"Any program that does not address our context is tantamount to window dressing." -- Bernice Heloo, President of the Society for Women and AIDS in Africa.
World AIDS Day (December 1) has already come and gone, but for those advocating for critical reforms to PEPFAR (The President's Emergency Plan for AIDS Relief) and its HIV prevention policy, the day marked just the beginning of calls to Congress and the Bush Administration urging them to Start Taking Effective Prevention Seriously. Congress is scheduled to reauthorize PEPFAR in 2008, which means that activists and lawmakers alike have an important opportunity to take the steps needed to ensure that prevention strategies in the next phase of PEPFAR truly address the needs of women and youth across the world (visit our recent posting for more information about the "STEPS" campaign).
More Than "Window Dressing"
The Center for Health and Gender Equity (CHANGE), Advocates for Youth, and the Unitarian Universalist Association of Congregations took several steps in recognition of World AIDS Day to shed light on the shortcomings of U.S. global HIV prevention programs. We brought stories from leading advocates in Africa and the United States to the media in an audio press conference and took our demands to the streets at marches and rallies in Washington, D.C. The resounding message? Prevention policies need to be holistic, integrated, and evidence-based, and they must address the varying life circumstances of those most at-risk of infection: women and adolescents.
"For us women in Africa, already marginalized and made vulnerable by deep-seated, harmful social and cultural practices; gender inequities; conflicts; gender-based violence; illiteracy; poverty-any program that does not address our context is tantamount to window dressing," said Bernice Heloo, President of the Society for Women and AIDS in Africa (based in Ghana), on the audio press conference.
Reverend J.P. Heath, Cofounder and Director of International Programs at the African Network of Religious Leaders Living with or Affected by HIV and AIDS (based in South Africa), echoed that the societal and cultural factors that increase vulnerability to infection "must be addressed holistically because HIV is, in many ways, like a volcano. It's the outbreak. It's the place that we see this final symptom of all these ills in our society."
Moving Beyond ABC
According to Ms. Heloo, the narrow "ABC" (Abstinence, Be faithful, Use Condoms) approach to HIV prevention currently being implemented in PEPFAR programs "does not work for African women." Neither do ideologically-driven funding restrictions, such as the requirement that one-third of PEPFAR's HIV prevention funding go toward abstinence-until-marriage programs or the mandate that nongovernmental organizations adopt a policy explicitly opposing prostitution in order to receive PEPFAR funding for HIV/AIDS programming (referred to by advocates as the "anti-prostitution pledge").
We fail women and girls when U.S. global AIDS policy does not deliver the full range of information, treatment, and prevention options-including access to, and effective programming around, female condoms-that is essential to empowering individuals and ultimately saving lives. Women and youth must be able to take prevention into their own hands, in a way that fits within the context of their lives. But as Ms. Heloo and Rev. Heath illustrated, this is difficult to accomplish when hands are tied by "red tape," such as the moralistic prescriptions and funding restrictions currently mandated in U.S. global HIV prevention policy.
Cut The Red Tape!
On the eve of World AIDS Day, armed with these stories from the ground, faith-based, health, and women's rights activists took their demands to the Office of the Global AIDS Coordinator (OGAC)-the U.S. agency that oversees the implementation of PEPFAR. Dozens of advocates marched to and rallied at OGAC's office in Washington, D.C. and called upon the agency to take the steps necessary to ensure that global HIV prevention programs under PEPFAR work for women and youth. Specifically, they urged OGAC to cut the red tape on prevention by:
Equipped with giant scissors and red tape, advocates invited OGAC to join the rally and symbolically cut the red tape. OGAC declined their request but invited the rally's organizers to meet with OGAC leadership prior to the rally. Serra Sippel, Executive Director for CHANGE, and Rev. Bill Sinkford, President of the Unitarian Universalist Association of Congregations, hand-delivered a letter signed by over 40 organizations-representing millions of concerned citizens across the nation-that echoed the demands of those rallying outside of OGAC. They expressed their concerns to OGAC and requested a written response.
Take Action: Not a Minute To Lose
"We need to move away from piecemeal and politically handcuffed solutions and ensure that our prevention strategies are holistic and address the diverse complexities in women's lives worldwide," reiterated Serra Sippel, addressing the crowd at the OGAC rally.
CHANGE and allied partners will be mobilizing advocates across the nation in the upcoming months to urge members of Congress to support evidence-based, comprehensive, and integrated HIV prevention programs in the next phase of PEPFAR. We encourage you to take action with us -- contact Kim for more information.
