Botswana

World Aids Day 2004

Gantsi, 1st December 2004
Message from Secretary General:
“The Burden of Women and Girls in the Age of HIV/AIDS”

Master of Ceremonies, His Excellency, the President of the Republic of Botswana, Mr. Festus Mogae, The Hon. Minister of Health, Sheila Tlou, The Hon. Minister of Agriculture, Johny Swartz, Hon. Member of Parliament, De Graaf, Heads of Diplomatic Missions and International Organisations, NACA Coordinator, Mr. Molomo

Invited Guests and Dignitaries in your respective capacities

It is my honour and privilege to read to you the following message from the Secretary General of the United Nations, Mr. Kofi Annan:
This year's World AIDS Day is an occasion to recognize the burden that women and girls bear in the age of HIV/AIDS, but equally, to celebrate their achievements in the fight against the epidemic.

Women are our most courageous and creative champions in the fight against HIV/AIDS. In most countries and communities I have visited around the world, it is women’s voices that are heard above all others; women advocates and activists who are moved to act selflessly and speak publicly, often risking prejudice, abuse or violence, in order to improve the lives of others.

The courage that women are showing in this fight is matched only by the toll the disease is taking on them. Women already bear the brunt of poverty. AIDS makes the poverty trap even easier for them to fall into, and even harder to break.

Women continue to face discrimination on a number of fronts -- from the workplace to laws governing land ownership and inheritance. AIDS puts them at even greater risk.

Girls already make up the majority of children not in school. When AIDS strikes the family, those girls who are attending school are all too often taken out, to help run the household and care for sick relatives.

Women now account for about half of all people living with HIV worldwide. In sub-Saharan Africa, where more than three quarters of all HIV-positive women live, almost 57 percent of adults living with HIV are women.

Why are women more vulnerable to infection?

Why is that so, even where they are not the ones with the most sexual partners outside marriage, nor more likely than men to be injecting drug users?

Usually, it is because society’s inequalities put them at risk -- unjust, unconscionable risk. A range of factors conspires to make this so: poverty, abuse and violence, lack of information, coercion by older men, and men having several concurrent sexual relationships that entrap young women in a giant network of infection. Nor does marriage always offer protection: in some heavily affected countries, married women have higher rates of HIV infection than their unmarried, sexually active peers.

These factors cannot be addressed piecemeal. What is needed is real, positive change that will give more power and confidence to women and girls. Change that will transform relations between women and men at all levels of society. Change that can only be brought about through the education of girls, through legal and social reforms, and through greater awareness and responsibility among men. Change that will allow women to play to the full their role in the fight against HIV/AIDS.

Empowering women in this struggle must be our strategy for the future. It is among them that the real heroes of this war are to be found. It is our job to furnish them with hope.

This was the message from the Head of the United Nations in the war against the epidemic. Allow me also to add a few comments from the UN Country Team in Botswana, because the issue of women and girls has been high on our agenda during the past year.

In 2003, the UN Secretary General decided to establish a Task Force on ‘Women, Girls and HIV/AIDS in Southern Africa’, chaired by the Executive Director of UNICEF, Ms Carol Bellamy. This initiative was warmly welcomed by the UN Country Team in Botswana, because we saw this as an opportunity to contribute constructively to the battle on one of the many fronts where His Excellency, President Festus Mogae, has declared ‘war’.

The Task Force comprised eminent individuals and leaders from government and civil society within the Southern Africa region. From Botswana we decided to recommend that High Court Justice Unity Dow and the Honourable Minister of Health, Professor Sheila Tlou, should be members of the Task Force. I am happy to say that they have both contributed in a sterling manner with their wellknown dedication and huge knowledge of the issues.

The work of the Task Force was guided by a framework, which corresponds largely with the one agreed for action on ‘Women and AIDS’ at the global level. It covers the following six issues: HIV infection among girls and women; girl’s education; violence against women and girls; property and inheritance rights of women and girls; the burden of care within the context of household labour; and access to HIV/AIDS care and treatment.

In July this year a regional report by the Task Force on the current status of women, girls and HIV/AIDS in the nine most affected countries in the region was launched. At the same time we launched a Botswana Country Report with more detailed country specific data on existing initiatives and gaps in relation to programming on women, girls and HIV/AIDS in Botswana.

I am happy to say that His Excellency, President Mogae, agreed to meet with the Eminent Persons and the UN Country Team when we had finalised the reports. We had a long meeting where His Excellency made it very clear that he welcomed the initiative, and in particular he challenged us to provide action that would make a difference in the lives of women and girls.

We believe that this is possible!

We know that it might at times seem as if the task is insurmountable. It might seem as if there is almost no way out of the trap that the pandemic is creating.

But there is a way out! By being the most vulnerable to HIV, women and girls – and of course the men surrounding them - hold the key to the hope of finally being able to control the epidemic.

Let us use that key!

Thank you.

