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Facing the future together: UN SG's taskforce on women, girls and HIV in Southern Africa

Executive summary

“I don’t want to die before I’m 110 with great grandchildren. I don’t want to die before I turn 25. I refuse to sit down and watch my generation fall to pieces. I am going to make a difference…will you?”
Rumbidzai Grace Mushangi, 15, Zimbabwe1

If we can stop the spread of HIV among women and girls in southern Africa, we can turn the epidemic around. While HIV prevalence is high among all sexually active women, girls and young women are particularly affected – the vast majority of young people aged 15-24 living with HIV/AIDS in southern Africa are female. Even more worrying, data shows that many young women are being infected almost as soon as they start having sex.2 The findings of the United Nations Secretary General’s Task Force on Women, Girls and HIV/AIDS in Southern Africa show that gender inequality fuels HIV infection because many women and girls cannot negotiate safer sex or turn down unwanted sex. The findings also demonstrate that HIV/AIDS deepens and exacerbates women’s poverty and inequality because it requires them to do more domestic labour as they care for the sick, the dying and the orphaned. Although the problems are complex, the Task Force has identified key actions in relation to its six focus issues, which can make an immediate difference:
  1. Prevention among Girls and Young Women
    We must collapse the bridge of infection between older men and younger women and girls. Many girls have sexual partners who are five to ten years older than them, and these men are more likely to be infected than boys and younger men. Relationships with older men are also more likely to be premised on unequal power relations, leaving girls vulnerable to abuse and exploitation.

  2. Girls’ Education
    We must protect female enrolment figures – AIDS may be taking girls out of school. Although gender parity has largely been achieved in educational enrolment in southern Africa, we need more information on the impact of the epidemic on the education of girls, particularly orphans.

  3. Violence against Women and Girls
    We must protect girls and women from the direct and long-term risks of HIV infection as a result of violence Girls and women who have been sexually assaulted are at increased risk of HIV infection, through direct transmission and because of the long-term effects of sexual violence on risk-taking behaviour

  4. Property and Inheritance Rights
    We must protect the rights of women and girls to own and inherit land In Task Force countries there are but a handful of small initiatives by determined organisations that provide women and girls with legal education and advice or assistance to prevent dispossession or restore taken property.

  5. Women and Girls as Care Givers
    We must put in place a Volunteer Charter articulating the rights and responsibilities of women and men who provide care and support to the sick and orphaned. Communities, families, governments and development partners cannot continue to rely on ‘women’s resilience’ to provide safety nets for the sick and orphaned.

  6. Access to Care and Treatment for Women and Girls
    We must address gender norms, violence, stigma and discrimination as potential barriers to women’s access to care and treatment.
Although women may have greater access than men to anti-retroviral treatment through public health systems, they may miss out on treatment opportunities because of fear that their partners will discover their HIV status.

Gaps in the Response

The report highlights a number of important gaps in the response by governments, international agencies and civil society organisations identified by the Task Force:

  1. Many people know what the gender-based challenges facing women and girls are. However, the complexity of gender relations means that many find it difficult to focus on what exactly to do.
  2. Although girls and women represent the bulk of new infections, budgets, programmes, policies and human resource commitments do not reflect this. Many interventions continue to be aimed at an imaginary boy or man or a fictional gender-neutral public.
  3. Even organisations that are explicitly trying to address the problems of women and girls find it difficult to deal with the root causes of gender inequality. Because changes in gender relations occur slowly, not enough funding or attention is given to programmes that try to address the deeper connections between gender and HIV/AIDS.
Strategies that Work

After twenty years of HIV/AIDS programming, and thirty years of gender and development programming we know that applying the following approaches can yield success:

