Commission on the Status of Women
Forty-fifth session
Summary submitted by the Moderator of the panel discussion on women, the girl child and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (Ellen Margrethe Loej)
1. At its 6th meeting, on 8 March 2001, the Commission held a panel discussion followed by a dialogue on women, the girl child and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), one of the thematic issues of the Commission’s forty-fifth session. The panellists were Mabel Bianco (Argentina), Expert on Women and HIV/AIDS; Sharifah H. Shahabudin (Malaysia), Professor of Medical Education and Director of the Academic Development Centre on Women, AIDS and Health; Sheila Tlou (Botswana), Associate Professor, Department of Nursing Education, Faculty of Education, University of Botswana; and Elhadj Sy, Representative of the United Nations Programme on HIV/AIDS (UNAIDS) Liaison Office in New York. The panel was moderated by Ellen Margrethe Loej (Denmark), State Secretary, Ministry of Foreign Affairs.
2. Many participants stressed that the vulnerability to and impact of HIV/AIDS could not be ameliorated unless the fundamental gender inequalities were addressed by fostering an enabling environment that transformed relationships and promoted true partnerships, respect for human rights and equal opportunities for both women and men. Since women’s empowerment was a complex issue, participants stressed that in order to be addressed effectively it required a holistic approach. Gender mainstreaming should be pursued and be put into a context of human rights, survival, safety and all other factors related to human security. Participants also stressed that, since the mandate of the Commission on the Status of Women was to mainstream a gender perspective in United Nations policies and programmes, the Commission could provide added value to the preparation process of the special session of the General Assembly on HIV/AIDS to be held from 25 to 27 June 2001 and to the special session itself by sending to the special session a clear message on the importance of addressing the gender impact of the AIDS epidemic.
3. Participants emphasized the gender dimensions of the HIV/AIDS pandemic. They identified the imbalance of power between women and men, often promoted by cultural, social and religious norms, as being one of the main causes of the spread of HIV/AIDS. Women often did not have the power to decide about their lives, especially as regards sexual relations. In particular, young women and girls were often victims of gender-based violence, including sexual abuse and domestic violence, which besides violating their human rights also significantly exposed them to the risk of contracting HIV/AIDS.
4. Participants emphasized that violence could be eliminated through formal and informal sexual education for children and adolescents, particularly before they started engaging in sexual relationships, and through programmes which promoted equality and autonomy in sexual relations, mutual respect and protection. It could furthermore be eliminated through the modification of a number of laws which contributed to sexual violence, such as those that did not punish rape inside marriage or condoned a girl’s rape if the violator married her. The need to address the issue of mass media and their role in fuelling gender violence and perpetuating gender stereotyping was also pinpointed. Participants also discussed the need to carefully analyse the complexities of the relations between women and men in order to correct the disfunctionalities of such relationships and thus contribute towards achieving the respect for the human rights of women and girls and more equal gender relations.
5. Many participants recognized that HIV/AIDS was a human security issue. The depletion of the skilled workforce, the decline in national food security resulting in malnutrition and starvation and increased illiteracy as children, particularly girls, dropped out of school in order to become breadwinners or care for the sick and dying, jeopardized national development and threatened the security of countries affected by the pandemic. The increase of child orphans, often cared for by elderly grandmothers, was also stressed. The poverty, violent conflict, political and social instability which could result from HIV/AIDS might have repercussions in other countries too, especially as HIV could easily spread across borders due to the movement of migrants in search of employment, long-distance drivers, military and militia groups, tourists, and traders and trafficking in women, young girls, boys and drugs.
6. Participants stressed that poverty was another factor responsible for the spread of HIV/AIDS, particularly among women, who constituted the majority of the world’s poor. Due to poverty, girls were often trafficked into prostitution and sexual slavery, including in foreign countries, where, being illegal migrants, they were not protected by the law and lacked access to social services. Some participants emphasized that poverty had created an environment of risk to HIV and that risk was also gendered as women tended to take different risks from men, depending, inter alia, on their economic security. Therefore, integrated programmes aimed to eradicate poverty, particularly among women and girls, should be developed.
7. Participants pinpointed the need for working with men in the fight against HIV/AIDS. Until recently, men tended to be considered responsible for rapidly transmitting the virus. Such a stereotypical label did not facilitate male involvement. Many participants brought up successful examples of programmes and projects undertaken in the last few years involving men in the fight against HIV/AIDS, such as working with religious and traditional leaders through the development of programmes based on religious core values, working with men’s organizations, such as the Society for Men and AIDS in Africa, or involving men in Latin America in the fight against violence, especially sexual violence. Men should be involved in all national and international activities relating to the prevention, impact alleviation and care of people living with HIV/AIDS. Examples of successful programmes to involve men were also cited by the Joint United Nations Programme on HIV/AIDS (UNAIDS), which had launched the "Men make a difference" campaign, the results of which had been posted on its web site.
