International Women's Health Coalition - Top Ten Wins for Women's Health and Rights in 2008

Top Ten Wins for Women's Health and Rights in 2008

Each year, the International Women's Health Coalition issues the "Top Ten Wins for Women's Health and Rights."

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1. New U.S. Administration offers hope for women and girls

The election of Barack Obama as the 44^th President of the United States provides an opportunity to uphold human rights, promote health for all, and change the future of millions. Women's health and rights advocates in every corner of the world expressed excitement and hopefulness.

What's next: For many, the most urgent issues facing the United States are the financial crisis and the wars in Iraq and Afghanistan, but achieving global peace requires securing every woman's right to a just and healthy life. The Obama Administration now has the chance to reestablish U.S. credibility and leadership. One of its first actions should be to provide funding and support to ensure that every woman and girl has the information and services she needs to make her own choices about sex, pregnancy, and childbearing, and to protect herself against sexually transmitted infections, including HIV/AIDS. The International Women's Health Coalition (IWHC) was among the first to outline an agenda for women's rights and health for the new Administration and is working with the transition team and other advocates to promote priorities for women and girls.

2. A new "Mexico City policy" leads the way on comprehensive sexuality education

Prior to the XVII International AIDS Conference in Mexico City in August, health and education ministers from through Latin America and the Caribbean pledged to invest in comprehensive sexuality education and increase access to health services to strengthen the region's HIV/AIDS response. The Mexico City Declaration on Sex Education in Latin America and the Caribbean, outlines these commitments to teach young people about human rights, women's rights, and gender equality, and ensure youth-friendly health services. Several IWHC partners, including Instituto de Educacion y Salud, participated in developing the declaration, which was unanimously endorsed. A majority of governments rejected efforts to promote abstinence-only-until-marriage education and repudiated the Bush administration's earlier attempts to remove the term "sex education" from the original draft.

What's next: A group of non-governmental organizations, including IWHC and the Mexican Association for Sex Education, are working with the Pan American Health Organization to assist countries in fulfilling their commitments, including dramatically increasing the number of schools that provide comprehensive sexuality education by 2015.

3. U.S. citizens turn back attempts to restrict abortion access

In November, U.S. voters overwhelmingly rejected ballot measures to restrict access to safe abortion. A second attempt at a near-total ban on abortion in South Dakota was defeated by 10 percentage points. In Colorado, 73 percent of voters rejected an initiative to provide rights to a fertilized egg, which would have effectively banned all abortions. In California, voters defeated a measure that would have required adolescents seeking an abortion to wait 48 hours after a parent, guardian, or substitute adult had granted approval.

Elsewhere in the world, there were important incremental gains toward legalizing safe abortion services. In April, the Council of Europe called for all 47 member countries to make abortion safe and legal. The Uruguayan legislature also approved a comprehensive sexual and reproductive health bill, supported by IWHC partner Mujer y Salud en Uruguay, which would have legalized abortion up to the twelfth week of pregnancy. Although the measure was vetoed by the Uruguayan president, it progressed much further than a similar bill proposed in 2002.

What's next: In South Dakota, abortion opponents insist that they will try to pass an abortion ban in 2010, despite their repeated failures, and a new organization has formed to push measures in 17 other states similar to the measure to provide rights to a fertilized egg defeated in Colorado. These campaigns are costly and distract health care providers and advocates from the real priority of building sexual and reproductive health programs that can prevent unintended pregnancies and support women's rights. They are also out of touch with a wider global trend of liberalizing abortion laws, according to a recent study by researchers at Harvard School of Public Health and the Center for Reproductive Rights.

4. Indian government puts the power of prevention in women's hands

This year, India's National AIDS Control Organization (NACO) will provide sex workers in four states with about 1.5 million female condoms, which is the only woman-initiated HIV prevention technology currently available. The primary manufacturer of female condoms worldwide, the Female Health Company, is collaborating with Hindustan Latex to manufacture the condoms in India for the first time, which cuts production costs in half.

NACO's landmark initiative builds on their 2007 program, which distributed half a million female condoms to sex workers and housewives. A year-long study of 60,000 women found that 60 percent of these women purchased a condom more than once, and 98 percent found them comfortable. Given that the majority of new HIV infections occur through unprotected sex, this program has enormous potential to prevent new infections in women, who account for nearly 40 percent of new infections each year in India.

