Those words are a paraphrase of those spoken by a committed South African activist who was encouraging civil society at the 2006 U.N. General Assembly Special Session (UNGASS) AIDS meeting to risk our badges by protesting the disgustingly weak consensus document reached by member nations. (She was successful in getting us to take action. You can read a blog about that protest here.)
I am reminded of her words as I think about how civil society has responded to the PEPFAR reauthorization bill that has now passed both the House and Senate committees and is headed to the floor of both chambers for a vote. I have been shocked over the last few weeks by the number of organizations and prominent individuals who have responded positively, or even neutrally, to the compromise bill. Some who have been through these processes before eagerly remind the more outraged among us that this is how it works: you simply don't make great leaps forward on these issues.
Why have so many of us accepted that the way it has been is the way it has to be? And why wouldn't we exhaust our options before settling? Why are we doing this work if not to demand something other than "business as usual"?
We call ourselves a movement. A movement demands progress; it demands big dreams backed up by big action. And last I checked, a movement does not accept compromise that comes at the price of lives without at least putting up one heck of a fight.
As we approach our last chance to change the PEPFAR reauthorization bill, we must ask ourselves: do we care about claiming a victory on a mediocre piece of legislation (by Congressional standards -- it's a horrible piece of legislation by the standards of what is actually needed) and maintaining untainted relationships with Congressional offices, or do we care about taking a principled stand for the needs of people around the world? It is time for our community to face the facts. Not only is this piece of legislation an unacceptable compromise, but that if we so-called advocates do not call it what it is, no one else is going to. If we don't hold lawmakers' feet to the fire, no one else is going to.
When it's time to draw the line in the sand, which side are you on? Are you on the side of a comfortable Washington, D.C. NGO existence that won't push the envelope beyond the agreeable gray area of compromise? Or are you on the side of the billions of people around the world who suffer as a result of (and simultaneously resist) our complacency and tacit complicity in a global system that robs their nations of resources, exploits their labor, prevents access to life-saving medicines and contraceptive supplies, and floods their communities with ideological misinformation about sex and sexuality?
It's time to let go of our delusions about what we continue to permit our world to look like today. It's time that we stand together, knowing that we have let this slide too far, and say in unison: The PEPFAR reauthorization legislation is a sell-out.
You might say I'm overreacting. But give yourself an advocate's reality check. Ask yourself why you do this work - what does it mean for you to be an "advocate"? Then, ask yourself why you are saying that this bill is acceptable (or that it's acceptable for us not to resist it). Maybe you're protecting an organizational position on the issues, Congressional relationships, respectability in the media, or community approval. Or maybe you're protecting your need to believe that the last five years of work to change PEPFAR have paid off.
As the final part of your advocate's reality check, ask yourself what these relationships, this "respectability," approval, or sense of accomplishment are worth if they don't help us challenge the misogynist, racist, nationalist, capitalist, homophobic system that let the AIDS pandemic take hold as it did. Are they worth the lives they cost?
My personal reality check leads me to conclude that it's time to stop deluding ourselves. We need to realize that:
"Well at least we tried; we'll do better next time" is not something a community caregiver can tell a young man for whom there isn't enough treatment, or a visiting healthcare worker can tell a thirty-year-old woman for whom having another baby may mean death in the face of inadequate healthcare. And it isn't something that we, as a movement, can afford to tell ourselves.
Social change is not accomplished overnight and it is not accomplished through one piece of legislation, but it is also most certainly not accomplished by backing down. If we don't fight this fight here, no one will. If we're not willing to fight back, then our silence will mean death and the U.S. Congress and the Bush Administration will not be the only ones to blame.
Having worked through my own reality check, I conclude that it is time to act decisively and aggressively; it is time to commit ourselves to changing this bill before it is signed into law.
