Izabella Parowicz

Cardinal Burke on faith, the right to life, and the family: English exclusive

Izabella Parowicz
By Izabella Parowicz

Editor’s note: The following interview with Cardinal Raymond Burke, prefect of the Vatican's Apostolic Signatura, by Izabella Parowicz was conducted in English January 7, 2014 and originally published in Polish by Polonia Christiana magazine (http://www.pismo.poloniachristiana.pl). It is republished exclusively here in English with permission.

1. Your Eminence, is it at all possible to be partially Catholic? Frequently we hear statements like: “I am Catholic but...” To what extent are Catholics allowed to compromise when it comes to defending human life, marriage and family? 

The notion of “partial Catholicism” is a contradiction in terms, which reflects the current cultural tendency to individualism and relativism, in other words, the tendency to accommodate any reality, without respect for its objective nature, to one’s own thoughts and desires. Catholics who have such a notion of their Catholic faith and practice are sometimes called “cafeteria” Catholics, because they pick and choose what they want to believe and follow from among the Church’s teachings on faith and morals. A true Catholic accepts, without compromise, all the truths which the Church teaches regarding the faith and the moral life.

2. Why is innocence downplayed nowadays? I refer to the life of unborn babies, to children who are psychologically raped during compulsory sex education classes, and to innocence understood as purity of thoughts and (premarital) purity of flesh?

The totally secular agenda, if it is to succeed, must win children and youth to its way of thinking. Education is the ultimate key to its victory in society. The only way to capture children and youth is by usurping the solemn duty of parents and teachers to educate in accord with what is true, good and beautiful. Parents and teachers, who work with parents in the correct education of their children, must necessarily respect totally the period of innocence of children and young people. Respecting that natural innocence which is a reflection of God’s gift of conscience to every child, parents and teachers will prepare children and young people to respond clearly and courageously to those forces which would rob them of their innocence, both from within themselves – due to the effects of original sin – and from outside, for example, from bad companions and from bad communications like pornography on the internet. Parents and teachers should be vigilant that nothing is introduced into the curriculum which violates a child’s innocence and even attempts to instill in the child gravely wrong ways of thinking, for example, a curriculum endorsed by a certain major government which teaches 4 and 5 year olds that marriage can take other forms than the lifelong, faithful and procreative union of one man and one woman.

3. Hippocrates was not a Catholic, yet he swore to his gods the following: “I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.” Nowadays attacks on human life are becoming stronger and stronger. Even nominally Catholic doctors, who also take (a modern version of) the Hippocratic Oath, tend to take the sacredness of human life lightly and allow solutions which involve killing (i.e. abortion and euthanasia) in order to ensure personal fulfilment, comfort or to eliminate a “problem” of an individual. How can we prevent this intrinsic, disguised evil from spreading further?

The situation you describe is tragically real. Often, I am deeply saddened to see the medical art, which by its nature is directed to the healing and preserving of human life, reduced to a technology of mutilation and death. It is critical to give children, among whom are the future physicians of the world, a solid catechesis, including essential formation in respect for the inviolable dignity of innocent and defenseless life, for the integrity of marriage and the family, and for the free exercise of a rightly-informed conscience. It is also critical to provide occasions for medical doctors and other healthcare professionals to come together for continued education regarding the ethical and religious dimensions of healthcare, and for the building up of their solidarity in the battle against the culture of secularism and death. An excellent example of such a work is the St. Gianna Physician’s Guild which has developed “The St. Gianna Physician’s Guild Catholic Hippocratic Oath."

4. There is a growing pressure being put on Poland to legalize in vitro techniques, public funds have already been allocated to selected hospitals to “help” desperate couples. Catholic doctors who stand up publicly for the human life and do not hesitate to protect it are often referred to as lunatics or fanatics even if they support their position with strong, well-based and honest research. The same label is applied to ordinary people engaged in pro-life activities. What arguments can be used to persuade the red-headed (and frequently confused) minds which do not want to listen to ‘the Papists’?

