Central to sex worker activism at the XVII International AIDS Conference was the call for an extensive revision of the UNAIDS Guidance Note on HIV and Sex Work, published in April 2007. According to sex workers and activists present at the conference, the guidance note was to take into consideration outcomes and recommendations from a sex worker consultation with UNAIDS and UNFPA that took place in 2005, but the guidance note almost completed ignored the sex workers' input. Instead it focused on a rehabilitative approach to sex work, following a policy in which sex workers need to be rescued from their vocation. A global working group on sex work policy, comprised of sex workers and sex worker activists from around the world, has submitted a suggested re-write of the guidance note to UNAIDS.
According to Ly Pisey, sex worker activist from Cambodia, policy makers and others are under the false assumption that adult sex workers are not in the trade because of choice, and that they want to be rescued from their victimhood. According to Pisey, these people only hear half of the story when they hear "I don't want to do sex work." Pisey noted that it is rather that sex workers think "I don't want to do sex work because it is not an accepted part of society."
Sex workers at the AIDS Conference advocated for governments and international policy bodies to recognize sex work as a legitimate profession. They cited the case of Brazil, in which sex workers have successfully lobbied their government to include sex work as an official profession in the list published by the Ministry of Work. Prostitutes in Brazil, as they prefer to be called, can also retire if they contribute to the social security system. Brazil is also noted for having rejected USAID funding for HIV and AIDS in 2005 because of the U.S. Government's policy to make aid recipients sign an anti-prostitution pledge. In doing so, the Government of Brazil publicly acknowledged that inclusion of sex workers in their national AIDS strategy contributed largely to their success in responding to the epidemic.
A third item for sex worker advocacy at the conference was the decriminalization of sex work. According to Meena Seshu, longtime sex worker activist from India, criminalization makes sex work go underground, increases violence against sex workers, and makes sex workers harder to reach with condom promotion and HIV prevention messages. Currently the Indian government enforces a neutral policy on sex work, but due to increasing pressure from the United States government, is pushing for implementation of the Immoral Traffic Prevention Act, which criminalizes entry into sex work and categorizes all sex workers as "trafficked victims." Seshu also stated that it is important to differentiate between adult sex work and child prostitution, and that sex worker activists are definitely opposed to the latter.
Sex workers who are in the profession by choice have been drastically hurt by anti-trafficking laws. In Cambodia, U.S. government encouraged anti-prostitution and anti-trafficking laws have led to a rise in imprisonment and rape and violence by policemen towards sex workers. In the Democratic Republic of Congo, there was also a marked increase in sexual violence towards sex workers by military and police, and a number of sex workers who experienced this trauma later tested positive for HIV.
The message of sex workers at the International AIDS Conference was loud and clear -- sex workers demand to be recognized as a legitimate profession and see themselves as part of the solution. Sex workers called for a massive scale up of services and resources from the international community, as currently only one in three sex workers has access to HIV prevention services. As Elena Reynaga shouted to the plenary before being greeted by a standing ovation, "Some may say sex work is not decent. We reply, indecent are the conditions in which we work...We don't want to sew. We don't want to knit. We don't want to cook. We want to improve our working conditions."
]]>Now 23 years old, Uiras shared her story in front of nearly 500 Christian religious leaders and delegates during the Ecumenical Pre-Conference to the XVII International AIDS Conference in Mexico City. Not commonly a topic of discussion in religious circles, gender-based violence and human trafficking was given its own plenary session and six workshop slots during the three-day event leading up to the world's largest conference on a single health issue.
"Many faith-based organizations are ill-prepared to deal with gender based violence and HIV and AIDS," stated Pauline Muchina, Senior Women and AIDS Advocacy Officer at UNAIDS, and member of the Anglican Church in Kenya. She noted that religion has often been used to perpetuate gender based violence, promote patriarchal views, and that churches have too often remained silent on the issue. In a workshop earlier in the pre-conference Muchina said that the church needs to re-educate its members, rethink its teachings on gender, and involve men, boys and male religious leaders in its response to gender based violence.
However, Muchina noted, there are already some faith-based organizations involved in addressing gender based violence. She cited the Malawi Ecumenical Counseling Center, which has created a manual on gender based violence for religious leaders, and the Salvation Army, which offers advocacy and a rehabilitative program for trafficking survivors. Uiras herself is now working with Churches United Against HIV and AIDS in Southern and Eastern Africa (CUAHA), a network of churches that has pledged to target human trafficking into South Africa in light of that country hosting the 2010 FIFA World Cup by helping victims, training counselors, and educating police about the dangers and potentials of trafficking.
Reflecting on her own experience of being molested as a child, Kay Warren, Executive Director of the HIV/AIDS Initiative at Saddleback Church, a mega-church in Lake Forest, California, said she felt like her church couldn't help her deal with her experience. Today her church has raised the issue of sexual, physical and emotional violence during church services, organized support groups for survivors, and created a resources page on its website.