If your reality check leaves you where mine has left me, then let's start acting like a movement. Let's stop putting off until tomorrow (a day that, conveniently, never comes) the real change we believe in. Let's do something NOW to change PEPFAR reauthorization. If we don't we will have to admit that we did not do all we could to end the AIDS pandemic, that when push came to shove we weren't willing to put up the fight necessary, and that we let a movement with real potential fizzle because we were too jaded to believe we might be able to accomplish more. I'm not ready to do that. I hope you aren't either.
Related Posts
Today, I combat another treatment myth—that generics account for 70% of PEPFAR's expenditure on anti-retroviral AIDS drugs. And I take issue with the argument that since the abstinence-until-marriage spending requirement is "only one-third of the prevention budget, it really isn't that big of a problem."
]]>Today, I combat another treatment myth—that generics account for 70% of PEPFAR's expenditure on anti-retroviral AIDS drugs. And I take issue with the argument that since the abstinence-until-marriage spending requirement is "only one-third of the prevention budget, it really isn't that big of a problem."
Myth: Generic drugs now make up 70% of the PEPFAR expenditure of ARVs (antiretroviral drugs).
Reality Check: In FY2006, generics accounted for 27% of the money spent by PEPFAR in the 15 focus countries on antiretroviral drugs.
Where did the myth come from? From unclear charts in a PEPFAR report in May of 2006.
In May 2006, PEPFAR released a report entitled Bringing Hope: Supplying Antiretroviral Drugs for HIV/AIDS Treatment. Figures on pages 9 and 10 indicate the percentage of "FDA-approved generic products" of total procurement in the focus countries. The figures show this number to be 70%. A footnote for the chart on page 9 says that "FY06 data represents a limited sample of four respondents." The larger chart on page 10 includes no such footnote, so anyone looking only at that chart (which is also easier to read for many people because it's a pie chart instead of a line graph) would not know that the 70% figure represented only four "respondents."
(It's not clear from the footnote or the surrounding text whether "respondents" means countries or programs in countries. However, a chart on page 10 of Bringing Hope, shows generic drugs percentages for three countries—Haiti, Nigeria, and Zambia—and these are the three countries that a November 2006 Boston Globe article reported as having 70% generics.)
Poorly footnoted figures aren't the only thing to blame for the confusion on generics numbers. There is also the issue of what the numbers are a percentage of. That is, what "total procurement" are we talking about? And that's a question I can't figure out the answer to based on the information in the reports. The figure that included 70% was based on a "total procurement" of the ARVs pot that was expected to be $279 million for FY06 (see page 1 of Bringing Hope). However, the numbers in the annual report (where the 27% generics number came from) indicate that PEPFAR spent $109.8 million in FY06 (fiscal year 2006) to procure ARVs.
While there are certainly questions to be answered about what that 70% figure really referred to, the fact of the matter is that for more than half a year advocates and the media praised PEPFAR for its major scaling up of generic drugs in the programs it is funding. The 2007 annual report to Congress shows that the "major scale-up" has not been very major. The U.S. is only spending 27% of its spending on antiretroviral drugs on generic drugs.
Myth: "Abstinence-until-marriage is only a third of the prevention budget so it's not that big of a problem."
Reality Check: As CHANGE (Center for Health and Gender Equity) has said for some time now, the question shouldn't be what percentage of the total prevention budget is going to abstinence-until-marriage programs but what percentage of the budget for the prevention of the sexual transmission of HIV is going to abstinence-until-marriage programs. Since 40% of the prevention budget in FY2006 went to preventing the non-sexual transmission of HIV (prevention of mother-to-child transmission and preventing the medical transmission of HIV), this is a crucial distinction.
In FY2006, one-third of the total prevention budget went to meeting the abstinence-until-marriage earmark and those programs represented 56% of the prevention of sexual transmission budget. Other programs to prevent the sexual transmission of HIV accounted for just 44% of the budget for the prevention of sexual transmission of HIV and just 27% of the total prevention budget.
