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1. GLOBAL HIV INITIATIVES PRIORITIZE WOMEN

The Global Fund to Fight AIDS, Tuberculosis, and Malaria decides to develop gender policy…

At its November meeting the Board of the Global Fund agreed to encourage and support national AIDS control programs to invest in girls and women.  The United Nations Joint Programme on HIV/AIDS (UNAIDS) also announced this year that gender equality would be a corporate priority to foster attention to women and young people, who are the least able to protect themselves or to obtain life-saving information and prevention support.

An estimated 15.4 million women were living with HIV in 2007; 1.6 million more than in 2001.

What's next...Words are not enough.  How will these commitments play out?

The Global Fund has created senior positions, "gender champions," within the agency, charged with ensuring that women and girls get their due. UNAIDS' Global Coalition on Women and AIDS also has a new director, whose charge includes integrating concern for gender throughout the agency.  

The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has provisions for "gender" programs, but restricts uses of funds in other ways that actually increase women's and young people's vulnerability.  Congress can change this.

On December 5, Sen. Hillary Rodham Clinton (D-NY) introduced the Protection Against Transmission of HIV for Women and Youth (PATHWAY) Act  to better empower women and girls against the pandemic.  A similar bill in the House was introduced by Reps. Barbara Lee (D-CA) and Christopher Shays (R-CT).  If enacted, PATHWAY would require that PEPFAR support concrete programs to reduce women's and girls' disproportionate vulnerability to HIV, such as increasing access to female condoms and bolstering health care services that women use. 

2. HEALTH AND RIGHTS TRUMP ABORTION BANS

Mexico City's legislature legalizes abortion, making it the largest city in Latin America to allow abortion….

In the first 100 days following legalization, doctors performed some 1,500 legal abortions with no fatalities, compared to an estimated 3,500 deaths from unsafe abortion in the year before legalization. Portugal's much-debated law, which legalizes abortion during the first ten weeks of pregnancy, went into effect in July.  In a long-awaited decision, Slovakia's Constitutional Court recently ruled against a request made by the Christian Democratic Party to make abortion illegal.

What's next...More governments must act.

African leaders have called for "political commitment" to curb unsafe, illegal abortions, and Brazilian President Ignacio Lula Da Silva labeled unsafe abortion a public health issue. Now, these leaders and others must pave the way for legalization and access to services. 

In the United States, antiabortion activists have long pushed for a state court case to directly challenge Roe v. Wade.  State governments and the U.S. Supreme Court must resist repeated attempts to erode and overturn the historic ruling. 

3. MATERNAL DEATHS MADE A GLOBAL PRIORITY

Global donors pledge new funds to end more than half a million deaths and 10 million injuries—annually….

The United Kingdom pledged over $200 million to the United Nations Population Fund over five years to prevent unwanted pregnancies and make childbirth safer. To reduce global maternal and child mortality rates, Norway has committed $1 billion over ten years and the Netherlands $175 million over three years.

United Nations (UN) agencies, U.S. foundations, and international corporations also pledged to take action. Two examples: The John D. and Catherine T. MacArthur Foundation announced an $11 million initiative to introduce new lifesaving technologies such as an anti-shock garment, into maternal health care in Nigeria and India. The University of California, San Francisco announced a $1.4 million grant from the Bill & Melinda Gates Foundation for continuing research on how these technologies can be employed in preventing maternal deaths in remote areas worldwide.

What's next...More investment is needed.
The Global Health Council estimates that each $100 million invested will prevent 12,000 maternal deaths and provide basic medical care for four million women.   Saving lives requires relatively inexpensive and simple interventions such as contraception and safe abortion, treatments for common problems in pregnancy and childbirth, and emergency obstetric care, not costly technologies or scientific breakthroughs. In 2007, an investment of an additional $2 billion dollars would have funded maternal health care, globally."

4. "ABSTINENCE-ONLY" GETS A FAILING GRADE, AGAIN.

Two new reviews of "abstinence-only" sex education find the approach ineffective... 