It is important to underline that the Church’s opposition to “in vitro” techniques for human conception is based on the natural moral law and not on a specifically Catholic precept. In discussing the question publicly, it is important to show how right reason regarding the inviolable dignity of human life and the integrity of human procreation makes the artificial generation of human life, even if for some good purpose, always and everywhere gravely wrong. Regarding the question of “in vitro” fertilization, one should have reference to the Instruction Donum Vitae of the Congregation for the Doctrine of the Faith, published by order of Blessed John Paul II on February 22, 1987. It presents the foundation of the Church’s teaching in the natural moral law and then addresses specific questions like “in vitro” fertilization.

5. The world today is often contemptuous of numerous families (especially of the “reckless” parents), on the other hand many families try to give their children the best possible upbringing and education and in order to be able to do so (in the time of economic crisis), they decide not to have “too many” children. Undoubtedly, the knowledge of contraceptive methods (whether approved by the Church or not) has influenced the modern family model. How can we promote openness to new life when so many families, also in developed or developing countries, are preoccupied with financial uncertainty? Aren’t also we, Catholics (i.e. Catholic marriages) tainted with a certain fear of having more children? Aren’t we seeking for excuses to justify our closing off to new life? 

Two fundamental ethical and religious principles must be kept in mind. First of all, the conjugal bond is by its very nature procreative. A husband and wife will, therefore, welcome the procreation and education of children as “the crowning glory” of their marital love, to use the words of the Pastoral Constitution on the Church in the Modern World (Gaudium et Spes) of the Second Vatican Ecumenical Council (no. 48). Secondly, the procreation and education of children is a most serious responsibility of parents which they exercise with full respect for the nature of human procreation, not employing either devices or chemicals to alter artificially that nature. Pope Paul VI provided for us the perennial teaching of the Church on responsible parenthood in his Encyclical Letter Humanae Vitae (July 25, 1968). Blessed Pope John Paul II devoted his Wednesday audience addresses during the first years of his pontificate to the discussion of marital love and its particular expression in the procreation of offspring. It is instructive to note that Pope Benedict XVI, in his Encyclical Letter Caritas in Veritate, makes special reference to Pope Paul VI’s Encyclical Letter Humanae Vitae, underscoring that the teaching in Humanae Vitae is not simply a matter of “individual morality” and that a right understanding of human sexuality is essential to true human development (no. 15). In the words of Pope Benedict XVI, it is necessary “once more to hold up to future generations the beauty of marriage and the family, and the fact that these institutions correspond to the deepest needs and dignity of the person” (no. 44).

In the end, what is essential is to understand that marital love is a sacramental participation in divine love which is pure and selfless, that is, totally generous. Parents, then, while they will take care to provide for what is essential for the correct upbringing of their children, will be generous in accepting every gift of new human life from God, recognizing in the act of procreation a cooperation in the mystery of God’s love which is particularly theirs. In that way, they will teach their children to love in the same way, to accept the sacrifice of material goods for the sake of loving God and neighbor. The contraceptive mentality, which radically distorts the beauty of marriage and family, teaches us to seek material goods above all else and, therefore, to become selfish. It is no wonder that the contraceptive mentality leads individuals to justify in their minds procured abortion, an intrinsically evil act.

6. In the last 50 years the ecclesiastical annulment has become a relatively easy way out of a difficult or inconvenient marriage. Valid reasons for declaring a marriage null and void are often confused with mere excuses to start life anew. There have been cases in which one or both spouses fictitiously change their address to obtain a favourable decision from another, fast acting or more “open-minded” diocese tribunal. It also happens that, while one spouse pushes for the annulment, the other is negative about it and – if the annulment is granted - eventually suffers greatly or even loses faith. Additionally, there seems to be a new market niche for lawyers specialising in these annulment cases. Could Your Eminence offer us some insights into how the highest judicial authorities of the Church prevent the abuse of the institution of the annulment? How can lay people resist the temptation of using the annulment as an “emergency exit” from unbreakable marriage?