PEPFAR refers to this other prevention of sexual transmission money as "Condoms and Related Prevention Activities," however this is a misnomer intended to mislead Congress, the media and members of the advocacy community. Footnote number 2 on page 38 of the annual report explains briefly what that category includes:
"Examples include mass media and community outreach programs to promote avoidance of or reduction of HIV risk behavior, community mobilization for HIV testing, and the social marketing or promotion of condoms, including work with high-risk groups such as injecting drug users, men who have sex with men, people in prostitution and their clients, and people living with HIV or AIDS."
So, the category "Condoms and Related Prevention Activities" actually includes a lot of programs that aren't condom education and distribution or even necessarily related to condoms. Also, the U.S. requires that ...
"... [f]or programs that include a ‘C' component, information about the correct and consistent use of condoms must be coupled with information about abstinence as the only 100 percent effective method of eliminating risk of HIV infection; and the importance of HIV counseling and testing, partner reduction, and mutual faithfulness as methods of risk reduction."
(That's from the PEPFAR ABC Guidance.)
So, whereas it has been argued that the earmark is only one-third of prevention money, we see that when taken as a share of prevention of the sexual transmission of HIV (which is all abstinence-until-marriage is used for), abstinence-until-marriage programs (which are really abstinence-only-until-marriage programs) account for 56% of funding. Only 44% of the budget for prevention of the sexual transmission and 27% of the total prevention budget goes to non-abstinence-only-until-marriage responses to the sexual transmission of HIV even though sexual transmission accounts for 80% of all new HIV infections.
Intrigued by my reporting on the PEPFAR report to Congress? Check out www.pepfarwatch.org for more information about PEPFAR. You can also visit www.pepfar.gov/progress for more of PEPFAR's public reports.
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Healy Thompson is Senior Associate for Advocacy and Outreach for the Center for Health and Gender Equity (CHANGE).
PEPFAR (the President's Emergency Plan for AIDS Relief) is no stranger to criticism. However, most of the focus of the criticism to date has been PEPFAR's requirement that one-third of prevention money be spent on abstinence-until-marriage programs.
Other than some initial criticism about not buying generic AIDS medications, the global AIDS advocacy community has mostly praised PEPFAR on its treatment efforts. (PEPFAR's goal of "supporting treatment for 2 million people in 15 focus countries by 2008" has been seen as a crucial step in gaining universal access to treatment by 2010.) Reports that PEPFAR is on-target to reach 2 million people by 2008 (treating 822,000 by the end of 2006) and that it has scaled-up its use of generic drugs have increased that praise lately.
However, PEPFAR's third annual report to Congress (The Power of Partnerships: Third Annual Report to Congress) reveals that we need to reconsider most of the advocacy community's assumptions about the scale of PEPFAR's treatment efforts.
]]>Healy Thompson is Senior Associate for Advocacy and Outreach for the Center for Health and Gender Equity (CHANGE).
PEPFAR (the President's Emergency Plan for AIDS Relief) is no stranger to criticism. However, most of the focus of the criticism to date has been PEPFAR's requirement that one-third of prevention money be spent on abstinence-until-marriage programs.
Other than some initial criticism about not buying generic AIDS medications, the global AIDS advocacy community has mostly praised PEPFAR on its treatment efforts. (PEPFAR's goal of "supporting treatment for 2 million people in 15 focus countries by 2008" has been seen as a crucial step in gaining universal access to treatment by 2010.) Reports that PEPFAR is on-target to reach 2 million people by 2008 (treating 822,000 by the end of 2006) and that it has scaled-up its use of generic drugs have increased that praise lately.
However, PEPFAR's third annual report to Congress (The Power of Partnerships: Third Annual Report to Congress) reveals that we need to reconsider most of the advocacy community's assumptions about the scale of PEPFAR's treatment efforts.
