Speakers and Abstracts for the World AIDS Day Meeting 1 December 2004 Marlborough House Message from the Commonwealth Secretary General on World AIDS Day When I met with Kousalya, a young HIV positive woman from India, a year ago, she told me: “after I learned I was infected, my dreams were shattered and I didn’t want that to happen to any other woman.” Since then, she joined the Commonwealth Youth Ambassadors for Positive Living, helping other HIV positive young people rebuild their lives. As part of her work, Kousalya visits schools, colleges, rural and slum areas to spread awareness and disseminate accurate information on HIV/AIDS. Kousalya is one of the 13 million women living with HIV in the Commonwealth. Increasingly, it is women who face the greatest challenges in the fight against HIV/AIDS. Increasingly, AIDS has a woman’s face. Women and girls are disproportionately affected by the devastation caused by HIV/AIDS and women in the Commonwealth are more likely to be infected with the virus. Indeed, 60% of people who carry the virus are Commonwealth citizens. Nearly 60% of all HIV-positive adults in sub-Saharan Africa are now women, whereas a decade ago, the majority of cases were men. Moreover, teenage girls are five to six times more likely to get infected than their male counterparts, as they are often not in a position to negotiate safe sex. In many countries, women are denied the right to own land and property, severely restricting their economic freedom. Without enforceable rights to own or inherit property, women and girls face destitution after the death of their husbands; partners or parents, while poverty and economic dependence leave them exposed to increased sexual exploitation and exacerbates their vulnerability to HIV/AIDS. Given that women often bear the brunt of the HIV/AIDS pandemic, they must be at the centre of any strategy to tackle the problem. Prevention and care programmes need to challenge gender stereotypes and reduce gender inequalities while encouraging the active involvement of men and boys in all prevention and care activities. Men can make a positive and direct contribution to ending violence against women. The Commonwealth plays an important role in addressing the gender dimension of HIV/AIDS. We established a strong partnership with UNAIDS and hosted the launch of the Global Coalition on Women and AIDS on 2 February 2004. We work closely with national AIDS commissions, governments and civil society partners to strengthen their capacity to respond to the social and economic impact of HIV/AIDS, especially on women and girls. Prevention must also be at the centre of our strategy. Educating about the risks of HIV/AIDS can save more lives than physicians can. That is why we developed the Ambassadors for Positive Living. No effective attempt to tackle HIV/AIDS can ignore the fact that gender inequalities are at the core of the pandemic. Women and girls should be at the centre of our joint efforts to halt the spread of AIDS. Not simply because they are victims of AIDS, but because they are key to the solution. Dr Gareth Tudor-Williams Senior Lecturer in Paediatric Infectious Diseases, Imperial College London Abstract "Prevention of Mother-To-Child Transmission: Where is the Mother?” The early focus of efforts to reduce mother-to-child transmission of HIV was aimed at understanding the science of how the virus passed from mother to infant, and targeting the key events. Avoidance of breast feeding, pre-labour caesarean section and antiretroviral use around the time of delivery have the potential to reduce transmission from around one in three to less than one in fifty babies. For too long however the mother was viewed as a vehicle by which to administer interventions that protected her baby. The needs of the mother and the vulnerability of an uninfected baby whose mother has been allowed to die were slow to be acknowledged. This is graphically illustrated by a short film made by Professor Samuels and colleagues in Chennai, India for World AIDS Day last year. It is crucial that the tide is turned, and the need to provide care for mothers and fathers is given as high a priority as preventing transmission to infants.
Bio Dr Gareth Tudor-Williams is a Senior Lecturer in Paediatric Infectious Diseases at Imperial College and Consultant Paediatrician at St. Mary's NHS Trust, London. His interest in paediatric infectious diseases was sparked by two years working in the Himalayas for Save the Children Fund UK. He has been involved in the care of children infected and affected by HIV since 1989, as a Fellow at Duke University, N. Carolina and a Visiting Scientist at the National Institutes of Health, Bethesda, MD, USA. In 1994 he returned to the UK to help develop a multi-disciplinary service for HIV infected children and their families at St. Mary's Hospital, London, which is now one of the leading centres nationally. Dr Tudor-Williams is the elected Chairman of the Children¹s HIV Association of the UK and Ireland. He is involved in clinical trials with the Paediatric European Network for the Treatment of AIDS (PENTA). He is a co-principal investigator for the PENPACT 1 study, a collaboration between European and United States investigators. He is currently involved in innovative therapeutic trials for infants and for acutely infected pregnant mothers in Durban, S. Africa. Dr Alice Welbourn, Chair, Board of Trustees, The International Community of Women living with HIV/AIDS (ICW). Abstract "Where are the Women in ABC?"HIV positive women around the world have learnt the hard way that the ABC message is far too simplistic as an effective prevention response to the HIV pandemic. For example, Abstinence-only programmes for young people have been shown by Christian Aid and others not to work; Being faithful is no good if your husband is having unprotected sex with others and you are wanting children; and Condom use is extremely difficult to negotiate both for men and for women. Alice Welbourn will explore the challenges of "ABC" for women in particular in her presentation. Bio Alice Welbourn is a trainer, writer and activist and has been working in international development for 25 years. Her doctorate based on rural Kenyan livelihoods shaped her future work on gender, health, participation, rights and community development. Diagnosed positive in 1992, she is chair of ICW, which has a global membership of positive women. In this capacity she advises WHO, UNAIDS and others on global policy issues in relation to HIV positive women. She is married with two teenage children. Tania Boler, Education and HIV Adviser, Action Aid Abstract The benefits of formal education are well known - better life expectancy, job prospects, nutrition and choices. In a world fundamentally changed by AIDS, education takes on a new role as protector against HIV. Education is especially empowering for girls and young women, and this is key to its efficacy against HIV, a disease which thrives on the social and economic vulnerability of young women. However, the same gender inequality which makes girls vulnerable to HIV, is also keeping them out of school: more than half of the countries that are not on track to reach the goal of universal primary education are also those worst affected by HIV/AIDS. In many countries, AIDS is changing the educational landscape, with girls affected by AIDS often the first to drop out of school. The relationship between gender, HIV and schools is complex. This talk will aim to discuss some of the key points raised above, and the potential to dovetail previously separate campaigns around gender inequality, education and HIV. Bio Tania is the Education and HIV/AIDS adviser for ActionAid International. She is coordinating a number of different projects including an 18-country advocacy and research project with UNESCO, looking at educational response to HIV/AIDS. As HIV focal person for the Global Campaign for Education, she advises on how education coalitions in over 35 countries can start mainstreaming HIV/AIDS into their work. With respect to girls and HIV, she is co-convenor (with UNICEF) for the Global Coalition on Women and AIDS, on girls' education; a member of the UN inter-agency task team on HIV/AIDS and Education; and has written a number of papers around the role of schools in preventing HIV.Outside of ActionAid, Tania is also busy finishing her PhD at the London School of Hygiene and Tropical Medicine, which focuses on the impact of AIDS on children and education in KwaZulu-Natal, South Africa.