Executive Director of UNAIDS

Dr Peter Piot

This World AIDS Day, the news is sobering -- the epidemic continues to spread in every region of the world. The number of people living with HIV globally has reached its highest level with close to 40 million people, up from 36.6 million in 2002. The steepest increases in HIV infections occurred in East Asia, Eastern Europe and Central Asia over the past two years.

The number of women living with HIV is on the rise in every region. Today the face of AIDS is increasingly young and female. This has profound implications—we will not be able to stop this epidemic unless we put women at the heart of the response to AIDS.

Prevention methods such as the “ABC” approach – Abstinence, Be faithful, and use Condoms – are good but not enough to protect women where gender inequality is pervasive. We must ensure that women can choose marriage, to decide when and with whom they have sex, and to successfully negotiate condom use.

Half of all women live on less than US$2 a day; illiteracy rates among women are nearly 50 percent higher than among men in many countries; only a small fraction of land is owned by women; and inheritance laws and criminal laws make it easy for men to take advantage of women. Each of these realities makes women more vulnerable to HIV.

We need to give girls everywhere a chance at education, and petition governments around the world to enable women to own and inherit property. Women who are economically self-sufficient and secure are far less vulnerable to HIV. We need to get laws passed everywhere that make domestic abuse illegal, that treat rape as a real crime to be punished harshly.

To reverse these inequities we must focus attention and resources on increasing access to prevention and treatment services for women. We need to make female condoms readily accessible in more parts of the world. And even more urgently is the need for investment in a microbicide that a woman can confidently and confidentially use to protect herself from HIV.

If we can do a better job preventing HIV among women and girls, we can ultimately get ahead of the epidemic and save millions upon millions of lives. The good news is we are seeing more women and men joining together to support, energize and drive the response against AIDS and to improve the lives of women and girls around the world.

Together we must be bold by challenging inequality whenever and wherever it appears—as we strive for a world free of AIDS.

Message from the UNDP Administrator

Mr. Mark Malloch Brown

Despite concerted efforts by governments, civil society, and international agencies, HIV/AIDS is still devastating societies at an alarming rate. In 2004 alone, 3.1 million people died of AIDS and an estimated 5 million people were newly infected with HIV, bringing the total of those affected to about 40 million worldwide.

One of the most troubling aspects of the pandemic is that women now account up nearly half of those living with HIV. This year’s World AIDS Campaign draws special attention to women, girls and HIV/AIDS: Addressing women’s vulnerability and the underlying gender issues fuelling the epidemic is not an option, it is an imperative. We recognise and applaud the efforts of women around the world who are at the forefront of providing care and support to families and communities affected by AIDS.

While many organizations – and women’s organizations in particular – are making outstanding contributions to address these challenges, the global community needs to do much more to empower women, to ensure equitable access to treatment, education and information, and to protect women’s property and inheritance rights. Men, too, must be actively involved in protecting their families and communities.

UNDP recognises that effective responses to HIV/AIDS require us to move away from conventional methods. In support of the work of the Global Coalition on Women and AIDS, we are embarking on a partnership with UNIFEM to address a wide range of issues related to the inequalities in inheritance and property rights.

In South Asia, UNDP is working to protect the rights of survivors of trafficking and helping women and girls find alternative and safe livelihoods. Our Leadership Development Programme in Ethiopia supported the formation of a Women’s Coalition on HIV/AIDS that is promoting women's leadership to stem HIV/AIDS, and Community Capacity Enhancement Initiatives have resulted in the reduction of harmful practices.

In just nine months world leaders will gather at the UN for the five-year review of our quest to achieve the Millennium Development Goals – including the vital goal of stopping the spread of HIV. Only if we radically scale up efforts to challenge the epidemic immediately will we be able to halt its expansion by 2015. This is our commitment - and our responsibility.

Statement by UNFPA Executive Director

Thoraya Ahmed Obaid

In every region of the world, AIDS is taking a terrible toll on women and girls, who are experiencing rising rates of HIV infection and a disproportionate burden of caring for those who are sick and orphaned. Despite this alarming trend, women and girls know less than men about how HIV/AIDS is transmitted, and what little they do know is often rendered useless by the discrimination and violence they face.

To reduce the spread of HIV/AIDS, we must confront widespread poverty and gender discrimination and violence. We must expose child marriage for the dangerous practice it is. And we must expand sexual and reproductive health information and services and respect for reproductive rights. Today, the vast majority of HIV infections worldwide are sexually transmitted or associated with pregnancy, childbirth or breastfeeding. We must integrate HIV/AIDS services and reproductive health care in ways that work for women and girls and increase their access to these vital services.

All nations should introduce school curricula that include sexual and reproductive health and life skills education. Young people are more likely to avoid or delay sexual activity and protect themselves when they have the information and skills to make informed and responsible decisions.

Condoms are the most effective prevention tools at our disposal and we must ensure that they are available and used consistently and correctly. At the same time, we must increase access to female-controlled methods of prevention. Making sure that women have life-saving tools, such as female condoms and microbicides, could change the course of epidemic.