Today I use the report to combat the myth that PEPFAR is treating 822,000 people. Tomorrow, I will blog on the myth that PEPFAR is using 70% generic drugs and the myth that abstinence-until-marriage programs account for only one-third of the prevention budget so they're really not that big of a problem.
Myth: PEPFAR is treating 822,000 people in the 15 focus countries. (Part I)
Reality Check: PEPFAR is supporting treatment for 822,000 people in the 15 focus countries if you use a very broad definition of "support."
PEFPAR has two categories of support: "upstream systems-strengthening" and "downstream site-specific". Upstream support "includes those supported through contributions to national, regional, and local activities such as training, laboratory support, monitoring and evaluation, logistics and distribution systems, protocol and curriculum development" (footnote 2 on page 60 of the annual report). Downstream support "refers to ... instances where the Emergency Plan [PEPFAR] is providing all or part of the necessary components for quality services at the point at which services are delivered."
293,700 of the 822,000 people that the United States is "supporting" treatment for are receiving only upstream support. In other words, more than 35% of the people we're claiming to support treatment for are receiving no more than systems-strengthening support from the United States. The other 528,300 people receive all or part of the necessary components of treatment ("essential services, training, commodities, infrastructure") from PEPFAR. The annual report does not report how many are receiving all vs. how many are receiving part of the necessary components; however, we can be sure that the United States is not providing the full costs of treatment for those 528,300 people.
In a setting in which multiple players are providing treatment support (national governments and the Global Fund to fight AIDS, TB, and Malaria in addition to PEPFAR, for instance), it makes sense that PEPFAR would not pay for the full costs of treatment for any given patient. However, since the goal of treating 2 million people in the 15 focus countries by 2008 was designed to significantly increase access to treatment, PEPFAR should be responsible for the full costs of treatment for 2 million people. So, if PEPFAR is paying for 50% of the treatment for 100 people, it should report that as 50 people on treatment, not 100 people.
Myth: PEPFAR is treating 822,000 people in the 15 focus countries. (Part II)
Reality Check: PEPFAR may be counting the Global Fund's treatment numbers in the 15 focus countries (418,000) as its own since the United States is a 30% contributor to the Global Fund.
A confusing section of the treatment part of the annual report talks about the treatment numbers for the Global Fund. Pages 64 and 65 say, "The Emergency Plan is the largest contributor to the Global Fund, providing approximately 30 percent of all resources to date. The Global Fund has reported support for 770,000 people globally as of the end of 2006; strikingly, 418,000 of those were reported in PEPFAR focus countries." There is a figure on page 64 (figure 2.5) that is headed "Treatment: People Receiving ARV Treatment with Support from the President's Emergency Plan for AIDS Relief in Focus Countries through FY 2006." It has two boxes; one reads "PEPFAR and Global Fund Joint Support = 418,000" and the other reads "Global Fund Focus Country Results = 418,000." Below those two boxes is a third box that says "Combined Total = 822,000." To the left of the two boxes is text that reads, "Includes those programs receiving support from U.S. bilateral programs—100% funded by the President's Emergency Plan and those receiving support from the Global Fund to Fight AIDS, Tuberculosis and Malaria—approximately 30% funded by the President's Emergency Plan."
This figure appears to show that PEPFAR is counting the Global Fund's treatment numbers in the focus countries towards its 822,000 total even in the 400,000+ instances in which the United States is not providing any upstream or downstream support other than being a contributor to the Global Fund. It is not clear how this fits into the breakdown of upstream and downstream. Since the Global Fund's treatment numbers in focus countries exceed the 293,700 people for whom the United States claims to be providing upstream support, they certainly can't be all counted in the "upstream" support number.
