Women's and Girls' Health in South Asia: Challenges for Global Policy

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A woman suffering from HIV/AIDS uses a stick to walk back to her bed in hospital. Cambodia. (© Masaru Goto / World Bank)

But for the subcontinent, which still has time to prevent a major catastrophe, these global agencies need to invest HIV/AIDS resources - human resources as well as money-in building reproductive health services and health systems, which are the only way to reach the 70% to 90% of girls and women in South Asia who live in rural villages. Global actors are also not yet supporting universal access to sexuality education for adolescents in South Asia. They are leaving that difficult and taboo task to creative but overburdened NGOs. They are not speaking out about boys' and men's behaviors or demanding that they change. They must and we must.

While global health policies are too narrowly constructed, the Bush Administration's policies are dangerously shortsighted. As of now, and we hope we can change this, none of the President's $15 billion AIDS package is going to Asia. Furthermore, the US government currently as the largest donor and the sole superpower also has inordinate impact on international strategies. For example, the White House and Congress would severely limit funds for condom distribution and comprehensive sexuality education programs. In Washington this week, the Senate is debating international reproductive health and HIV/AIDS funding. On the floor today, Senator Diane Feinstein urged her colleagues to ease proposed constraints on US funds, arguing for the widest possible range of strategies known to slow the spread of HIV rather than narrowly defined and unproven abstinence only programs. As we sit here tonight, the Senate is debating this and other amendments. They will vote tonight or tomorrow. Let us hope they vote for girls' and women's health and rights and their lives.

Let's turn now to our panelists who will provide concrete insights into what needs to be done and the challenges that lie ahead. First I will ask Kati Marton to join me. She and I traveled just this month to India and she will share with you the impact of that.

Kati Marton: Thank you Adrienne. Good evening ladies and gentlemen and thank you for coming this evening to hear what is obviously not a terribly cheerful message but one, which with your help can actually be turned around. I had the privilege a week ago to have the most remarkable guide to India in Adrienne Germain and it was an eye-opening visit for me - only my second. And I am now determined that our organization, the International Women's Health Coalition, will be even more engaged in what is obviously a pivotal crisis for the world and which hopefully after this evening all of you will also feel you can do something about, in whatever capacity you chose.

What I observed during Adrienne and my recent visit to India is the creation of a new caste, lower than any existing caste in India, and it is made up of HIV positive women. No matter that 90% of these infected women are married and monogamous. They are nonetheless shunned by their own families, left to fend for themselves, with no or few skills and very little training. So many of them are forced to sell themselves. This obviously is another way that the disease is spread.

Women are the key to the AIDS crisis in India. It seems to me obvious that the only real solution to this challenge is empowering women - through education, information, and finally guaranteeing their human and reproductive rights. You do not need to be a feminist or even a humanitarian to reach this conclusion. You just have to spend a little time in India.

As most of you are aware, India is an incredibly complicated, confusing place. I have rarely met so many strong, accomplished, powerful women as we did in India. And yet the vast majority is just the opposite. They are disenfranchised, and voiceless and powerless, married off much too young, uneducated and lacking status either in Indian society, or equally important, inside their marriages-- unable to demand that their husbands use condoms or make any other sexual demands. Violence is often the answer to such demands. And AIDS is the consequence of their powerlessness. This unequal situation is sadly not new. What is new of course is the presence of HIV, which has made this situation urgent.