  • Challenging the social norms and values that contribute to the lower social status of women and girls and condone violence against them, e.g. through dramas and community-based educational initiatives;
  • Increasing the self-confidence and self-esteem of girls, e.g. through life-skills and other school-based programmes in which they are full participants;
  • Strengthening the legal and policy frameworks that support women’s rights to economic independence (including the right to own and inherit land and property) e.g. by restructuring justice systems, enacting laws and training NGOs to popularise these laws;
  • Ensuring access to health services and education, in particular life skills and sexuality education for both boys and girls, e.g. by training health workers and teachers on gender, and re-orienting health and education systems so that they are flexible, participatory and community-centred rather than bureaucratic and hierarchical; and
  • Empowering women and girls economically, e.g by providing them with access to credit, and business, entrepreneurship and marketing skills.
Strengthening the Response

There are actions that can be taken today, which will make a significant difference. In order to expand the capacities of communities and of those working on HIV/AIDS programmes to do what is necessary to ensure the fulfilment of the rights of women and girls, the following actions are necessary:

  • We must expand the pool of gender experts. Despite the fact that many gender frameworks have been developed, not enough people know how to ‘do gender’ – in other words, how to conduct a thorough gender analysis of the situation and design responses tailored to the different requirements of men, women, boys and girls. There is an urgent need to make the language of gender more practical and accessible to people at community and programme levels.
  • We must address the fears and resistance that surround gender. Some women’s groups have argued that there has been little progress towards gender equality in some spheres because an honest analysis of power relations provokes discomfort or even active resistance on the part of some men. As a result, those who occupy decision-making positions in donor agencies, community-based organisations, households, governments and NGOs do not prioritise initiatives that seek to challenge the status quo.
  • We must support and strengthen local women’s movements and organisations. Partnerships between governments, women’s organisations and community-based organisations are crucial.
  • We must increase public awareness and debate about the relationship between gender inequality and HIV/AIDS.
  • We must address the causes of gender inequality, not only the consequences.
In the weeks, months and years following this report, we must work with girls and women to thoroughly analyse their situation using a human rights- and gender-based approach. Together, we must devise strategies that fight HIV/AIDS and simultaneously address gender inequality. We must take this task seriously. To ensure success we must redirect existing resources and mobilise significant additional funds. And we must make sure these resources get to where they are most needed, to the women and the girls in the cities, towns and villages of southern Africa.

Gupta/Tallis Gender & HIV/AIDS Framework (See Annex 1)

Five types of HIV programmes:

Stereotypical – The programmes promote images of men as forceful and powerful while women are portrayed as “powerless victims.”

Gender-neutral – These programmes do not distinguish between the different needs of women and men and are aimed at the general population. While they are not trying to deliberately exclude women, they often are based on research and messages that have been tested on men, or work better for men. According to Tallis the bulk of AIDS programmes fall into this category.

Gender-sensitive – These programmes respond to the different needs and constraints of individuals based on their gender and sexuality. Some current AIDS programmes operate at this level, where women’s practical needs are identified and attempts are made to meet those needs through service delivery (e.g. female condoms). Some of these programmes work with men, often helping them to consider how they can make better, safer decisions to protect themselves, their partners and their children. However, these programmes operate within the paradigm of men’s roles as providers, decisionmakers and heads of households.

Empowering – These programmes support women to take the necessary actions at personal, as well as group/collective/’‘community’ levels. Yet without shifting the laws and community values that often make women’s lives harder, empowerment is not sustainable.

Transformational – The objective of these programmes is to transform gender relations between women and men so that they are equitable. They focus on radical change at the personal, relationship (including the redefinition of heterosexual relations), community and societal levels. Transformational programmes address the systems, mechanisms, policies and practices that are needed to support such genuine change and include changing laws such as those governing property and inheritance, domestic violence and marital rape, changing the attitudes of men and women about male and female behaviour, and empowering women to access credit, employment and other opportunities for broader development.

  1. Posting on UNICEF’s Voices of Youth Website:
  2. Pisani, E, The Epidemiology of HIV at the Start of the 21st Century: Reviewing the Evidence, UNICEF Programme Division Working Paper, New York, 2003, p. 27
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