All-in-all, although the United States is claiming to provide support for treatment for 822,000 people, well more than 35% of those people are receiving nothing from the our country other than "upstream systems-strengthening support" or the U.S.'s contribution to the Global Fund (and, I should add, the United States was a contributor to the Global Fund before the advent of PEPFAR). And, if the United States is counting all of the Global Fund's people on treatment as receiving downstream support from the United States (which it may not be, but it didn't provide the information one way or the other in the annual report) simply because this country is a 30% contributor to the Global Fund, then more than 85% of the 822,000 people are receiving nothing from the United States other than "upstream systems-strengthening support" (or the U.S.'s contribution to the Global Fund). Whether 35% or 85% or somewhere in between, clearly the United States is not "supporting" treatment for 822,000 in the way that people thought they were, especially when even "downstream" support requires only that the United States provide at least part of the components of treatment.
Tune in tomorrow for "PEPFAR MythBusters: Episode Two."
]]>Healy Thompson is a policy analyst and outreach coordinator for the Center for Health and Gender Equity (CHANGE).
Almost half of the women in sub-Saharan Africa who want to delay their next pregnancy or have no more children don't have access to modern contraception or other family planning services. Some of those women want to use contraception to space or limit births, because they're too young or too old or too sick or too tired to add new members to their families. Some have other aspirations for their lives right now than childbearing. Whatever the reason, a woman who doesn't want to get pregnant should be able to choose to use contraception and should have access to that contraception and to all reproductive and sexual health care services.
]]>Healy Thompson is a policy analyst and outreach coordinator for the Center for Health and Gender Equity (CHANGE).
Almost half of the women in sub-Saharan Africa who want to delay their next pregnancy or have no more children don't have access to modern contraception or other family planning services. Some of those women want to use contraception to space or limit births, because they're too young or too old or too sick or too tired to add new members to their families. Some have other aspirations for their lives right now than childbearing. Whatever the reason, a woman who doesn't want to get pregnant should be able to choose to use contraception and should have access to that contraception and to all reproductive and sexual health care services.
In addition to being able to choose when to be pregnant (or not pregnant), women who are pregnant should have access to prenatal care, safe delivery, and postnatal care and effective HIV prevention information and services. Reproductive and sexual health services provided in family planning and antenatal clinics are essential to the prevention of HIV and other sexually transmitted infections. A woman who is having unprotected sex is not only at risk of an unplanned pregnancy but also of HIV infection. In fact there are 4.3 million new HIV infections a year and in sub-Saharan Africa, women are 1.5 times more likely to be living with HIV than men. Male and female condoms are an essential method of contraception and HIV prevention that can be made available to women around the world when family planning programs are fully funded.
Every year, 525,000 women die from pregnancy or childbirth-related causes and 99% of those deaths are in the global South. An additional 8 million women endure serious health complications as a result of pregnancy and childbirth.
In the face of this extensive unmet need for reproductive and sexual health care, President Bush cut funding for international family planning programs by 25 percent in his budget for fiscal year 2008.
Now, I realize that I may not see eye to eye with the President on a lot of things, but I would think we could at least agree that childbirth should be a chosen and healthy experience for women.
But then again, adequately funding international family planning programs (which we weren't doing even before the 25 percent cut) might be interpreted as saying that a woman should have control over whether or not she has children. Someone could interpret it as suggesting that a woman's value should not be defined by, diminished by, or enhanced by the fact that she is or isn't a mother, is or isn't pregnant. And people might even go as far as to think that it means that reproductive and sexual health and agency is a basic human right.
And those are things that you just aren't going to get people to agree on.
After all, the oft-blamed Religious Right hasn't supported those things. But conservatives aren't the only ones to blame on this. Many moderates and liberals have checked their support for reproductive and sexual health and rights at the political door. So have many members of the global AIDS advocacy community who fear raising these issues will irk conservatives with whom they have cultivated relationships and result in losses for "more important and less controversial" things, like funding for treatment access. But those who choose to remain silent on reproductive and sexual health and rights do so despite the centrality of those issues to women's well being, in general, and to HIV prevention more specifically.
