WWW Call on Donors of the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM) to take urgent action around the intersection of violence against women and girls and HIV&AIDS
Neelanjana Mukhia
Neelanjana.Mukhia@actionaid.org
Neelanjana Mukhia
International Women's Rights Policy and Campaign Coordinator
Action Aid International Secretariat
Johannesburg, South Africa
September 2007
As some of the world's wealthiest donors gather to replenish their contributions to the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM), and to reaffirm their commitment to a comprehensive response to the AIDS pandemic, the Women Won't Wait campaign calls for action, not just more words.
Violence against women and girls is an incessant, endemic and gross violation of all women's and girls human rights that requires urgent action from all, in and of itself and when it intersects with HIV&AIDS. It is no secret that women and girls are disproportionately impacted by HIV&AIDS, both in terms of the increased incidence of HIV in women (and young women in particular), but also because of the significant responsibility women carry for sustaining their families and communities.
All women face a persistent and sometimes unrelenting threat of violence and, in many cases, this violence brings with it the threat of of infection. At the same time, while all women struggle against the omnipresence of violence, women who are HIV positive face the increased likelihood of violence that results from the stigma and discrimination they face because of their health status. The overwhelming of violence, coupled with gender inequality hampers women's and girls ability to take full advantage of crucial even life-saving - services. Lack of access to services may become especially egregious when stigma, discrimination and negative and/or discriminatory treatment they receive from health care workers combine. For example, Human Rights Watch reported that in September 2006 in Kolkata, India an HIV-positive woman was forced to perform an abortion on herself at a state-run hospital. The doctors had refused to treat her because of her HIV status, instructed her as to how to terminate her six-month pregnancy, and forced her to leave the hospital afterwards (1). In a more insidious way, women face shaming and isolation by their family, the community and by the police and other justice authorities when they report sexual abuse or rape. As a result, they may miss the benefits of prophylactic treatment after possible exposure to HIV (2).
The Women Won't Wait coalition seeks to ensure that women's human rights, specifically their right to be free of violence and to the highest attainable standard of health, be placed at the center of all AIDS responses. Addressing the intersection of all forms of violence against women and girls and HIV&AIDS requires acknowledging the critical role played by efforts to: (i) respect, protect and fulfill women's human rights; and (ii) achieve gender equality in the fight against poverty and underdevelopment, specifically as these concerns relate to HIV.
The current funding environment
A research report by the campaign called Show Us the Money: is violence against women on the HIV&AIDS donor agenda? found that major HIV donor agencies tend to treat gender-based violence and violence against women and girls as an add-on rather than as integral to all aspects of their work on HIV; and within policies and programmes, violence against women and girls is rarely highlighted as a major driver and consequence of the disease, nor measured statistically as a means of contributing to the evidence base.
While significant increases in resources have been made available to fight AIDS in 2004 and 2005, these rates of increase will have to double in order to reach the goal of near universal access to treatment. Indeed, current levels of funding will fail to sustain treatment for those currently receiving it, let alone approach a commitment to come as close as possible to universal treatment, prevention, care and support made by the international community (3). A study on violence against women and girls in the context of HIV and AIDS by the Global AIDS Alliance recently estimated that additional resources, at the level of at least $2 billion beginning in 2007, are urgently needed for effective, evidence-based programs that address violence (4).
In addition, HIV&AIDS responses are only reaching a small number of those in need to testing, treatment, care and support, and those receiving services are disproportionately living in urban areas. This reality ignores the fact that today the increase of the pandemic is significantly affected by the forced displacement, migration, armed conflict and post conflict situations. Because these groups are not recorded in the statistics, this negation leaves behind large numbers of women and girls living in distant rural areas.
A distinct and serious gap in funding to address each epidemic and their intersections means that significant change is needed by the GFATM as well as its donors if resources are to comprehensively address the complexity of the HIV epidemic.
What can the GFATM do?
The Women Won't Wait campaign call on donors of the GFATM to demonstrate their leadership through:
(i) Broader and increased support to prevent and redress violence against women and girls and HIV&AIDS
With its unique structure and flexible funding capacity, the GFATM can play an essential role in supporting broader and increased funding to address the negative alchemy of violence and AIDS. This response should include increased funding for sexual and reproductive health and rights and the promotion of the empowerment of women and girls as an integral and indivisible part of any AIDS response, whether this be focused on prevention, treatment, or care. The GFTAM can play a key role in reaching historically marginalized groups living in distant rural areas where responses do not arrive not only of their location but also because of the discrimination women suffer on the basis of their ethnicity, race, class, location, education, sexual orientation, gender identity, etc
In upping the ante, it is imperative that the donors support the GFATM, by prominently underscoring the epidemic of violence against women and girls as a major driver and consequence of HIV&AIDS, reiterating that violence against women and girls is a human rights crisis, and that the fight against one epidemic--HIV--cannot be won without tackling the other epidemic gender-based violence. It is high time that that every strategy, program, and intervention aimed at stemming the spread of HIV and expanding access to treatment integrally addresses the issues of violence, rights violations, stigma, and discrimination that fuel this epidemic or the world will continue to lose ground.
(ii) Raise attention and concrete action by all to the intersection of violence against women and girls and HIV
Building on work articulated in the G8 Gleneagles Summit (2005), the recent G8 communiqué (Heiligendamm, 2007) called for particular attention to be paid to the needs of those most vulnerable to infection, including adolescent girls, women and children, and emphasized the importance of programs to promote and protect human rights of women and girls as well as the prevention of sexual violence and coercion especially in the context of preventing HIV/AIDS infections. The G8 called, in particular, for GFATM partner governments, to support a gender-sensitive response by the GFATM, with the goal of ensuring that greater attention and appropriate resources are allocated by the Fund to HIV/AIDS prevention, treatment, and care that addresses the needs of women and girls.
