Edward C. Green
Encyclopedia
Edward C. Green is an American medical anthropologist currently affiliated with the Dept. of Population and Reproductive Health, Johns Hopkins University. He was a Senior Research Scientist at the Harvard School of Public Health
and served as director of the AIDS Prevention Research Project at the Harvard Center for Population and Development Studies. He was appointed to serve as a member of the Presidential Advisory Council on HIV/AIDS
(2003–2007), served on the Office of AIDS Research Advisory Council for the National Institutes of Health
(2003–2006), and serves on the board of AIDS.org and the Bonobo Conservation Initiative
. He has worked for over 30 years in international development. Much of his work since the latter 1980s has been in AIDS and sexually transmitted diseases, primarily in Africa, but also in Asia, Latin America, the Caribbean, the Middle East and Eastern Europe. He served as a public health advisor to the governments of both Mozambique and Swaziland. He was widely quoted in March 2009 when he publicly agreed with Pope Benedict XVI
's claim that the distribution of condoms may be aggravating the problem of AIDS
in Africa.
(B.A., 1967, Anthropology
), Northwestern University
(M.A., 1968, Anthropology) and the Catholic University of America (Ph.D., 1974, Anthropology). He held a post-doctoral fellowship at Vanderbilt University
(1978–79), Harvard University
(2001–2002), visiting lectureships at the University of Kentucky
and West Virginia University
, and taught public health and anthropology at both Boston University
and George Washington University
for a short time (1988–89). Since 1981, he has held various research positions in social science and consultancy roles in many countries in Africa, Asia and eastern Europe. Since 2002, he has continued these research projects while serving as a Senior Research Scientist at Harvard University's School of Public Health. He is the author of 8 books and over 400 scientific articles, book chapters, and commissioned reports.
For his dissertation ethnographic research in the early 1970s, Green spent two years living with the Matawai Maroons of Suriname, descendants of escaped African slaves who have lived in the Amazon rain forest for over two centuries.
A review of Rethinking AIDS Prevention in the Journal of the American Medical Association stated: "If Green’s analysis is correct, we are faced with a troubling paradox: while our technologically sophisticated system often operates at the margin of acceptable cost efficacy, halfway around the world, secular bias and biomedical fiscal power are responsible for discouraging and discrediting simple yet effective solutions, at the cost of millions of lives."
Green responded with a March 29, 2009 editorial in The Washington Post ("The Pope May Be Right"). In this editorial he argued that empirical data supported the Pope, and that condoms have not worked as a primary HIV-prevention measure in Africa. Green argued that the tendency of people in steady relationships to not use condoms, and the "risk compensation" phenomenon ("if somebody is using a certain technology to reduce risk, a phenomenon actually occurs where people are willing to take on greater risk"), may account for the failure of condoms to reduce HIV infections in Africa. (Articles in the prestigious medical journals British Medical Journal and The Lancet, by Cassell et al. (2006) and Richens et al. (2000) have discussed the potential for condom use to lead to risk compensation or behavioral disinhibition.) Green concludes, "So what has worked in Africa? Strategies that break up... sexual networks -- or, in plain language, faithful mutual monogamy or at least reduction in numbers of partners, especially concurrent ones."
Green also gave an extended interview with the BBC Northern Ireland on March 29, 2009 to explain his response to the Pope's statement. In this interview, he stated that while there was no proof of a causal connection between condom usage and an increase in HIV prevalence, some evidence supported an association between condom distribution and riskier sexual behavior. He cited a study published in the journal JAIDS which "followed two groups of young people in Uganda, and the group that had the intensive condom promotion. actually were found to have a greater number of sex partners. So that cancels out the risk reduction that the technology of condoms ought to provide."
Green also stated, "the distribution and marketing of condoms is not the solution or the best solution to African Aids." When questioned on his belief that condom promotion should be a backup strategy, he answered, "they should have a back-up role even in the generalised epidemics of Africa. I believe condoms should be made available to everyone. It should be, and as you say, the ABC strategy: Abstinence, be faithful, use a condom
.".
During the same interview, he stated that his Harvard research project was ending. When asked if Harvard had ended the project because of his "politically incorrect" views on the failure of condom distribution programs in Africa, Green replied: "My position is very politically incorrect. I have always been politically incorrect. I have always questioned authority and tried to speak truth to power whatever the consequences.... I don't know whether our programme would have ended when it's ending if I had been more politically correct. You would have to ask Harvard." The administrator of Green's Harvard project later clarified in a statement posted on the BBC website that the end date of the project was unrelated to Green's statements about the Pope or condoms in Africa. The statement said (in part): "The research grant that Dr. Green runs through Harvard University had a 3 year term which would have ended on February 28, 2009. Harvard University and the funder agreed to an extension for an additional year... So I can verify that in no way has Harvard University ended the project."
