Edward C. Green

Last updated

Edward C. (Ted) Green (born 1944) is an American medical anthropologist working in public health and development. He was a senior research scientist at the Harvard School of Public Health [1] and served as senior research scientist at the Harvard Center for Population and Development Studies for eight years, the last three years as director of the AIDS Prevention Project. He was later affiliated with the Department of Population and Reproductive Health at Johns Hopkins University (2011–14) and the George Washington University as research professor (since 2015). He was appointed to serve as a member of the Presidential Advisory Council on HIV/AIDS (2003–2007), [2] and served on the Office of AIDS Research Advisory Council for the National Institutes of Health (2003–2006). Green serves on the board of AIDS.org [3] [4] and the Bonobo Conservation Initiative. [5] and Medical Care Development.

Contents

Green has worked for more than 40 years in international development. [6] Much of his work since the latter 1980s has been related to 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 adviser to the governments of both Mozambique and Eswatini (Swaziland.) In March 2009 Green's comments were widely quoted in the media when he publicly agreed with Pope Benedict XVI's claim that the distribution of condoms was not helping and might be aggravating the problem of the spread of AIDS in southern and east 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 post-doctoral fellowships at Vanderbilt University (1978–79), Harvard University (2001–2002), and visiting lectureships at the University of Kentucky and West Virginia University.

He taught public health and anthropology at both Boston University and George Washington University for a short time (1988–89). Since 1981, Green has held various research positions in social science and consultancy roles in many countries in Africa, Asia and eastern Europe. Between 2002 and 2010, he continued these research projects while serving as a Senior Research Scientist at Harvard University's School of Public Health. He was the 2011 Elizabeth Eddy Visiting Professor of Anthropology at the University of Florida. He is the author of 9 books and over 500 scientific articles, book chapters, and commissioned reports. [7]

For his dissertation ethnographic research in the early 1970s, Green spent two years living with the Matawai [8] Maroons of Suriname, descendants of escaped African slaves. They are one of five groups of Maroons (Saramaka) in Suriname whose descendants have lived for more than two centuries in the Amazon rain forest.

Research on indigenous healers

Green is a pioneer in anthropological research on indigenous healers. He is one of the first to develop public health programs based on collaboration between African indigenous healers and western-style 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. He has written the following three books on these topics: Practicing Development Anthropology (1986), [9] AIDS And STDs in Africa: Bridging the Gap Between Traditional Healing and Modern Medicine (1994), [10] and Indigenous Theories of Contagious Disease (1999). [11] Regarding the last, Prof. Charles Good wrote in Ethnology and reprinted on Amazon.com, "Green ranks among the foremost practitioners of applied medical anthropology who work in developing societies. His focused contract work and extensive published scholarship reflect a strong commitment to separating myth from reality in public health and medical pluralism."

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, HIV counseling and testing as prevention strategies. He argued that epidemiological evidence showed it was behavioral change leading to 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. He also noted evidence of changes in sexual behavior and HIV-prevention success in other countries. Green summarizes 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." [12]

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." [13]

Controversy over Pope Benedict and distribution of condoms

In March 2009, Green generated controversy when he supported a remark from Pope Benedict XVI about the role of promoting use of condoms among sexually active persons to prevent AIDS in Africa. In a mid-flight news conference en 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." [14] [15]

Green commented on this with a March 29, 2009, editorial in The Washington Post ("The Pope May Be Right"). [16] 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 avoid using 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 medical journals British Medical Journal and The Lancet, by Cassell et al. (2006) [17] and Richens et al. (2000) [18] 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 gave an extended interview with the BBC Northern Ireland on March 29, 2009, to expand on his comments. [19] In this interview, he said that, while there was no proof of a causal connection between condom usage and a decrease or increase in HIV prevalence at the population level, 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. Members of group that had the intensive condom promotion actually was found to have a greater number of sex partners. [20] 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." [19] 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, as you say, the ABC strategy: Abstinence, be faithful, use a condom." [19]

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." [19]

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." [21]

Green updated his argument that sexual behavior needs to be addressed in AIDS prevention in two later books: Broken Promises: How the AIDS Establishment Has Betrayed the Developing World, and, with Allison Herling Ruark, AIDS, Behavior, and Culture: Understanding Evidence-Based Prevention, both published in 2011. On the back cover of the latter book, Africanist scholar Prof. John Janzen wrote "(this book) should be on every Africanist medical anthropology reading list".

