Center for Health and Gender Equity Releases Ten-Point Plan of Action for U.S. Global Leadership on Women and HIV

5/14/2003

From: Jodi L. Jacobson of the Center for Health and Gender Equity, 301-270-1182 or 301-257-7897 (cell); e-mail: jjacobson@genderhealth.org WASHINGTON, May 14 -- With the Senate poised to vote this week on the United States Leadership Against HIV/AIDS Tuberculosis, and Malaria Act, the D.C.-based Center for Health and Gender Equity (CHANGE) released a Ten-Point Plan of action for U.S. funding to reduce the vulnerability of women and girls to HIV and AIDS, and called on the Congress to reject ideological agendas in favor of saving women's lives. A Ten-Point Plan for Leadership on Women and HIV "Heterosexual sex is the primary factor in HIV transmission worldwide, and women and girls now make up more than 50 percent of those infected with HIV worldwide, and more than 58 percent of those in sub-Saharan Africa," noted Jodi L. Jacobson, executive director of CHANGE. Moreover, women's risks of infection increase the more likely they are to live in poverty or to face racial or ethnic discrimination. In the United States, for example, African American women accounted for over two-thirds of all new infections among women in 2001. High rates of sexual violence and coercion by husbands and intimate partners worldwide, and discriminatory cultural practices leave even monogamous married women increasingly vulnerable to both unsafe sex and infection due to the behavior of their husbands and intimate partners. Stigma and discrimination and lack of information heavily impede women's access to essential services. Poverty and social dislocation have led increasing numbers of women and girls to engage in prostitution and in the informal trading of sex for food, housing, and other basic needs. Women often are unable to negotiate the timing and frequency of sex. "For millions of women worldwide," notes Jacobson, "abstinence is not an option." Reducing the vulnerability of women and girls to HIV infection is critical to reducing the toll of the HIV epidemic, to stemming the rapid increase in AIDS orphans, and to maintaining the viability of families and communities. "To achieve its goals, the United States should first allocate at least $3.5 billion to global AIDS funding for 2004," notes Jacobson. "Adequate funding is urgently needed to address this global public health crisis." "But our success will depend both on the amount of money we spend and how we spend it," Jacobson asserted. "The United States should commit to a Ten-Point Plan of action on women and HIV by providing simultaneous and unequivocal support for: -- Comprehensive HIV prevention strategies. -- Expanded access to integrated health services. -- Dramatically increased access to the female condom. -- Increased funding for research and development of vaginal microbicides. -- Strategies to reduce gender violence, sexual coercion, and harmful traditional practices. -- Strategies to reduce stigma and discrimination against women with HIV. -- Strategies to ensure equitable access to treatment and care for all women. -- Strategies to promote economic and social empowerment. -- Strong and sustained support for the Global Fund for AIDS, Tuberculosis, and Malaria. -- Strategies to alleviate poverty and debt. The Ten-Point Plan-the full text of which is available from CHANGE--outlines the basic strategies needed to address the specific vulnerabilities of women and girls. "Women and girls need programs geared toward their specific needs," notes Jacobson, " and which address, among other things, gender-based violence, increased access to female controlled prevention methods, and equitable access to treatment and care." Comprehensive strategies to prevent HIV infection are successful precisely because they meet the widest range of needs and are most able to respond to local circumstances. And efforts to reduce stigma and discrimination encourage people to seek out voluntary counseling and testing free of fear of violence or reprisal. "In addition, increased support for the Global Fund and efforts to alleviate poverty and reduce debt are also women's issues," asserted Jacobson. The Global Fund provides critical support to those countries and regions with the greatest need and proposals are prepared through a process that involves broad participation from government and civil society. "Programs supported by the Global Fund are more directly accountable to the constituencies they serve in the countries in which they operate," notes Jacobson, "and accountability, transparency, and participatory mechanisms for setting priorities are critical to meeting the needs of women and girls and marginalized populations. Pending Legislation Fails to Address Core Issues The Senate is expected to vote this week on the global AIDS authorization bill, known as the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003. At the urging of the White House, Senate Majority Leader Bill Frist has decided to offer the same bill passed by the House of Representatives May 1, 2003, rather than a substitute bill based on one he co-sponsored last year. "But rather than promoting the most effective response to the global epidemic, the bill now supported by Frist will impede efforts to reach the most vulnerable groups," Jacobson said. "This bill contains numerous ideologically-driven restrictions that will undermine sound prevention strategies, limit individuals' access to the full range of HIV prevention information and restrict the activities of organizations working with women in prostitution, among other things." In addition, the bill authorizes only a fraction of the money required to fulfill the United States "fair share" contribution to the Global Fund for AIDS, Tuberculosis, and Malaria. For example, a provision in the bill will deny U.S. funding to organizations that do not have a policy explicitly opposing prostitution. The organizations with the most effective programs have a sophisticated understanding of the social and personal dynamics underlying prostitution and some operate in countries where prostitution -- as opposed to exploitation and pimping -- is legal. These groups -- which work with prostitutes to encourage consistent condom use, improve health, and provide education and training -- do not take positions stating unequivocal opposition to prostitution because doing so would cause them to lose credibility with the populations they seek to serve, and also further feed the stigma and discrimination that makes it so difficult for prostitutes to secure their own rights and to leave prostitution in the first place. Yet this bill will refuse funding to such groups, despite their proven success in assisting women in prostitution to avoid infection, lead healthier lives, and develop the very skills needed to leave prostitution permanently. "This is a purely ideologically driven agenda that will inevitably lead to increased infection among prostitutes, their clients, and ultimately the general population," notes Jacobson. "Moreover, it is self defeating because it will lead to diminished economic alternatives for women in prostitution resulting from reduced funding for organizations that provide them with education, alternative skills and job training, and micro-credit funds." The Senate bill, which is strongly supported by the White House, is riddled with these and other ideologically driven amendments, including those that limit the scope and content of proven prevention strategies, curtail informed choice, and seek to undermine effective and consistent condom use. "President Bush is trying to have it both ways," asserts Jacobson. "He wants the American people and the world to think of him as compassionate, but his greatest passion appears to be catering to the demands of the far right and replacing science and best practices with ideology." "Ultimately," says Jacobson, "the increasing intrusion of religious and political ideologies in HIV prevention programs represents an ominous threat to the lives of people everywhere, and will have the greatest impact on women and vulnerable populations." The Republican majority is now attempting to force a vote on the bill without amendments, although several Democrats are in fact ready to offer amendments to address the most egregious aspects of this bill. "If the President and the Republican majority really want to fight the HIV epidemic, then they should adopt the Ten-Point Plan for combating HIV among women and girls, allocate at least $3.5 billion dollars to the war on HIV, and ensure that full support is given to effective institutions such as the Global Fund." EDITORS: The complete 10-Point Plan of Action is available at http://www.genderhealth.org.