The Supreme Tribunal of the Apostolic Signatura has the responsibility to oversee the right administration of justice in the Church. This includes the justice administered by the matrimonial tribunals in the case of the accusation of the nullity of a marriage on the part of one or both parties to the marriage. By means of the process employed at the matrimonial tribunals, a process set forth in the universal law of the Church, the judge or judges arrive at a decision regarding the truth of the claim that a marriage was null from the beginning, even though it appeared to be a valid marriage. The universal law of the Church also establishes the grounds upon which one or both of the parties can make such a claim. The process is directed solely to the discovery of the truth regarding the claim, for only the truth can serve the good of the parties involved. The decision of the tribunal is correctly called a “declaration of nullity,” not an “annulment,” so as not to give the impression that the Church is annulling a valid marriage. The declaration signifies that the judge or judges, by means of a process in which all of the arguments in favor of the validity of the marriage and all of the arguments in favor of the nullity of the marriage have been carefully weighed, have concluded with moral certitude that the marriage was null from the beginning. Moral certitude means that the judge or judges, having weighed all of the arguments – having God only before their eyes – , have no reasonable doubt regarding the nullity. The process also includes the means for parties to seek effective remedies if they believe that the truth is not being served by the process. 

The breakdown of a marriage can be owed to a cause other than the nullity of the marriage consent from the beginning of the marriage. For instance, it can be owed to the sinfulness of one or both of the parties. A party should only make the claim of marriage nullity when he is convinced that his marriage, which he previously thought was valid, was in fact invalid.

Apart from receiving complaints about possible injustices committed at local tribunals, the Supreme Tribunal of the Apostolic Signatura also receives an annual report on the status and activity of each matrimonial tribunal. After studying the report, it sends observations to the matrimonial tribunal to assist it to carry out its work more correctly. The Apostolic Signatura also sometimes requests a copy of the definitive decision in a marriage nullity case, in order to verify that justice and, therefore, truth was served in the process leading to the decision. On the other hand, the Apostolic Signatura has the competence to grant certain favors to tribunals for the more efficacious administration of justice.

7. I would like to touch upon the issue of nominally Catholic politicians who act against the teaching of the Church by, for instance, publicly supporting the abortion or the legalisation of homosexual “marriages”. Your Eminence frequently emphasises that these politicians must not be given the Holy Communion so as to avoid the sin of sacrilege. How should priests proceed in order to ensure that this ban fulfils not only a punitive but also a corrective function?

The exclusion of those who persist in manifest and grave sin, after having been duly admonished, from receiving Holy Communion is not a question of a punishment but of a discipline which  respects the objective state of a person in the Church. Even as Saint Paul, in chapter 11 of the First Letter to the Corinthians, admonished the early Christians: “For any one who eats and drinks without discerning the body eats and drinks judgment upon himself” (v. 29), so also the Church, down the ages, has admonished those engaged in manifest and grave sin not to approach to receive Holy Communion. In the case of a politician or other public figure who acts against the moral law in a grave matter and yet presents himself to receive Holy Communion, the priest should admonish the person in question and then, if he or she persists in approaching to receive Holy Communion, the priest should refuse to give the Body of Christ to the person. The priest’s refusal to give Holy Communion is a prime act of pastoral charity, helping the person in question to avoid sacrilege and safeguarding the other faithful from scandal.

8. The gender ideology poisons in many countries the state politics towards family. It is now brutally forcing entrance into educational systems of several European countries. How should Catholic parents react to elements of gender ideology whether planned or already introduced into the school curricula? Is the Catholic Church able to offer a philosophy of femininity that could counter the narratives proposed by the feminists?

Parents today must be especially vigilant in instructing their children in the truth about human sexuality and in safeguarding them from all of the false messages regarding human sexuality conveyed in the schools and by the communications media. Parents should insist that their children not participate in lessons or activities in school which betray the truth about human nature, male and female. Particularly pernicious is the so-called “gender theory” which is promoted ever more aggressively, especially through educational curricula for children and young people.

In fact, the Church’s Tradition offers a powerful model of true femininity in the Blessed Virgin Mary and in many female saints. Blessed John Paul II addressed the question of true feminism in his Apostolic Letter Mulieris Dignitatem (August 15, 1988).

9. What is Your Eminence’s opinion of the American Catholic universities and their faithfulness towards teaching of the Church? What does Your Eminence think of their acceptance for the so-called birth control policy?                               