New Paradigm Research Fund

Upon the conclusion of the Harvard AIDS Prevention Research Project grant in April 2010, Dr. Green established the New Paradigm Fund to identify, develop and share superior models for addressing the problems associated with AIDS, addiction, rain forest and primate conservation, and aspects of poverty associated with stateless and minority peoples. The New Paradigm Fund collaborated with the Ubuntu Institute Ubuntu Institute – Home working toward the prevention of HIV/AIDS, empowerment of women, eradication of poverty and providing access to education in Africa through the use of African cultural values, heritage and indigenous knowledge systems.

Smithsonian Archive

In 2016, with funding from the Wenner Gren Foundation, the “Edward C. Green papers, circa 1970-2016” were processed through the National Anthropological Archives at the Smithsonian Institution. The organized and indexed collection includes field notes, personal observations and reflections, photographs, audio recordings, and other materials. Additional content is currently under review for inclusion in the archive.

An extensive directory of the materials Edward C. Green papers | Collection: NAA.2016-31 is available online. In addition, sound recordings, including music and field interviews among the Matawai Maroons (descendants of Africa slaves who escaped from the coastal plantations in the 17-18th centuries) of Suriname, have been digitized and can be streamed online. Other materials are available for review by appointment at the National Anthropological Archives.

Dr. Green also released a memoir in 2023 (On the Fringe: Confessions of a Maverick Anthropologist).

Board memberships

Bibliography

Books

Congressional testimony

Music

Guitarist in rock band in the 1960s in Seoul, Korea (The Silvertones). Fiddler and multi-instrumentalist in Appalachian string bands in the 1970s (Sweetwater String Band, Washington, DC, [mentioned in the Greater Washington Folklore Society March 1979 newsletter, p. 3: [28] ], and the Wild Turkey String Band, Morgantown, WV [an article on the band appears in the July 1977 issue of "Goldenseal," Vol 3 #3, p 55-58; See Author index page,under Charles Bell; [29] also mentioned in the book "Mountaineer Jamboree: Country Music in West Virginia" (1984) by Ivan M. Tribe, p. 161.] ).

Related Research Articles

<span class="mw-page-title-main">Safe sex</span> Ways to reduce the risk of acquiring STIs

Safe sex is sexual activity using methods or contraceptive devices to reduce the risk of transmitting or acquiring sexually transmitted infections (STIs), especially HIV. "Safe sex" is also sometimes referred to as safer sex or protected sex to indicate that some safe sex practices do not eliminate STI risks. It is also sometimes used colloquially to describe methods aimed at preventing pregnancy that may or may not also lower STI risks.

<span class="mw-page-title-main">HIV/AIDS in the United States</span> HIV/AIDS epidemic in the United States

The AIDS epidemic, caused by HIV, found its way to the United States between the 1970s and 1980s, but was first noticed after doctors discovered clusters of Kaposi's sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981. Treatment of HIV/AIDS is primarily via the use of multiple antiretroviral drugs, and education programs to help people avoid infection.

<span class="mw-page-title-main">HIV/AIDS in Africa</span> HIV/AIDS in Africa

HIV/AIDS originated in the late 20th century and has been a major public health concern and cause of death in many countries. AIDS rates varies significantly between countries, though the majority of cases are concentrated in Southern Africa. Although the continent is home to about 15.2 percent of the world's population, more than two-thirds of the total population infected worldwide – some 35 million people – were Africans, of whom c.1 million have already died. Eastern and Southern Africa alone accounted for an estimate of 60 percent of all people living with HIV and 100 percent of all AIDS deaths in 2011. The countries of Eastern and Southern Africa are most affected, AIDS has raised death rates and lowered life expectancy among adults between the ages of 20 and 49 by about twenty years. Furthermore, the life expectancy in many parts of Africa is declining, largely as a result of the HIV/AIDS epidemic with life-expectancy in some countries reaching as low as thirty-nine years.

