Speeches

The betrayal of women in the Democratic Republic of the Congo

Fri, 29 Oct 2010 16:32:39 -0400

Paula Donovan, Co-Director of AIDS-Free World, addresses the XVII International AIDS Conference session Political Crises, Sexual Violence and HIV in Mexico City.

It is now 11:06 p.m. on August 7th in the city of Bukavu, in the province of North Kivu, in the war-torn eastern region of the Democratic Republic of the Congo. At the Panzi Hospital, the post-operative ward is dark and quiet, except for the moans of the two dozen or so women who underwent surgery today to repair their shredded vaginas.

Down the hall, another 100-plus women and girls fill the beds of the fistula ward, hopefully waiting out the recuperative period that will ascertain whether their recent operations succeeded in mending the internal ruptures they sustained when their attackers drove penises, sticks, bayonets, tree branches, broken bottles or gun barrels into their vaginas. And across the hospital grounds, several hundred more wait in misery for their turns on the operating table, unable to control the feces and urine that have been running down their legs since the brutal rapes that ripped fissures between their rectums or bladders and their vaginas, knowing that the flow of feces and urine will continue to stain their clothing and pool at their feet and create a stench around them until they are operated on — and if their surgery fails, for the rest of their lives.

Tens of hundreds of other survivors of rape ranging in age from eight months to 80 years have not been seen by a medical person since they were raped. Right now they crouch in the displaced persons’ camps where they fled after their attacks; they cower in the bush, where they have taken refuge since being driven from their homes by angry, confused husbands and fathers who cannot fathom why their wives or daughters were raped, and concoct rationales for the inexplicable: "she must have been asking for it."

Each woman and girl has a different horror story to tell. Some were snatched on the way to school and held captive for days, tied to trees and raped over and over and over again. Some were attacked as they farmed their fields, or as they walked to collect water, or lugged goods to market. Ten-year-old Mercy was playing near her home when her village was raided by armed militiamen. She watched in silent horror and then somehow made her way to the Panzi Hospital where, weeks later, she regained the voice she’d lost and told nurses her situation: the militias had raped her, and murdered her parents and all the members of her family.

Throughout the region, hundreds of thousands of women are attempting to sleep, alert for the sounds of those marauding gangs of militias. They live under constant terrorist threat, knowing that theirs might be the next village taken. They know that at any moment, armed thugs may crash into their homes, round up the men and boys and force them to form a circle and watch as the women and girls are dragged to the center by their feet or their hair. They wonder if they’ll make it through another night without meeting the fate that has been dealt so many other Congolese women — without being stripped naked, without having their breasts and buttocks whipped until the skin falls off in bloody clumps, without being hurled to the ground and raped by soldier after soldier, without feeling the steel of a militia man’s gun barrel in their vaginas and hearing the explosion when he pulls the trigger, without choking on semen, without watching a machete come down on their wrists and seeing their severed hands fall to the ground as their stupefied husbands and brothers and children stare in petrified disbelief, unable to come to their aid.

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"...a commentary on contemporary misogyny," Stephen Lewis Tells African Women's Development Fund

Thu, 28 Oct 2010 16:07:55 -0400

Extract from remarks to the African Women and Political Participation Conference, part of the 10^th Anniversary Celebrations of the African Women’s Development Fund, November 12, 2010, Accra, Ghana.

It’s been quite a week, as all of us would agree. The most vivid moment, in the context of this conference, undoubtedly occurred when Iran lost its bid for a seat on the Executive Board of the new international agency, UN Women.

Iran certainly had it coming. It was particularly satisfying to see the David and Goliath parable played out in such vivid modernity: Iran was demolished in the vote by East Timor, population 1 million versus Iran’s population of 72 million.

The possibility of Iran joining the Board of UN Women was truly outrageous. Virtually the entire world was aghast at the case of Sakineh Ashtiani, the woman who faced death by stoning for adultery. Iran backed away in the face of massive international protest, but in a trumped-up trial, worthy of Stalinist doctrine, Sakineh was found guilty of conspiring with the murderer of her husband and sits on death row, in isolation, awaiting execution.

Iran is a country where domestic violence is legal; marital rape is legal. A charge of rape can indeed be brought by a woman, but four male witnesses are required, or three men and two women, and if the charge fails, the woman who made the accusation receives eighty lashes.

Iran is a country where a woman requires her husband or father or male relative to sign her passport application. Iran is a country where a husband’s permission is required should the wife choose to go abroad.

It is all infinitely revolting, and in places, infinitely fatal.

Quite simply, putting Iran on the Board of UN Women would have been like putting a Nazi on the Board of a Holocaust Museum.

As it turned out, Iran lost. But think about it for a moment: Iran was included in a block of ten countries for an election by acclamation. That is to say, no election at all. It’s worth considering what the Asian regional UN group really thinks of women in the circumstances. It’s quite a commentary on contemporary misogyny.

It’s also a commentary on the poisonous back-room wheeling and dealing at the United Nations, as countries trade votes and money and seats and positions to achieve election to Boards and Commissions. In this instance, it amounted to international trafficking in the rights of women.

But the story doesn’t end with what almost happened with Iran.

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"A consortium of fabrication"

Thu, 28 Oct 2010 16:07:55 -0400

Remarks about the behavior of the world’s wealthiest nations, delivered at the RESULTS Educational Fund Annual Conference in Washington, DC.

Let me take a hard look at the issues arising from the G8. Everyone is aware of the solemn promises that were made at Gleneagles in July of 2005. They followed in the wake of Tony Blair’s Commission on Africa, with all of the attendant triumphalism, and it seemed to promise a new dawn for the African continent. In particular, they promised a breakthrough in addressing the pandemic of HIV/AIDS.

The two centerpieces of Gleneagles are etched in everyone’s memory: foreign aid (Official Development Assistance) to Africa would double from $25 billion a year to $50 billion a year by 2010. Equally, by 2010, the G8 pledged to do everything in its power to achieve universal access to treatment for those who need it.

Bob Geldof, in one of his more memorable spasms of hyperbole gave the G8 “ten out of ten.”

Some of us never believed Gleneagles for a moment. The fundamental dishonesty of the pledges came to light just two months later, in September of 2005, when the G8 countries at a pledging conference for the Global Fund to Fight AIDS, Tuberculosis and Malaria, fell billions short of their commitments. You have to wonder how western leaders can be so stunningly cavalier about the lives of millions of people, the great majority of them in Africa.

Fast forward, then, to 2007 and the G8 Summit just completed in Germany. In the weeks prior to the Summit itself, quite predictably a number of groups and institutions took stock of the extent to which the promises at Gleneagles had been honored. Every single assessment found a staggering shortfall.

The first was the Development Assistance Committee (DAC) of the OECD, one of the most authoritative vehicle for expert western analysis. It found that, incredibly enough, Official Development Assistance had actually declined internationally between 2005 and 2006, and for Africa the verdict was virtual stagnation.

This finding by the DAC, shocking though it seemed, was given the stamp of accuracy by the very group that was established by Tony Blair at the time of Gleneagles to monitor progress. It’s chaired by Kofi Annan, and has a membership comprising a number of celebrated figures from Michel Camdessus to Graça Machel to Bob Geldof himself. They did an analysis of the aftermath of Gleneagles and came to the same conclusion as that of the OECD. Geldof on this occasion used the word 'grotesque' to describe the behavior of the G8.

Then, in addition to those two definitive commentaries, Bono weighed in with his advocacy group, ‘DATA’ whose findings were every bit as damning as the others.

It seemed implausible to most of the world (and I deliberately exclude myself because I’ve put in writing my complete skepticism of the G8 process) — that after the absolute commitments of Gleneagles, everything could go so lamentably off course. But one learns, painfully, that the betrayal of Africa is almost a matter of principle for the G8.

With that in mind, no one should have imagined significant progress in Germany this year. The good intentions that flowed from President Merkel were no different in tone and content from those which preceded Gleneagles. People were willing to give her the benefit of the doubt, in part because of George Bush’s announcement, just ten days before the Summit, that he would recommend a doubling of his original PEPFAR pledge, from $15 Billion to $30 Billion over the five years from 2009-2013. The pledge was greeted with the uncritical applause of a compliant media, completely failing to grasp, as the Global AIDS Alliance immediately pointed out, that PEPFAR had already reached over $5.4 Billion for 2007, and would probably exceed that sum in 2008. Since that’s the case, it means that the new $30 Billion dollar total, divided by five years, will amount to a real increase of only several hundred million each year (if that). Worse, there was no recognition of the fact that the minimum amount that the President should have announced — measured against the United States share of world GDP — was $50 Billion over the five year period, and even then, a shortfall would almost certainly result.

However, the heady use of the deceptive PEPFAR figures (and this is to say nothing of the continued preposterous "abstinence" clauses, and the continued underfunding of the Global Fund), seemed to proffer hope that the G8 would somehow restore its credibility.

Well, we really have our work cut out for us. What actually happened in Germany is deeply, deeply troubling, and it’s worthy of every piece of scorn that can be heaped upon it. The G8 communiqué is deficient in so many ways: fundamentally, it’s intellectually dishonest and riddled with arithmetic sleight-of-hand. It’s hard to know where to begin, but let me at least take a crack in five areas.

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Keynote Speech at the Disability and the Majority World Conference

Thu, 28 Oct 2010 16:07:55 -0400

The following speech was delivered by AIDS-Free World Advisor on Disability and AIDS Myroslava Tataryn as a keynote at the Disability and the Majority World Conference held at Manchester Metropolitan University in Manchester, England.

Thank you, Shaun, for this opportunity to speak.

Now, I know that I said I would speak about AIDS, Power and Politics but, actually, today I’m just going to talk about relationships. AIDS, Power, Politics...dealing with each of these and all of these boils down to relationships.

In order to explain how, I would like to share a bit of my own history with you. I would like to tell you a bit about my first experience living outside Canada. I did not spend a gap-year in Europe...rather, as a student of development studies and environmental science I embarked on a year of studying abroad in Ghana.

I was not a disability activist. I was an environmental activist — committed to student organizing throughout secondary school and into my undergraduate years. Yes, I had a congenital condition that meant I had lived with a disability all my life. I trained and competed in wheelchair sports throughout secondary school and spoke out about issues of injustice, inappropriate language, exclusion but I didn’t see myself a disability activist. I was an environmentalist (and would love to continue to be, but with the amount of carbon miles I’ve incurred in the past few years, I’m afraid I can’t really claim that label).

In any case, I arrived in Ghana for the beginning of my 3rd year of undergraduate studies. I moved in with a Ghanaian family upon my arrival and was determined to listen and to learn that year. I was interested in traditional medicine, herbalists and village healers. Or so I thought...but what struck me was that in the first couple of weeks the only disabled people I saw were on the side of the road begging. So, sure, in the day time in lectures I was pondering community projects and post-colonial theories but on my way home I was wondering if that’s the corner I would be sitting on if I had been born in Ghana. Was begging the only option? Before too long, I met some musicians practicing under a tree outside the gates of the University of Legon (in Accra). I loved the music and would sit under a nearby tree listening to them on my way home from lectures. Many of the musicians seemed to be more or less my age, and one of them had a visible mobility impairment, having had polio at a young age. This was my first glimpse...that, no, even here begging was not the only option.