What's next: Female condoms are available in 116 countries, and public-sector programs are underway in over 90 countries. But the programs are small: the Female Health Company distributed about 26 million condoms worldwide in 2007-one for every 100 women in Asia, Africa, and Latin America between the ages of 15 and 49-in contrast with the 3.1 billion male condoms supplied by global donors last year. The Prevention Now! Campaign, the United Nation Population Fund's Global Female Condom Initiative, and the Netherlands Ministry of Foreign Affairs are all to make female condoms more widely available, and IWHC is working with international agencies, donors, and our partners to increase access to female condoms. In Cameroun, IWHC partner The Society for Women and AIDS in Africa - Cameroun Chapter is advocating for a national strategic plan to ensure that women, including those living in rural areas, have continued access to female condoms. This month, a U.S. Food and Drug Administration Advisory Committee unanimously voted to approve the Female Health Company's second-generation female condom, the FC2 Female Condom.

5. Clinton Global Initiative prioritizes adolescent girls

IWHC and its longtime partner the Girl's Power Initiative (GPI) participated in the Clinton Global Initiative (CGI) annual meeting in September as experts on the health and rights of adolescent girls. GPI co-founder Bene Madunagu spoke about the pressing needs of the world's nearly 2 billion young people for comprehensive sexuality education programs. The vast majority of these youth live in the developing world where one in seven young women marries before age 15, and nearly 60 percent of all young people (ages 15-24) living with HIV/AIDS are female.

The CGI annual meeting is a forum for heads of state, government and business leaders, scholars, and civil society leaders like Madunagu to debate and commit to solutions to urgent global issues. As part of the sessions, CGI participants are asked to make a Commitment to Action on one or more of the focus issues. Both IWHC and GPI made commitments to securing adolescent girls' rights and health.

What's next: Over the next two years, IWHC will invest nearly $1 million in 19 organizations in Nigeria, Cameroun, Pakistan, Brazil, Peru, and Mexico to ensure that education and health services for young people integrate human rights, gender equality, health, and sexuality. At the same time, IWHC will train and support 100 young, emerging advocates to become leaders in their own countries. GPI will continue to collaborate with education officials in four Nigerian states to reach nearly one million young people with information and education about their health and rights.

6. Women's advocates secure advances in Ecuadorian Constitution

After a year of negotiations, Ecuador's Constitution now says that young people must receive sexuality education and that the State has an obligation to provide sexual and reproductive health services to its people. According to the country's new Constitution, agreed upon in September, the right to personal integrity includes the right to make free, informed, voluntary, and responsible decisions about one's sexuality, sexual orientation, and reproductive life. The Constitution also includes a commitment to separation of church and state and includes new clauses to prevent violence against women and discrimination, including discrimination based on sexual orientation.

With the support of IWHC, the Centro Ecuatoriano para la Promoción Acción de la Mujer (CEPAM-Quito) and other advocates worked tirelessly to secure these wins in the new Constitution. CEPAM-Quito staff traveled countless times from Quito to the headquarters of the Constituent Assembly in Montecristi, approximately 400 miles each way, to advocate for sexual and reproductive rights.

What's next: Ecuador's President, Rafael Correa, is opposed to legalization of abortion and same sex marriage. CEPAM-Quito and other advocates were unable to prevent some harmful language, including prohibition of marriage and adoption by same-sex couples. CEPAM-Quito is working in coalition with other women's groups in Ecuador to protect the advances and prevent further challenges.

7. Colombia's high court rules on the side of science-and women's rights

In June, the highest administrative court in Colombia ruled that the sexual and reproductive health services provider Profamilia can continue to import and distribute emergency contraception (EC)-in accordance with women's right to access a full range of safe and effective contraceptive methods.

An anti-choice citizen had challenged the government's 2000 authorization of EC in court, arguing that EC is "abortive" and violated the right to life of Colombian citizens. Yet scientific experts have repeatedly confirmed that EC does not cause abortions. In fact, the International Consortium for Emergency Contraception and the International Federation of Gynecology & Obstetrics released a new statement in October confirming that EC prevents pregnancy by acting before implantation or fertilization takes place.