Men who have sex with men (MSM) refers to all men who engage in sexual activity with other men, regardless of sexual identity. The term was created by epidemiologists in the 1990s, to better study and communicate the spread of sexually transmitted infections such as HIV/AIDS between all sexually active males, not strictly those identifying as gay or bisexual, but also for example male prostitutes. The term is often used in medical literature and social research to describe such men as a group. It does not describe any specific kind of sexual activity, and which activities are covered by the term depends on context. An alternative term, males who have sex with males is sometimes considered more accurate in cases where those described may not be legal adults.

<span class="mw-page-title-main">Presidential Advisory Council on HIV/AIDS</span>

The Presidential Advisory Council on HIV/AIDS (PACHA) advises the White House and the Secretary of Health and Human Services on the US government's response to the AIDS epidemic. The commission was formed by President Bill Clinton in 1995 and each president since has renewed the council's charter.

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 a combination of "risk avoidance" and harm reduction which modifies the approach of abstinence-only sex education by including education about the value of partner reduction safe sex and birth control methods. Abstinence-only sex education is strictly to promote the sexual abstinence until marriage, and does not teach about safe sex or contraceptives. The abstinence-based sex education program is meant to stress abstinence and include information on safe sex practices. In general terms, this strategy of sex education is a compromise between abstinence-only education and comprehensive sex education. The ABC approach was developed in response to the growing epidemic of HIV/AIDS in Africa, and to prevent the spread of other sexually transmitted diseases. This approach has been credited by some with the falling numbers of those infected with AIDS in Uganda, Kenya and Zimbabwe, among others. From 1990 to 2001 the percentage of Ugandans living with AIDS fell from 15% to between 5 and 6%. This fall is believed to result from the employment of the ABC approach, especially reduction in the number of sex partners, called "Zero-Grazing" in Uganda.

Condoms, needles, and negotiation, also known as the CNN approach, is a harm reduction approach to reducing the rate of transmission of sexually transmitted infections such as HIV/AIDS by:

The very high rate of human immunodeficiency virus infection experienced in Uganda during the 1980s and early 1990s created an urgent need for people to know their HIV status. The only option available to them was offered by the National Blood Transfusion Service, which carries out routine HIV tests on all the blood that is donated for transfusion purposes. The great need for testing and counseling resulted in a group of local non-governmental organizations such as The AIDS Support Organisation, Uganda Red Cross, Nsambya Home Care, the National Blood Bank, the Uganda Virus Research Institute together with the Ministry of Health establishing the AIDS Information Centre in 1990. This organization worked to provide HIV testing and counseling services with the knowledge and consent of the client involved.

<span class="mw-page-title-main">The Mpowerment Project</span>

The Mpowerment Project is a model community building and HIV prevention program that has been designed specifically to address the needs of young adult gay/bisexual men ages 18 – 29. It is the first documented HIV prevention intervention for young gay/bisexual men to succeed in reducing sexual risk behavior. The program has been developed, evaluated and continually refined by prominent behavioral scientists from the University of California, San Francisco's Center for AIDS Prevention Studies, the largest research center in the world dedicated to social, behavioral and policy science approaches to HIV.

HIV/AIDS in Eswatini was first reported in 1986 but has since reached epidemic proportions. As of 2016, Eswatini had the highest prevalence of HIV among adults aged 15 to 49 in the world (27.2%).

<span class="mw-page-title-main">HIV/AIDS in Canada</span>

HIV/AIDS was first detected in Canada in 1982. In 2018, there were approximately 62,050 people living with HIV/AIDS in Canada. It was estimated that 8,300 people were living with undiagnosed HIV in 2018. Mortality has decreased due to medical advances against HIV/AIDS, especially highly active antiretroviral therapy (HAART).