Harvard School of Public Health
The Harvard School of Public Health is one of the professional graduate schools of Harvard University, located in the Longwood Area of the Boston, Massachusetts neighborhood of Mission Hill, which is next to Harvard Medical School. HSPH is considered a significant school focusing on health in the...
and served as director of the AIDS Prevention Research Project at the Harvard Center for Population and Development Studies. He was appointed to serve as a member of the Presidential Advisory Council on HIV/AIDS
Presidential Advisory Council on HIV/AIDS
The Presidential Advisory Council on HIV/AIDS was a commission formed by PresidentBill Clinton in 1995 to provide recommendations on the US government's response to the AIDS epidemic. President George W. Bush and Secretary Tommy G. Thompson renewed the Council's charter on July 19, 2001.- History...
(2003–2007), served on the Office of AIDS Research Advisory Council for the National Institutes of Health
National Institutes of Health
The National Institutes of Health are an agency of the United States Department of Health and Human Services and are the primary agency of the United States government responsible for biomedical and health-related research. Its science and engineering counterpart is the National Science Foundation...
(2003–2006), and serves on the board of AIDS.org and the Bonobo Conservation Initiative
Bonobo Conservation Initiative
The Bonobo Conservation Initiative is a non-profit organization based in Washington, D.C. and the Democratic Republic of the Congo that promotes conservation of the bonobo and its habitat in the tropical forests of the Congo Basin....
. He has worked for over 30 years in international development. Much of his work since the latter 1980s has been in AIDS and sexually transmitted diseases, primarily in Africa, but also in Asia, Latin America, the Caribbean, the Middle East and Eastern Europe. He served as a public health advisor to the governments of both Mozambique and Swaziland. He was widely quoted in March 2009 when he publicly agreed with Pope Benedict XVI
Pope Benedict XVI
Benedict XVI is the 265th and current Pope, by virtue of his office of Bishop of Rome, the Sovereign of the Vatican City State and the leader of the Catholic Church as well as the other 22 sui iuris Eastern Catholic Churches in full communion with the Holy See...
's claim that the distribution of condoms may be aggravating the problem of AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
in Africa.
Education and research history
Edward Green attended the Groton School, in Groton, Massachusetts and Seoul American High School in Korea (1960–62). He was educated at George Washington UniversityGeorge Washington University
The George Washington University is a private, coeducational comprehensive university located in Washington, D.C. in the United States...
(B.A., 1967, Anthropology
Anthropology
Anthropology is the study of humanity. It has origins in the humanities, the natural sciences, and the social sciences. The term "anthropology" is from the Greek anthrōpos , "man", understood to mean mankind or humanity, and -logia , "discourse" or "study", and was first used in 1501 by German...
), Northwestern University
Northwestern University
Northwestern University is a private research university in Evanston and Chicago, Illinois, USA. Northwestern has eleven undergraduate, graduate, and professional schools offering 124 undergraduate degrees and 145 graduate and professional degrees....
(M.A., 1968, Anthropology) and the Catholic University of America (Ph.D., 1974, Anthropology). He held a post-doctoral fellowship at Vanderbilt University
Vanderbilt University
Vanderbilt University is a private research university located in Nashville, Tennessee, United States. Founded in 1873, the university is named for shipping and rail magnate "Commodore" Cornelius Vanderbilt, who provided Vanderbilt its initial $1 million endowment despite having never been to the...
(1978–79), Harvard University
Harvard University
Harvard University is a private Ivy League university located in Cambridge, Massachusetts, United States, established in 1636 by the Massachusetts legislature. Harvard is the oldest institution of higher learning in the United States and the first corporation chartered in the country...
(2001–2002), visiting lectureships at the University of Kentucky
University of Kentucky
The University of Kentucky, also known as UK, is a public co-educational university and is one of the state's two land-grant universities, located in Lexington, Kentucky...
and West Virginia University
West Virginia University
West Virginia University is a public research university in Morgantown, West Virginia, USA. Other campuses include: West Virginia University at Parkersburg in Parkersburg; West Virginia University Institute of Technology in Montgomery; Potomac State College of West Virginia University in Keyser;...
, and taught public health and anthropology at both Boston University
Boston University
Boston University is a private research university located in Boston, Massachusetts. With more than 4,000 faculty members and more than 31,000 students, Boston University is one of the largest private universities in the United States and one of Boston's largest employers...
and George Washington University
George Washington University
The George Washington University is a private, coeducational comprehensive university located in Washington, D.C. in the United States...
for a short time (1988–89). Since 1981, he has held various research positions in social science and consultancy roles in many countries in Africa, Asia and eastern Europe. Since 2002, he has continued these research projects while serving as a Senior Research Scientist at Harvard University's School of Public Health. He is the author of 8 books and over 400 scientific articles, book chapters, and commissioned reports.
For his dissertation ethnographic research in the early 1970s, Green spent two years living with the Matawai Maroons of Suriname, descendants of escaped African slaves who have lived in the Amazon rain forest for over two centuries.