The campaign calls publicly on G8 members and other core GFATM donors to implement the 2007 Heiligendamm, commitment to ending violence against women and stemming the HIV pandemic by supporting efforts by the Fund to raise attention and concrete action by all to the intersection of violence against women and girls and HIV through the following actions:
a) Develop and integrate targets and indicators on violence against women and girls in its monitoring and evaluation toolkit;
b) Urge grantees to collect baseline data on the extent, nature, and drivers of violence against women in specific settings, develop and disseminate guidance to facilitate the collection and analysis of this information, and provide flexible funding to address these factors.
c) Ensure that expertise on the intersection of violence against women and girls is fully available among technical review panel membership;
d) Determine as technically faulty any national AIDS plans that fail to grapple with preventing and responding to violence against women and girls as a central feature of AIDS prevention, treatment, care and support.
(iii) Designate separate funding to build the capacity of a range of civil society organizations to more fully participate in national AIDS priority-setting processes and country coordinating mechanisms (CCMs).
While the GFATM is founded on a commitment to country control, many external agencies influence the process and provide input, technical assistance and support to Country Coordinating Mechanisms (CCMs) as they prepare a GFATM grant proposal and, once accepted, implement the grant agreement. Yet, women's rights organisations and organisation of women living with HIV&AIDS have had a notably difficult time gaining access to participating in the national priority-setting process conducted by national CCMs, and as a result the issue of violence against women and girls, in particular, has received little support through GFATM mechanisms.
It is imperative that GFATM donors provide the leadership that is required to ensure that the GFATM becomes a more significant source of support for these efforts, in particular, by including voices and experience of women's rights and anti-violence organizations, women and girls living with HIV&AIDS (whilst acknowledging the diversity of this group, and also ensuring that participation encompasses not only the easiest to reach or those with the strongest voice within this group but that it includes a cross-section of women and girls living with HIV&AIDS) in the national priority setting process to ensure that interventions addressing the intersection of violence against women and girls and HIV are included in country grant proposals. To fail to include this intersection must be understood as a failure to develop an adequate national plan.
We support the commitment of April 2007, when the Global Fund Board agreed that available resources for Global Fund grants should grow from approximately $2 billion a year currently to as much as $8 billion per year by 2010 (5) or $18 billion over the next three years (6). This figure represents the Global Fund's share of total resources needed to achieve the Millennium Development Goals (MDGs) and universal access to HIV prevention, treatment, care and support - which in total are estimated $89 billion in 2008-2010.
At the current juncture where the majority of those infected and affected by HIV&AIDS are women, it is critical that the core business of HIV&AIDS responses is targeted at addressing those issues that make women vulnerable and impact on their human rights. The Women Won't Wait campaign urges donors of the GFATM to act NOW.
Women Won't Wait seeks to accelerate effective responses to the linkages of violence against all women and girls and the spread of HIV by tracking and, where necessary, calling for changes in the policies, programming and funding streams of national governments and international multilateral and bilateral donor and technical agencies.
The Women Won't Wait campaign has released a report: Show Us the Money: is violence against women on the HIV&AIDS donor agenda? that analyses the policies, programming and funding patterns of the four largest public donors to HIV&AIDS. The report is the first step in an effort by this coalition to monitor the policies, programmes, and funding streams of international agencies and national governments, and to hold these agencies accountable to basic health and human rights objectives.
For more information about the Women Won t Wait campaign, please contact: info@womenwontwait.org
Members of the Women Won t Wait End HIV and Violence Against Women. Now. campaign:
Action Aid; African Women's Development and Communications Network (FEMNET); Association for Women's Rights in Development (AWID); Center for Women's Global Leadership (CWGL); Center for Health and Gender Equity (CHANGE); Fundación para Estudio e Investigación de la Mujer (FEIM); GESTOS-Soropositividade, Comunicação & Gênero; International Community of Women Living with HIV&AIDS Southern Africa (ICW-Southern Africa); International Women's AIDS Caucus; International Women's Health Coalition (IWHC); Latin American and Caribbean Women's Health Network; Open Society Initiative for Southern Africa (OSISA); Program on International Health and Human Rights, Harvard School of Public Health; SANGRAM; United Nations Fund for Women (UNIFEM); VAMP; and Women and Law in Southern Africa (WLSA).
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(1) Human Rights Watch, Sydney AIDS Conference: Scientific Advances Undercut by Rights Abuses Advances in HIV/AIDS Prevention, Treatment Hinge on Respecting Human Rights. Press release, New York, July 20, 2007.
(2) The Drama of Sexual violence, Clarín, November 22, 2006.
(3) International Treatment Preparedness Coalition (ITPC), Missing the Target. Off target for 2010: How to avoid breaking the promise of universal access. (Update to ITPC s AIDS treatment report from the frontlines). 24 May 2006: p. 5.
(4) Global AIDS Alliance, 2006. ZERO TOLERANCE: Stop the Violence Against Women and Children, Stop HIV/AIDS, p. 4.,. GAA Policy Brief.
(5) From the Global Fund Board report: The Global Fund s 2007 Resource Needs report currently projects a level of demand to the Global Fund of US $6 billion per year in 2010, which would represent a tripling in the size of the Global Fund. The Board recognizes that, if its partners and stakeholders in developing and developed countries scale up their efforts to strengthen and improve the quality of demand from country partnerships, such demand could potentially reach the level of $US 8 billion by 2010.
(6) Scenarios B and C from the Global Fund s Resource Needs for the Global Fund 2008-2010.