The Catholic Church is a major provider of medical care to HIV/AIDS patients. Much of its work takes place in developing countries, although it has also had a presence in the global north. Its opposition to condoms, despite their effectiveness in preventing the spread of HIV, has invited criticism from public health officials and anti-AIDS activists.

The relationship between religion and HIV/AIDS has been an ongoing one, since the advent of the pandemic. Many faith communities have participated in raising awareness about HIV/AIDS, offering free treatment, as well as promoting HIV/AIDS testing and preventative measures. Christian denominations, such as Lutheranism and Methodism, have advocated for the observance of World AIDS Day to educate their congregations about the disease. Some Churches run voluntary blood testing camps and counselling centers to diagnose and help those affected by HIV/AIDS.

HIV prevention refers to practices that aim to prevent the spread of the human immunodeficiency virus (HIV). HIV prevention practices may be undertaken by individuals to protect their own health and the health of those in their community, or may be instituted by governments and community-based organizations as public health policies.

<span class="mw-page-title-main">HIV/AIDS in South African townships</span>

South Africa's HIV/AIDS epidemic, which is among the most severe in the world, is concentrated in its townships, where many black South Africans live due to the lingering effects of the Group Areas Act.

Since reports of emergence and spread of the human immunodeficiency virus (HIV) in the United States between the 1970s and 1980s, the HIV/AIDS epidemic has frequently been linked to gay, bisexual, and other men who have sex with men (MSM) by epidemiologists and medical professionals. It was first noticed after doctors discovered clusters of Kaposi's sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981. The first official report on the virus was published by the Center for Disease Control (CDC) on June 5, 1981, and detailed the cases of five young gay men who were hospitalized with serious infections. A month later, The New York Times reported that 41 homosexuals had been diagnosed with Kaposi's sarcoma, and eight had died less than 24 months after the diagnosis was made.

Nancy Romero-Daza is a medical anthropologist with an appointment as associate professor at the University of South Florida. From 1994 to 1998, she worked for the Hispanic Health Council in Hartford, Connecticut in several capacities, including senior research scientist. Her work covers many different areas of medical anthropology, including HIV/AIDS, women's health, health problems in the inner city, infant mortality, drug abuse, syndemics, and commercial sex. Romero-Daza's geographical areas of interest include Costa Rica, Southern Africa, and the United States.

<span class="mw-page-title-main">Lisa Bowleg</span> American social psychologist

Lisa Bowleg is an applied social psychologist known for conducting research on intersectionality in social and behavioral science and the relationship between social-contextual factors and stress, resilience, and HIV risk in Black communities.

<span class="mw-page-title-main">Puppets Against AIDS</span>

In the late 1980s, the African Research and Educational Puppetry Program (AREPP) founded "Puppets Against AIDS", a traveling puppet show that visited African villages and cities to encourage audience members to use condoms to prevent HIV/AIDS transmission.

Traditional and Modern Health Practitioners Together against AIDS(THETA) is a non-government organization in Uganda that promotes collaboration between traditional healers and biomedical practitioners to prevent the spread of HIV/AIDS and provide care for HIV-positive patients. It was seen to be the first significant effort in Africa to involve traditional healers in the efforts against HIV/AIDS.