Research of Indigenous Healers
Green is a pioneer in anthropological research of indigenous healers and in developing public health programs that involve collaboration between African indigenous healers and biomedical personnel. He has guided such programs in Mozambique, Swaziland, South Africa and Nigeria. He has published extensively on indigenous African healing roles and behaviors, as well as underlying health-related knowledge and beliefs, and has written the following 3 books on these topics: Practicing Development Anthropology(1986), AIDS And STDs in Africa: Bridging the Gap Between Traditional Healing and Modern Medicine (1994), Indigenous Theories of Contagious Disease (1999), which has been called a "highly readable contribution to medical and applied anthropology".Views on AIDS Prevention
In Rethinking AIDS Prevention: Learning from Successes in Developing Countries (2003), Green challenged the accepted wisdom of the AIDS prevention community about the efficacy of condoms and HIV counseling and testing as prevention strategies. He argued that epidemiological evidence showed it was declines in number (and perhaps concurrency) of sexual partners that was primarily responsible for Uganda's two-thirds decline in HIV prevalence from 1992 to 2003, and also noted evidence of changes in sexual behavior and HIV prevention success in other countries. Green summarises the book's thesis as follows: "The largely medical solutions funded by major donors have had little impact in Africa, the continent hardest hit by AIDS. Instead, relatively simple, low-cost behavioral change programs--stressing increased monogamy and delayed sexual activity for young people--have made the greatest headway in fighting or preventing the disease's spread. Ugandans pioneered these simple, sustainable interventions and achieved significant results."A review of Rethinking AIDS Prevention in the Journal of the American Medical Association stated: "If Green’s analysis is correct, we are faced with a troubling paradox: while our technologically sophisticated system often operates at the margin of acceptable cost efficacy, halfway around the world, secular bias and biomedical fiscal power are responsible for discouraging and discrediting simple yet effective solutions, at the cost of millions of lives."
Controversy: Pope Benedict and the distribution of condoms
In March 2009, Green generated controversy when he supported a remark from Pope Benedict XVI about the role of condom promotion in Africa. In a mid-flight news conference in route to Cameroon, Pope Benedict had said: "If the soul is lacking, if Africans do not help one another, the scourge cannot be resolved by distributing condoms; quite the contrary, we risk worsening the problem."Green responded with a March 29, 2009 editorial in The Washington Post ("The Pope May Be Right"). In this editorial he argued that empirical data supported the Pope, and that condoms have not worked as a primary HIV-prevention measure in Africa. Green argued that the tendency of people in steady relationships to not use condoms, and the "risk compensation" phenomenon ("if somebody is using a certain technology to reduce risk, a phenomenon actually occurs where people are willing to take on greater risk"), may account for the failure of condoms to reduce HIV infections in Africa. (Articles in the prestigious medical journals British Medical Journal and The Lancet, by Cassell et al. (2006) and Richens et al. (2000) have discussed the potential for condom use to lead to risk compensation or behavioral disinhibition.) Green concludes, "So what has worked in Africa? Strategies that break up... sexual networks -- or, in plain language, faithful mutual monogamy or at least reduction in numbers of partners, especially concurrent ones."
Green also gave an extended interview with the BBC Northern Ireland on March 29, 2009 to explain his response to the Pope's statement. In this interview, he stated that while there was no proof of a causal connection between condom usage and an increase in HIV prevalence, some evidence supported an association between condom distribution and riskier sexual behavior. He cited a study published in the journal JAIDS which "followed two groups of young people in Uganda, and the group that had the intensive condom promotion. actually were found to have a greater number of sex partners. So that cancels out the risk reduction that the technology of condoms ought to provide."
Green also stated, "the distribution and marketing of condoms is not the solution or the best solution to African Aids." When questioned on his belief that condom promotion should be a backup strategy, he answered, "they should have a back-up role even in the generalised epidemics of Africa. I believe condoms should be made available to everyone. It should be, and as you say, the ABC strategy: Abstinence, be faithful, use a condom
Abstinence, be faithful, use a condom
Abstinence, be faithful, use a condom, also known as the ABC strategy or abstinence-plus sex education, also known as abstinence-based sex education, is a sex education policy based on harm reduction which modifies the approach of abstinence-only sex education by including education about safe sex...
.".
During the same interview, he stated that his Harvard research project was ending. When asked if Harvard had ended the project because of his "politically incorrect" views on the failure of condom distribution programs in Africa, Green replied: "My position is very politically incorrect. I have always been politically incorrect. I have always questioned authority and tried to speak truth to power whatever the consequences.... I don't know whether our programme would have ended when it's ending if I had been more politically correct. You would have to ask Harvard." The administrator of Green's Harvard project later clarified in a statement posted on the BBC website that the end date of the project was unrelated to Green's statements about the Pope or condoms in Africa. The statement said (in part): "The research grant that Dr. Green runs through Harvard University had a 3 year term which would have ended on February 28, 2009. Harvard University and the funder agreed to an extension for an additional year... So I can verify that in no way has Harvard University ended the project."