Sadly, many Catholic universities in the United States are no longer faithful to Catholic teaching and practice, in contradiction to the Apostolic Constitution Ex Corde Ecclesiae (August 15, 1990) of Blessed Pope John Paul II. They permit teaching contrary to the doctrine of the faith in various courses, especially courses of philosophy and theology, and allow activities which are directly opposed to the moral law as it is taught in the Catholic Church. There are, however, a few universities which are outstanding for their Catholic identity. Certainly, no Catholic university should teach contraception to the students or provide to them contraceptive services.

10. The policy of the President of the US towards the Christian civilisation becomes more and more aggressive. Does Your Eminence notice any symptoms of Catholic reactions against this policy? If yes, what are they, if not why?

It is true that the policies of the President of the United States of America have become progressively more hostile toward Christian civilization. He appears to be a totally secularized man who aggressively promotes anti-life and anti-family policies. Now he wants to restrict the exercise of the freedom of religion to freedom of worship, that is, he holds that one is free to act according to his conscience within the confines of his place of worship but that, once the person leaves the place of worship, the government can constrain him to act against his rightly-formed conscience, even in the most serious of moral questions. Such policies would have been unimaginable in the United States even 40 years ago. It is true that many faithful Catholics, with strong and clear leadership from their Bishops and priests, are reacting against the ever-growing religious persecution in the U.S. Sadly, one has the impression that a large part of the population is not fully aware of what is taking place. In a democracy, such a lack of awareness is deadly. It leads to the loss of the freedom which a democratic government exists to protect. It is my hope that more and more of my fellow citizens, as they realize what is happening, will insist on electing leaders who respect the truth of the moral law as it is respected in the founding principles of our nation.

11. I would like to touch upon the issue of legalisation of same-sex “marriages”. Venerable Fulton J. Sheen said: “A religion that does not interfere with the secular order will soon discover that the secular order will not refrain from interfering with it”. The liberal media eagerly support the secular order in this respect. How can public opinion be made aware of the fact that the reason why the Church interferes with these new practices is because the politics has been more and more interfering with the natural law? Can - according to Your Eminence’s opinion – the recent reaction of the French society on the arrogant introduction of the ‘right’ to contract a same-sex‘marriage’ give us hope for a Catholic awakening in Europe?

The issue in question is precisely the natural law, which is the irreplaceable foundation of all legislation. The natural law written upon every human heart, as Saint Paul observes in the Letter to the Romans (2:15), teaches those non-negotiable principles of law without which it makes no sense to speak of justice and love. I refer to respect for the dignity of human life, for the integrity of marriage and the family, and for the exercise of religion. Governments which impose legislation recognizing the relationship of two persons of the same sex as matrimonial violate the natural law, which teaches that marriage is the union of one man and one woman and that the sexual union belongs properly to marriage. The recent response of the citizens of France to such legislation both points to the truth of the natural law and calls the government to reform an unjust law. The logo of Manif pour Tous is powerful; it points to the truth that, according to nature, according to God’s plan for us and our world, a child comes from a father and mother, and needs a father and mother for his or her healthy growth and development. The action of the French has become a model for other nations who are facing or will face similar governmental action. If such gravely unjust legislation is to be corrected, the citizens must be alerted and must be ready to take action by manifesting their firm objection to it.

12. Is there any hope that the evil trend in the US legislation concerning the life protection be reversed? Are the pro-life activists able to act effectively in this matter? Why was the tactics adopted by the abortionists so effective and how can it be successfully countered?

There is hope that the evil anti-life laws of the United States can be overthrown and that the anti-life movement which urges yet more of such legislation can be resisted. The pro-life movement in the United States has been working since 1973 to reverse the unjust decision of the Supreme Court which struck down state laws prohibiting procured abortion. It is true that the Supreme Court decision stands, but it is also true that the pro-life movement has grown ever stronger in the United States, that is, that more and more citizens, especially young citizens, have been awakened to the truth about the grave evil of procured abortion. 