References

  1. "Researcher Directory". Harvard University. Archived from the original on November 19, 2012. Retrieved April 6, 2009.
  2. "Teaching the ABCs". The Washington Times . August 8, 2003.
  3. "AIDS Information, Education, Action, Awareness - HIV, AIDS Facts". www.AIDS.org. Retrieved May 19, 2017.
  4. "AIDS Information, Education, Action, Awareness | AIDS.org Leadership". Aids.org. Archived from the original on August 25, 2010. Retrieved July 6, 2012.
  5. ":: Bonobo Conservation Initiative :: What Is The Bonobo Initiative?". Bonobo.org. Archived from the original on October 1, 2011. Retrieved July 6, 2012.
  6. "Edward C Green CV" (PDF). harvardaidsprp.org. Archived from the original on January 6, 2009.
  7. "edward green anthropology". Google Scholar. Retrieved May 19, 2017.
  8. "People in between: the Matawai Maroons of Suriname" (PDF). dbnl.org.
  9. Green, Edward C. (December 11, 1986). Practicing Development Anthropology. Westview Press. ISBN   978-0813372563.
  10. Green, Edward C. (November 3, 1994). Aids And Stds In Africa: Bridging The Gap Between Traditional Healing And Modern Medicine. Westview Press. ISBN   978-0813378473.
  11. Green, Edward Crocker (1999). Indigenous Theories of Contagious Disease. Rowman Altamira. ISBN   9780761989417.
  12. Green, Edward Crocker (2003). Rethinking AIDS Prevention: Learning from Successes in Developing Countries. Greenwood Publishing Group. inside cover. ISBN   978-0-86569-316-6.
  13. Glanz, Morton. "Review of Rethinking AIDS Prevention: Learning from Successes in Developing Countries," JAMA 293(17): 2161–2162.
  14. Kathryn Jean Lopez (March 19, 2009). "From Saint Peter's Square to Harvard Square". National Review . Archived from the original on March 26, 2009. Retrieved April 3, 2009.
  15. John-Henry Westen (March 20, 2009). "Harvard AIDS Expert: Pope Correct on Condom Distribution". Catholic Online. Archived from the original on October 11, 2012. Retrieved April 3, 2009.
  16. Edward C. Green (March 29, 2009). "The Pope May Be Right". The Washington Post . Retrieved April 3, 2009.
  17. Cassell, Michael M.; Halperin, Daniel T.; Shelton, James D.; Stanton, David (2006). "Risk compensation: The Achilles' heel of innovations in HIV prevention?". BMJ. 332 (7541): 605–607. doi:10.1136/bmj.332.7541.605. PMC   1397752 . PMID   16528088.
  18. Richens, John; Imrie, John; Copas, Andrew (2000). "Condoms and seat belts: The parallels and the lessons". The Lancet. 355 (9201): 400–403. doi:10.1016/S0140-6736(99)09109-6. PMID   10665571. S2CID   17687217.
  19. 1 2 3 4 William Crawley (March 29, 2009). "The pope was right about condoms, says Harvard HIV expert". BBC Will and Testament. British Broadcasting Corporation.
  20. Kajubi, Phoebe; Kamya, Moses R.; Kamya, Sarah; Chen, Sanny; McFarland, Willi; Hearst, Norman (2005). "Increasing Condom Use Without Reducing HIV Risk". Journal of Acquired Immune Deficiency Syndromes. 40 (1): 77–82. doi: 10.1097/01.qai.0000157391.63127.b2 . PMID   16123686. S2CID   20174322.
  21. William Crawley (April 1, 2009). "Harvard and the Aids Prevention Research Project". BBC Will and Testament. British Broadcasting Corporation . Retrieved April 3, 2009.
  22. Green, Edward C. (2023). On the Fringe: Confessions of a Maverick Anthropologist. Black Rose Publishing. ISBN   978-1685132965.
  23. Green, Edward C.; Ruark, Allison Herling (January 3, 2011). AIDS, Behavior, and Culture: Understanding Evidence-Based Prevention. Routledge. ISBN   978-1598744798.
  24. 1 2 Green, Edward C. (February 15, 2011). Broken Promises: How the AIDS Establishment Has Betrayed the Developing World. Polipoint Press. ISBN   978-1936227006.
  25. "Archived copy" (PDF). Archived from the original (PDF) on December 7, 2014. Retrieved January 6, 2015.{{cite web}}: CS1 maint: archived copy as title (link)
  26. Senate Archived April 4, 2011, at the Wayback Machine .
  27. "Prepared Witness Testimony: Green, Edward C". Archived from the original on December 27, 2006. Retrieved January 6, 2015.
  28. Newsletter fsgw.org [ dead link ]
  29. "Goldenseal Author Index". Archived from the original on October 22, 2016. Retrieved July 4, 2017.