Women's Rights Equals Women's Lives - from Mexico

Women’s rights and gender based violence (GBV)seemed to be everywhere at Mexico 2008 – from the March to Zocolo square to the fashion range produced by sex workers as an income generation enterprise to the almost dazzling range of sessions on gender equality, gender based violence, sexual and reproductive health, women on the margins and stigma and discrimination. We heard that 61% of all cases of HIV in sub-Saharan Africa are still in women and that violence and HIV go hand in hand as parallel epidemics feeding off one another. There were calls for zero tolerance to gender based violence: as one speaker put it “when the world denies women their most basic human rights, the world is vulnerable to HIV”.

Sessions on rape as a method of war in the DRC, Zimbabwe, Darfur, Rwanda and more recently in Kenya discussed some good NGO responses but ultimately pointed to the failure of UN Security Council Resolution 1325 and more recently UN Resolution 1820 to protect women and girls. Paula Donovan of “AIDS Free World”, a US based advocacy group, was visibly outraged by the appalling levels of violence in Bukavu in eastern DRC and the corresponding levels of impunity afforded to perpetrators of these crimes. She called the recently signed Peace Accord “a triumph for impunity and a trading of women for peace” and ended by saying that the sad reality is that none of what has been agreed, declared or committed to has had an effect on a single girl in the Congo.

I went along to Paul Spiegel’s talk on HIV rates in conflict settings knowing that his findings are controversial and while scientific, seem to defy logic. His study shows that there is no additional risk of contracting HIV in conflict despite the appalling levels of sexual and gender based violence in these situations. There are a number of possible reasons for this but none of it takes away from the need to provide full services and protection to women and men who suffer such a basic violation of their rights. Speakers from the floor commented that if the international community is having difficulty understanding the findings then surely there’s a danger that the press will misinterpret them – which is a fair point.

Violence against women of course is not confined to conflict. Sex workers spoke of discrimination of women and abuse suffered at the hands of the authorities in Cambodia, where police are rounding up women in rehabilitation centres. They suffer many violations of their rights in these settings – cut off from medication and services and often subject to rape by police and prison officers. This story is repeated in many countries and points to the need for legislative change, adequate services and for groups to self-organise and be part of the solution. The criminalisation of transmitting HIV knowingly is also worrying – 15 African counties, including Sierre Leone and Zimbabwe, have enacted laws which extend to a woman who might pass the virus onto her child. Edwin Cameron from South Africa spoke of how this legislation will hit women hardest and far from protecting them will victimise and oppress them further.

Speakers also talked of the shared risk of gender based violence and HIV and the need to programme these areas together. The “Image Project” from the London School of Hygiene and Tropical Medicine linked a microfinance programme with one targeted at addressing HIV and GBV. The programme has been very successful at empowering women, reducing their risk to HIV and gender based violence and reducing poverty levels and is about to be scaled up. It’s worth watching.

The academic presentations were fascinating but the women themselves could not fail to move you with their courage, resilience and commitment. We heard from a woman in Rwanda who had been raped in the genocide and went on to set up a peer support group, from HIV positive women in Kenya who organised themselves in camps to ensure that vulnerable groups received HIV medication and from the strong women living with HIV who wanted to get on with their lives, to invest in relationships and have children. A young woman from Argentina spoke of her desire to have a baby and the stigma she faced when she shared this news with family and friends. A man in the audience queried why there wasn’t a man on the panel and commented that men struggle with the same issues as potential fathers – perhaps something for AIDS 2010?

There is little to report in the line of new methods to protect women. The microbicide and vaccine trials have failed. Male circumcision may have a long term protective effect for women as the number of infections decreases in men but does not have an immediate benefit for women. There is some concern that it does not require men to change their behaviour in a way that will support a woman to have greater control over her sexual health. The combination prevention that has been pushed so strongly at this conference is perhaps the best hope for women until the science catches up with their daily reality.
Posted by Finola Finnan

Responding to HIV and AIDS, International Women's March, Mexico City

Men and Women take to the streets in Mexico to demand

All Rights for All Women!

Some of the speakers that addressed the crowd

gathered in the Consitutional Square

Annie Lennox delighting the protesters with her Spanish

Stephanie Rapper from Austalia showing

youth leadership

Nyaradzai Gumbonzvanda from Zimbabwe

calling for all rights for all women

L-R Finola Finnan, Sandra Sierra, Caroline Hurley (Trócaire)

and Ann Smitih (CAFOD) add their voices to the crowd

Make Children Visible in the AIDS Response

The topic of Children and HIV was given centre stage on day 3 of the conference starting with an excellent plenary session on the state of the epidemic in children. Linda Richter from the University of Kwa Zulu Natal spoke with passion about how children have been invisible in the response for too long. The failure in children points to a massive failure in prevention and in particular the prevention of mother to child transmission of the virus– currently just one third of pregnant women receive this low cost effective treatment that could stop transmission to their babies. It also brings sharply into focus the inequities facing children in the poorest parts of the world. A child’s risk of becoming infected is down to 2% in countries such as Ireland but a child in Africa (with the exception of Botswana) will have a one in ten to one in three chance of contracting HIV from his or her mother during pregnancy. The result is a huge tragedy for future generations; 370,000 children became infected last year and 2 million children are living with HIV today. Most children will die before their second birthday without treatment. The vast majority of these children are in sub-Saharan Africa and less than 10% are receiving antiretroviral therapy.

