OneWorld.net (U.S.)

WASHINGTON, D.C., Dec 3 (OneWorld) – With the rates of women and girls living with HIV/AIDS climbing sharply worldwide, public-health experts and activists this week urged policymakers to go beyond the “ABCs” of AIDS prevention promoted by the Bush administration to a more comprehensive and long-term strategy.

Marking World AIDS Day, which this year fell on Wednesday, experts and anti-AIDS groups stressed that the “feminization” of HIV/AIDS poses a major and relatively new challenge to efforts to fight the epidemic which last year is estimated to have killed three million people worldwide and which infected five million others.

“Of the 14,000 people newly infected with HIV every single day, nearly half of them are women,” said Geeta Rao Gupta, president of the International Center for Research on Women (ICRW).

In sub-Saharan Africa, the region hardest by the disease by far, nearly 60 percent of all adults infected with HIV and more than 75 percent of African youth with HIV are girls. Even in the United States, AIDS has become the leading cause of death for African-American women between the ages of 25 and 34.

The “ABC” of AIDS prevention, which takes up a considerable portion of Bush’s five-year, US$15 billion Emergency Plan for AIDS Relief (PEPFAR), focuses on infection prevention through Abstinence, Being faithful to one’s partner, and using Condoms.

Although the U.S. officials have claimed that the ABC approach played an important role in sharply reducing infection rates in Uganda, where it was pioneered, many experts have argued that the strategy is not nearly sufficient, particularly when it comes to defending women against infection.

“Millions of women became infected while monogamous and faithful, so focusing solely on personal behavior and risk absolutely does not go far enough,” said Gupta at a press briefing Wednesday.

“The how and why of women’s vulnerability to HIV and AIDS has been known for more than a decade,” she said, noting that her agency had predicted in the early 1990s that HIV would spread fastest among women and girls because of their lack of power in many societies. “But …the response was weak then and remains a low priority today.”

“The international community must act now to invest in strategies that are known to reduce the vulnerabilities affecting women and girls,” she added, calling for what she called an “ABC-Plus” approach that should provide women with new, female-controlled prevention technologies, such as microbicides; greater access to existing technologies, such as the female condom; and longer-term strategies designed to reduce domestic violence and enhance the social, educational, and economic status of women.

“The simple truth is that empowering women and girls to protect themselves and their families from AIDS is key to turning the tide,” agreed Dr. Peter Piot, executive director of UNAIDS, who participated in the same briefing.

“Women are the backbone of society. Therefore, keeping women healthy is not just the right thing to do; it’s the smart thing to do. If there’s one place in this epidemic to intervene, one place where our efforts will yield dramatic results, this is it,” he said.

That same message was also heard across time at a Wednesday morning rally and “die-in” in front of the World Bank and the International Monetary Fund (IMF).

“In Africa and increasingly around the world, AIDS has a woman’s face,” said Marie Clarke Brill of Africa Action, a grassroots activist group. “If we are to turn the tide of this pandemic, we need to promote strategies that will address the gender inequalities that leave women and girls most vulnerable to HIV/AIDS.”

Since 2002, the number of women living with HIV has risen in every region of the world. Nearly half the nearly 38 million adults with HIV infection worldwide are women, according to UNAIDS.

Experts argue that the unequal power relations between men and women play a major role in increasing women’s vulnerability to contracting the disease.

“Sexual and physical violence against women increases their risk to HIV, both directly and indirectly, as does the practice of child marriage in many developing countries – since an older husband is more likely to be infected, and a young bride is less likely to be able to negotiate protection,” according to Rao.

Similarly, less access for women and girls to education, particularly secondary education, and to gainful employment, as well as their lack of control over family income and other economic assets, also undermine their ability to gain information about HIV/AIDS and how to protect against it and to obtain medical assistance.

In addition, “economic insecurity and dependency make it more likely that women will sell or exchange sex for money, goods or favors,” according to Rao, who noted that a number of relatively small-scale projects in developing countries, such as Kenya and Vietnam, that have tried to address the broader issues have shown good progress. But, she stressed, “these efforts are far too few. More must be done.”

UNAIDS, which recently helped launch the new Global Coalition on Women and AIDS, has come to similar conclusions, according to Piot.

The new Coalition is promoting strategies that are designed to reduce violence; protect property and inheritance rights of women; ensuring their access to health care; investing more in female-controlled prevention technology, including microbicides and female condoms; and supporting programs designed to enhance access to education and economic opportunity.

While donors, such as the U.S. Agency for International Development and the World Bank have also placed increasing emphasis in their work on empowering women over the decade, the overall macro-economic policies that they promote in developing countries, often work to undermine that goal, according to Clarke and other activists who rallied in front of the two Bretton Woods institutions.

They also called for the two agencies to cancel the debt of the world’s poorest countries so that their governments could afford to spend more on education and health care, rather than on debt service.

“Women and girls are hardest hit by HIV/AIDS globally, but the budget austerity policies imposed by the IMF continue to undermine efforts to address the impact of this health crisis on women,” said Njoki Njehu from the ‘Fifty Years is Enough’ network. “If the World and IMF are serious about defeating this pandemic and promoting women’s rights, they must cancel the debt and austerity policies that deepen poverty and perpetuate gender inequality.”