Whether they remain silent because they fear the controversy or because they mistakenly believe sexual and reproductive health to be outside their purview, moderates and liberals give permission, in their silence on the issue, for the devastation of international reproductive health and family planning programs to continue. This silence reinforces the mindset that providing women basic health care and allowing them control over their procreation is politically subservient to other goals and is a nice thing to do if we have extra money but that it isn't necessary, lifesaving work. This silence also becomes complicit in the spread of HIV infection, unintended pregnancy, unsafe abortion, and a raft of other means through which women suffer higher rates of mortality and morbidity than men. In effect, silence equals death for millions of women and girls worldwide, deaths that are no more or less important if they occur due to complications of AIDS or complications of labor and delivery, unsafe abortion, vesico-vaginal fistula, or violence against women who dare to use contraceptives to forestall bearing another child.
Reproductive and sexual health and agency is fundamental. It is fundamental to human rights. It is fundamental to the health and autonomy of 100% of the population and especially to the 50%+ of the population that has the ability to become pregnant. In addition, reproductive and sexual health and agency, especially that of women, is fundamental to infant and children's health, to HIV prevention, to economic and social development, and to environmental preservation.
Some advocates in the U.S. do recognize the fundamental nature of reproductive and sexual health and rights and have come together across differences to support family planning funding. A diverse and growing coalition of organizations—women's rights, faith-based, environmental, health, etc—are supporting the Focus on Family Health Worldwide Act, for instance. This bill, which is even more necessary in the face of the President's requested 25% cut, would authorize an increase in funding for international family planning programs through the U.S. Agency of International Development (USAID).
On March 1, more than 30 leading advocates from around Washington, DC are heading to Capitol Hill to meet with the offices of more than 40 members of Congress about family planning funding and to ask for passage of the Focus on Family Health Worldwide Act.
But as impressive as this coalition is, it is still too small for the significance of this issue. This is not just an issue for organizations that have the phrase "reproductive and sexual health and rights" in their mission statement.
Everyone who works on any issue that relies on healthy women needs to support family planning funding. Everyone who supports women's economic, social, or legal rights needs to support family planning funding. In fact, everyone who believes "women are people, too" (or is too embarrassed to admit they don't believe it), needs to support family planning programs. Additionally (and I'll just throw this out there to stir up trouble) anyone who has ever had sex where the intention wasn't procreation needs to support funding for family planning.
Go ahead, you can do it, pick up your phone (right now) and call your U.S. Representative and ask him or her to become a co-sponsor of the Focus on Family Health Worldwide Act, H.R. 1225. Then send an email to "the decider" in your office and explain why you think your organization should sign on in support of the Focus on Family Health Worldwide Act (you can email me with your organization's endorsement). If you don't work for an organization, or even if you do, find organizations in your community that might sign on (a place of worship, a community organization, etc.) and get them on board.
And if for some reason, the Focus on Family Health Worldwide Act isn't the vehicle for you or your organization, you still need to write to Congress and the media and explain why we must increase, not decrease, funding for family planning programs worldwide.
]]>Healy Thompson is a policy analyst and outreach coordinator for the Center for Health and Gender Equity (CHANGE).
On December 1, a church bell in downtown Washington, DC will toll every 5 seconds as people head to work. For most of the people who hear that bell and see people gathered outside of the church with signs and banners, it will be their first exposure to World AIDS Day. Even though World AIDS Day was first declared by the World Health Organization and the UN General Assembly in 1988, most people around the world have no idea that it exists, much less what day it is - and this is despite the fact that 4.1 million people were newly infected with HIV and 3 million people died of AIDS in 2005 according to UNAIDS.
The fact that most people have no idea that World AIDS Day exists makes it particularly difficult to live up to the theme of this World AIDS Day: Accountability. In order to hold the U.S. accountable for its promises to treat 2 million people, prevent 7 million new HIV infections, and provide care to 10 million in fifteen focus countries by 2008 (promises made as a part of the President's Emergency Plan for AIDS Relief--PEPFAR), we need people around the country to demand that the Bush Administration and the U.S. Congress implement the best prevention, treatment, and care strategies possible and make changes to the policy and legislation that stand in the way of this.
