Commission on Status of Women
COMMISSION PANEL ON WOMEN AND AIDS DISCUSSES RELATIONS BETWEEN MEN AND WOMEN, NEED FOR
NEW YORK, 8 March (UN Headquarters) -- During an expert panel discussion this afternoon on "Women, Girls and HIV/AIDS", the Commission on the Status of Women was told that the disease was a relational issue and thus a gender and human security issue.
In his presentation, Elhadj Sy, New York Representative of the Joint United Nations Programme on HIV/AIDS (UNAIDS), said the virus was about security because it dealt with survival, safety, and opportunity, among other things. The epidemic revealed dysfunctionalities in "our respective societies", the norms and values that shaped those societies and the relations between men and women. He stressed the need to deepen understanding of those relations.
Dr. Mabel Bianco, Director of the HIV/AIDS and Sexually Transmitted Diseases Executive Coordination Unit in the Ministry of Health of Argentina, said the incidence of the virus among girls and women had increased rapidly since the early 1990s. Yet that fact was not sufficiently acknowledged, and when it was, it was limited to mere talking. The virus was not resting while very little had been done since the International Conference on Population and Development (Cairo, 1994) and the Fourth World Conference on Women (Beijing, 1995).
Addressing the related issue of violence and abuse, she said globalization of the media was promoting the dissemination of messages that portrayed sexual violence like a fashion. Altogether there were too many negative messages being transmitted to young people and children.
Sheila Dinotshe Tlou, Associate Professor, Department of Nursing Education, University of Botswana, said that men, especially African men, had been tarnished as being irresponsible, violent, predatory and fast in transmitting the HIV/AIDS virus. Such labels were stereotypical, did not facilitate male involvement and also ignored the fact that there were many good caring, responsible, loving and gender-sensitive men. It was only now that stakeholders realized that the qualities of such men could be tapped and used as role models.
She regretted that governments often hid under the cloak of "drugs being too expensive" to the point where very little was being done to procure needed drugs. Yet those same governments had spent millions of dollars on armed conflicts. In Africa, about one eighth of the military budget of most countries would be enough to provide free anti-retroviral drugs to all citizens living with HIV/AIDS, yet it was the drug companies who were being blamed for exploiting the situation.
Dr. Sharifah Shahabudin, Professor of Medical Education and Director of the Centre of Academic Development, said the HIV/AIDS epidemic should be regarded as a disaster, and as such required both short-term and long-term actions. She recommended disaster relief measures for AIDS-affected areas; the economic-empowerment of women; provision of accurate, culturally and gender-sensitive prevention and education services; and access to treatment and care, including free voluntary counselling and testing. She also recommended working with religious and traditional leaders to identify cultural and religious practices that were harmful to women so they could be eliminated.
Responding to the issue of mandatory AIDS testing, she said the question was not so much one of whether there should or should not be such testing but more one of "why and what do we want to do with the results". Truthful answers to the latter question would reveal how human rights could be violated. Testing without permission was an invasion of privacy and contributed to stigmas.
The Commission will meet again at 10 a.m. tomorrow to begin its review of communications on the status of women.
The Commission on the Status of Women met this afternoon to hold an expert panel discussion on one of its thematic issues "Women, Girls and HIV/AIDS".
The panellists were:
Dr. Mabel Bianco, Director of the HIV/AIDS and Sexually Transmitted Diseases Executive Coordination Unit in the Ministry of Health of Argentina, Executive Coordinator of the Ministry and World Health Organization (WHO) Project on HIV/AIDS -- Lucha Contra El Sida (LUSIDA) and President of the Foundation for Studies and Research on Women;
Dr. Sharifah Shahabudin (Malaysia), Professor of Medical Education and Director of the Centre of Academic Development, Founder and Deputy President of the Malaysian AIDS Council and member of the National Council for the Integration of Women in Development;
Elhadj Sy (Senegal), New York Representative of the Joint United Nations Programme on HIV/AIDS (UNAIDS); and
Dr. Shelia Dinotshe Tlou, (Botswana), Associate Professor in the Department of Nursing, Faculty of Education at the University of Botswana.
(For detailed background on the thematic issue, see Press Release WOM/1263 issued 2 March.)
Statements by Panellists
SHEILA DINOTSHE TLOU said that until recently, men had been almost invisible as part of the solution to the HIV/AIDS epidemic, even though it was obvious that their socialization and subsequent behaviours determined how and to whom the virus was transmitted. Men, especially African men, had been tarnished with one long brush that painted them as being irresponsible, violent, predatory and fast in transmitting the virus. Such labels were stereotypical and ignored the fact that there were a lot of good caring, responsible, loving and gender-sensitive men. It was only now that stakeholders realized that good men could be tapped and used as role models.
