, and more than 1 million of them will die, mostly in very poor countries. Yet there is no fear of malaria in the rich world; there is no hysterical media coverage, and thus there is still no satisfactory prevention or cure.

By contrast, designs for preventions and cures for swine flu are already, after a mere two weeks of hyperattention, well on track. The U.S. Centers for Disease Control and Prevention has not only developed a test kit to detect the presence of the H1N1 virus that causes the flu; it has already shipped this test kit to all 50 states, plus Puerto Rico and several other countries. Genetic sequences of the virus have been analyzed and databased. A vaccine will probably be ready in time for flu season next fall. Boxes of Tamiflu have been transported to guarded warehouses around the globe, where they await distribution.[...]

if the H1N1 virus mutates into something really dangerous, we'll all be in trouble. But not in as much trouble as we would be if it hadn't been for that brief, possibly ludicrous but nevertheless useful moment of mass hysteria that brought us such terrific headlines over the past couple of weeks.

All of this is true. But I'm not sure about the conclusion. First, I don't really understand Applebaum's argument that infectious disease, in particular, are an issue that benefits from public hysteria as opposed to any other threat. If the media was doing a public service by treating thirty deaths in Mexico like the black death, shouldn't they be trying to work people into a panic over nuclear terrorism or global warming? The argument that "Without panic, nothing happens" could apply to any number of very real threats, but I'd still prefer not to live in a state of perpetual terror.

Beyond that, is a state of panic really the best time to be making critical decisions? There were certainly some rational government responses to the flu. But there were also quite a number that were really, really stupid. Thankfully, the U.S. government resisted the urge to do anything too drastic in response to swine flu, (congress wasn't exactly a big help) but from Japanese Internment to Gitmo, the United States has done some very regrettable things during times of high public fear. I'm not sure it's wise to make it a regular thing. I also think its likely that the hysteria over the swine flu outbreak could make us less likely to take it seriously if a real pandemic should emerge.

"We should call this Mexican flu and not swine flu," Israeli deputy health minister Yakov Litzman -- an ultra-Orthodox Jew -- said April 27. He stated that the reference to pigs is offensive to Jews and Muslims, whose respective religions prohibit consumption of pork. Pork producers -- likely worried about their product's image -- also have reservations about the name "swine flu."

Of course, Mexicans probably find "Mexican flu" offensive, but the name does seem to fit with the tradition of naming flu pandemics after the places where they were originally identified. On the other hand, there's debate about whether the current swine flu even originated in Mexico. "It was a human who brought this to Mexico," the Mexican ambassador to China told the New York Times, saying that the person was from someplace in "Eurasia." (The virus contains part of a swine flu virus of Eurasian origin.)

Meanwhile, "North American influenza" is the name suggested by the World Organisation for Animal Health. Additionally, "H1N1 virus" was the term used by U.S. Agriculture Secretary Tom Vilsack and Homeland Security Secretary Janet Napolitano at an April 28 news conference. They avoided using "swine flu" because they didn't want to mislead people into thinking they could get the illness by eating pork.

Whatever you want to call it, check out FP's latest photo essay, "Pig Panic," about the true "Spring Break Gone Wrong."

RAUL ARBOLEDA/AFP/Getty Images