There are a number of reasons why anti-life legislation and decisions of the courts have prevailed in the United States until the present. The forces of secularization have been and remain powerful, and are supported by the greater part of the mass media. There has been a gravely defective catechesis in the United States for several decades, which has left adults and young people ill-equipped to defend the truth of the moral law. There has also been the tendency for the Church to be timid regarding its solemn duty to defend the truth in the public forum, coupled with an erroneous interpretation of the non-establishment clause of the Constitution of the United States. The non-establishment clause prohibits an established religion or religion of the state in the USA, but it does not prohibit the Church from witnessing publicly to the truth. The false interpretation is usually called “the separation of Church and State” and would restrict the activity of the Church exclusively to ecclesiastical matters. These are some of the factors which have favored the anti-life and anti-family movements in the USA.

13. What should countries like Poland do in order not to repeat the mistakes of Western countries (legal acceptance for deviations, giving up the legal life protections, e.g. allowing abortion regardless of the age of the unborn baby)?

Adults, young people and children must be educated about the central moral questions of the day. Education regarding the natural law and its application to current issues is fundamental. For the Church, such education takes place through the Sunday homily, catechetical instruction, Catholic schools and universities, and educational events dedicated to deepening an understanding of the Christian witness demanded of us in our times. In addition to education, the media should be regularly used to present the teaching of the Church. We should not be hesitant to repeat the teaching of fundamental truths. Nothing today can be presumed in terms of moral education. Public manifestations in favor of sound legislation, in accord with the moral law, are also important. We need to demonstrate publicly the strength of our convictions.

14. Unless we truly love God, we will not be able to love our neighbours. How can our worship of God help us stand up in defence of human life?

According to the ancient wisdom of the Church, the law of worship is essentially connected to the law of belief and the law of practice. Christ comes into our midst through the Sacred Liturgy, especially the Sacraments of the Most Holy Eucharist and of Penance, to cleanse our hearts of sin and to inflame our hearts with His own love through the outpouring of the Holy Spirit. Only when we have a strong sense of the reality of the encounter with Christ in the Sacred Liturgy will we understand the truths of the faith and the moral life, and what they mean for our daily living. This sense is fostered by a manner of celebrating the Sacred Liturgy with our eyes fixed on Christ and not on ourselves. It should not surprise us that the period of post-Conciliar experimentation with the Sacred Liturgy, a period which was marked by so many liturgical abuses, was accompanied by a loss of faith and by moral decline. If the Sacred Liturgy is seen as a purely human activity, an invention of man, it will no longer be true communion with God and, therefore, will no longer nourish the faith and its practice in everyday living.


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Jonathon van Maren Jonathon van Maren Follow Jonathon

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Arguments don’t have genitals

Jonathon van Maren Jonathon van Maren Follow Jonathon
By Jonathon van Maren

“As soon as he grows his own uterus, he can have an opinion.”

That was a comment left on The Abortion Rights Coalition of Canada’s Facebook page by a woman who presumably opposes men speaking out against misogyny, domestic abuse, rape culture, and female genital mutilation as well. Apparently, you see, male genitals disqualify people from speaking out on various human rights issues deemed by women who define themselves by their uteruses while protesting angrily against being defined by their uteruses as “women’s issues.”

Which abortion isn’t, by the way. It’s a human rights issue.

To break it down really simply for our confused “feminist” friends: Human beings have human rights. Human rights begin when the human being begins, or we are simply choosing some random and arbitrary point at which human beings get their human rights. If we do not grant human rights to all human beings, inevitably some sub-set of human beings gets denied protection by another group with conflicting interests. In this case, of course, it is the abortion crowd, who want to be able to kill pre-born children in the womb whenever they want, for any reason they want.

Science tells us when human life begins. Pro-abortion dogma is at worst a cynical manoeuvre to sacrifice the lives of pre-born human beings for self-interest, and at best an outdated view that collapsed feebly under the weight of new discoveries in science and embryology. But the abortion cabal wants to preserve their bloody status quo at all costs, and so they make ludicrous claims about needing a uterus to qualify for a discussion on science and human rights.

Click "like" if you are PRO-LIFE!

In fact, feminists love it when men speak up on abortion, as long as we’re reading from their script, which is why the carnivorous feminists have such a support system among the Deadbeat Dads for Dead Babies set and the No Strings Attached Club.

Male abortion activists have even begun to complain about “forced fatherhood,” a new cultural injustice in which they are expected to bear some responsibility for fathering children with women they didn’t love enough to want to father children with, but did appreciate enough to use for sex. Casual fluid swaps, they whine, should not result in custody hearings.