So, months went by and I moved up to Tamale in Northern Ghana where we were to begin a sort of 4-month volunteer placement or work-experience after which we would write a paper and present on our experiences to gain credit for this portion of the course. I wasn’t planning on working on disability rights. But, during my course-work, I had come across the Resource Centre for People with Disabilities in Tamale (which, at the time, was funded by UK-based Action on Disability and Development). I was surprised and delighted when the chairperson of the resource centre asked if I would spend my 4-months with them. Of course I agreed! My other Canadian classmates had to almost beg to be accepted at other agencies and here I was being invited. I was grateful.

Soon upon my arrival at the Centre, the people who worked and spent time at the resource centre told me that they had never met a “white disabled” before. Now, I bring this up not to make my Ghanaian colleagues at the Centre seem backwards or uneducated but rather to just remind us of who it is that we (in the west) usually send on international placements. Where I was in Tamale was far from the capital, a city but in a very rural region. Goats and cattle in the streets with bicycles weaving between. The Canadians (and other foreigners) that show up there from overseas are, for the most part: young, white, well-educated, non-disabled. Not quite representative of the cultural, linguistic, racial and other diversity that I encounter in Canadian towns and cities.

To be honest, when I started coming to the Resource Centre on a daily basis, I felt I didn’t do much real work — sure I helped refine some funding proposals, helped plan a few events, went to pick up the post...but mostly I just had long conversations. People wanted to know what it was like being disabled where I came from. Probably the most common question was if I was married and if...in our place, it was also difficult for a disabled woman to find a husband. We talked about husbands, wives, boyfriends and children...you see? Relationships! We talked about the struggles families with disabled children face.

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Keynote Speech on the International Day for the Elimination of Racial Discrimination

Thu, 28 Oct 2010 16:07:55 -0400

In this speech, delivered to the Toronto Police Service on International Day for the Elimination of Racial Discrimination, AIDS-Free World Legal Advisor Maurice Tomlinson calls for all groups subjected to discrimination to coordinate their efforts to end hate.

Permit me to express my sincere thanks to Division 23 of the Toronto Police Service for inviting me to address this very important topic; my dear friend Pierre Brouard, Deputy-Director of the Centre of the Study of AIDS at the University of Pretoria for providing invaluable research guidance for this presentation; my organization AIDS-Free World for facilitating my presence here today; and all of you for being present to demonstrate your commitment to working towards the elimination of the scourge of racial discrimination that still stalks our human family.

I have been advised that this year’s focus for the International Day for the Elimination of Racial Discrimination will be on the often invisible Lesbian Gay Bisexual Transgender and Intersex (LGBTI) community which transects all other communities and visible minorities. This is by no means an un-contentious focus because, while some view "gay" (an admittedly clumsy shorthand for LGBTI individuals) as the new "black" others, find even this designation and ranking of discrimination racist. To them this says to the world that homophobia is wrong because white gays and lesbians are now being treated like blacks and it is this — and not the evil of homophobia — that we must seek to challenge. Instead of this unhelpful formulation, it is the intersectionality between racism and homophobia that needs to be addressed, not some artificial ranking of hate.

Whatever your views, the fact is that even after over 60 years of the Universal Declaration of Human Rights which proclaimed "all human beings are born free and equal in dignity and rights" and 45 years of this International Day for the Elimination of Racial Discrimination, the topic of what constitutes discrimination still divides nations and peoples. This day, which remembers the savage extra-judicial killing by police of 69 people in Sharpville, South Africa, as they peacefully demonstrated against the apartheid "pass laws," was designed according to the UN General Assembly to call on the international community to redouble its efforts to eliminate all forms of racial discrimination.

Yet, while much progress has been made in this noble quest, for example the apartheid system in South Africa has been dismantled; a universal Convention to fight racism has still not yet been ratified. The UN, ever hopeful, claims that this International Convention on the Elimination of Racial Discrimination is nearing "universal ratification," yet still, in all regions, too many individuals, communities and societies suffer from the injustice and stigma that racism brings.

My experience has been that racial discrimination lurks in even the most tolerant societies and manifests itself in subtle but insidious ways. For example, despite having traveled the world over, I have only had the "N" bomb used against me when I had the privilege of studying at the University of Calgary as a Canadian Commonwealth Scholar from 1996-1998. I have also experienced that some forms of racism can be downright silly. For example, the Italian Prime Minister notoriously commented on US President Obama’s "nice tan."

Similarly, I have experienced that discrimination on the grounds of sexual orientation, gender identity and gender expression can range from the sublimely subtle (such as government officials in my country arguing that they criminalize homosexual conduct but not homosexuals as a class) to the ridiculously crass (such as Uganda’s attempted imposition of the death penalty on "habitual" gays).

But what happens when these two extreme forms of intolerance, racism and homophobia, collide? And what must a multicultural country like Canada, which is now home to many representatives of other nationalities, do to address these problems? At AIDS-Free World we believe that AIDS discriminates because we discriminate. Therefore, ending discrimination isn't just a kindness — it's a matter of public health. Any group that finds itself the target of discrimination, anywhere in the world, will score lower on health indicators than those in the mainstream. For example, the HIV prevalence among Jamaican men who have sex with men is 32% as against 1.6% among the general population. And if you are a member of two or more groups that are subjected to discrimination, your health (including access to preventive and curative medicines and care) will be multiply threatened. This is the reality of AIDS.

In regards to homophobia and racism and the connection between these two it is important to recognize that racist people can be both homophobic and non-homophobic and homophobic people can be both racist and non-racist. Essentially most human beings, however, want the same things: the right to simply exist, the ability to do meaningful work to make themselves self-sufficient, the right to express their mutual adult love in their various relationship configurations, the right to relax and have recreation, the right to normal personal and social protections, and the right to have a say in their governance.

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Mass Rape Proceeds Apace in the Congo and Zimbabwe while the World Watches

Thu, 28 Oct 2010 16:07:55 -0400

Stephen Lewis delivers the inaugural Julia Taft Lecture, hosted by the Women's Commission for Refugee Women and Children in New York.

This is my last formal speech in 2008. I’d like to use the occasion as a kind of stream-of-consciousness to indulge in some cumulative and very personal reflections.

The organizers have been kind enough to allow me to range broadly over the issue of sexual violence in conflict, and that I shall do.

This audience will surely agree that it’s impossible to discuss sexual violence without the recognition that it’s rooted in gender inequality. In my lifetime, I’ve had the extraordinary benefit of being influenced on matters of gender by three women.

The first is, predictably, my wife, Michele Landsberg. She’s had a hugely distinguished career in journalism in Canada, where her uncompromising principles, and the gifted, searing, inspired, knowledgeable pen of a columnist at Canada’s largest daily newspaper, helped to shape the feminist sensibilities of more than a generation of young women and men. When we met and married, I was an active democratic socialist with a fragile grip on feminism. I am now an active feminist with a fragile grip on socialism. Thus does life change. Michele has said, on many occasions, usually from a public platform, that it took her twenty years to turn me into a human being, and the next twenty-five were then mildly tolerable.

The relevance to the subject at hand is clear: everything must be measured through the lens, the prism of feminism. I’ve learned that you can never approximate the objectives of social justice and equality by marginalizing fifty-two per cent of the world’s population. The struggle for gender equality is the most important struggle on the planet, and nowhere is this more evident than in issues of sexual violence.

The second is my closest friend and collaborator for well more than a decade, and co-Director of AIDS-Free World, Paula Donovan. Paula has, over the years, unflinchingly kept me on track around international issues of gender when my Pavlovian male egocentricity threatened to derail or undermine what we were jointly fighting to attain. She is as intellectually tough and principled as they come, and it’s frankly a Godsend to have a feminist with nerves of steel in every fray. It sure keeps you on the straight and narrow. And I daresay that I would never have been seen as someone competent to speak on sexual violence were it not for the laser clarity in direction, the probing analysis, and often the very words of Paula Donovan. I have filched shamelessly from Paula’s framing of the issues over the years.

And again, the relevance to tonight is clear. You can’t equivocate about feminist analysis; you can’t seek some clever compromise to get past the tough stuff. You can’t finesse the reality of what’s being done to women around the world. Yet that’s exactly what we’ve been doing with sexual violence: it won’t wash.

And the third woman will be surprised when I tender her name, because Eve Ensler and I have known each other for barely a year. I was of course familiar with the Vagina Monologues — my wife and older daughter saw the first-ever opening night performance in New York — and I was vaguely familiar with Eve’s movement, V-Day. But I was catapulted into renewed awareness about sexual violence in conflict when I read the astonishing and annihilating piece that Eve wrote in Glamour Magazine, September 2007, after returning from the Democratic Republic of the Congo. Life, for me, has not been quite the same from that day to this.

It wasn’t that I was unconscious. But like everyone else, I needed that jolt to my moral and intellectual gestalt to focus again on what’s really important in life. There’s a lot to be said for repetition. The relevance lies in the need to hammer home, relentlessly, the issue of sexual violence, even to the converted, so that we trigger a shift from commonplace recognition to imperative action.

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“No Funding for Peace Talks Unless Women are at the Table,” Lewis Says

Thu, 28 Oct 2010 16:07:55 -0400

Stephen Lewis at the 10th annual Policy Forum of The Institute for Inclusive Security in Washington, D.C.

This is a difficult speech to make: timing, content, language, rhythm. It’s almost sacrilege to attempt to put words to paper after so remarkable an inaugural address, and the subsequent waves of incandescent euphoria.

But this is a most serious gathering, and it may also be perfect timing, coming as it does right at the outset of an administration of which so much is hoped and so much is expected.

And there is for me — and for the organization I represent, AIDS-Free World — another unanticipated happenstance. I had not met Ambassador Hunt before today, nor — however embarrassing the admission — did I know much of the Institute for Inclusive Security (IIS), or indeed, the work of Women Waging Peace that preceded it (albeit I’d certainly heard the name on many occasions). But I have to say that reading the material that was sent to me spawned an instant sense of solidarity, and my colleagues and I really felt drawn to the advocacy on behalf of women that lies at the heart of the IIS. It’s an advocacy that we not only endorse, but that sustains our own work, and frankly I feel more than a little foolish to have come to this discovery so late.

And by the way, I’m not shamelessly currying favor; I’m too old to curry favor.

As I read through the avalanche of briefing notes that Jacqueline O’Neill sent to me on behalf of the IIS, two things struck home. First, the simple, unvarnished truth that men make war, and women lead lives without resorting to violence, so it makes unassailable logic to have women at the center of peacemaking and peacebuilding initiatives. They are indispensable to negotiating peace agreements that last, and indeed, will never be sustained without the leadership of women.

But the other item was in a way transformative. In a Christian Science Monitor op-ed back in October, 2007, written by Carla Koppell, Director of the Initiative for Inclusive Security, she argues, and I quote “We could reserve seats at the table for those who have not borne arms but have a stake in peace. Most radically, mediators could invite non-belligerents to the table first and have them set the agenda for talks.” It means, says Carla “ … that those who haven’t picked up weapons get to choose priorities.”