We must also work within cultures to challenge the social norms that contribute to the lower status of women and girls and that condone violence against them. Stopping violence against women and girls and promoting their human rights must be a priority.

As a co-sponsor of the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the Global Coalition on Women and AIDS, UNFPA is committed to reducing the impact of HIV and AIDS on women and girls. This commitment is directly linked to our work in some 140 countries to advance sexual and reproductive health, women’s empowerment and gender equality.

World leaders agreed on these global priorities in 1994 in Cairo at the International Conference on Population and Development. Today, 10 years later, I call on world leaders to keep the promises made in Cairo and ensure universal access to reproductive health and rights by the year 2015.

Message from the WHO Rregional Director for Africa

Dr. Ebrahim M. Samba

It is a distinct honor and my pleasant duty to draw our attention once more to the theme of World AIDS Day. The theme “Women, Girls and HIV/AIDS” has been selected for reflection and action. This theme is a clear manifestation of our collective effort to address the plight of women and girls, including their vulnerability with respect to HIV/AIDS. I would like to link the theme with the “3 by 5” target of placing three million people on anti-retroviral therapy by the end of 2005, in which women play a vital role.

It is evident that women and girls are most vulnerable to HIV for many reasons beyond their control. Women are 1.2 times more likely to be infected than men. Risk of infection in girls aged 15 to 24 years is three times higher than in boys the same ages. Women also represent a large proportion of people living with HIV/AIDS, who are in need of care, treatment and support. Yet, they have less access to treatment. In most cases, women in our region have few rights to protection and cannot insist on safer sex practices with their partners. Globally, between one fifth and half of all girls and young women are forced or coerced into their first sexual experience, often violently.

Generally, societal norms and economic conditions do not empower women to deal with these issues and challenges, but, rather, subject them to these harsh realities. Women are expected to obey and be faithful while norms of masculinity permit men and boys not to be answerable to their wives or partners. Sexual violence against women is still blamed on them with hardly any strong family or societal support for the offended. In this era of high HIV prevalence rates and of the international concerted action to curb HIV transmission, sexual violence against women MUST stop.

Education is fundamental to the emancipation of human beings. Yet, not enough has been done to achieve the universal goals of education of the girl child, improving women’s access to credit and other productive resources and providing life skills training for women and girls out of school. We need to accelerate our multi-sectoral actions for preventing HIV infection by addressing the structural causes of women’s vulnerability and involving all relevant stakeholders in policy decisions, planning and programme implementation.

Now is the time for taking stock and defining what changes in our strategies will make a difference in reaching global and national goals for women’s health in general, and in reducing their vulnerability to HIV/AIDS in particular.

Women and girls are a formidable force in the fight against HIV/AIDS and the bedrock of care and support in homes and communities in our region. However, the development and execution of HIV/ADS policies and strategies is weak in gender analysis and provisions. For example, to continue their largely uncounted contribution in care and treatment support, women’s and girls’ own needs for HIV/AIDS treatment need to be prioritized. I particularly recommend that this be so as countries expand HIV/AIDS treatment services within the framework of the “3 by5” Initiative. We are starting to get anecdotal evidence that provision of free or heavily subsidized HIV/IDS treatment services greatly increases women’s access – in some national or NGO programmes which provide free services, women use such services in larger numbers than men. We need to document better the factors that improve women’s access to these services and promote their incorporation into national treatment strategies. Women also need to be more adequately compensated for services they provide, and this need should be reflected in national care and treatment scale-up programmes.

To our national authorities, the international community, colleagues, members of the civil society , I say NOW IS THE TIME TO DO THINGS DIFFERENTLY. We must re-commit ourselves to improving women’s access to ART and strengthening life skills education for girls and boys. I am pleased with and fully support the call by Global Coalition on Women and AIDS on stakeholders to ensure that 50% of the recipients of ART within the 3 by 5 Initiative are women. I therefore encourage all of us, including governments of the region to take this as a challenge and make this happen! It is possible.

Ladies and gentlemen, in most countries and at international level, data and documentation exist that eloquently confirm the importance of the health and contribution of girls and women to our families, communities and the economic development of our nations. As the main source of care in homes affected by HIV/AIDS, they are partners and must be treated with equity. We must advocate for families to stop discriminating against them by prioritizing men’s access to treatment as a more important family economic decision. Their ill health would only further exacerbate the toll of HIV/AIDS in families.

Let us, on this World AIDS Day, re-dedicate ourselves to turning our many statements and intentions about improving women’s lives and reducing their vulnerability to HIV/AIDS to concerted action and expanded programmes. Let us change the practices, laws and norms that stand in the way of progress in this regard. I wish you, in all the countries of our region, fruitful planning for reaching your target of access to antiretroviral treatment and the resultant reduction in mortality, stigma and discrimination related to HIV/AIDS. Together, in partnerships involving governments, civil society, the private sector and international partners, we can make it! The race is ours to win!