The double tragedy is that these same children are being orphaned or are living in very vulnerable circumstances as a result of the epidemic. 15 million children have been orphaned as a result of HIV and AIDS; 12million of them are in sub-Saharan Africa. Many of these children still have one parent alive since orphaned in this context means that one or both parents has died. The shocking statistic is that only 15% of vulnerable families receive any form of support. Linda Richter reminded us that the epidemic affects more than those infected – for families living in poverty there are few differences between orphaned children and those affected by HIV and AIDS. The message from AIDS 2008 is to support children in families, to keep parents alive, to create social protection for the poorest families and expand income transfers. Children are best cared for and protected in functional families with income support to keep them from the poverty trap with high risk of contracting HIV or dying as a result of an AIDS related illness. It seems obvious but the best orphan and vulnerable children’s programme cannot replace a parent.

The resilience of these children is often lost in the cold statistics of prevalence and deaths. Bill Clinton told a story about a shy young 15 year-old boy who lost both his parents to AIDS when he was 7 and had been brought up by his older sister who was just a few years his senior. When he bent down to tell the boy not to give up, the up-until-then shy youngster looked up to him in astonishment and said – ‘give up but I’m going to be a doctor’. Young teenagers at this conference have also spoken with the wisdom of Solomon. Thembi Ngubane, a young South African woman who was diagnosed at 16 took a year and a half out at 19 to write about her experience as a way of coping with her diagnosis and to inspire and guide other young people. Her diary is now online (see http://www.radiodiaries.org/aidsdiary/) and is broadcast on radio in South Africa with huge outreach to others who were going through the same experience.

All of these issues will no doubt be debated in Ireland and the upcoming Global Partners Forum on Children co hosted by Irish Aid and UNICEF in October. In preparation for this Irish Aid held a symposium event on children for Irish participants and associates on Wednesday afternoon. Health and Development Networks used adult and child key correspondents to cover all the sessions that focused on children. They fed back to the group and were joined by Mary Robinson and Brendan Howlin who attended as the Deputy Chair of AWEPA. The correspondents echoed many of the messages in earlier sessions but they also spoke of the role of civil society holding governments to account to fulfil their commitments to children. The highlight of the session however had to be the children’s feedback - they were brilliant - my only complaint was that they are all boys! They read out their impressions and thoughts from the many things that they had heard. The eldest was 13 and the youngest 7 and I’ll leave you with the words of Daniel Kezaala, a 9 year old who shared his thoughts after he heard Bill Clinton speak “ If I was HIV positive I would feel scared and sad. When Bill Clinton told us the story of a boy named Jean Pierre, HIV positive, this story made me feel sad but I also thought it was amazing. This boy who was 15 years old was still determined to be a medical doctor even though he’s only in the third grade. It also made me more determined to choose my own goals”. Let's hope that the world responds to the calls to afford millions of children the dignity that they deserve and the potential to reach their goals in secure and safe environments.
Posted by Finola Finnan

Combination Prevention is the key ask at the AIDS 2008 Conference

by Finola Finnan, Programme Leader, Trócaire's Gender & HIV/AIDS Team.

AIDS 2008 is now well underway. It got off to a start officially on Sunday night and we were amongst the thousands who filed into the Auditorio National in torrential rain. Our spirits were lifted by the amazing Folkloric Ballet of Mexico and the inspirational messages from civil society activists and a host of government and UN leaders over the three hour session. AIDS 2008 is a huge event - twenty three thousand delegates are attending the conference and over 7000 different presentations will be delivered over the coming five days. It can be overwhelming and exhausting – we are lucky that a number of us are covering different events and different issues - Sally and Sandra from Central America, Deirdre, Caroline and I from Head Office, Jihad from EIFDDA in Ethiopia, Theresa and Bernadette from DRC.

The sessions cover diverse topics but the messages are consistent – all speak of the need for continued and accelerated action to turn the tide of the epidemic. There’s a consistent call for a scaled up response to prevention and to ensure that prevention is based on individual contexts and realities. The epidemic took hold firmly in the 1990’s when there was too little investment in AIDS globally and the practice failed to keep pace with the science. The new millennium saw a huge increase in global investment and initiatives and a scale up in treatment. These are finally bearing dividends but there is a real concern that we must maintain a level of leadership to sustain and improve on these advancements. Jeff O’Malley from UNDP spoke of “politics mattering as much as programmes”. The UNAIDS 2008 report published in advance of the conference indicates that the epidemic is stabilising. Some positive signals of change are emerging – treatment is reaching 3 million globally – one million of these in 2007 alone and the numbers of new infections are falling. But it’s not nearly enough – for every 2 people put on treatment, five become infected. 2.7 million people became infected with HIV last year and 33 million are still living with HIV globally. HIV still affects women and young girls disproportionately in sub-Saharan Africa and gender-based violence is pervasive in many cultures and women suffer disproportionately from stigma and discrimination– as one speaker commented – as if women don’t have enough to worry about.

