Gender inequality fuels global AIDS pandemic, speakers say

By Donald E. Messer*

TORONTO (UMNS) - The increasing percentage of women infected with HIV and AIDS was a major concern at the Aug. 13-18 International AIDS Conference here.

"Women carry a disproportionate share of the burden of the HIV and AIDS crisis," declared retired Bishop Fritz Mutti, chairperson of the United Methodist Global AIDS Fund. "Unless gender inequality also is addressed, emphasis on the familiar prevention strategy of 'ABC' (abstinence, being faithful, and condoms) will be doomed to failure."

Bishop Mutti's remarks at an ecumenical pre-conference of more than 500 religious leaders were reinforced at the opening session of the six-day conference.

UNAIDS reports women account for almost 46 percent of the estimated 40 million people infected with HIV and AIDS in the world, and the percentage is increasing yearly. In sub-Saharan Africa, about 57 percent of infected people are women. Each day, 1,500 children worldwide become infected with HIV at birth. Last year, 3 million people died of AIDS, and more than 4 million became newly infected with HIV.

Microbicides for women
Bill and Melinda Gates, the richest couple in the world, called upon some 20,000 participants in the conference to "put the power to prevent HIV in the hands of women" by accelerating research on microbicides and other new HIV prevention tools. Microbicides are prevention products such as vaginal creams, gels and capsules that would destroy harmful microbes, including HIV. Still under scientific study, microbicides would aid in prevention, but they are not yet 100 percent effective.

"We need tools that will allow women to protect themselves," said Bill Gates, founder of Microsoft Corp. "This is true whether the woman is a faithful married mother of small children or a sex worker tying to scrape out a living in a slum. No matter where she lives, who she is, or what she does, a woman should never need her partner's permission to save her own life."

Melinda Gates emphasized that every life is of equal importance and "saving lives is the highest ethical act. ... In the fight against AIDS, condoms save lives. If you oppose the distribution of condoms, something is more important to you than saving lives." She noted that less than one in five people at risk of HIV infection has access to condoms, clean needles, education and testing.

"That's a big reason," she said, "why we have more than 4 million new infections every year."

The Bill and Melinda Gates Foundation has made stopping AIDS the top priority of its billion-dollar donations. On the eve of the conference, the couple contributed an additional $500,000 to the Global Fund to Fight AIDS, Tuberculosis and Malaria, an organization initiated in 2001 at the urging of U.N. Secretary-General Kofi Annan.

Caregivers and marching grandmothers
"Women bear the brunt of almost all the care of orphans and provide the overwhelming majority of home-based care to persons suffering with HIV and AIDS," said Linda Bales, a staff executive with the United Methodist Board of Church and Society. Global AIDS has resulted in more than 15 million orphans and vulnerable children, and women are the primary caregivers.

To illustrate the inequities in gender, 100 Africans and 100 Canadians participated in a colorful "Grandmothers March against AIDS."

A panel of women from Africa, Asia, and North America noted that violence is a close companion of the virus. They said young girls and women are vulnerable to the disease because of domestic violence, rape and the absence of control over their own bodies. Panel members also cited the lack of education and inadequate access to female condoms as additional reasons for increasing numbers of women being affected by the disease.

Due to the pervasive male practice of having more than one sexual partner, faithful women often get infected even though they have had only one partner. It was noted, for example, that in some parts of Africa, a woman on her wedding day doubles her chances of getting HIV.

Circumcision of men
Prevention possibilities for men were also highlighted during the 16th session of the biannual conference. Male circumcision may reduce the risk of contracting HIV by up to 60 percent, according to recent scientific studies. Preliminary studies in South Africa were cancelled when it appeared that circumcision was significantly reducing HIV transmission, and it was deemed unethical not to offer the option to all men in the study. Results from Kenya and Uganda are expected in 2007.

In several candid speeches, former President Bill Clinton said that while "persuading boys and older men to get circumcised might be a 'hard-sell,'" every life-saving approach must be employed. The future challenge will be convincing men that circumcision can be safe, effective and not too painful. Decisions as to how much money should be invested in providing access to this treatment have yet to be made.

Both Clinton and Bill Gates stressed their support for President George Bush's efforts against AIDS. They noted that as a result of the administration's pledge of $15 billion over five years, more than 500,000 people in 15 countries in Africa, Asia, and the Caribbean are receiving antiretroviral drugs.

No magic solution
Conference speakers said dreams of a vaccine or a cure remain at least 10 years distant. No magic solution exists for HIV prevention. A continuing danger of every prevention mechanism - be it condoms, circumcision, or microbicides - is that some people will increase risky sexual behavior, leading to more, rather than fewer infections. Public health officials, therefore, recommend education programs that emphasize both risk avoidance (abstinence, faithfulness) and risk reduction (condoms and clean needles).

Dr. Cristina Pimeta of Brazil noted that less than 50 percent of the world's youth have access to information about prevention. She highlighted the importance of linking prevention to treatment and care to address the current tendency to see biomedical interventions as quick or magic solutions to HIV and AIDS prevention.

Enhancing women's status
Stephen Lewis, U.N. special envoy for HIV/AIDS in Africa, closed the international conference by declaring, "Gender inequality is driving the pandemic, and we will never subdue the gruesome force of AIDS until the rights of women become paramount in the struggle."

He called for the creation of a new U.N. agency for women, "staffed to the teeth," and dedicated to enhancing the role and status of women worldwide.

Bishop Mutti said he hopes United Methodists, especially women, will embrace efforts to raise $8 million through the United Methodist Global AIDS Fund.

He noted that Musa Dube, a United Methodist woman and a New Testament professor from Botswana, will keynote the upcoming United Methodist Global AIDS Conference in Washington Sept. 8-9. In keeping with the conference theme to "Lighten the Burden," Dube will challenge United Methodists to join women and other activists around the globe in working towards an AIDS-free world.

*Messer is the executive director of the Center for the Church and Global AIDS and president emeritus of the Iliff School of Theology, Denver. He is the author of Breaking the Conspiracy of Silence: Christian Churches and the Global AIDS Crisis, and co-author with former Senators George McGovern and Bob Dole of Ending Hunger Now: A Challenge to Persons of Faith.