8. Participants emphasized that HIV infection among women led to an increase in the violation of women’s human rights, such as the right to bodily integrity, access to health services, including for reproductive health. Frequently, even in countries where abortion was not legal, HIV-positive women were forced to have an abortion if pregnant. Compulsory sterilization was another frequent practice imposed on women living with HIV/AIDS.
9. It was pointed out that the stigmatization suffered by HIV-infected women often prevented them from seeking medical assistance. Therefore, the need to combat stigmatization was emphasized. Some participants stressed that language was also responsible for stigmatizing women, and suggested the use of "parent-to-child" transmission rather than "mother-to-child" transmission as a preferred terminology in order not to associate women with the blame related to transmitting HIV to children. That would also help in decreasing women’s self-blame for transmitting the diseases to their children. Some stressed the need to include a psychological support component to HIV/AIDS services, programmes and policies.
10. Some participants emphasized that mandatory testing violated human rights. It was also mentioned that in order to be effective testing should be voluntary and accompanied by adequate counselling. Counselling was considered as being a very good opportunity for educating people about HIV/AIDS, particularly for reaching out to men. The need for education on HIV/AIDS was emphasized, including through the use of the new information and communication technologies, which could play an important role in reaching out to young people. However, it was also stressed that education was not sufficient to empower people if access to care was not available to all. For example, if care was located to mother-to-child transmission and natal care, men, even if aware of the disease, might not be reached by care programmes.
11. Many participants in the panel discussion emphasized the need for access to affordable treatment, including antiretrovirals and prophylaxis of opportunistic infections, particularly for developing countries. Emphasis was placed on the need for concerted action at the international level to lobby for the reduction in the price of drugs. Some participants stressed the need for a more morally acceptable approach than the one based on loans for drugs. Some stressed that accepting loans for drugs would lead to an increase in the already heavy debt burden carried by poor countries. Cooperation with pharmaceutical companies should be envisaged in order to find a balance between an increase in the accessibility to affordable drugs by the poor and the need to allow companies to invest in research for a cure.
12. However, it was also stressed that drugs were not a panacea and had to be complemented by good health services in such a manner that the issue of access to drugs was treated in a broad framework, encompassing both health care and developmental assistance, as well as the formation of effective systems of distribution and basic infrastructure. It was noted that access to reproductive health services for all women, not only for HIV infected women, would enable them to control their bodies and make informed choices.
13. Some participants stressed the need to explore the use of alternative therapies, such as traditional medicine, which would be cheaper and more women-friendly. Others stressed the need for developing countries, particularly for African countries, to intensify their own research, including in herbal medicine. A link between gender-sensitive research and the implementation of policies and programmes should be made. The need to respect the human rights of people in the context of research was also stressed.
14. Some participants stated that in many countries, the main form of HIV/AIDS transmission was through substance use, thus emphasizing the need to combat the drug problem. However, others stressed that substance abuse was only one of the entry points for a pandemic which, once inside a community, could be spread through various means. Therefore, the strategy to combat HIV/AIDS should have a multi-pronged approach. The involvement of people living with HIV/AIDS in sensitizing community members was considered crucial, although problematic unless the stigmatization associated with HIV/AIDS was eliminated.
15. Participants emphasized the importance of political commitment at the highest level in order to combat HIV/AIDS. The significant role of political leaders was emphasized. It was further stated that the decision makers at the national level should make every effort to provide the necessary financial resources. In fact, while it was recognized that more resources should be allocated to the fight against HIV/AIDS by the donor community, countries affected by HIV/AIDS should also be responsible for mobilizing more resources. Armed conflicts were also seen as a major impediment to the fight against HIV/AIDS due to the high costs involved in the purchase of armaments and increased vulnerability to violence of women and girls. Thus, peace was considered as being a possible contribution to combat HIV/AIDS.
16. It was noted that States should acknowledge that the threat to their security came from both within and across national borders. Concerted action among States, intergovernmental organizations, transnational corporations and civil society was needed as an effective way to maximize the use of resources, coordinate programmes and apply and share knowledge to combat the spread of the disease and alleviate the sufferings of HIV-infected people. Action should be taken at the national, regional and international levels. In particular, the need for action at the regional level was stressed, and it was suggested that Governments establish mechanisms for joint regional plans and collaborate to creatively develop new culturally sensitive programmes and new ways of addressing the pandemic within a human rights framework. United Nations entities, including the World Bank, and other international institutions should review economic and trade policies and practices that resulted in increased unemployment and cuts in social services, and thus made people vulnerable to HIV/AIDS, particularly in developing countries.