This is not to mention a genuine social tragedy that has men forcing or pressuring women to have abortions or abandoning them when they discover that the woman is, indeed, pregnant.

Or the fact that abortion has assisted pimps, rapists, and misogynists in continuing the crimes of sex trafficking, sexual abuse, and sex-selection abortion.

And coming against these disgusting trends are thousands of men in the pro-life movement who believe that shared humanity means shared responsibility, and that when the weak and vulnerable are robbed of their rights, we have to stand up and speak out.

We are not at all convinced by the feminist argument that people should think with their reproductive organs or genitals. We think that the number of people currently doing that has perhaps contributed to the problems we face. And we refuse to be told that protecting the human rights of all human beings is “none of our business” and “outside of our interests.”

Arguments don’t have genitals, feminists. It’s a stupid argument trying to protect a bloody ideology.

Reprinted with permission from CCBR.


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Rachel Daly

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Gvmt strikes UK Catholic school admission policy that prefers Mass attendees

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By Rachel Daly

St. Joseph's Catholic Primary School in Epsom, England, was ordered to change its admissions policy after it was ruled discriminatory by the nation's Office of Schools Adjudicator, according to Your Local Guardian. St. Joseph's reportedly had been granting preferred acceptance to students whose families attended Mass at the affiliated church.

St. Joseph’s School is for students from age 4 to 11 and describes itself as “enjoy[ing] a high level of academic success.” The school furthermore places high priority on its Catholic identity, affirming on its homepage that “We place prayer and worship at the center of everything we do.”

The school states in its current admissions policy that it was "set up primarily to serve the Catholic community in St Joseph’s Parish" and that when the applicant pool exceeds 60 students, its criteria for prioritizing students includes "the strength of evidence of practice of the faith as demonstrated by the level of the family's Mass attendance on Sundays." 

Opponents of this policy reportedly argue that since donations are asked for at Mass, it could allow donation amounts to influence acceptance, and that forcing non-accepted local students to seek education elsewhere imposes a financial burden upon their families. 

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As Your Local Guardian reports, the adjudicators dismissed claims that donation amounts were affecting school acceptance, given that it is impossible to track donations. Nonetheless, the adjudicators maintained that "discrimination ... potentially arises from requiring attendance at the church rather than residency in the parish."

The Office of Schools Adjudicators, according to its website, is appointed by the United Kingdom’s Secretary of State of Education, to perform such functions as mediating disputes over school acceptances. The Office's ruling on St. Joseph's will require the school to release a revised admissions policy, which is expected in the next few days.

Reprinted with permission from the Cardinal Newman Society.


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Carolyn Moynihan

African women at risk of HIV, hostages to birth control

Carolyn Moynihan
By Carolyn Moynihan

Which should be the priority for a health organisation: preventing an incurable disease, or preventing a natural function that might have adverse physical consequences?

Preventing the disease, you would think. But the World Health Organisation would rather expose African women to HIV-AIDS than withdraw its support from a suspect method of birth control, arguing that childbirth is also risky in Africa. Riskier, apparently, than the said contraceptive. And at least one of WHO’s major partners agrees.

This is one of the stories you will not have read in coverage of the International AIDS Conference held in Melbourne last week, despite the fact that WHO made an announcement about it during the conference and the findings of a highly relevant study were presented there.

The story is this: there is increasing evidence that the method of contraception preferred by family planning organisations working in Africa (and elsewhere) facilitates the transmission of HIV. The method is the progesterone injection in the form of either DMPA (Depo Provera, the most common) or NET-En (Noristerat).

Millions of women in sub-Saharan Africa receive the injection every three months. The method overcomes problems of access. It can be given by nurses or health workers. A wife need not bother her husband for any special consideration; the teenage girl need not remember to take a pill.

But for 30 years evidence has been accumulating that, for all its “effectiveness” in controlling the number of births, the jab may also be very effective in increasing the number of people with HIV.

Three years ago at another AIDS conference in Rome, researchers who had analysed data from a number of previous studies delivered the disturbing news that injectables at least doubled the risk of infection with HIV for women and their male partners.