I love it. Of course it’s radical: it would induce cardiac arrests in every warlord from Sudan to Zimbabwe. But it’s brilliant in the way it captures the quintessential fact that in every existing or anticipated peace negotiation, in every conflict everywhere, the women are missing. Oh to be sure, there are the obligatory tokens. But everyone must surely acknowledge that the implementation of the famous Security Council Resolution 1325 (PDF, 36KB) has been a cosmic bust. And it’s more than eight years.

In a recent representative sample of 35 major peace negotiations since October of 2000 when 1325 was passed, it was revealed that 1.2% of signatories to peace agreements had been women, and not a single woman played the role of lead mediator in any of the negotiations. How do you define discrimination?

So here we have a world awash in conflicts from Afghanistan to Iraq to the Middle-East; two weeks ago the Lord’s Resistance Army from Northern Uganda attacked a village in the Democratic Republic of the Congo, killing 620 men, women and children, savagely raping nearly one hundred of the women before inflicting dismemberment and death upon them, and just yesterday morning up to two thousand Rwandan troops crossed into the Eastern Region of the Congo to hunt down, it is said, the Hutu genocidaires.

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Scientists must use their talents and consciences to combine activism with scientific inquiry

Thu, 28 Oct 2010 16:07:55 -0400

A speech by Stephen Lewis, co-Director, AIDS-Free World, delivered at the opening of the International AIDS Society Conference on Pathogenesis, Treatment and Prevention Cape Town, South Africa.

In my younger days, decades upon decades ago, we were consumed by the threat of nuclear annihilation. The forces of darkness, East and West, seemed in the ascendance. The Doomsday clock inched its way to midnight.

And then there arose, across a spectrum ranging from the scientists and engineers writing in the Bulletin of Atomic Scientists, through to the Physicians for the Prevention of Nuclear War, a loud clamouring cry of protest, accompanied by marches, banners, polemics, statements, press conferences demanding, in the name of humankind, that the madness end.

And it did, at least for a time at the end of the Cold War. And the scientists and doctors won Nobel Peace Prizes and showed the power of scholarly activism for the whole world to see.

Two weeks ago, just prior to the meeting of the G8, a full-page ad appeared in the Financial Times, with the headline “Scientists Call on World Leaders to Take Action on Climate Change”. It was signed by twenty-five of the most renowned climatologists and earth scientists. They didn’t get all they wanted by any means, but they jolted the political leadership into the recognition that the scientists are mobilized, are watching, are keeping the rest of the world informed and will not be silenced.

I was immediately reminded of the letter, signed by eighty-one acclaimed medical clinicians and researchers right after the Toronto AIDS conference, demanding the resignation of the then South African Minister of Health for reasons everyone in this audience understands. It was an important moment in the accelerating, cumulative pressure for a change in policy, a change now underway.

In truth, there are many in this audience who fought for that change. This is an audience that has devoted itself to making the world a better place, so I hope that what I’m about to say will comfortably resonate.

No one should underestimate the power and influence of science when it decides to take a stand. The two co-Chairs of this Conference are striking examples, amongst many, of the extraordinary impact scientists can have. And never has the exercise of power and influence been more imperative than at this moment in the fight against the AIDS pandemic. Your individual and collective voices are needed … sure, you have the technological and laboratory acumen, you know about vaccines and microbicides and triple combination therapy and viral loads and CD4 counts and pre- and post-exposure prophylaxis … the entire panoply of sophisticated scientific discovery and intervention.

And that’s your work, and it’s of inestimable value. We need you to unravel the secrets of the science, to make all of that elusive and mysterious information accessible to the untutored rest of us. But we need the scientific community as well to speak clearly, and unequivocally, boldly and evocatively to the power-brokers of this world, telling them of the risks and the benefits, and what will happen if they make the wrong choices.

Somehow, along with the science, we need the activism. They are inseparable.

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Secretary-General of the UN Failing to Combat Violence Against the Women of the Congo

Thu, 28 Oct 2010 16:07:55 -0400

Stephen Lewis at the Portraits of War: The Democratic Republic of Congo,photo exhibit held at Rayburn House in Washington, DC.

Many years ago, I did a series of radio interviews for the Canadian Broadcasting Corporation (CBC) with writers who had produced works of fiction on the Holocaust … the likes of George Steiner, William Styron, D.M. Thomas, Elie Wiesel. The series was called "Art out of Agony," and was further enhanced by interviews with exponents of sculpture and film.

The force of that undertaking lives with me to this day. It taught me the power of culture to inform and shape opinion. But the medium that was missing, of course, was photography.

The exhibition on display here today, “Portraits of War,” shows just how powerful and evocative photographs can be when dealing with the most desperate of human themes — in this case, the wanton, insensate sexual violence visited on the women of the Congo. While a direct analogy with the Holocaust would be misplaced, it is not misplaced to say that these images by four exceptional photographers capture the indomitable power of women under siege, and the accompanying essays drive home the torment and horror they’ve been forced to survive, in what has been described as the worst place in the world for women.

These pictures sear themselves into the brain. They need no narrative. They speak, as words can never speak, of the agony that art exposes. They teach, more than any lecture can ever teach, the heroism and resilience of women who face the perils of the damned, simply and solely because they are women.

But they do much more. They remind us of the fury of similar terrifying episodes in the catalogue of human iniquity. At this moment in time, Darfur looms large … and it is important to note that yesterday, the President of Sudan was charged by the International Criminal Court with war crimes and crimes against humanity, with mass rape explicitly included in the dossier of guilt.

This is a man for whom a river of crocodile tears is being shed in Africa and beyond. Allow me a momentary digression: when I was Deputy Executive Director of UNICEF in the 1990’s, I met with al-Bashir on two occasions at summits of the Organization of African Unity. I pleaded with him, on behalf of UNICEF, to stop supporting the Lord’s Resistance Army in its lunatic abduction of adolescent boys and girls from Northern Uganda, turning the boys into child soldiers and the girls into sex slaves, taking them across the border into Sudan, there to suffer the worst imaginable physical and sexual assaults.

The President lied through his teeth. He expressed ignorance of any such happenings. He showed such a ruthless indifference to the plight of the children that it surprises me not at all that he should show an equal indifference to the raping and destruction of the women of Darfur.

The photographs remind us that the women of the Congo are not alone. Such images merge, from country to country, wherever crimes against humanity stalk the land.

The organization I co-direct here in the United States, AIDS-Free World, has been engaged in a heart-rending venture over the last several months: we’ve been taking affidavits from Zimbabwean women, raped by Mugabe’s henchmen during the period of the election turmoil last year. The pattern that has emerged is diabolically clear: these are politically-motivated rapes, often accompanied by grotesque torture, directed exclusively at women who support the MDC, the political opposition.

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Speech to Harvard University conference on UN Reform and Human Rights

Thu, 28 Oct 2010 16:07:55 -0400

Speech made to the Harvard University Human Rights Journal Conference on UN Reform and Human Rights.

As recently as ten days ago, I wasn’t at all sure what I wanted to say in this luncheon address. Then, on February 16th, the United Nations announced the appointment of a new High-Level Panel on UN System-Wide coherence in areas of development, humanitarian assistance and environment. My uncertainty was swiftly brought to an end.

The appointment of the panel was done in response to a fiat delivered by the governments of the world during the General Assembly last September. In the so-called “Outcomes Document” of that gathering, the Secretary-General was ‘invited’ to launch work “to further strengthen the management and coordination of United Nations operational activities so that they can make an even more effective contribution to the achievement of the … Millennium Development Goals, including proposals for … more tightly-managed entities in the fields of development, humanitarian assistance and the environment.”

Quite a mouthful, although positively mellifluous in the literary aesthetics of UN reform. And I may say, just as an aside, that if the High-Level Panel ever deigned to seek my opinion, I would love to provide some thoughts about the role of some of the multilateral "entities."

However, that’s not why I raise the panel. I raise the panel because there are fifteen members, and of the fifteen appointees, with the whole world to choose from, three are women. Twenty-seven years after the passage of the Convention on the Elimination of all Forms of Discrimination Against Women, now ratified by 180 governments; thirteen years after the International Conference on Human Rights in Vienna, when we coined the mantra “Women’s Rights are Human Rights;” eleven years after the Fourth World Conference on Women in Beijing, twice now reaffirmed at five-year intervals; almost exactly one month after the inauguration of the first-ever woman to be elected President in Africa (Ellen Johnson-Sirleaf of Liberia); two weeks before the 50th anniversary session of the Commission on the Status of Women; and in the very year when the new President of Chile broke all known precedents to inaugurate a cabinet of exact gender equality, the multilateral system disgorges a high-level panel of fifteen people to look at the re-design all those areas of the United Nations system which so significantly address the lives of women, and but three members of the panel are women.

Now it’s obviously difficult for me to be critical; the UN is my second home. And for more than twenty years now, I’ve loved and defended the organization, whatever warts it may display on occasion. And I shall continue to be a multilateral patriot. But in the spirit of UN reform, which is the centerpiece of this conference, allow me to say that when I read the composition of the High-Level Panel, the natural instinct was to throw up one’s hands in dismay and ask, “When will things ever change?” What do you have to do to get multilateralism to embrace even the simplest element of gender equality: the element called "parity?" I’m reminded, by extension, of the Commission on Africa, appointed last year by Prime Minister Blair, with three women amongst seventeen members: by far the weakest part of the Commission report was the way in which it dealt — or more accurately, failed to deal — with the women of Africa. It is ever thus. Over and over again we’re guilty of the same folly. I remember Lord Acton’s dictum: “There is another world for the expiation of guilt, but the wages of folly are payable here, below.”

Women, world-wide, are paying here, below, for that folly with their lives. I see it all around me in the AIDS pandemic in Africa, exacting a carnage amongst women that knows no parallel in modern history. What is more, in the presence of AIDS, it’s virtually impossible to talk plausibly of women’s human rights … every right a woman might have can be held to the ransom of the virus.

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Speech to the Global Justice Student Conference

Thu, 28 Oct 2010 16:07:55 -0400

Stephen Lewis, speaking at the Global Justice student conference, talks about the need to stand up to the United Nations in the fight to provide antiretroviral drugs to all who need them.

Statement by Stephen Lewis at the Aspen Ideas Festival

Thu, 28 Oct 2010 16:07:55 -0400

As we meet here, in Aspen, Colorado, discussing ideas that can change the world, there is another meeting taking place, of far greater import, in Nairobi, Kenya. It’s the International Women’s Summit, the first ever global conference on women and AIDS, sponsored by the World YWCA, comprising 1,500 women activists and a gaggle of UN and political leaders all gathered for the purpose of confronting the appalling feminization of the AIDS pandemic.

The Conference has been going for two days, with a predictable array of issues presented, but the one item that could dramatically change the world for women, especially women struggling with every wrenching aspect of the virus, has yet to be raised in a serious and substantial way: the creation of a new, international United Nations Agency for Women.

And therein lies a developing tale.

Such an agency has never been more desperately needed. Just last month, the Global HIV Prevention Working Group estimated that if prevention initiatives remain as paltry and ineffective in the future as they have been in the past, there would be 60 million new infections by 2015. According to their calculus, that means 36 million of those infections will be in Africa. According to my calculus, even if the ratio of women to men infected remains where it is today (highly unlikely, since the percentage who are women has been rising steadily for years), that will mean an additional 21 to 24 million infections amongst the women of Africa in less than a decade.