]]>Healy Thompson is a policy analyst and outreach coordinator for the Center for Health and Gender Equity (CHANGE).
On December 1, a church bell in downtown Washington, DC will toll every 5 seconds as people head to work. For most of the people who hear that bell and see people gathered outside of the church with signs and banners, it will be their first exposure to World AIDS Day. Even though World AIDS Day was first declared by the World Health Organization and the UN General Assembly in 1988, most people around the world have no idea that it exists, much less what day it is - and this is despite the fact that 4.1 million people were newly infected with HIV and 3 million people died of AIDS in 2005 according to UNAIDS.
The fact that most people have no idea that World AIDS Day exists makes it particularly difficult to live up to the theme of this World AIDS Day: Accountability. In order to hold the U.S. accountable for its promises to treat 2 million people, prevent 7 million new HIV infections, and provide care to 10 million in fifteen focus countries by 2008 (promises made as a part of the President's Emergency Plan for AIDS Relief--PEPFAR), we need people around the country to demand that the Bush Administration and the U.S. Congress implement the best prevention, treatment, and care strategies possible and make changes to the policy and legislation that stand in the way of this.
So, on December 1, advocates from the religious and secular community will gather in front of Foundry United Methodist Church to publicly (and loudly) call attention to the fact that there is much work to be done to hold the U.S. government accountable to its promises on HIV and AIDS. We will toll the church's bell every 5 seconds because, on average, every 5 seconds someone is infected with HIV or dies of AIDS. That's right, every 5 seconds of every hour of every day of the year. In fact, if you read at approximately the same speed that I do, 9 people were newly infected with HIV and 7 people died of AIDS in the time it took you to get to this point in the blog (and that's if you didn't click on any links).
People participating in this event - named For Whom the Bell Tolls: A Resounding Vigil - will be calling for the passage of the Protection Against Transmission of HIV for Women and Youth (PATHWAY) Act, which would remove the requirement that the U.S. spend 1/3 of its international HIV prevention dollars on abstinence-until-marriage programs. It would also require the Office of the Global AIDS Coordinator (which coordinates PEPFAR) to establish a comprehensive and integrated HIV prevention strategy to address the vulnerabilities of women and girls in each country receiving U.S. assistance to combat HIV/AIDS, including efforts to address such factors as sexual violence and coercion and early marriage as an integral component of prevention efforts.
The event in Washington, DC, which is also being replicated across the country, is titled For Whom the Bell Tolls because the fact of the matter is that when the U.S. government pursues bad HIV policy (usually the result of corporate influence - take for example the undermining of generic drugs in PEPFAR treatment regimens, religiously driven ideology, or the requirement that 1/3 of all U.S. international HIV prevention dollars be spent on abstinence-until-marriage programs), real people are affected. Every time the bell tolls in Washington, DC on Dec. 1, it is representing an actual person who dies of AIDS or is newly infected with HIV. And that's what World AIDS Day is really about - having at least one day a year when people actually pay attention to what misguided policy and inaction allow to happen every day.
This World AIDS Day there will also be a treatment-focused demonstration in front of the White House, calling on the U.S. to take the steps necessary to guarantee universal access to treatment by 2010 - consistent with the promise made by the heads of state of United Nations countries to reach universal access to HIV/AIDS prevention, treatment and care by 2010.
To learn more about the For Whom the Bell Tolls event in Washington, DC or events around the country or to learn more about the PATHWAY Act and what needs to be done to hold the U.S. accountable for its promises on HIV and AIDS, visit www.pepfarwatch.org. The Washington, DC event is being co-sponsored by Advocates for Youth, Catholics for a Free Choice, Center for Health and Gender Equity (CHANGE), General Board of Church & Society of The United Methodist Church, Health GAP (Global Access Project), National Council of Jewish Women, Religious Action Center of Reform Judaism, Religious Coalition for Reproductive Choice, Sexuality Information and Education Council of the United States (SIECUS), and Unitarian Universalist Association of Congregations.