As the Rev. Bill Sinkford said, "If we truly want to save lives, we must get serious about delivering effective prevention." The time to get serious about effective HIV prevention is now.
]]>While the U.S. is a leading source of funding for HIV/AIDS programs worldwide, after four years of PEPFAR, we've seen a lot of missteps in making HIV prevention strategies work for women and youth, including a misguided "ABC" (Abstain, Be Faithful, Use Condoms) approach to HIV prevention and ideologically-driven funding restrictions like the one-third abstinence-until-marriage earmark and anti-prostitution pledge. World AIDS Day offers an opportunity to raise awareness about necessary reforms to PEPFAR prevention policy and to call upon Congress to step up and stand up for the lives of women and youth worldwide.
Consider the abstinence-until-marriage earmark. When Congress authorized $15 billion for PEPFAR, it mandated that at least thirty-three percent of HIV prevention funds be spent on abstinence-until-marriage programs. Not surprisingly, this funding restriction has harmed women and youth by failing to address the varied realities of their lives. The vast majority of youth in PEPFAR's fifteen focus countries are sexually active by the time they are twenty, and half of all new HIV infections occur in youth aged 15-24. Counter to what the abstinence-until-marriage policy suggests, marriage is not a safe haven from infection. Eighty percent of HIV infections among women worldwide result from sex with their husbands or primary partners.
In the vein of funding restrictions and missteps, there is also the anti-prostitution pledge -- the requirement that nongovernmental organizations adopt a policy explicitly opposing prostitution in order to receive PEPFAR funding for HIV/AIDS programming. Women and men who engage in sex work are among the most marginalized persons in any society and are at increased risk of HIV infection. Yet organizations that advocate for the health and human rights of commercial sex workers face a difficult decision: sign the pledge and further stigmatize and marginalize those most in need of comprehensive HIV/AIDS prevention, treatment and care or renounce the pledge and risk closure due to lack of funds.
Reproductive health and HIV/AIDS services are generally operated separately -- a burdensome arrangement for women and girls in resource-poor countries who must often visit one provider for family planning or prenatal care and another for HIV testing or treatment. To improve access to life-saving health care, PEPFAR must take steps toward integrating sexual and reproductive health services with HIV/AIDS services and programs. This makes sense because for women who have sex with men, unprotected sex may result in pregnancy and/or HIV infection. Integrated service sites staffed by trained and sensitive practitioners would also help ensure that U.S. global AIDS policy respects the childbearing decisions of HIV positive individuals and people living with AIDS.
As the U.S. prepares to usher in the next phase of PEPFAR, we must step away from ideological funding restrictions and centralize effective, integrated prevention programs and policies for those most vulnerable to infection.
That's why for World AIDS Day 2007, organizations and advocates across the nation are participating in the "STEPS" to Effective U.S. Global HIV Prevention Policy for Women and Youth campaign. STEPS stands for "Start Taking Effective Prevention Seriously" -- which is our message to Congress as members deliberate over changes to PEPFAR. We're encouraging supporters to join the campaign by taking literal steps, like organizing and participating in marches, and figurative steps, like making the case for reform to policy makers and the media. Around the country, people will call or write their Representatives and Senators to co-sponsor the PATHWAY Act or the HIV Prevention Act (both bills would remove the 1/3 abstinence-until-marriage funding earmark), write letters-to-the-editor about effective U.S. global HIV prevention policy, or even get tested for HIV. Nationally, our goal is that 4 million steps be taken, representing the approximate number of new HIV infections each year.
As part of the STEPS campaign, we're calling on Congress to take three major steps for PEPFAR reauthorization:
These global HIV prevention demands will be shouted loud and clear at a World AIDS Day "STEPS" march in Washington, D.C. on Friday, November 30. Advocates will be marching from the Office of the Global AIDS Coordinator (OGAC -- the U.S. agency that oversees the implementation of PEPFAR), where they will be calling on OGAC to support our calls to Congress. We will then join with a larger rally that brings together local, national, and global anti-AIDS activists in Lafayette Park at 1:00 p.m. To learn more about the STEPS World AIDS Day campaign and the D.C. march and rally, please visit www.pepfarwatch.org/worldaidsday. For those looking to take STEPS toward effective domestic HIV prevention policy, we recommend joining the Prevention Justice Mobilization, which can easily be integrated with a global STEPS message.
Together, our STEPS can go a long way!
]]>