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Stephen Lewis speaks to the Microbiocides 2004 conference
Speech by Stephen Lewis, UN Special Envoy for HIV/AIDS in Africa. 30 March 2004. Microbiocides 2004 Conference.
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Below is a transcript of the speech delivered by Stephen Lewis, the UN Secretary-General's Special Envoy for HIV/AIDS in Africa, to the Microbicides 2004 conference in London, on Tuesday, March 30, 2004.There is, I will admit, a touch of amiable irrationality in racing across the ocean for a half hour speech. I want to assure you that I don?’t do it as a matter of course. But in this instance, it seemed to me that your kind invitation to address the Conference could not possibly be forfeited. I?’m here because I think the work in which you?’re collectively engaged ?… the discovery and availability of microbicides ?… is one of the great causes of this era, and I want to be a part of it. It is in this room that morality and science will join together.
I?’ve been in the Envoy job for nearly three years. If there is one constant throughout that time, a large part of which has been spent traversing the African continent, it is the thus-far irreversible vulnerability of women. It goes without saying that the virus has targeted women with a raging and twisted Darwinian ferocity. It goes equally without saying that gender inequality is what sustains and nurtures the virus, ultimately causing women to be infected in ever greater disproportionate numbers.
And the numbers tell a story. It was the report issued by UNAIDS on the eve of the International AIDS Conference in Barcelona in 2002, that identified the startling percentages of infected women. And it was during a panel, at the same conference, when Carol Bellamy of UNICEF used a phrase --- for the first time in my hearing --- that was to become a repetitive mantra: ?“AIDS has a woman?’s face?”.
But the problem is that the phenomenon of women?’s acute vulnerability did not happen overnight. It grew relentlessly over the twenty years of the pandemic. What should shock us all, what should stop us in our tracks, is how long it took to focus the world on what was happening. Why wasn?’t the trend identified so much earlier? Why, when it emerged in cold statistical print did not the emergency alarm bells ring out in the narrative text which accompanied the numbers? Why has it taken to 2004 --- more than twenty years down the epidemiological road --- to put in place a Global Coalition on Women and AIDS? Why was it only in 2003 that a UN Task Force on the plight of women in Southern Africa was appointed to do substantive work? Why have we allowed a continuing pattern of sexual carnage among young women so grave as to lose an entire generation of women and girls?
Ponder this set of figures if you will: in 2003, Botswana did a new sentinel site study to establish HIV prevalence, male and female, amongst all age groups. In urban areas, for young women and girls, ages 15 to 19, the prevalence rate was 15.4%. For young men and boys of the same age, it was 1.2%. For young women between 20 and 24, the rate was 29.7%. For young men of that age it was 8.4%. For young women between the ages of 25 and 29, the rate was 54.1% (it boggles the mind); for young men of the same age, it was 29.7%.
Have I not addressed the fundamental question? The reason we have observed --- and still observe without taking decisive action --- this wanton attack on women is because it?’s women. You know it and I know it. The African countries themselves, the major external powers, the influential bilateral donors, even my beloved United Nations ?… no one shouted from the rhetorical rooftops, no one called an international conference and said what in God?’s name is going on, even though it felt in the 1990s that all we ever had time for were international conferences? It amounts to the ultimate vindication of the feminist analysis. When the rights of women are involved, the world goes into reverse.
For more than twenty years, the numbers of infected women grew exponentially, so that now virtually half the infections in the world are amongst women, and in Africa it stands at 58%, rising to 67% between the ages of 15 and 24. This is a cataclysm, plain and simple. We are depopulating parts of the continent of its women.
And while finally, after the doomsday clock has passed midnight, we?’re starting to be engaged and agitated, very little is changing. Please believe me: on the ground, where women live and die, very little is changing. Everything takes so excruciatingly long when we?’re responding to the needs and rights of women.
Between three and four years ago, I visited the well-known pre-natal health clinic in Kigali, Rwanda. I met with three women who had decided to take a course of nevirapine; they were excited and hopeful, but they asked a poignant question which haunts me to this day: they said ?“We?’ll do anything to save our babies, but what about us??” Back then, more than four years after antiretrovirals were in widespread use in the west, we simply watched the mothers die.
Well, thanks to the Columbia School of Public Health, funded by several Foundations and USAID, and working with the Elizabeth Glazer Foundation, UNICEF and governments, the strategy of PMTCT PLUS (Prevention of Mother to Child Transmission Plus) has been carefully put into place in several countries, where the ?“Plus?” represents treatment of the mothers and partners; indeed, of the entire family. But it?’s a slow process, and though Columbia will roll it out as quickly as possible, it is necessarily incremental. In principle, the majority of such women will one day fall under the rubric of public antiretroviral treatment, through Ministries of Health, when it?’s finally introduced in most countries. But there?’s no clear guarantee of when that day will dawn, or that women will get the treatment to which they?’re entitled. It?’s entirely possible that the men will be at the front of the bus.
Everything proceeds at glacial speed for women, if it proceeds at all, in the face of this global health emergency.
The full text of this speech can be downloaded on the righthand side of this pagae |
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