Even to contemplate such a prospect is an unmitigated nightmare.

So you would imagine that every effort in the world would be made to prevent such a catastrophe. Indeed, one of the reasons that a High-Level Panel on UN Reform recommended the creation of a new UN Agency for Women was precisely to deal with issues such as AIDS.

Almost exactly two weeks ago, the General Assembly of the United Nations spent an entire morning debating the Panel’s recommendations, specifically focused on the prospect of the new international agency. In the course of that debate, there were several gleams of light and some disconcertingly ominous portents.

In opening the General Assembly session, the Deputy Secretary-General made a superb speech in favor of the agency. Indeed, I can’t recall an occasion when so high-ranking a member of the UN Secretariat has gone so far out on a limb in so principled a fashion on an issue of undoubted controversy. She should be applauded for her leadership. She was absolutely right to do what she did: gender equality is at the heart of the UN Charter, and if the Secretariat can’t take a stand on equality, what is left of its credibility?

The position of the Deputy SG was subsequently endorsed by Germany speaking on behalf of the European Union, and by Sweden speaking on behalf of the Nordics. Support also came from Brazil and a number of other Latin American countries.

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The Proof is in the Dying

Thu, 28 Oct 2010 16:07:55 -0400

From Geneva, remarks made by Stephen Lewis to a High-Level Panel on UN Reform calling for an agency for women equivalent in size and strength to the UN's agency for children.

There is a crying need for an international agency for women. Every stitch of evidence we have, right across the entire spectrum of gender inequality suggests the urgent need for a multilateral agency. The great dreams of the international conferences in Vienna, Cairo and Beijing have never come to pass. It matters not the issue: whether it’s levels of sexual violence, or HIV/AIDS, or maternal mortality, or armed conflict, or economic empowerment, or parliamentary representation, women are in terrible trouble. And things are getting no better.

This Panel can create such an agency and show fundamental courage by doing so, or it can tinker at the edges of ‘gender architecture’ and consign the world of women, yet again, to perpetual second-rate status.

I’m not going to equivocate about my expectations: I expect the Panel to take the road of least resistance, and come up with some high-sounding scheme, probably with a few choice rhetorical morsels about ‘gender-mainstreaming’ and expect that that will do the trick. It won’t. If that’s the chosen path, I can confidently predict that we’ll be back again, less than ten years from now, driven by a new impetus for UN reform, the Millennium Development Goals unmet in a majority of countries, and the lives of women will be every bit as hazardous, compromised, marginalized and desperate as they are today.

Let’s look at the options.

The suggestion has been made that all the present fragments of women’s agencies in the United Nations be thrown together, given a little more money and staff, and be led by an Under-Secretary General. We’d take the Division for the Advancement of Women, the Office of the Special Advisor to the Secretary-General, the UN Development Fund for Women (UNIFEM) and the International Research and Training Institute for the Advancement of Women (INSTRAW) and turn them into a viable women’s organization. It’s not enough; it won’t work … too little experience, too few mandates, too much unbridled competition, too many areas of programming that are entirely unfamiliar. It’s a recipe for stalemate. (I might note that in the July 1^st edition of the Canadian newspaper, the Toronto Star, a story was carried suggesting that I thought a women’s agency could replace the mandates of various agencies where they intersect with women … e.g., WHO on health; ILO on labour; UNFPA on sexual and reproductive health. That was a matter of simple confusion that I may well have caused. I hold no such view).

The suggestion has been made that UNIFEM alone should be transformed into a new, free-standing women’s agency. The sentiment is perfectly understandable; UNIFEM has at least made some impact despite being confined to subservient status as a department of UNDP (United Nations Development Programme). But it won’t work … UNIFEM, in its present form has never had extensive programming expertise, or operational experience in countries, or a range of government counterparts in Ministries, or financial and human resource autonomy, let alone sufficient breadth in its focus to represent half the world’s population.

UNIFEM can most assuredly be folded into something new; it cannot become what it was never meant to be. It is part of a gender architecture so dysfunctional as to lead one to believe that the design was deliberate.

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Where It All Began

Thu, 28 Oct 2010 16:07:55 -0400

University of Pennsylvania: Statement by Stephen Lewis to the Summit on Global Issues in Women's Health, presenting the case for an international agency for women.

I well realize that this is a conference on women’s global health, and everything I’m about to say will apply to that generic definition. But the more I thought of the subject matter, the more I want to use HIV/AIDS in Africa as a surrogate for every international issue of women’s health, partly because it’s what I know best; partly because it’s an accurate reflection of reality.

I’ve been in the Envoy role for four years. Things are changing in an incremental, if painfully glacial way. It’s now possible to feel merely catastrophic rather than apocalyptic. Initiatives on treatment, resources, training, capacity, infrastructure and prevention are underway. But one factor is largely impervious to change: the situation of women. On the ground, where it counts, where the wily words confront reality, the lives of women are as mercilessly desperate as they have always been in the last twenty plus years of the pandemic.

Just a few weeks ago, I was in Zambia, visiting a district well outside of Lusaka. We were taken to a rural village to see an “income generating project” run by a group of Women Living With AIDS. They were gathered under a large banner proclaiming their identity, some fifteen or twenty women, all living with the virus, all looking after orphans. They were standing proudly beside the income generating project … a bountiful cabbage patch. After they had spoken volubly and eloquently about their needs and the needs of their children (as always, hunger led the litany), I asked about the cabbages. I assumed it supplemented their diet? Yes, they chorused. And you sell the surplus at market? An energetic nodding of heads. And I take it you make a profit? Yes again. What do you do with the profit? And this time there was an almost quizzical response as if to say what kind of ridiculous question is that … surely you knew the answer before you asked: “We buy coffins of course; we never have enough coffins.”

It’s at moments like that when I feel the world has gone mad. That’s no existential spasm on my part. I simply don’t know how otherwise to characterize what we’re doing to half of humankind.

I want to remind you that it took until the Bangkok AIDS conference in 2004 — more than twenty years into the pandemic — before the definitive report from UNAIDS disaggregated the statistics and commented, extensively, upon the devastating vulnerability of women. The phrase “AIDS has a woman’s face” actually gained currency at the AIDS conference in Barcelona two years earlier, in 2002, and even then it was years late. Perhaps we should stop using it now as though it has a revelatory dimension. The women of Africa have always known whose face it is that’s withered and aching from the virus.

I want to remind you that when the Millennium Development Goals were launched, there was no goal on sexual and reproductive health. How was that possible? Everyone is now scrambling to find a way to make sexual and reproductive health fit comfortably into HIV/AIDS or women’s empowerment or maternal mortality. But it surely should have had a category, a goal, of its own. Interestingly, the primacy of women is rescued (albeit there’s still no goal) in the Millennium Project document, authored by Jeffrey Sachs.

And while mentioning maternal mortality, allow me to point out that this issue has been haunting the lives of women for generations. I can remember back in the late 90s, when I was overseeing the publication of State of the World’s Children for UNICEF, and we did a major piece on maternal mortality and realized that the same number of annual deaths — between 500 and 600 hundred thousand — had not changed for twenty years. And now it’s thirty years. You can bet that if there was something called paternal mortality, the numbers wouldn’t be frozen in time for three decades.

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Whose Agenda Counts?

Thu, 28 Oct 2010 16:07:55 -0400

Julia Greenberg, Associate Director of AIDS-Free World, addressed women’s rights activists and delegates to the 52nd Session of the Commission on the Status of Women on Feb 27, 2008, as part of a panel called, “Whose Agenda Counts? Grassroots Women Set Financing and Policy Priorities to Realize Pro-Poor Equality and Empowerment,” co-sponsored by the Huairou Commission and UNDP.

I would like to take advantage of the kind invitation to participate on this panel to amplify AIDS-Free World’s call for support for a UN agency for women, headed by an Under Secretary- General, with adequate staff, operational capacity at country level, and initial funding of $1 billion.

Many of my fellow panelists today know me from my previous job as a donor at American Jewish World Service, where I constantly lamented the abysmal lack of funds for the kinds of cutting edge work that we heard described by the previous speakers.

You may be thinking, how can she, who knows the value of a $5,000 grant for a nascent women-led home-based care group, be calling for another mega-agency? My only hope is that your potential shock and bemusement at seeing me in this new role will provoke lively discussion during the Q and A.

I still firmly believe that the world cannot and will not change unless the contributions of grassroots women are acknowledged, honored and funded. I think there is plenty of room in this world for the type of responsive, flexible funding undertaken by the African Women’s Development Fund, the Global Fund for Women, American Jewish World Service, Mama Cash and Kvinna Till Kvinna —all organizations that are not afraid to get cash into the hands of local activists who know, better than anyone else, what their communities need.

I am aware that my comments may elicit significant skepticism among the activists in the room who are making change at the community level, who have long fought to be heard by the UN and other donor organizations operating at country level. And yet, AIDS-Free World is calling for a UN Agency for Women without equivocation, or apology—with full recognition of the fact that, in many ways, the UN up until now has failed grassroots women.

With the full participation of women at the community level, a strong agency for women could be our last chance to hold the UN accountable to its commitments to gender equality and women’s empowerment. There is some momentum now—as you all probably know, a high level panel appointed by the former Secretary General has recommended a stronger “women’s entity” as part of a broader package for UN reform. The panel’s recommendations seemed to acknowledge the incontrovertible truth: that not one single global goal will be met if gender inequality is not addressed.

Here are just a couple of reasons why these goals won’t be met, in case anyone in this room needs reminders. Women make up 70 percent of the world’s poor and 67 percent of the world’s illiterate. They own only one percent of the world’s assets. Girls and young women now comprise 78% of Sub-Saharan Africa’s 15-24 year-olds infected with HIV.

Believe me, I have no illusions that a Women’s Agency will be a panacea for the challenges facing poor women, and I am absolutely convinced that without the meaningful participation of the Ana Lucy’s and Esther’s [fellow panelists] of the world—this agency will fail.

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A UN Agency for Women and the Democratic Republic of the Congo

Thu, 28 Oct 2010 16:07:00 -0400

Stephen Lewis remarks on the UN Agency for Women and the current situation in the Democratic Republic of Congo at the 8th Women Ambassadors’ Luncheon.

United Nations, NY — When I served at the United Nations in the 1980’s, out of the, then, 159 Member States, there were three represented by women Ambassadors. One of them was the formidable feminist and quite wonderful human being, Dame Nita Barrow of Barbados. So highly did many of us think of Dame Nita, and so anxious was she to serve the world, that she was persuaded to run for the post of President of the General Assembly.

She lost. She lost to a male foreign minister, of one-tenth her competence and capacity. She lost, in part, because she was a mere Ambassador and he was a foreign minister. But mostly — and everybody knew it — she lost because she was a woman.

At the time, incredibly enough, there had not yet been appointed, since the beginning of the United Nations — a span of forty years — a single permanent Under-Secretary General who was a woman.

Things have obviously improved. But we’re still achingly far removed from gender parity in the senior positions of the United Nations system. We have failed internally, we have failed externally, and no one should derive any special solace from the incremental progress over the years.