Is the focus on gender based violence in this Christian conference, and the handful of churches already addressing it an encouraging sign that churches are moving past patriarchy and coming to term with a reality that affects an estimated 1 in 3 women worldwide? A packed session room for a workshop on addressing sexuality and masculinity in the church, and research presented by an evangelical Christian organization that presented a program that was successful in changing gender attitudes and cultural norms among churchgoers in two African countries show signs of hope.
With 500 Christians attending the pre-conference, and an estimated 1.5 billion followers worldwide, the true test will come over time. Creating a fora for dialogue on gender based violence and human trafficking amongst religious leaders and people of faith involved in the global response to HIV is just the beginning, but sends a clear message to churches that it is time to stop the silence and inaction surrounding these issues.
]]>In a breakout session on July 5, Bhatupe Mhongo, coordinator of UN+, an international organization for United Nations employees who are HIV-positive, advocated for more resources and leadership positions to be devoted specifically for HIV-positive women. She noted that positive women and girls should not be just the recipients, but the change leaders. Mhongo stressed the need to move past tokenism, stating, "When we're talking money, positive women and young women are the guests of honor."
Dr. Christoph Benn, Director of External Relations at the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), was optimistic that significantly more resources will be available within the next few years. He based this assumption on the pledge given by G8 (Group of Eight) countries during their June 2007 meeting in Germany to scale up contributions to respond to the world's three leading killers by infectious disease. However, the G8 countries have not always followed through with their commitments to international aid in the past.
Despite the fact that 57 percent of the 1.1 million people GFATM currently supports on anti-retroviral treatment are women, speakers in the plenary "If Women Really Matter, Where's the Leadership and the Money" were critical of bilateral and multilateral donors' support of women and HIV. Citing research on funding for women's rights conducted by the Association for Women's Rights in Development (AWID), Zawdai Nyong'o noted that women-led HIV initiatives are significantly underfunded.
According to AWID's research of over 1,000 women's rights organizations, the majority of women-led HIV initiatives worldwide operate on a budget of less that $50,000 per year, with over one-third of the organizations surveyed operating on less than $10,000 per year. Nyong'o expressed concern that the trend in funding by international bilateral and multilateral donors and foundations has shifted to larger grants for fewer organizations. This excludes many women-led organizations which are operating at the grassroots level.
Nyong'o also presented a list of the top twenty donors for women and HIV in 2005. HIVOS, the Global Fund for Women, Oxfam, the Norwegian government, and individual donors topped the list. Large international donors such as the World Bank and the United Nations Development Program (UNDP) were at the bottom of the list.
One donor agency that contributed more than the World Bank and UNDP was the African Women's Development Fund (AWDF). AWDF is an African wide grant-making organization, led by African women, that funds predominantly small and medium-sized women's organizations in 42 African countries. Addressing the plenary, AWDF's Executive Director Bisi Adeleye Fayemi stated that while large international donor agencies are slow to respond to women's issues, "the future of women's rights lies with individual donors."
The African Women's Development Fund's 13 Campaign, seeking to mobilize resources for women and HIV, was launched in Kenya during the summit. The 13 Campaign targets individual donors and foundations to give a contribution with the number 13 in mind, making contributions such as $13, $1300, $130,000. AWDF's HIV and AIDS Fund, begun in November 2005, has thus far awarded $642,000 to 39 organizations in 22 African countries.
While most international bilateral and multilateral donors and foundations have been especially slow in responding to women's needs in the face of HIV and AIDS, Fayemi noted that, as individuals, we have too. She provided the example of the World YWCA, which is currently fundraising for its $25 million endowment fund. With an international membership of 25 million women that translates to a $1 contribution per person, but thus far the endowment fund only has raised $10 million.
So while we advocate our governments, the private sector and international agencies to scale up the response to HIV and AIDS, especially for women and girls, what else can we do? According to Fayemi, the individual response has been unacceptable. "Let us fund our own revolution," she stated. "We matter. We have the money. We have the leadership."
]]>The International Women's Summit is also noteworthy in that nearly one-third of the participants were openly HIV-positive. Ninety grassroots home-based caregivers from 15 African countries, India and Guatemala also participated in a Grassroots Women's International Academy in Nairobi prior to the YWCA Summit.
The opening ceremony on July 5 included keynote addresses from Dr. Asha Rose Migiro, Deputy Secretary General of the United Nations; Dr. Margaret Chan, Director General of the World Health Organization; Dr. Peter Piot, Executive Director of UNAIDS; Dr. Helene Gayle, Chief Executive Officer of Care USA; and His Excellency Honorable Mwai Kibaki, President of the Republic of Kenya.
