Time to Deliver for Women and Girls


Adrienne Germain is the President of the International Women's Health Coaltion.

A lot of the buzz from Toronto this week centered on women, led by the "Bill and Bill show," and especially the Gates' attention to microbicides.

Microbicides will be a key HIV prevention tool, but no technology is going to end this pandemic. Girls' and women's vulnerability is driven by discrimination in education, employment, and property rights, and by sexual coercion and violence. These fundamental issues – and ways to fix them – were not on the lips of most of the conference "star power."

When gender inequality was addressed, the record was disgraceful. A telling example comes from Richard Feachem, soon to step down as head of the Global Fund to Fight AIDS, Tuberculosis, and Malaria. He acknowledged at a high level meeting, "Time to deliver for women and girls," on August 13, that his agency knows nothing and has done little, using four indicators.

First, he suggested that although nine out of 20 voting board members are women, including the Chair and Vice Chair, given the statistics on the pandemic, 11 or 12 women would be more representative. He gave the Fund an "OK" grade on this indicator.

Next, he considered whether the Country Coordinating Mechanisms (CCMs), which are responsible for writing proposals to submit to the Fund, are gender-balanced. While gender balance is encouraged, it is not required, he said. The Fund doesn't ask CCMs what their record is, so he doesn't know whether they are gender-balanced or not.

His rating? Poor.

Third, he asked himself whether the Global Fund invests in programs that emphasize gender. Again, he didn't know, because the Fund doesn't ask and doesn't track.

Rating? Poor.

The final criteria in his rating system was whether the Fund is learning systematically about gender issues. On this measure, he responded with an unequivocal "No," especially with regard to HIV/AIDS prevention.

Rating? Poor.

His conclusion? "We must do more."

We must, of course, give Mr. Feachem his due for acknowledging failure. And there are signs that things are looking up.

In June, at the United Nations High-Level meeting on HIV/AIDS, 140 governments agreed to ensure women's rights and gender equality. The UNAIDS board has since requested guidelines for governments and UN agencies on how to realize these commitments. And in Toronto this week, women and human rights leaders and the head of UNAIDS met to discuss how to get the guidelines written with strong input from women who have worked for gender equality and women's rights for decades.

So in 2008 – at the next International AIDS Conference in Mexico – the new Director of the Global Fund, Bill and Melinda Gates, President Clinton, and many more should have tangible, well-funded actions to report. It's time that they deliver!

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  • mernlar

    It seems like this problem may be symptomatic of what increasingly being recognized as a problem in health care as a whole–neglecting the needs of women. After years and years of performing clinical trials to treat heart disease on men, it has suddenly occured to the medical establishment that women experience heart disease in a totally different way, and thus, much of what they know about men is less relevant in treating women. Suddenly, after years of promoting it to help stave off the symptoms of menopause, we discover that HRT may do more harm than good. And of course, no Plan B–it might encourage young girls to think that their bodies are their own to control, and of course that trumps any scientific data!

    The entire medical establishment, in the US and around the world, is sorely in need of serious reforms around the subject of gender and health!