HIV/AIDS and women

In December 1977, the UN General Assembly adopted a resolution proclaiming March 8 a United Nations Day for Women's Rights and International Peace.

In many countries, provisions guaranteeing the enjoyment of human rights without discrimination on the basis of sex have been included in constitutions; measures have been introduced to alert and to educate women about their rights and to ensure access to them; the world community has identified violence against women as a clear violation of women's rights and incorporating gender perspectives into policies has become a priority at the United Nations and in many member states.

From a European perspective, most pertinent for women, the Amsterdam Treaty also contained a new article, number 13, that empowered the Council of Ministers, acting unanimously, to take "appropriate action" to combat discrimination based on sex, racial or ethnic origin, religion or belief, disability, age, or sexual orientation.

Although progress has been registered, both in developed and developing countries, much remains to be done to achieve full equality. In the context of this article, equality has a much wider meaning than "simply" achieving one's legal rights!

A new initiative titled The Global Coalition on Women and AIDS was launched in London in February this year.

This coalition is made of "activists, government representatives, community workers and celebrities", all coming together to "stimulate concrete action on the ground to improve the daily lives of women and girls".

The coalition's efforts will focus "on preventing new HIV infections among women and girls, promoting equal access to HIV care and treatment, accelerating microbicides research, protecting women's property and inheritance rights and reducing violence against women.

"All too often, HIV prevention is failing women and girls," said Peter Piot, UNAIDS executive director. He was reported as saying: "Because of their lack of social and economic power, many women and girls are unable to negotiate relationships based on abstinence, faithfulness and/or use of condoms. It is precisely to address these inequalities and reduce women's vulnerability to HIV that the Global Coalition on Women and AIDS has been created". Women make up about half the global HIV epidemic and where the epidemic is longer standing, say, in Africa, they are well over half.

A ministerial conference in Dublin last month was titled Breaking the Barriers: Partnership to Fight HIV/AIDS in Europe and Central Asia. The UN secretary general, the WHO director general, the UNAIDS executive director, the UNICEF executive director, the president of the European parliament, the European commissioner for health and consumer affairs and other very high officials representing various international organisations met to discuss the issue.

The conference's discussion paper put forward some salient facts that cannot be ignored, not even by those who still think that HIV/AIDS is a non-issue!

In Europe and Central Asia differences in the course of, and responses to, the epidemic, result in inequities in provision of treatment and care. In western Europe, including Malta, antiretroviral treatment [ART] is available to all, or most, of those who need it. However, recent increases in HIV and AIDS raise concerns about increased risk behaviours, treatment complacency, waning government commitment and slipping of prevention efforts.

High levels of risk behaviour, low levels of knowledge and poorly developed prevention and treatment services create conditions for potentially devastating epidemics. In eastern Europe and central Asia, HIV rates increased dramatically between 1995 and 2002, mainly among injection drug users and their sexual partners.

Eastern Europe and Central Asia also have the highest incidence of tuberculosis, multi-drug resistant tuberculosis and TB/HIV co-infection in Europe.

Access to ART is severely limited or unavailable in many eastern European countries and those in central Asia that are experiencing the most serious escalation of the epidemic.

The fact that women are twice more likely than men to contract HIV from a single act of unprotected sex and still they remain dependent on male cooperation to protect themselves from infection is the epitome of true vulnerability. Violence against women is common in practically all societies and it reinforces discrimination against and subordination of women. For many women worldwide the threat of violence that permeates their everyday lives exacerbates their vulnerability to HIV. Sex workers, including those who have been trafficked, are especially vulnerable.

Quoting from the Dublin Declaration on Partnership to Fight HIV/AIDS in Europe and central Asia, representatives of states and governments expressed "profound concern that in the European and central Asian region, at least 2.1 million of our people are now living with HIV/AIDS;

"Agree that we must act collectively to tackle this crisis through a deepening of coordination, cooperation and partnership within and between our countries;

"Confirm that the respect, protection and promotion of human rights is fundamental to preventing transmission of HIV, reducing vulnerability to infection and dealing with the impact of HIV/AIDS;

"Recognise that women and girls are particularly vulnerable to HIV infection;

"Stress that without urgent action, HIV/AIDS will continue to move into the general population;

"Develop national and regional strategies and programmes to increase the capacity of women and adolescent girls to protect themselves from the risk of HIV infection, and reduce their vulnerability to HIV/AIDS;

"Control the incidence and prevalence of STIs (sexually transmitted infections), particularly in high-risk groups, through increased public awareness of their role in HIV transmission, improved and more accessible services for prompt diagnosis and efficient treatment".

The message is loud and clear, it is now up to us to make more sense of Women's Day.

Ms Bugeja is executive director, National Commission for the Promotion of Equality for Men and Women.