So clear is the failure, especially in the lamentable record of the United Nations on women’s rights around the world that, as you all know, a High-Level Panel on System-Wide Coherence recommended, in the fall of 2006, the creation of a new international agency for women. It’s useful to recall the words of the Panel: “The message is clear: While the UN remains a key actor in supporting countries to achieve gender equality and women’s empowerment, there is a strong sense that the UN’s contribution has been incoherent, under-resourced and fragmented.”

For a UN report, those are fighting words; scalding language. It’s clear that the panelists wanted something entirely different. They went on to say: “We believe that the importance of achieving gender equality cannot be overstated.”

Some will bridle at my use of the word “agency” because diplomacy, fearful as always of offending anyone’s precious sensibilities, wanted to rely on abstractions like “entity” so as not to cause apoplexy among the faint of heart.

But as things have evolved, it’s clear that we’re moving to the equivalent of an agency, whatever it’s ultimately called, and we’re moving with surprising rapidity.

Even now, the office of the Secretary-General (more explicitly, the Deputy Secretary-General and her designees), responding to a request from Member States, is fleshing out a model of what the new agency will look like, chosen from amongst four alternative possibilities, one of which is a self-contained separate new fund or programme; another of which is an as-yet-to-be-defined hybrid institutional arrangement. At the moment the hybrid seems to be favoured.

The organization that I represent — AIDS-Free World — has no doubt whatsoever which is the best model, and that’s the separate, independent fund. Nor do we have any hesitation about the three indispensable ingredients: first, an Under Secretary-General chosen, without prejudice, from amongst the women of the world … there are, as it happens, a number of remarkable women, in various countries, quietly thinking of vying for the job. Second, the agency should be funded initially at a level of $1 billion annually (a mere third of UNICEF’s yearly budget), and it will be fascinating to see whether the current international financial turbulence is used as an excuse to prejudice the funding of a women’s agency. It would be the ultimate irony if the hapless men, corporate and political, who orchestrated the subprime mortgage convulsion, and then found a trillion dollars in the western world to bail out Wall Street and the European banks, could not find one-tenth of one per cent of that amount to address the needs and rights of women world-wide.

If that should prove the case, you can forget about the Millennium Development Goal dealing with gender equality.

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Call for a New UN Initiative to End Sexual Violence in the Eastern Region of the DRC

Thu, 28 Oct 2010 16:07:00 -0400

On Monday of this week, John Holmes, the UN Emergency Coordinator and Under-Secretary General for Humanitarian Affairs returned from a trip to the eastern Democratic Republic of the Congo and characterized sexual violence against women as "almost unimaginable." He termed it a "weapon of terror," adding that the intensity and frequency is worse than anywhere else in the world.

That’s pretty strong language coming from a UN official, many of whom are given to the sonorous dispassion of diplomacy. But as frontal were the words of John Holmes, he was positively reserved compared to others.

Nor were the words a revelation. They were simply the latest installment in an ongoing litany of horror.

Last month, August 6 to be exact, Eve Ensler, celebrated author of "The Vagina Monologues" held a press conference to seek support for the Panzi hospital in Bukavu, DRC, where women who have been subjected to sexual violence are treated. She had just completed a visit to eastern Congo, and wrote an extraordinary magazine piece which began with the words, "I have just returned from hell. I am trying for the life of me to figure out how to communicate what I have seen and heard in the Democratic Republic of the Congo … How do I convey these stories of atrocities … How do I tell you of girls as young as nine raped by gangs of soldiers, of women whose insides were blown apart by rifle blasts and whose bodies now leak uncontrollable streams of urine and feces?"

There follows an incomparably blood-chilling account of interviews with survivors of rape and sexual violence … violence so insanely savage as to reverberate with Hitlerian brutality. When I read Eve Ensler, I was shaken to the core.

Interestingly, in advance of Eve Ensler, the Special Rapporteur on Violence Against Women, appointed by the United Nations Human Rights Council, felt exactly the same way. Just a week earlier, July 30, 2007, the rapporteur, Professor Yakin Erturk, returned from an official visit to the DRC conducted between July 16 and July 27.

In a public statement , preliminary to a full report, she writes of the roaming gangs of psychopaths in the eastern Congo: "The atrocities perpetrated by these armed groups are of an unimaginable brutality that goes far beyond rape. The atrocities are structured around rape and sexual slavery and aim at the complete physical and psychological destruction of women with implications for the entire society… Women are brutally gang raped, often in front of their families and communities. In numerous cases, male relatives are forced at gun point to rape their own daughters, mothers or sisters. Frequently women are shot or stabbed in their genital organs after they are raped. Women who survived months of enslavement told me that their tormentors had forced them to eat excrement or the human flesh of murdered relatives."

I note that this is the language of a formally-appointed UN rapporteur, delivered to a formal UN body. Absolutely nothing has come of it.

In February of 2007, here in Nairobi, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), in conjunction with the Integrated Regional Information Networks (IRIN) published an astonishingly comprehensive and powerful monograph, with extensive narrative and searing photographs, titled "The Shame of War: Sexual Violence Against Women and Girls in Conflict." It is, without doubt, one of the finest publications, in content and analysis, that the United Nations has produced in many a year.

The monograph followed an earlier publication by OCHA/IRIN in 2005, called "Broken Bodies, Broken Dreams," an initial compilation dealing with gender-based violence. The point to be made is that even though both texts covered sexual violence in several war zones, the material dealing with DRC was enough to sound the highest-decibel alarm.

For example, this excerpt from The Shame of War: "As a result of the systematic and exceptionally violent gang rape of thousands of Congolese women and girls, doctors in the DRC are now classifying vaginal destruction as a crime of combat. Many of the victims suffer from traumatic fistula — tissue tears in the vagina, bladder and rectum. Additional long-term medical complications for survivors may include uterine prolapse (the descent of the uterus into the vagina or beyond) and other serious injuries to the reproductive system, such as infertility, or complications associated with miscarriages and self-induced abortions. Rape victims are also at high-risk for sexually transmitted infections."

Alas, OCHA and IRIN were simply repeating, in 2007, what had been endlessly hammered home in the previous years. On November the UK newspaper, The Guardian, ran a story under the headline "Hundreds of Thousands Raped in Congo Wars," reporting on just one province in eastern DRC, South Kivu, where 42,000 women had been treated for rape. In October, 2006, UN Under Secretary-General for Peacekeeping, Jean-Marie Guehenno, reported that "In the eastern Congo, over 12,000 rapes of women and girls have been reported in the last six months."

But Jean-Marie Guehenno well knows that the number of rapes that go unreported are usually ten or twenty times higher than those that come to official attention, and vastly higher still during a war. Indeed, USG Guehenno was about to receive a report from the Human Rights Division of his own peacekeeping operation in the Congo, known as MONUC, that surveyed "The Human Rights Situation in the Democratic Republic of the Congo during the period of July to December, 2006." In the section of the report headed "Sexual Violence," there is a catalogue of depraved and ferocious assaults on women that makes the blood run cold.

Thus: Despite all initiatives undertaken to counter sexual violence … rape continues to be widespread throughout the country.

Thus: "Throughout the country, young and old women, pregnant women and girls as young as six were allegedly raped at roadblocks and in private homes, on their way home from school or in the fields."

Thus: "In Ituri, where the local population suffers hardships caused by the continuous military operations against armed groups … the (security forces) have carried out brutal acts of sexual violence in a legal vacuum without being held responsible for their actions."

There’s more, much more.

It’s no wonder, then, that Jan Egeland, the former UN Under Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, told the Security Council in September of 2006 that sexual violence in the DRC was a "cancer that seemed to be out of control." He went on to note that the "Congo is the world’s deadliest crisis since the Second World War. Yet Congo’s immense suffering has gone virtually unnoticed by the outside world."

At the outset of 2006, however, it did not escape the notice of the highly-esteemed medical journal, The Lancet. In the issue of January 7th, there appeared a learned article, "Mortality in the Democratic Republic of the Congo: a nationwide survey." The authors examined mortality rates between January 2003 and April 2004, and came to the conclusion, by extrapolation, that the total death toll, 1998-2004 was 3.9 million. It would doubtless be closer to 5 million today. In the introduction to the article, the authors argue that "… the war began in 1998 and quickly engulfed the country in a conflict characterized by extreme violence, mass population displacements, widespread rape, and a collapse of public health services. The outcome has been a humanitarian disaster unmatched by any other in recent decades, but one that has drawn little response from the international community."

It is a self-evident truth that there is a terrifying pattern here, evolving over many years, and the most terrifying component of that pattern, the one unbroken stream of nightmare continuity, is the sexual violence.

Jan Egeland, ever-engaged, ever-enraged, ever-eloquent, knew what was happening. And so it was, on June 21st, 2005, that he poured his heart out on the occasion of another report to the Security Council:

"Mr. President, the recurrent use of sexual violence is arguably one of the worst global protection challenges due to its scale, prevalence and profound impact. Often ostracized by their communities, survivors have to battle with the physical injuries, trauma and stigma of such violence for the rest of their lives. Although we repeatedly condemn such violence, it persists virtually unchallenged. Far from making general progress, we have in too many places regressed. We have information of more and more women being attacked, younger and younger children are victims of these atrocities."

He goes on to say: "I could provide a devastating catalogue of violations, but let me highlight … where sexual violence is at its worst. In North Kivu, in the DRC, a local NGO just reported over 2,000 cases of gender-based violence in the month of April (2005) alone. An estimated 50% were committed against minors. MONUC estimates at least 25,000 cases of sexual violence a year in North Kivu alone, just one region of the DRC. The cultural breakdown and the disintegration of the line of command in the armed forces, has resulted in a culture of violence in which sexual violence had become endemic. If this is not stopped, such violence will have terrible long-term ramifications for Congolese society, threatening future peace and stability. The United Nations have recognized this as one our highest priorities. More forceful action should have been taken earlier."

Well, action wasn’t taken. It’s entirely beyond belief that this war on women excited virtually no response from the United Nations. The establishment of MONUC is hardly a complete answer. Indeed, as has been shown by the United Nations itself, the situation for women — more than two years later — has progressed from despair to doomsday even as the UN forces are in the country.

And no one can claim ignorance. Not only was the Security Council regularly briefed (what an indictment of the five permanent members), but journalists and human rights organizations around the world had maintained a relentless drumbeat of concern.