Turning to the responsibilities of governments, she regretted that they often hid under the cloak of "drugs being too expensive" to the point where very little was being done to procure the drugs. Yet these same governments had spent millions of dollars on armed conflicts. In Africa, about one eighth of the military budget of most countries would be enough to provide free anti-retroviral drugs to all citizens living with HIV/AIDS, yet it was the drug companies who were being blamed for exploiting the situation. She asked whatever happened to State accountability to its citizens.
What was needed was political commitment to the fight against HIV/AIDS at the highest level, she said. Political leaders needed to create supportive socio-political and legal frameworks for gender equality. Societies should be transformed into "noble societies" which had programmes for governance, political will and commitment to human rights. She called for less talk and more action from all concerned.
She made six recommendations for global response to HIV/AIDS. There should be an emphasis on a human rights approach to the epidemic which entrenched the principle that governments should be accountable to their people, she said. The international community and the relevant United Nations agencies should intensify their support of national efforts against the virus, especially in the worst-hit areas in Africa. Research was important and should therefore inform and drive policy. In addition, forums for interaction between researchers, policy makers and implementers of programmes should be established. She concluded that Africans who suffered the most from the disease should take responsibility for their destiny by taking every step possible to rid the continent of the disease.
SHARIFAH SHAHABUDIN said that culturally accepted and socially constructed gender roles often left women in a subordinate position to men in many ways. That was the case concerning decisions about sexual relations. However, the same gender roles and relations that enhanced women’s vulnerabilities to HIV/AIDS also increased some of its risks for men, thus multiplying the risks for women. The widespread abuse of human rights and fundamental freedoms associated with HIV/AIDS had also emerged globally in the wake of the pandemic.
Other factors which contributed to the stigmatization of and discrimination against women with the virus included: limited access to relevant information and education; women’s and girls’ relative lack of autonomy over their sexual lives; compromise of the right to health and life by under-investment in research and product development of affordable female-controlled methods of protection and prevention; and the perpetuation of poverty -- a high risk factor for infection.
She concluded that the HIV/AIDS epidemic should be regarded as a disaster, and, as such, it required both short-term and long-term responses. She recommended disaster relief measures for AIDS-affected areas; the economic-empowerment of women; provision of accurate, culturally and gender-sensitive prevention and education services; access to treatment and care, including free voluntary counselling and testing; and working with religious and traditional leaders to identify cultural and religious practices in order to eliminate those harmful to women.
MABEL BIANCO, Director of the HIV/AIDS and Sexually Transmitted Diseases Executive Coordination Unit in the Ministry of Health of Argentina, Executive Coordinator of the Ministry of Health and World Health Organization Project (WHO) on HIV/AIDS -- Lucha Contra El Sida (LUSIDA) and President of the Foundation for Studies and Research on Women, said that in Latin America and the Caribbean, HIV/AIDS was a growing problem.
She said the incidence of the virus among girls and women had been increasing rapidly since the beginning of the 1990s. That fact was not sufficiently acknowledged and when it was, it was limited to mere talking. The virus was not resting, while very little had been done since the International Conference on Population and Development (Cairo 1994) and the Fourth World Conference on Women (Beijing 1995).
She said the increase in poverty and the imbalance of power between males and females, and cultural guidelines, particularly religious beliefs, perpetuated gender imbalances. The belief that poor girls in Latin America and the Caribbean, for example, could say no to sex was not widespread. The prostitution of girls and young women was even a strategy for family survival. Sexual abuse and rape which was inflicted on many young girls and adolescents was increasing throughout the world and particularly in her region. Home today was an unsafe environment for many young and adolescent females.
She said globalization of the media was promoting the dissemination of messages that portrayed sexual violence like a fashion. Altogether, there were too many negative messages being transmitted to young people and children. There were thousands of cases of violence and sexual abuse that never reached the police but affected thousands of young girls and adolescents every day. Sexual education was not a reality in many countries, particularly in the countries of her region. Acting fairly to oneself within a family situation was one key to confining the HIV/AIDS virus.
She said the existence of HIV/AIDS in women increased the violation of their human rights. They had no right to work, earn or have access to health services. They were even denied the right to carry on their sexual lives. Also, while abortion was not legal in most Latin American and Caribbean countries, the paradox was that many HIV positive women were forced to abort; some were even sterilized without their consent. Pregnant women living with the virus were also not guaranteed treatment.