Dr. Asha Rose Migiro confirmed the United Nations' support for women and HIV, pledging to "work to ensure HIV and AIDS is high on [the United Nations] agenda ... where it belongs."
Dr. Peter Piot stated that feminization is transforming the AIDS epidemic and called the International Women's Summit "a defining moment in the fight against AIDS." Piot noted that stronger and more effective leadership is needed in the response to HIV and AIDS by giving more resources to women and giving women decision making power. While addressing a crowd of nearly 2,000 people, Piot declared that the world cannot afford to promote condoms with messages that promote male aggressive sexual behavior, stating that "we will accept nothing less than zero tolerance for gender-based violence."
Another highlight of the opening ceremony was the presentation of the Women Leading Change Awards, given to fourteen women around the world who have significantly contributed to the response to HIV and AIDS in their communities. The award winners have been involved in organizing support groups for HIV-positive women, increasing access to anti-retroviral drugs (ARVs), and working to address cultural practices such as polygamy and wife inheritance, which contribute to the spread of HIV.
The Nairobi 2007 Call to Action on Women's Leadership on HIV and AIDS was launched at the closing ceremony on July 7. Dr. Musimbi Kanyoro, General Secretary of the World YWCA, noted that the Nairobi 2007 Call to Action is not meant to supersede previous documents written about this issue including statements from the International Community of Women Living with HIV, the Barcelona Bill of Rights of 2002, the Canadian Blueprint document of 2006, and the Johannesburg Position on HIV/AIDS and Women's and Girls' Rights in Africa of 2006. However, Kanyoro stated, the Nairobi 2007 Call to Action is unique in that it calls individual women to be personally accountable in the response to HIV and AIDS at the local, national and international levels by working to end stigma and discrimination towards people living with HIV, increasing their knowledge and the knowledge of those around them, and committing their time and resources to improve the future for women and girls. The call to action states:
We affirm the human rights of women and girls and recognise that the realisation of these rights is critical to an effective response to the global AIDS pandemic and the future of our world. We commit to lead change in our communities to transform the lives of women and girls everywhere, especially those infected and affected by HIV and AIDS. We believe that women's leadership is essential in changing the course of this pandemic ... By taking leadership into our hands and uniting in strength as a movement of women, we can lead the change we wish to see in the world.
The document was endorsed by the International Community of Women Living with HIV, Huairou Commission, ATHENA, Blueprint for Action, and the World Council of Churches. Grassroots women participants also issued their own statement, declaring that "it is time for the world to recognize and resource grassroots women's on-going care giving and work and leadership in the response to HIV and AIDS." Deborah Landey, Deputy Executive Director of UNAIDS, summed up the summit by proclaiming that "women's leadership is on the move."
]]>Twenty-six years into the HIV pandemic, women account for nearly 80 percent of new HIV infections in young people, and women have now surpassed the number of men worldwide living with HIV. While female-controlled modes of HIV prevention such as microbicides and pre-exposure prophylaxis are still undergoing clinical trials, the reality remains that there is still less than one female condom available each year to every sexually active person in need of one. Despite this, nearly half of U.S. Congressional representatives don't believe access to low-cost contraceptives is an important component in the President's Emergency Plan for AIDS Relief (PEPFAR) funding, as indicated in their recent support of amendments which keep abstinence-until-marriage earmarks in U.S. foreign aid. Although billions of dollars are poured into HIV prevention and AIDS relief each year, it seems very little of the funding is actually reaching the people in most need of it.
The first-ever International Women's Summit on Women's Leadership and HIV and AIDS, co-hosted by the World YWCA and YWCA of Kenya, will open on July 5 in Nairobi, Kenya. Bringing together leaders such as UNAIDS Executive Director Dr. Peter Piot, WHO Director General Dr. Margaret Chan, celebrities, activists, and community women, the summit will highlight the difference women's leadership is making on HIV and AIDS, offer an exchange of ideas on programs which are taking place around the world, and demand accountability for future resources to address the feminization of the pandemic.
The summit will begin with a forum exclusively for HIV positive women on July 4, expected to draw 500 women. The larger event will feature workshops and breakout sessions on a variety of topics including women's rights, investing more resources for women, addressing violence against women in the context of HIV and AIDS, women and religion, and ensuring women's representation in decision making. A plenary session on the final day of the summit is called "If Women Really Matter, Where's the Leadership and the Money?"
Coincidentally, the final day of the summit, July 7, 2007, also represents the mid-point of meeting the Millennium Development Goals. So how are we doing on Goal #3: Promoting Gender Equality and Empowering Women and Goal #7: Combating HIV and AIDS and other diseases? Will the summit itself be instrumental in bringing women's issues in the context of HIV to international attention? Are we at a turning point in recognizing that women's specific needs matter and need to be addressed? I am optimistic, but as they say in Kenya, polepole—slowly, slowly—we will get there. The question remains—will we get there in time?
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