An independent analysis by Mathematica Policy Research, Inc. found no difference in the sexual behavior of U.S. students who had received instruction in abstinence-only programs and those who had not.  A U.S. Institute of Medicine (IOM) review of PEPFAR found no evidence to justify the allocation of prevention funds for abstinence-until-marriage programming. Yet, the U.S. government funds these programs at home and is exporting them to young people in low-income countries through U.S. foreign assistance.

What's next...The pressure is on to stop funding what doesn't work and start implementing what does.

Public pressure is growing for the U.S. Congress to stop wasting taxpayer money on ineffective programs and start providing adolescents with the information they need to stay healthy. In 2008, Congress is expected to consider major reauthorization legislation for PEPFAR where the issue will again be up for debate.

Many developing countries, even traditionally conservative ones, are leading the way. In Cameroun, longtime IWHC partner Femmes, Santé, Développement (FESADE) launched a sexuality education curriculum in April 2007.  It teaches young people about their bodies, how to build respectful and equality-based relationships, and how to protect themselves and each other. In strong support, Minister of Public Health, Urbain Olanguena Awono called the curriculum "a lasting symbol… [of] the promotion and continued growth of the health, prosperity and development of adolescents and youth."

5. NIGERIA SUPPORTS SEXUAL RIGHTS

The Nigerian Parliament rejects an anti-gay bill…

After a concerted educational and advocacy effort led by IWHC's partner, the International Centre for Reproductive Health and Sexual Rights (INCRESE), Nigerian lawmakers voted down the bill, citing human rights concerns and recognizing its encouragement of far-reaching discrimination on the basis of sexual orientation.  

INCRESE coordinated 20 nongovernmental organizations to campaign against the bill. Their success with policymakers, lawmakers, and the media shows the power of broad coalitions that employ persuasive human rights arguments.

What's next...The tide is turning. Despite heated opposition, more countries are expected to support sexual rights.

In 2001 the Netherlands became the first country to allow same-sex marriage. Since then, five other jurisdictions have legalized gay marriage: Belgium, Canada, South Africa, Spain, and the U.S. state of Massachusetts. A further 16 countries and nine U.S. states recognize civil unions that give same-sex couples all or some of the rights and responsibilities of marriage.

On December 13, leaders of the European Union member states signed the Reformed Treaty which includes the Charter of Fundamental Rights. The Charter is the first international treaty containing explicit prohibition of discrimination on the basis of sexual orientation.

6. STATES ENSURE ACCESS TO EMERGENCY CONTRACEPTION

Lawmakers pass measures to provide emergency contraception…

Several states, including Connecticut, Oregon, and Colorado mandated hospitals, including Catholic hospitals, to inform sexual assault survivors about emergency contraception (EC) and make it available upon request. New York went one step further, covering EC up to six times per year for women ages 18 and older under Medicaid.

In the United States, half of all pregnancies are unintended and half of these occur among a small minority (11 percent) of women who are not using any method of contraception. EC gives women a second chance to prevent unintended births and abortion.

What's next...Despite opposition, countries around the world are holding the line to ensure EC availability.

In Chile, the government instituted fines against pharmacies that refuse to sell EC.  To date, the government has fined nearly 100 pharmacies a total of $300,000 for failing to provide EC. 

Politicians and pharmacists in Italy responded angrily to Pope Benedict XVI's appeal in October for pharmacists to refuse to dispense EC if they object on moral grounds.  Italian Health Minister Livia Turco, noted that while the Pope had the right to urge young people to be sexually responsible, his warning to pharmacists to be "conscientious objectors" to EC "should not be taken into consideration." 

7. NEW HAMPSHIRE RESPECTS THE RIGHTS OF MINORS

New Hampshire becomes the first U.S. state to repeal a parental notification law for abortion…

In June, New Hampshire repealed a law requiring health care providers to notify parents at least 48 hours before providing an abortion to a woman under the age of 18. Alaska followed suit in November when its State Supreme Court declared a similar law unconstitutional. The Court ruled that the law violated the state constitution's explicit right to privacy by giving parents "veto power" over a minor's decision to have an abortion.

More than 30 states have laws requiring some form of parental consent.  Legislators backing such laws hold the contradictory ideas that teenagers are not ready to decide to have an abortion but are mature enough to raise a child. By delaying a teen's decision about abortion, these laws compromise her health because an earlier abortion is a safer one.