What's next: Since 2000, Profamilia has provided EC to Colombian citizens through its network of clinics. Yet emergency contraception in Colombia still requires a prescription-an important barrier to access, considering that EC must be taken within 72 hours of unprotected sex. Profamilia has worked to overcome this barrier by offering EC to women without an appointment. Preventing as many unintended pregnancies as possible requires that governments permit the sale of EC without a doctor's prescription, ensure that women who have experienced rape can access EC in a timely manner, and enact laws and policies that recognize adolescents' rights to EC. Profamilia's Executive Director, Maria Isabel Plata, is a member of IWHC's board of directors.

8. Connecticut, Colombia, and others stand strong for sexual rights

This year, Connecticut joined Massachusetts in legally recognizing same-sex marriages. Legal marriage confers more than 1,000 rights and protections, including social security and insurance benefits, and hospital visitation rights.

Internationally, same-sex marriages are only recognized in six countries, including South Africa. This year, a Colombian court extended pension benefits to same-sex partners, acknowledging that to exclude them would violate the principles of non-discrimination and human dignity. Earlier this month, 66 nations at the UN General Assembly supported a groundbreaking statement confirming that international human rights protections include sexual orientation and gender identity. It is the first time that a statement condemning rights abuses against lesbian, gay, bisexual, and transgender people has been presented in the General Assembly.

What's next: In November, California voters approved Proposition 8 by a slim margin, amending the Constitution to restrict the definition of marriage as between a man and a woman and overturning an earlier state Supreme Court decision allowing same-sex marriage. The decision has sparked peaceful protests and candlelight vigils throughout the state, and three lawsuits have been filed to overturn Proposition 8. Globally, IWHC's partners continue to promote sexual rights in the face of conservative opposition. For example, the International Centre for Reproductive Health and Sexual Rights in Nigeria is currently working with other African feminists to combat unbalanced attacks by some media groups on lesbian, gay, bisexual, transgender, queer, questioning and intersex community groups there.

9. U.S. states prioritize youth health over ideology

In 2008, the number of U.S. states refusing to participate in the federal government's abstinence-only-until marriage education program (Title V) reached 25, as state governments recognize what research and evaluations have repeatedly shown: abstinence-only programs are ineffective.

Three years ago, California became the first state to reject Title V federal funding, followed by Maine. Today, millions of dollars of Title V funding are being turned down by states-especially significant during tough economic times for many states.

What's next: Despite pushback from the states, Congress may vote to extend Title V for another year or longer. President-elect Obama has repeatedly called for "age-appropriate" and "science-based" sex education in schools. The U.S. federal government and the states now have a new opportunity to work together to develop state and federal programs that support the comprehensive sexuality education young people need to make informed choices about their bodies and their health.

This approach is consistent with that of IWHC and its partners, including Femmes, Santé, et Développement en Afrique Sub-Saharienne (FESADE) in Cameroun. With IWHC's support, colleagues like FESADE provide and advocate for comprehensive sexuality education to teach young people how to effectively build respectful relationships and protect themselves from HIV and other sexually transmitted infections. This year, the Society for Women and AIDS in Africa selected IWHC to receive its Excellence Award for individuals and organizations demonstrating excellence in the fight against HIV/AIDS.

10. Muslim women in the United Kingdom granted equal rights in marriage

Muslim leaders in the United Kingdom succeeded in creating a new marriage contract under Sharia'h law that gives husbands and wives equal rights, after four years of negotiations. The new contract no longer permits men to practice polygamy and grants women the right to initiate divorce. In the past, women were not given written proof of their marriages, which meant that they were often unable to retain any financial rights in the case of divorce.

What's next: This change represents a powerful example for Muslim leaders and communities throughout the world. In Northern Nigeria, Islamic Sharia'h law was introduced at the state level in 2000. Based in the state of Kano, IWHC partner Action Health Information Projects (AHIP) has built relationships with religious leaders throughout northern Nigeria to encourage their support for women's reproductive health through their sermons and influence in the community. AHIP has trained over 1,000 religious leaders across 19 states in Northern Nigeria in HIV/AIDS prevention and treatment and reproductive health. Each of these leaders reaches an average of 5,000 people every week through Friday congregational prayers and sermons.

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