That study had its weaknesses but one of the experts present in Rome, Charles Morrison of FHI 360 (formerly Family Health International, a family planning organisation that also works in AIDS prevention), considered it a “good study” and subsequently led another meta-analysis that addressed some of the issues with previous research.

Last week at the Melbourne conference he presented the results. His team had re-analysed raw data on the contraceptive use of more than 37,000 women in 18 prospective observational studies. Of these women, 28 percent reported using DMPA, 8 percent NET-En, 19 percent a combined oral contraceptive pill, and 43 percent no form of hormonal contraception. A total of 1830 women had acquired HIV while in a study.

The analysis showed that both injectables raised the risk of infection by 50 percent:

Compared to non-users [of any hormonal contraceptive], women using DMPA had an elevated risk of infection (hazard ratio 1.56, 95% CI 1.31-1.86), as did women using NET-En (1.51, 95% CI 1.21-1.90). There was no increased risk for women using oral contraceptives.

Similarly, comparing women using injections with those using oral contraceptives, there was an elevated risk associated with DMPA (1.43, 95% CI 1.23-1.67) and NET-En (1.30, 95% CI 0.99-1.71).

Morrison also noted:

The results were consistent in several subgroup and sensitivity analyses. However, when only studies which were judged to be methodologically more reliable were included, the increased risk appeared smaller.

Morrison acknowledged that observational studies such as the FHI analysis depended on have their limitations. He is looking for funding to conduct a randomised controlled study – something that, after 30 years of suspicions and evidence, still has not been done.

So what is his advice to the birth control industry? Stop using this stuff in regions with a high prevalence of HIV until we are sure that we are not feeding an epidemic?

No.

One reason is that FHI is at least as interested in contraception as it is in HIV prevention. Though its website reflects a broad range of development activities, its core business is integrating birth control programmes with HIV prevention. The WHO – one of its partners -- describes the US based, 83 percent US government funded non-profit as “a global health and development organization working on family planning, reproductive health and HIV/AIDS.”

Another reason is that FHI 360 has a vital stake in precisely the kind of contraceptives that are under suspicion. Its annual report refers to:

Our trailblazing work in contraceptive research and development continues, as we develop and introduce high-quality and affordable long-acting contraceptives for women in low-income countries. Research is under way to develop a new biodegradable contraceptive implant that would eliminate the need for removal services. We are also working with partners to develop an injectable contraceptive that would last for up to six months. Currently available injectables require reinjections monthly or quarterly, which can be challenging where health services are limited.

That project is funded by the Bill and Melinda Gates Foundation and USAID.

So Morrison did not argue in Melbourne for restrictions on the use of injectables, and neither did the WHO, whose representative at the conference outlined the UN body’s new guidelines on contraception and HIV. Mary Lyn Gaffield said a review of studies up to – but not including Morrison’s – did not warrant a change to WHO’s policy that DMPA and NET-En should be available, without restriction, in areas of high HIV prevalence.

The most WHO will advise is that women should be informed of the risk:

“Women at high risk of HIV infection should be informed that progestogen-only injectables may or may not increase their risk of HIV acquisition. Women and couples at high risk of HIV acquisition considering progestogen-only injectables should also be informed about and have access to HIV preventive measures, including male and female condoms.”

Condoms? How do they defend such cynicism? By equating the risk of HIV with the risks of motherhood – complications of pregnancy or childbirth, maternal death and the effect on infants... And yet motherhood remains risky precisely because 90 percent of the world’s effort is going into contraception!

Seven years ago a meeting of technical experts convened by WHO to study the injectables-HIV link showed the reproductive health establishment worried about that issue, to be sure, but also concerned that funding was flowing disproportionately to HIV-AIDS programmes, setting back the cause of birth control. The integration of family planning and HIV prevention spearheaded by FHI 360 looks like they have found an answer to that problem.

Whether African women are any better off is very doubtful. They remain pawns in a game that is, above all, about controlling their fertility. They and their partners are encouraged to take risks with their health, if not their lives, while researchers scout for funds to do the definitive study.

FHI had an income of $674 million last year, most of it from the US government. Couldn’t it give Charles Morrison the money to do his research today?

Reprinted with permission from Mercatornet.com.


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