At a session today on prevention – all the speakers spoke of the abysmal results despite 25 years of experience in the area. This conference is calling for Combination Prevention – moving beyond single solutions, recognising that people’s lives and risks are too complex to solve with a magic bullet. Thomas Coates from UCLA told us to bury the ABC and “to elevate the discussion beyond the incessant controversies on individual interventions”. The message is that we need to respond to the complexity of the epidemic and to take account of the behavioural, structural and political issues that affect people’s ability to protect themselves. We need a combination of options that are tailored to people’s needs, to learn by doing, to use what works well and use it more effectively. Programmes for particularly vulnerable groups such as sex workers, prisoners, drug users are a hot topic a the conference with debates on the effects of criminalisation, the stigma and discrimination faced by these most marginalized groups and the lack of services to meet their needs. They get a tiny proportion of the budget in some countries and are invisible in others.

And amongst all of this gender and human rights remain high on the agenda. Sessions on gender and gender-based violence are more visible at this conference than previous ones. The importance of addressing gender based violence and working with men to change cultural norms were stressed. We ended a busy day on a march to demand “All Women, All Rights” ending at the Zocolo, a majestic square in the city centre. The rain stayed away long enough to allow us to hear a young Australian 16 year old with HIV, a Mexican women’s activist, a Zimbabwean lawyer and Annie Lennox. Sadly Annie Lennox didn’t beat out an old Eurythmics song but she did woo the crowd with a rousing speech in Spanish demanding that women are given the rights and dignity they deserve to reach their potential and to protect themselves and their families from HIV and from violence. We left the square just as the skies opened and a four women country band in fluorescent gear took to the stage to head to a meeting of Catholic participants at the Jesuit Centre – I said it was diverse….. but more of that later and on Children and AIDS which is a key topic tomorrow.

Initial thoughts on the International Conference

by Deirdre Ni Cheallaigh, Trócaire HIV and Gender Policy Officer.

We took our place among the long snake of people shuffling forward to claim our conference badges and delegates bag. The air thick with Spanish and anticipation, the person beside me shrieking with delight each time she clocked a fellow Nicaraguan in the line. Kisses and Olas out of the way, she’d go on to explain who the new arrivals were – friends from organisations of men against violence working on issues of gender and masculinities or others from associations of positive people in Nicaragua.

Recurring themes among those in the queue was the curious decision to send the delegates badges by post, despite the fact that many are from countries without properly functioning postal systems. I ended up in the line among them, but was glad of the opportunity to get some Central American views on the AIDS conference being hosted in their region for the first time. While largely positive, more than a few wry smiles broke out when, having successfully registered, the Nicaraguans opened the ‘Spanish version’ of the delegates’ bag to find just one of the documents in Spanish.

‘It seems as if the location for the conference itself is incidental - that is really lamentable’, I heard one colleague say. She’s right - it’s a real missed opportunity to make the conference accessible to the majority of the participants. As an English speaker, I can open the phone-book sized programme and choose any session at random knowing that I can access it (well, with the exception of some of the scientific ones which, having abandoned the sciences almost 15 years ago, are in an entirely different language: NRTIs, NGFs, PBMCs or V1-V2 loops anyone?).

I was reminded of other recurring themes, when I scanned down through an AIDS 2008 message from SIDA, the Swedish government’s overseas development body. The opening paragraph reminds us of past conference themes – ‘Access for All’ (Bangkok, 2004), ‘Time to Deliver – Promises to Deliver’ (Toronto, 2006) and this year, this week here in Mexico ‘Universal Action Now’. Other themes that we’ve become familiar with include ‘Universal Access’, ‘Stop AIDS. Keep the promise’, ‘Faith in Action Now’.

With some slight variations, they all point to the same thing – a demand that the promises and commitments that have been made, must be translated into action, by those who made them. The response to HIV and AIDS, and the fulfilment of these promises, is about rights, equality and justice. This afternoon, setting out from Monumento a la Revolución, thousands of people will take part in a march entitled ‘Universal AIDS Action Now – treatment, testing and prevention’ organised by AIDS Health.

The official opening ceremony for the Conference takes place this evening. For me though, the march, and the opportunity to publicly remind ourselves and others of the promises that we made and are failing to keep, feels like the real opening ceremony. There won’t be the formality and protocol that will go along with the official proceedings this evening but there will be thousands of people, competing with the chaotic Mexican traffic and noise, raising their voices above it, and calling - loudly and clearly - for ‘Acción Universal En SIDA Ya – treatmiento, detección y prevención!’