In my own country of Canada, Stephanie Nolen of the Globe and Mail wrote searing stories of sexual violence in the eastern Congo, based on first-hand reporting. On November 27, 2004, the Globe headlined her story "The War on Women," followed by the cutline: "… in battle-weary Congo, Stephanie Nolen finds that all the warring factions have one tactic in common: brutal, mass rape." The article constituted a comprehensive review of what was happening in the eastern Congo, and no one who read it could come away unmoved. Then, in a special piece filed for Ms. Magazine in the spring issue of 2005, Nolen dealt with the very hospital and the very doctor that Eve Ensler reported on last month. She wrote of individual women mercilessly scarred by rape: "Across the DRC are tens of thousands of women like this: physically ravaged, emotionally terrorized, financially impoverished … Eight years of war have left the country in ruins, and Congolese women have been victims of rape on a scale never seen before." And later in the article: "An estimated 30 per cent of the women raped in Congo’s war are infected with HIV …" She quotes Dr. Mukwege, the sole gynecologist at the Panzi hospital in Bukavu: "They rape a woman, five or six of them at a time — but that is not enough. Then they shoot a gun into her vagina … In all my years here, I have never seen anything like it … to see so many raped, that shocks me, but what shocks me more is the way they are raped." Further on, Nolen speaks of another hospital in Kibombo, where the only doctor, Jean-Yves Mukamba "… knows he is surrounded by women suffering raging venereal infections, HIV, prolapsed uteruses, torn vaginas." She quotes the doctor: "Most cases were traumatization of the genitals: These women were raped with a tree branch or the barrel of a gun, or a bayonet. When you see a woman who was forced by ten men — the trauma …"

What is so incredible about the inertia and passivity of the international community is the weight of evidence they had before them, and the total blank indifference with which the evidence was treated.

In 2004, Amnesty International produced a 39-page treatise titled "Democratic Republic of Congo: Mass Rape – Time for Remedies." It makes very tough reading. But it’s almost unimaginable that it would engender almost no response whatsoever.

The study opens with what has now become a predictable preface: "In the course of the armed conflict in eastern DRC, tens of thousands of women and girls have been victims of systematic rape and sexual assault committed by combatant forces. Women and girls have been attacked in their homes, in the fields as they go about their daily activities. Many have been raped more than once or have suffered gang rapes. In many cases, women and young girls have been taken as sex slaves by combatants. Rape of men and boys has also taken place. Rape has often been preceded or followed by the deliberate wounding, torture (including torture of a sexual nature) or killing of the victim. Rapes have been committed in public and in front of family members, including children. Some women have been raped next to the corpses of family members."

In the section on "Rape: A Weapon of War," the report quotes a doctor: "In peacetime, the demands on Congolese women are limitless; but in this war, the most insane fantasies have found their expression. When seven soldiers rape a woman or little girl, and thrust a knife or fire shots into her vagina, for them the woman is no longer a human being, she is an object. And since there are no longer any laws or rules, combatants pour out their anger and their madness on to women and little girls."

The Amnesty International report, with its unendurable accounts of victims of sexual violence -- brought to the attention of all governments -- is a tour de force of analysis, and of recommendations for the United Nations, the peacekeepers (who, agonizingly enough, themselves became implicated in episodes of rape and sexual abuse), the Government of the Democratic Republic of the Congo, the surrounding African states, the bilateral donors, the NGOs. As history has shown, those who could intervene, primarily the governments of the international community, remained impassive. It forces one to think of the meaning of misogyny.

I cannot, however, conclude this partial review of reports, statements and documents, without noting a 114-page monograph, produced back in June of 2002 by Human Rights Watch, entitled "The War Within the War: Sexual Violence Against Women and Girls in Eastern Congo" .

It is absolutely definitive, amassing a torrent of evidence to make the case that everyone subsequently mirrored. If we had paid any attention to Human Rights watch more than five years ago, we would have saved the lives of hundreds of thousands of women and diminished the inexpressible agony for millions of others.

The evidence presented by Human Rights Watch is unassailable. Again, after chronicling an infinite number of examples of sexual violence, rooted in hatred and power, HRW makes recommendations to every entity from the United Nations to the International Criminal Court. That was back in 2002, based on evidence gathered in 2001.

It is impossible to imagine what those past five years have been like for the women featured in those accounts.

Throughout this exegesis, and particularly in regard to the article by Eve Ensler with which I began, I have refrained from quoting the most terrible and dreadful of the crimes against women and girls. But lest there is anyone who is somehow unconvinced of the monstrous nature of what is transpiring, on a daily basis, in the eastern Congo, I shall quote but one piece of testimony from the Human Rights Watch report. As though one were watching an x-rated film, a warning must be given to the reader.

I quote: " In some cases, rapists react with extraordinary cruelty to any efforts to resist their assault. One mother described the treatment of her daughter, Monique B., aged twenty, who was engaged to be married:

"On May 15 of this year (2001), four heavily armed combatants — they were Hutu — came to our house at 9 p.m. Everyone in the neighbourhood had fled. I wanted to hide my children, but I didn’t have time. They took my husband and tied him to a pole in the house. My four-month-old baby started crying and I started breastfeeding him and they left me alone.

They went after my daughter, and I knew they would rape her. But she resisted and said she would rather die than have relations with them. They cut off her left breast and put it in her hand. They said, "Are you still resisting us?" She said she would rather die than be with them. They cut off her genital labia and showed them to her. She said, "Please kill me." They took a knife and put it to her neck and then made a long vertical incision down her chest and split her body open. She was crying but finally she died. She died with her breast in her hand."

The entire world is preoccupied with Darfur. Understandably. But it must be said that between ten and twenty times the number of people have died in the eastern Congo as have died in Darfur. There are more displaced persons in the Eastern Congo than in Darfur. Darfur has been going on for four years; the eastern Congo has been ravaged for ten. And nowhere on this planet is there such a holocaust of horror visited on women and girls.

I’m not suggesting that we choose between the two. That would be invidious nonsense. I am suggesting that the time has come to realize that what is happening in eastern Congo is an abomination, the extent of which exists nowhere else. It’s also necessary to realize that the Government of the Democratic Republic of the Congo has no capacity (and it would appear, no inclination) to do anything about the carnage in the eastern region.

The United Nations has a principle called the Responsibility to Protect, a principle that calls for intervention by the outside world when a sovereign state is unable or unwilling to protect its citizenry. "R2P" absolutely and unequivocally applies to the destruction of the human rights of women in the Congo. Nonetheless, it is obvious that the Security Council has not the slightest intention of invoking "R2P."

I would therefore say to UN Emergency Coordinator John Holmes that along with visits to the eastern Congo to verify what others have known for more than five years, he and the Secretary-General have to face a truly unpleasant reality: neither the United Nations nor the international community has the faintest idea what to do about the catastrophe for women in the Congo.

Where the Congo is concerned, all the Security Council is really concerned about (as evidenced in their most recent discussions) is questions of troop numbers, arms embargoes and sanctions. Rape is not on the agenda.

We could construct all kinds of typical UN responses to the ongoing tragedy: give eastern Congo a profile equivalent to Darfur, with a similar involvement of the Secretary-General; have the Secretary-General meet with the International Criminal Court to invoke the use of rape as a crime against humanity in the issuance of scores of indictments; ask the Security Council to address the issue of the culture of impunity; argue for a doubling or trebling of the MONUC troop complement; establish a host of health facilities with trained professionals to treat the victims of sexual violence. The list of predictable recommendations could go on ad infinitum.

But it's all short of the mark. It's all achingly slow, and when action is finally taken, it's inadequate. And it all misses the point: there is no precedent for the insensate brutality of the war on women in the Congo. The world has never dealt with such a twisted and blistering phenomenon. That is not to say we weren’t given ample clues of a trend that was headed for this crescendo. From Bosnia-Herzegovina to Rwanda to Sierra Leone and Liberia, modern-day conflicts have employed the terrorist tactic of rape as a weapon of war. And the male instinct to unleash feelings of rage and frustration on women is hardly unfamiliar. But the capacity for brutality by so many perpetrators — and on the flip side, the capacity for indifference by so many witnesses — is the ugly apex of a trend gone unchecked. The international community has applied lacklustre remedies to similar, if less extreme crises of sexual violence in the past, and with little effect. It falls somewhere between inhumane and criminally negligent to pretend that remedies that have proven inadequate under less extreme conditions will somehow solve the problem in the Congo. The old nostrums won't work. There must be dramatic departures.

Just look at MONUC. It has the highest numbers of any UN Peacekeeping operation: as of the beginning of this year there were 16,475 in the military contingent, 719 military observers, 304 military police, 2,114 civilian personnel, and with astonishing impotence, they’ve simply watched the war on women accelerate. More, it’s under Chapter Seven of the UN Charter operation: MONUC has the right and obligation to employ arms to protect civilians from physical assault … but do they act on that obligation where sexual assault is concerned? For civilian women who need protection against rape, Chapter Seven is a travesty. And it costs over a billion dollars a year.

The natural inclination, then, simply to increase troop numbers, is less than an answer. It’s especially not the answer when the training has been insufficient to prevent those self-same troops from engaging in intermittent violence against women themselves.

Nor have the United Nations agencies been able to do more than ameliorate, ever so slightly, the victimization of the women of the eastern Congo. Yes, from time to time, as in the case of UNICEF, they draw attention to the most flagrant and chaotic aggression. But the momentary profile of gender-based insanity doesn’t begin to have permanence.

Let me readily admit that I don’t know what will work. But as the former Envoy on AIDS in Africa, I know that crises driven by the oppression of women do not simply fade away if they’re ignored. They explode. In the 1980s and well into the 90s, we allowed the whirlwind of AIDS transmission to tear through the African continent, aided and abetted by aggressive, often violent male behaviour that has never been targeted for elimination in a systematic, uncompromising way. The AIDS virus thrives on sexual violence. Sexual violence thrives on armed conflict. As if either one was not devastating enough, these two malevolent realities have joined forces to declare war on the women of the Congo. If we don’t do something, and soon, HIV/AIDS and violence against women are destined to win. And having chosen to do nothing, the world community will be to blame.

It seems to me that the Secretary-General should be instructed to draw together from every part of the world women who are expert in sexual violence, who have given their lives to the study of rape, its causes and consequences, women who can collectively draw up a series of responses to the Congo. Men in high places have applied a spectacular lack of energy, interest, insight and ideas to ending Congo’s war on women; it’s time that they turned this crisis over to women. You can be absolutely certain that the approach of the President of Liberia, or the President of Chile would be vastly different from anything presently lurking in the minds of men.

The expertise of women offers the world its best shot at a solution to the war on women. The United Nations secretariat should be humble enough to seek the answers from outside. The inside has failed. The Congo is strewn with the mutilated bodies of that failure.

Allow me to say that what has come to pass in the eastern Congo is an inevitable result of marginalizing 52% of the world’s population, and permitting multilateralism to turn its back on gender equality. AIDS and rampant sexual violence are just two of the resulting pandemics; one doesn’t need a crystal ball to predict that we’re in store for more. That’s why we so desperately need an international agency for women. There must be a voice, tenacious, indefatigable, unrelenting, well-financed, that never lets the world forget the indignities and human rights abuses visited on women. No one can say with certainty that had a women’s agency been around in 2001, the bleeding landscape of the Congo would have been different in 2007. But at least there would have been a fighting chance. At least the voices raised on the outside would have had allies on the inside. And at least the voices on the inside, like those of Jan Egeland, would not have been shouting into the void.

With a UN women’s agency of strength, one headed by an Under-Secretary General, with a billion dollars a year, and gender experts on the ground — preventing crises that haven’t yet happened, and ending the ones that have — the women of the Congo might have some glimmers of hope.