To keep the situation from worsening in her region required immediate action, she said. "We need to establish informal and formal sexual education programmes for males and females at an early age before they begin their sexual exploration", she said, as she highlighted responses to the epidemic. There was also a need to develop comprehensive programmes to decrease poverty. The implementation of programmes to reduce violence, particularly sexual violence, through the dissemination of messages, was also necessary. "We must guarantee comprehensive health services for women living with HIV/AIDS. We must also implement reproductive and sexual health programmes for adolescents that will ensure confidentiality, privacy and respond adequately to their needs", she said. It was time that governments and communities implemented such actions.
ELHADJ SY (Senegal), New York Representative of the Joint United Nations Programme on HIV/AIDS (UNAIDS), said conversations on HIV/AIDS used to be based on numbers and figures. Those were only numbers and there were many who had not been included in the count. Those people were the silent expression of pain, grief, loss and anger. They were the silent expression of the daily search for solutions, commitments and solidarity and answers to the challenges raised by the biggest epidemic of the times.
He said AIDS was about sex, blood and procreation. It was a relational issue and thus a gender and human security issue. It was about security because it dealt with survival, safety and opportunity, among other things. The AIDS epidemic revealed dysfunctionalities in "our respective societies", the norms and values that shaped those societies, and the relations between men and women. He stressed the need to deepen understanding of those relations.
He said that one of the issues to be addressed was risk and risk-taking. Depending on where one lived, one would perceive risks differently. Risk-taking also called into question the differences between men and women. How risks were taken depended on the socialization of boys or girls. Parents and society at large had different standards for different genders. Mothers, for example, complained, with pride, about the numerous sexual partners their sons had, yet were often embarrassed if a daughter did the same thing.
Women’s vulnerability was a fact, he said. But perhaps that should be looked at from the point of view of the dysfunctionalities of "our societies". Turning to self-esteem, he asked how could that be nurtured and promoted among men and women to make them what they really were -- partners. "How do we eliminate stigma and make the high percentage of people who do not know they are infected want to go for voluntary testing and counselling?" he asked. That called for leadership at all levels. Governments should do what they could do best through laws and regulations.
Response to Comments
Mr. SY, responding to a question from delegations on the stigma associated with HIV/AIDS, said that as long as there was a stigma and discrimination related to HIV/AIDS, there would still be problems, even if there was access to the best facilities.
Addressing the issue raised on drugs and treatment, he said access and availability had improved dramatically in the developing world. He supported equal access to treatment at both the international and national level.
Dr. BIANCO, responding to a question on treatment, said it was a great problem, especially for women, since discrimination affected their access. Action was needed to strengthen solidarity among countries. HIV/AIDS was an epidemic and had to be looked at in a way that really ensured the survival of people. Thus, a way was needed to decrease the prices of treatment and make them affordable to all countries. She suggested a revolving fund in cooperation with the Pan American Health Organization that would ensure affordable prices, continuity and accessibility of treatment. There was also a need to look at how research was progressing. In some countries, men and women were pushed into research studies simply because the researchers were producing HIV/AIDS related drug treatments.
Responding to questions and comments from the floor, Dr. TLOU said that at a time when developing countries were trying negotiate debt relief, it would be foolish for them to take on more debt to pay for HIV/AIDS drugs which were not cures but treatments. She called for collective efforts, especially in Africa, to do research into current drugs and to find ways of developing new drugs and treatments with herbs and plants available on the continent. Studies which had started had been abandoned. This was wrong, and those in Africa needed to persevere in the fight for a cure to the disease. Africans needed to look beyond what was available. She also hoped that the special session on HIV/AIDS would come up with concrete recommendations which could be implemented.
Dr. SHAHABUDIN thought that main task before the Commission was to ensure gender mainstreaming was in the June programme. But that was not just a question of addressing inequalities in relationships; it should also be looked at in the context of human security and human rights. When dealing with the issue of starvation, one dealt with food security. A lot of agricultural workers were women, but they had no land rights and faced constraints. They also had attention diverted from their agricultural work because they had to care for dying relatives. But the starting point was, of course, gender equality. In working with religious and traditional leaders which were invariably men, she often found it effective to use their religious values to change their attitude about women being subordinate to men.
Mr. SY responding to a question on free sex, multiple sexual partners and HIV/AIDS, said research had shown that a large percentage of young girls had become infected during their first sexual encounter which was sometimes their only sexual experience. Years ago, the preventive message was to reduce sexual partners. So there were efforts to reduce from 10 partners to five. What did that achieve? he asked. "The notion of safety has to be introduced, whatever you do, how many times you do it and whichever way you do it -- just do it safely", he said.
Addressing stigma, he said that pushed people with HIV underground because they feared being identified as someone with numerous sexual partners or someone who was reckless.
