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Let’s ‘C’
by William Fisher
February 26, 2005

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Let’s C.

C is for Cat? Car? Connecticut?

No. Not even close.


You’re getting warmer. Hint: You wear it.

Aha, the dreaded “C-word”: CONDOM!

The mere utterance is likely to lead to another battle in the culture wars.

But there: I’ve said it.

Which is more than the Bush Administration is prepared to do.

That’s what I discovered while surfing another bunch of Cs -- the CDC: Centers for Disease Control and Prevention.

I was Googling for some pre-travel health advice, and stumbled across something called “The Yellow Book”, which the CDC website tells me contains information for international travelers. It says its “Travelers' Health” section “is one of the CDC's most-visited websites…considered by many to be the gold standard on travel information”. I learn it has been “expanded to offer new information on scuba diving safety, high altitude travel, travelers with special needs, and traveling with children.”

So I click and navigate to the site, where I am diverted by the words “Sexually Transmitted Diseases.” There, “Travelers Health” offers the following advice to people infected with HIV:

“The importance of safe sex practices should be emphasized to the HIV-infected traveler to prevent other sexually transmitted diseases, avoid transmission of HIV to others, and prevent acquisition of different HIV strains that may limit therapeutic options (e.g. non-nucleoside reverse transcriptase inhibitors are not active against HIV-2). Bringing a personal supply of condoms may be advisable, as the quality and availability of condoms can be unreliable in parts of the developing world.” (italics mine)

But then I realize I’m reading the 2001-2002 edition, and learn that “The Yellow Book” is updated every two years.

So in “search within results” I type “2003-2004.”

Now, I’m in the most up-to-date spot.

I again navigate to “Sexually Transmitted Diseases,” where I find the following advice for HIV-infected travelers:

“Travel, particularly to developing countries, can carry substantial risks for exposure to opportunistic pathogens…especially those who are severely immunosuppressed. Discussing the itinerary with a health-care provider may identify area- and activity-specific risks that can be addressed. Patients should identify sources of medical care in the planned destination before departure and seek medical attention promptly when ill.”

It continues: “Because antiretroviral medications are not available in many parts of the world, patients should bring an adequate supply of their medications, along with copies of prescriptions. Attention should be given to refrigeration of medications. For extended visits, travelers should consult with their providers in advance regarding a plan for maintaining appropriate medical follow-up and supplies of medications. Avoid changes in the medication regimen shortly before travel, to ensure that no side effects or complications of a new regimen occur while traveling.”

But I have the sneaky feeling that there’s something wrong with this picture.

Aha! The dreaded “C-word” has disappeared. No more CONDOMS.

Why am I not surprised? Because what I’m being given to read follows a familiar pattern of the Bush Administration. The CDC website has been changed to push conservative ideology.

It’s not the first time either. For example, the President has consistently supported the view that sex education should teach “abstinence only” and not include information on other ways to avoid sexually transmitted diseases and pregnancy. As a result, a CDC initiative called “Programs That Work” identified sex education programs that have been found to be effective in scientific studies and provided this information through its website. All five “Programs That Work” provided comprehensive sex education to teenagers, and none were “abstinence-only”. CDC has now ended this initiative and erased information about these proven sex education programs from its website.

Information about condom use and efficacy was also deleted from the CDC website. The CDC replaced a comprehensive fact sheet on condoms with one emphasizing condom failure rates and the effectiveness of abstinence.

And the President’s “just say no” agenda also extends overseas. He has pledged $15 billion in an “Emergency Plan for AIDS Relief,” designed to provide support to the 15 African, Caribbean, and Southeast Asian nations most affected by HIV/Aids. But providing condoms is not part of the program. The Bush Administration has also renewed a ban on providing aid funds to overseas groups that help pregnant women, if they so much as discuss abortion.

Still, I’m disappointed. The website of the Centers for Disease Control and Prevention (CDC) is visited by millions of people looking for the most cutting edge information and advice. It’s a pity that the Bush Administration continues to delete science and substitute information designed to avoid offending his evangelical base.

Well, it’s just your tax dollars at work!

William Fisher has managed economic development programs in the Middle East, Africa, Latin America and Asia for the U.S. State Department and the U.S. Agency for International Development. He served in the administration of President John F. Kennedy. He can be reached through his blog at:

Other Articles by William Fisher

* Is George Bush Listening?
* What First Amendment?
* The Prince of Wonderland
* David and Goliath
* The Light is Going Out
* The Moral High Ground?
* Where Will It End?
* The Government We Deserve?