It's Not Complicated: Money Will End AIDS

Thu, 28 Oct 2010 16:07:00 -0400

Remarks by Stephen Lewis, Co-Director of AIDS-Free World, delivered at the Dutch Postcode Lottery’s ‘Good Money Gala’ Amsterdam, The Netherlands, February 9, 2012

I’m unreservedly delighted to be here this afternoon, and to have the privilege of speaking. I will admit, with appropriate shame, that I didn’t know of the Postcode Lottery until 2010 when I participated in the Dream Fund submission from the Clinton Health Access Initiative and STOP AIDS NOW.

But now that I do know of the Postcode Lottery, and have had some further contact, I’m filled with admiration for the astonishing range of grants, and the huge amount of money that the Lottery distributes to good causes and the search for social justice. This is especially true at a time when governments are so begrudging about honoring their national and international humanitarian commitments. If the Lottery could only swallow up the G8 and the G20, we could probably fix this world.

And in part, fixing the world is exactly what I want to talk about. I know that the subject of HIV/AIDS is not uppermost in the minds of the vast majority of organizations in this room. In contrast, it’s uppermost in my mind because I’ve personally been consumed by the pandemic throughout the last decade, first as the UN Envoy on AIDS in Africa, and then with my colleagues in the NGO, AIDS-Free World, for the last five years.

But there is a truth about HIV/AIDS that should galvanize your attention: we will never achieve the Millennium Development Goals on the African continent unless and until AIDS is defeated. The monumental work of the international community will ultimately be subverted by the virus.

There is an assumption, widely held in western countries, that because AIDS has become a chronic disease in North America and Europe, it’s somehow over. Nothing could be further from the truth. Not only is AIDS creeping up in numbers in many high-income countries like the United States, the UK and Japan, and soaring in a jurisdiction like Russia, but it remains a devastating plague in the high-prevalence countries in Africa. World-wide, there are 34 million people living with the virus, there were almost two million deaths last year and almost three million new infections. How, by any stretch of the imagination, can that be described as the end of the pandemic?

But let me make an admission. I’m mad at myself for using abstract figures. We’ve robbed the force of the pandemic, we’ve undermined the impact of the pandemic by an endless spouting of numbers. The UN has too many catchy slogans to keep track of: zero this, and zero that, and numbers of this and numbers of that, and percentages that will be achieved by this date or that date, and then an endless orgy of graphs and charts purporting to show this percentage decline and that percentage decline in this country and that country and this region and that region, not to mention an avalanche of financial data that leaves the head spinning. Statistics can of course be useful, but the real human beings whose lives have been decimated by the pandemic have been allowed to disappear. As it happens, I teach a course on the Millennium Development Goals at a university in Toronto. In last Monday’s class, I invited a close friend, Ida Mukuka, a woman from Zambia who acts as a field representative assessing the impact of AIDS on communities, to speak to the students. Her older brother died of AIDS some years ago, her younger brother died in December, her niece died ten days ago leaving a four-year-old orphan … a little boy, frantic and desperate at the funeral to understand what had happened to his mother, mirroring the bewilderment of those little kids all over the continent, struggling with pain, anguish, uncomprehending; orphans isolated in their grief, sleep riven by nightmares: a whole generation of children. It seems inconceivable.

Ida then told the class that her sister was HIV-positive and she herself was HIV-positive and she was about to lose her doctor because of financial cut-backs. The throbbing anxiety never ends. What a world.

What’s so incredibly frustrating is that we now know how to defeat the pandemic. Thirty years into the scourge of AIDS, with untold suffering and massive death, we finally know how to subdue the virus. There’s a package of preventive interventions on which virtually everyone has agreed. Three of them are particularly critical. First, is the prevention of vertical transmission from the mother to the child during pregnancy, delivery, and breastfeeding which, with the right combination of drugs, can reduce transmission by up to 99 percent! And then we must keep the mothers on those drugs so that they stay alive, the mothers who, in the past, have been overwhelmingly neglected as though mothers were expendable.

Second, is male circumcision. Studies prove that up to 60 percent of transmissions to men can be prevented if those men are circumcised. There’s a new book out showing, conclusively, that if international agencies hadn’t been irresponsible, we would have energetically pursued male circumcision over a decade ago with countless lives saved as a result.

And finally, there’s the new centerpiece of the international AIDS response called Treatment as Prevention. The logic is unanswerable. Forgive me for reducing the concept of Treatment as Prevention to a simple-minded formula, but it goes something like this: if you’re on a full regimen of anti-retroviral drugs, the amount of the virus in your body will be reduced to undetectable levels, and therefore, the likelihood that your infection will be transmitted to others through sex will be similarly reduced. The more people who are tested and go on treatment, the more the numbers of new infections decline.

It’s an astonishingly sensible theory. Back in 2006, at the International AIDS Conference in Toronto, a renowned Canadian scientist specializing in HIV, Julio Montaner, whom we’re lucky enough to have on our AIDS-Free World advisory board, said at a press conference that his years of cumulative evidence showed that Treatment as Prevention worked and should be implemented everywhere as soon as humanly possible. As you can imagine there was skepticism. But in the intervening years, Julio’s assumptions were confirmed time and time again, leading to the most unequivocal, definitive confirmation of all released just last year. And it’s not just sensible as a preventive measure. It’s humane. It’s ethical. There is no good reason to delay treatment until people’s immune systems are already failing.

A study called HPTN052, dealing with discordant couples — where one partner is HIV-positive and the other HIV-negative — showed that where the HIV-positive partner is on treatment, the decline in transmission is 96 percent. It’s fair to say that the world was stunned. It’s of course a credit to the scientists who labored for many years in the research trenches to have come up with such unambiguous results. But I must say that from my point of view, the five years between 2006 and 2011 should have been used to implement Treatment as Prevention with unflagging urgency … many more infections would have been prevented, many more lives would have been saved.

I can’t get over the fact that some scientists are now calling for caution until even more research is done. I’ve spent much of the last decade watching people die: I’m fed to the teeth with the endless delays and lack of resolve that has characterized the international response to the pandemic. The research is now indisputable. Get on with it. We’ve sacrificed too many on the altar of scientific waffling and bureaucratic paralysis.

That’s why we have to get over our obsession with numbers. We’re talking about flesh-and-blood human beings … whole communities on the continent of Africa where that flesh and that blood, with catastrophic consequences, is being corroded by the virus.

And that’s where the Postcode Lottery comes in, because in three powerful ways, you are to be saluted.

The Dream Fund award last year makes it possible for Swaziland to become the first-ever developing country to give full expression to Treatment as Prevention. Not only will the theory be further verified, but the effort will be made, over three years, to test the entire country, and get a truly significant additional number of people into treatment. Everyone is determined to achieve universal access to treatment. In the process, Swaziland is inevitably engaged in an extraordinary community mobilization to bring services to the people and people to the services. All things considered, this is an amazing undertaking … reaching an entire country. Swaziland has the highest prevalence rate in the world … over 25 percent of its adult population is living with the virus, and for pregnant women, it rises to nearly 50 percent. It’s an unspeakable horror. And as if things aren’t bad enough, Swaziland is ruled by an absolute monarch whose interest in the health of his citizens is negligible. It’s really a crime.

But partly as a result of the King’s indifference, there just isn’t enough money coming from the royal coffers to fight AIDS. That’s the second powerful reason to applaud the Postcode Lottery. Your Dream Fund award will make it possible to save tens of thousands of lives that might never have been saved without the Lottery.

Because you see, the only other potential major source of resources at the moment is the Global Fund to Fight AIDS, Tuberculosis and Malaria. The Global Fund has been going for exactly ten years. It’s bitterly ironic, brutally ironic, that on its tenth anniversary, the Global Fund has had to cancel its next round of grants as the money from the donors dries up. Solemn commitments were made by donors in October of 2010, and those solemn commitments are not being honored. There will be a terrible price to pay in human terms. Bill Gates makes the point that for $300, drugs can be purchased and a person kept alive for a year. For every $300 we don’t have, someone dies. A human life for three hundred dollars. And we can’t find the money … although we can find the money for Iraq, Afghanistan, bank bailouts, corporate bonuses and American election primaries.

The moral test is $300 for survival and the international community flunks the test. But the third and most important tribute to the Lottery’s support in Swaziland lies in the help for women. It’s women, hugely disproportionately infected, who will be the singular beneficiaries. I cannot adequately explain how significant that is. Most women in Swaziland have no sexual autonomy; they can’t deny sex; they can’t insist that their partners wear condoms; if a woman tests positive and discloses to her husband or partner, she risks being beaten or thrown out of the house. Whether or not they’re HIV-positive and sick unto death, women still provide all the household care, or work, gratis, as community caregivers for those who are ill in the village. They do the cooking, haul the wood, haul the water, do the farming. They run the family, and look after the orphans, discarded and left behind. And women are regularly subject to horrendous sexual violence … violence that transmits the virus: intimate partner violence, marital rape, gang rape … it never ends.

At least, thanks to the Postcode Lottery, women will be tested and treated. Thanks to the Postcode Lottery, some money will be available so that women won’t be completely overwhelmed and oppressed by the job of sustaining family life. Thanks to the Postcode Lottery, women will have the opportunity to stand up to the King and demand their human rights. The women of Swaziland are not women to whom the adjective ‘helpless’ applies. They’re strong, resolute, sophisticated, and courageous. They’ve just never had a chance. This is all part of the most important struggle on the planet: the struggle for gender equality. And the Lottery should be enormously proud to be at the heart of it.

I know there are a thousand competing global health priorities. But once in a rare moment, civilization has the chance to confound a disease: smallpox vanquished; polio on the brink. Thirty years is enough. Let HIV/AIDS be next. The Postcode Lottery has shown that it believes it can be done: would that governments were principled enough to share that conviction.

Download a copy of the speech here (PDF, 143KB)

Stephen Lewis's speech to the 2010 ACTSA Gender and Development in Southern Africa Conference

Thu, 28 Oct 2010 16:07:00 -0400

Stephen Lewis's address to the Annual General Meeting of Action for Southern Africa (ACTSA),"Gender and Development in Southern Africa, 2010," in London, England.

Part 1: Gender equality; the activism that led to the creation of UN Women

Part 2: UN Women cont'd; UN Resolution 1325 on Women, Peace and Security; sexual violence in the Democratic Republic of the Congo; rape as a crime against humanity in Zimbabwe

Part 3: Zimbabwe cont'd; women and AIDS; risking mothers' lives to save babies

On the Gutting of the Global Fund

Thu, 28 Oct 2010 16:07:00 -0400

Remarks by Stephen Lewis, Co-Director of AIDS-Free World, delivered at a colloquium hosted by Yale University’s Global Health Leadership Institute and the Yale School of Public Health in New Haven, CT, on November 28, 2011.

On the Gutting of the Global Fund

The Global Fund to Fight AIDS, Tuberculosis and Malaria has been the international financial armada in the battle against the three diseases. The collapse of the next round of Global Fund grants, known as Round 11, is the most serious, catastrophic setback in the Fund’s decade of existence. Hiding behind the banner of the financial crisis, the donor countries have clearly decided that if budgetary cuts are to be made, the Global Fund can be among the first to go.

It’s terribly important to recognize the moral implications. It’s not just the fact that people will die; it’s the fact that those who have made the decision know that people will die. How does that get rationalized? How does that get dealt with in the inner sanctums of development ministries and cabinet discussions? What in God’s name do they say to each other?