Addressing the issue of male involvement, he said that for those with Internet access, there was a list of best practices of how men could be involved in the fight against HIV/AIDS. Also, for those without access to the Internet, in each country his organization had a group on AIDS that would make information on that issue available.
Responding to questions about men’s involvement in the fight against AIDS, Dr. BIANCO said that in Latin America and the Caribbean, the development of equality between the sexes required very early education. It was necessary to start with children from a young age, otherwise it was useless. Through a project carried out on the prevention of domestic violence, it had been discovered that men were also victims of social and cultural values and often saw violence as a manly thing, even if they did not agree with it. Men in the project were told they would be exercising their rights by not being violent and not doing what was expected of them by society.
Addressing the issue of male involvement in HIV/AIDS projects in Botswana, Dr. TLOU said there had been a conference on men as partners in the fight against the disease, and that had attracted a large response from men. Another project on women and AIDS had also attracted men who felt they too should play a role, and some of them had been trained through the project and had in turn set up their own programme aimed exclusively at men. AIDS required a multi-pronged approach because no single action was adequate. Empowerment of women was just part of the response to dealing with the effects of the disease. If there was one disease that had made humanity look at human rights closely, it was HIV/AIDS. She said that if she had to choose one thing that would significantly help in the fight against the virus, it would be research. She called for all States, especially those in Africa, to dedicate more funds to action-oriented research that could inform practice.
Dr. BIANCO said that the issue of research and alternative care methods had been given much attention this afternoon. "We have to look carefully at changing the negative issue of testing positive for AIDS into something that is really a positive for women", she said. It was also necessary to have a specific policy to support women and girls diagnosed with HIV/AIDS. That did not mean just keeping them alive but also giving them access to nutrition.
Turning to the issue of research, which had been raised by many delegations, she said it was very important that the human rights of the participants were defended and respected, and that more importantly they had the right to choose. In poor countries, many participated because it was the only way for them to access treatment. That was really very dangerous.
She agreed with the view put forward this afternoon that reproductive and sexual rights had to be ensured not only for HIV positive women and girls but other women. All women could be in a situation where they might not have the right to say no to a sexual situation or to children.
Addressing a suggestion for periodic mandatory testing for HIV/AIDS, she said that while it was a good idea, there was also a need for counseling. Testing would be a good moment to highlight the risks and problems to people and instruct them on how to avoid transmission. It would also be a good opportunity to involve men.
Dr. SHAHABUDIN, also responding to the issue of mandatory testing, said the question was not so much one of whether there should or should not be such testing but more one of "why and what do we want to do with the results"? Truthful answers to the latter would reveal how human rights would be violated. Testing without permission was an invasion of privacy and contributed to stigmas. She felt that mandatory testing was a waste of time.
Responding to a point made on the risks associated with intravenous drug use, she asked delegations to think of that practice as just another entry point for HIV/AIDS to spread throughout communities. Women and girls were forced into prostitution and turned to illicit drugs to help them face their reality.
Addressing treatment drugs, she said that was an area that begged for regional and international cooperation. Also, affordable treatments required joint collaborative efforts which should include multinationals.
Returning to the issue of affordable drugs, Dr. TLOU stressed that drugs were not a panacea in an environment where health care systems were not functioning well. People, especially Africans, should be asking what programmes were available to alleviate HIV and to care for people before talking about moving from primary prevention to secondary prevention.
Admitting that she was playing devil’s advocate, she said when people called for affordable drugs, they should also consider how the pharmaceutical companies would fund their research. Lower costs could result in less research, which would leave everyone with a treatment rather than a cure in the long term. States needed to meet the drug companies halfway. None of the delegations present had dealt with the question of the impact of armed conflict on the HIV/AIDS issue. Could it be that an end to conflict in many parts of Africa would lead to more resources being available for the fight against AIDS? she asked.
Regarding the issue of women’s control of their sexuality, Mr. SY said one suggestion had been the use of the female condom. This, however, had met with criticism. He observed that many of the critics had never seen a female condom or used one. He ended by quoting an HIV/AIDS sufferer who had said: "We are not the problem but we would like to be part of the solution". This would never happen, Mr. Sy said, unless everyone worked towards creating an enabling environment in which people could be tested and receive treatment without being stigmatized.
Dr. SHAHABUDIN reiterated that gender mainstreaming should be viewed in the context of security and human rights. Members would have missed the point about the HIV/AIDS pandemic if they failed to do so. It should be looked at in the context of safety, survival, dignity and rights.
Dr. BIANCO concluded with the hope that the Commission would, in the next few days, find a good proposal in which women’s issues would be further reinforced. She believed that diseased or not, women were suffering, and it was important to use the HIV/AIDS issue in a way that would to empower women to achieve a more gender-balanced future in all communities.
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