Edward C. Green

Edward C. (Ted) Green is an American medical anthropologist. He is a Senior Research Scientist at the Harvard School of Public Health and since 2006 has 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.

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 University (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), and 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 6 books and over 350 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 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."

The book was the inspiration behind the feature-length documentary Miss HIV, directed by Jim Hanon and produced by Mart Green, and features in the film. Mart Green, a leading Christian entrepreneur and CEO of Mardel, Inc., says he read Rethinking AIDS and felt compelled to make a film about how programs encouraging monogamy were being overlooked as a successful anti-AIDS strategy in Uganda because politicised AIDS activists in the West refused to take them seriously.

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." The Pope's comments provoked outrage across the political and scientific worlds.

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 pontential 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." However, it is worth noting that, in the randomized trial, free condom vouchers were handed out to both the control and treatment groups. What actually varied between them was that the treatment group was also given a three-hour workshop on how to use condoms while the control group was given a general lecture about the HIV/AIDS situation. The study also had several limitations.

Green paraphrased the Pope as saying "the distribution and marketing of condoms is not the solution or the best solution to African Aids", instead of the actual statement “by distributing condoms... we risk worsening the problem.” When questioned on his belief that condom promotion should be a back up 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: Abstain, 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. While Dr. Green may have suggested a correlation between his comments and the project's end, that is not in fact an accurate representation of the situation. Dr. Green may be under public scrutiny for his response to the Pope's comments, but Harvard University does not change grant terms randomly."

Bibliography

• Rethinking AIDS Prevention: Learning from Successes in Developing Countries (2003)
• Indigenous Theories of Contagious Disease (1999)
• Indigenous Healers and the African State: Policy Issues Concerning African Indigenous Healers in Mozambique and Southern Africa (1996)
• AIDS And STDs in Africa: Bridging the Gap Between Traditional Healing and Modern Medicine (1994)
• Practicing Development Anthropology (1986)
• Planning psychiatric services for Southeast Africa (1979)

External links

• biography at Harvard AIDS Prevention Research Project website
• Edward C. Green's curriculum vitae
• Dialogue on AIDS Prevention, from Share the World's Resources