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Healy Thompson is a policy analyst and outreach coordinator for the Center for Health and Gender Equity (CHANGE).
I have spent a lot of time these last couple of months working with my colleagues at the Center for Health and Gender Equity (CHANGE) and with advocates, researchers, and people living with HIV around the world on the launch of a new campaign to dramatically increase access to the female condom.
During this time, I found myself mentioning the female condom and the campaign (Prevention Now! www.preventionnow.net) to my friends on more than one occasion. These well-meaning and pretty well-informed, progressive people (many of them global health activists) couldn’t figure out why I would be spending so much time on this campaign.
]]>Healy Thompson is a policy analyst and outreach coordinator for the Center for Health and Gender Equity (CHANGE).
I have spent a lot of time these last couple of months working with my colleagues at the Center for Health and Gender Equity (CHANGE) and with advocates, researchers, and people living with HIV around the world on the launch of a new campaign to dramatically increase access to the female condom.
During this time, I found myself mentioning the female condom and the campaign (Prevention Now! www.preventionnow.net) to my friends on more than one occasion. These well-meaning and pretty well-informed, progressive people (many of them global health activists) couldn’t figure out why I would be spending so much time on this campaign. Their confusion was expressed in comments like this:
Misconceptions, myths, misinformation, and skepticism (I ran out of “m” words) persist not just with my friends but with many without much exposure to effective female condom programs. Yet, Beatrice Were, a Ugandan HIV/AIDS advocates and the 2005 recipient of the Human Rights Watch Award has said this about the female condom: "HIV/AIDS is becoming a women’s pandemic…They need the only tool for HIV prevention that women can initiate." Why does she have hope in female condoms?
Once you take a moment to actually learn about the female condom, you can see why advocates for sexual and reproductive health, HIV prevention, and/or family planning are rallying behind efforts to expand access to the female condom. And then when you read the new studies about the acceptability of the female condom among users and about the cost-effectiveness of investments in the female condom, it’s a no-brainer!
The female condom provides an option in addition to the male condom that makes negotiating safer sex possible for many women for whom it would not otherwise be. Female condoms can reduce the rate of HIV transmission among women having sex with an infected male partner by more than 90 percent; are at least as effective in reducing other sexually transmitted infections as are male condoms; and can be used to avoid unintended pregnancy. (A quick aside—I’m talking about the advantages of female condoms for women who have sex with men, but the product we know as the female condom is also used by many men who have sex with men; in the interest of brevity and focus, I’ll leave it to another blogger to expand on that topic.)
My friends were all missing some basic information about the female condom. So I found myself going through my facts about the female condom shpiel with friend after friend, each time ending up with another die-hard advocate for the female condom.
While my friends were right that the female condom won’t eliminate the need for negotiation in many sexual relationships, the dynamic in those relationships changes significantly when a woman is able to say to her partner, “If you don’t want to wear yours, I can wear mine.” Female condoms can be inserted independently, hours before sex, and they are made out of polyurethane instead of latex (which means people with latex allergies can use them, they’re more durable and heat resistant than latex condoms, and they transmit body warmth better than latex, which can make sex with a condom more enjoyable). And one of the most impressive things about the female condom is that studies have shown that when female condoms are delivered with effective programs, female condom use leads to higher usage rates for both male and female condoms.
It’s clear that expanding prevention options and increasing access to female condoms is critical in the fight against HIV/AIDS, yet in 2005 there was only one female condom distributed for every 100 women between ages 15 and 49.
So, how do we get universal access to the female condom? We get universal access to the female condom by:
To find out more about the Prevention Now! Campaign for female condoms and to get involved in supporting it, check out www.preventionnow.net.
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