What's next...Recognition of the rights of young people is growing worldwide.

The Convention on the Rights of the Child recognizes young people's rights to make decisions according to their evolving capacity but these rights are widely violated. 

• In certain cultures, minor girls have no say in whether they undergo female genital cutting.
• Similarly, minor girls in many societies have no say about when and whom they marry. Child marriageis common in Africa, south Asia, and some countries in the Middle East and Latin America.

At a high-level UN meeting in December on children's health and human rights these basic issues were ignored.  Governments must make more progress in protecting and promoting the rights of children and young people. 

8. SEX EDUCATION IN INDIA GOES NATIONAL

India's government launches mandatory sex education classes nationwide in public schools….

Faced with an estimated 2.5 million HIV cases, India's national government recommended twice weekly sex education classes for students 14 to 18.  State governments are allowed to modify the curriculum, which was developed by government agencies and the UN.  

The curriculum, which includes lessons on gender equality, is supported by the Director of India's National Aids Control Organization, Sujatha Rao: "We want the message to be loud and clear for senior secondary students to understand," Rao said. "There should be no shadow-boxing around HIV/AIDS."

What's next...Will state governments gut the initiative or follow through?

Twelve of India's 29 states have banned sex education in their schools, saying that the curriculum is too explicit in conflict with "culture." In Maharastra state, the Indian teachers' union condemned the ban as a "retrograde step" and has continued to teach the curriculum.

Young people are also speaking out.  At the 4th Asia Pacific Conference on Reproductive and Sexual Health and Rights in India, young women working with IWHC through its Advocacy in Practice workshops, along with other youth groups, issued a news release protesting the ban because it violates the "right to information, right to education, right to health under the Indian Constitution and breaches India's international commitments under UN treaties and declarations." 

9. MORE U.S. STATES MANDATE PRESCRIPTION EQUITY

Oregon joins 26 other states in requiring that health insurance plans include contraceptives in prescription drug coverage…

Some 98 percent of American women use contraception during their reproductive years, but many insurers refuse coverage, even though they cover drugs like Viagra. Previously about half of the insurers in Oregon did not cover prescription contraceptives. Supporters say the bill, which goes into effect on Jan. 1, 2008, will affect nearly 1.5 million women.

In a related victory, after five years of litigation, Wal-Mart, the nation's largest private sector employer, began offering contraceptive coverage to its employees.
 
What's next...The outcome of the 2008 presidential election could impact women's health priorities, including contraceptive coverage, at the federal level.

Since 1997, Congress has failed to pass the federal Equity in Prescription Insurance and Contraceptive Coverage Act, despite bipartisan support. Many presidential candidates support equitable prescription coverage for contraceptives, while others have yet to take a position. The next President should push through this health policy, which has been stalled in Congress for a decade.

10. SCIENTISTS ADVANCE WOMEN-INITIATED HIV PREVENTION

U.S. scientists design a new female condom, receive funding for microbicide development… 

The only female-initiated method to prevent sexually transmitted infections (STIs), the female condom, allows women greater control over safe-sex negotiations and protection against pregnancy and STIs. PATH, a nonprofit research group based in Seattle, recently designed a cheaper and improved model. Proponents say the new female condom, which is not yet approved for use, will increase the popularity and availability of the condom and further initiatives against unwanted pregnancy and STIs.

Last month, the CONRAD Program of the Eastern Virginia Medical School received $28.5 million from the Bill & Melinda Gates Foundation to continue efforts to develop a microbicide for HIV prevention.  The award will support testing of new microbicides, substances like contraceptive foam or jelly that could be inserted into the vagina to prevent HIV infection.

What's next...Will the world dedicate itself to putting the power of HIV prevention in women's hands? 

The quest for affordable, women-initiated HIV prevention measures could accelerate with more funding and political commitment. 

There are currently 700 male condoms for every female condom available.  Increasing the marketing and distribution of female condoms globally from the present 20 million per year to 200 million per year would cut their cost by two-thirds. Studies estimate that an effective microbicide could prevent more than two million HIV infections worldwide over three years. Despite recent setbacks, research must continue.

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