They know, equally, that in the distribution of pain and suffering from AIDS, Africa is the epicenter. It has 68% of those living with the virus worldwide; it has 70% of new infections. They know that Africa is the one part of the world that cannot possibly reach the Millennium Development Goals by 2015. They know that many countries on the continent are reeling from poverty, conflict and disease.

What possesses the donor community to intensify the emotional and physical havoc?

Do they regard Africa as a territorial piece of geographic obsolescence? Do they regard Africans themselves as casually expendable? Is it because the women and children of Africa are not comparable in the eyes of western governments to the women and children of Europe and North America? Is it because Africans are black and unacknowledged racism is at play? Is it because a fighter jet is worth so much more than human lives? Is it because defense budgets are more worthy of protection in an economic downturn than millions of human beings?

I will never understand.

What happened at the Global Fund last week is of course merely the latest episode in the unvarying history of betrayal. Do you remember the G8 Summit in Gleneagles in 2005? The most solemn commitment was made to provide an additional $50 billion in aid to the developing world by 2010, $25 billion of which was destined for Africa. Come the Summit in 2010 (in Canada you will recall), the G8 was between $10 billion and $15 billion short of the target.

Prime Minister Tony Blair’s words on the $50 billion pledge at the 2005 Summit are memorable: “This is what we declare. We are going to be held to this; we are bound by it; we are committed to it; judge us by it.”

What a craven politician.

But of course, he’s not alone. Let me remind you that in June of this year, there was a High-Level Meeting on AIDS at the United Nations. It was the tenth anniversary of the UN Declaration of Commitment on HIV/AIDS, and the fifth anniversary of the UN Political Declaration on HIV/AIDS.

The commitments, the promises, the undertakings, the passionate affirmations of reaching the targets suffuse the newest document to emerge, titled “Political Declaration on HIV/AIDS: Intensifying our Efforts to Eliminate HIV/AIDS.”

Please forgive my cosmic cynicism, but these international expressions of intent, repeated ad nauseam on every obligatory anniversary, are the ultimate frauds of multilateralism. Why in the world numbers of well-meaning NGOs support this kind of intellectual drivel is beyond me. We didn’t need the inheritance of Tony Blair to know that the sanctimonious pledges would be rendered unto tatters as soon as the delegations left the confines of the UN. And it is surely worth noting that June of this year falls well beyond the financial downturn of 2008/2009: the pledges were made with full knowledge of fiscal austerity.

Listen to the language: “(We) recognize that HIV and AIDS constitute a global emergency, pose one of the most formidable challenges to the development, progress and stability of our respective societies and the world at large and require an exceptional and comprehensive global response … (We) note with deep concern that … the HIV epidemic remains an unprecedented human catastrophe inflicting immense suffering on countries, communities and families throughout the world … (We) recognize that Africa, in particular sub-Saharan Africa, remains the worst affected region and that urgent and exceptional action is required at all levels to curb the devastating effects of this epidemic … (We) express deep concern that funding devoted to the HIV and AIDS responses is still not commensurate with the magnitude of the epidemic … (We) note with concern that while the pledges (made in 2010) represented an increase in financing, they fall short of the amounts targeted by the Global Fund, and realize that to reach that goal it is imperative that the work of the Global Fund be supported and that it be adequately funded—let me repeat—that the work of the Global Fund be supported and that it be adequately funded … (We) commit to accelerate efforts to achieve the goal of universal access to antiretroviral treatment … with the target of working towards having 15 million people living with HIV on antiretroviral treatment by 2015 … (We) commit to supporting and strengthening the Global Fund … through the provision of funds in a sustained and predictable manner … (We) appreciate that the Global Fund is a pivotal mechanism for achieving universal access … (and) encourage Member States … to provide the highest level of support for the Global Fund"—let me repeat—"to provide the highest level of support for the Global Fund.”

There you have it. And there’s so much more of equally devoted fealty, inscribed with an almost religious fervor. So what do these honorable member states then do? They leave the meeting and gut the Fund.

It must be emphasized again that the Fund is the most important and effective financial facility addressing the pandemic of AIDS. It has saved and prolonged millions of lives. Millions. Admittedly, there have been instances where governments, in receipt of Global Fund grants, have abused trust, and some of the politicians and bureaucrats have engaged in corrupt practices, siphoning off the funds to enrich themselves. But in every instance where this has been discovered (primarily by the Global Fund itself), the Fund has transparently identified the malfeasance, and gone on a virtual crusade to recoup the money. And it must be pointed out that the amounts that were purloined are microscopic compared to the overall disbursements.

If the donor governments were as scrupulous with taxpayer money, we would be living in nirvana. The United States alone could sustain the Global Fund in perpetuity if a mere fraction of the money lost to corruption in Iraq and Afghanistan were recovered. The self-righteous claptrap that flows from the donors on the issue of corruption is disgusting. They know it and we know it, but they’re never called on it. You can be sure that no one at the Global Fund board allowed the word "Halliburton" to cross his or her lips.

It’s hard to find the words to characterize what the cancellation of Round 11 will mean. Quite simply, without adornment, people will die in large numbers. The Fund will attempt to sustain the programs presently in place, but the opportunity to enroll others who need treatment—and that number is 7.6 million—will be lost.

Apart from struggling with every means at our command to reverse the decision, what does one do with the people responsible for the decision? There is something called the International Criminal Court. It indicts people for war crimes, crimes against humanity and genocide. So far, those charges have been seen to flow exclusively from conflicts. But is it not a crime against humanity to abandon tens of thousands of people, perhaps hundreds of thousands of people to a certain death, after promising a stay of execution? Why should the leaders who make those decisions escape justice?

True, merely to put the proposition is to induce incredulity. But as I stand here I believe that one day the ICC will have the power to extend its reach beyond the purview of conflicts. That’s the way the application of justice works: one step at a time. And the next step to be taken is to see that crimes against humanity are applicable to the gross criminal negligence of the donors. It’s a principle of justice whose time is coming.

Curiously, unconscionably, there are voices from whom we have not yet heard, but should have heard the moment the ugly decision was made. Where is the leadership of the United Nations in the wake of the dismantling of the Global Fund? Why hasn’t a press conference been called, led by the Secretary-General, to denounce the donor decision and to demand a reversal? What about the ten United Nations agencies that constitute the committee of cosponsoring organizations that comprise UNAIDS? Where are their voices? Yes, UNAIDS has issued a guarded statement (God forbid the donors should be offended), but that’s to be expected. What should also be expected, but almost never happens, is that the cosponsoring agencies band together and mount the barriers to sound the alarm. It is the nemesis of the United Nations that the self-interest of the agencies is as bad as the self-interest of sovereign states.

What kind of conspiracy of silence is at work?

The only compelling UN-related voice has been that of Jeffrey Sachs, the advisor to the Secretary-General on the Millennium Development Goals. Knowing that all of the goals are put in jeopardy by the crude fiscal brutality of the donors, he wrote an eloquent and unanswerable column in The Huffington Post. It was directed primarily at the United States, but it has equal application to all the other western donors who have defected from the humanitarian imperatives. Yet, as powerful a force as Jeffrey Sachs is, he can’t go it alone.

We simply have to find the money. There are, I would submit, three possibilities.

First, there’s no earthly reason why money couldn’t be redirected from defense budgets. Taken collectively, we’re talking of trillions of dollars. Whenever there’s an Iraq, or Afghanistan, or Libya or soon-to-be Syria, money is found. Why is war the only surefire call on the public purse?

Second, there are the profits of the banks and multinational corporations. If governments claim they are running out of money, the answer lies in the failure to adequately tax corporate profits. It’s enraging to think of the penury of the Global Fund in the face of the staggering profits of multinationals whose greed nearly brought the world to its knees.

Just think of these figures: The third quarter profits for Morgan Stanley $2.2 billion; for Wells Fargo $4.1 billion; for J.P. Morgan Chase $4.6 billion; Bank of America $6.2 billion … these were the banking outfits that helped to fashion the near-depression. Remember all these figures are this year, well after the fiscal calamity of three years ago. Or take the oil companies in the third quarter of 2011: BP, despite paying out billions in compensation for the oil spill, made $5.1 billion; Shell made $7 billion; Mobil Exxon came in at $10.3 billion. And we can’t find money for the Global Fund? Is there any better definition of the 1%? And I haven’t even enumerated the restoration of corporate bonuses.

Do you see what’s at work here? In the reckless haste to coddle the multinationals, global public health has taken a merciless hit.

And here’s something else to think about. Not a one of these companies has given a direct nickel to the coffers of the Global Fund, despite endless requests that they do so. And BP, Shell and Exxon Mobil are all members of the Global Business Coalition Health (GBCHealth), successor to the Global Business Coalition on HIV/AIDS.

But if it’s too much to ask that capitalism re-direct priorities, there is one avenue that has been embraced by virtually all of Europe with the exception of the United Kingdom. It’s called the Financial Transactions Tax, or Robin Hood Tax in the vernacular. Even the IMF has given the tax a cautious stamp of approval, and both President Sarkozy and Chancellor Merkel have become champions. When Bill Gates appeared before the G20 last month, he energetically advocated a 0.1% tax on security transactions and a 0.02% tax on bonds that together would yield, in Europe alone, some $9 billion annually.
So I have a suggestion. Given that the United States, Canada and Japan don’t fancy the tax—heaven forfend that corporate profits should be infinitesimally reduced—let it be implemented in Europe. The FTT, from the earliest days of discussion, was always intended to finance development aid, and what better example than the Global Fund to Fight AIDS, Tuberculosis and Malaria. If the European economies are confident of raising $9 billion—and I would think that Bill Gates’s calculations could be relied upon—then let them replenish their contributions to the Global Fund out of the current central treasury and restore those funds from the first returns on the application of the FTT. Why not? It becomes a simple book-keeping exercise … there are many more balance sheet entries that are far more complicated.
It just takes political will, and the will appears to be bankrupt.

The most disappointing manifestation of that reality is the United States. Let me quote Jeffrey Sachs: He writes that the Global Fund has saved “more than 7 million lives and (protected) the health of hundreds of millions more. Yet now the Global Fund is under mortal threat because of budget cuts approved by President Obama and the Congress. The Obama administration had pledged $4 billion during 2011-2013 to the Global Fund, or $1.33 billion per year. Now it is reneging on this pledge. For a government that spends $1.9 billion every single day on the military ($700 billion each year), Washington’s unwillingness to follow through on $1.33 billion for a whole year to save millions of lives is a new depth of cynicism and recklessness.”

Three days from now, World AIDS Day on December 1^st, President Obama will speak of AIDS. He will probably promise no new money. He will probably argue that the United States will do more with what is already committed to be spent by PEPFAR, the President’s Emergency Plan For AIDS Relief. Parse the words of the speech carefully. This is a tremendous opportunity for the President to come to the rescue of the Global Fund, an opportunity to go down in history—much as George Bush has gone down in history for creating PEPFAR—as a President who grasped the nettle of the greatest humanitarian emergency of the last half century and said to his country and the world “we are bringing this pandemic to an end. We will not allow more death from AIDS to stalk the planet.”

There is no time to lose. As things now stand, the Global Fund will not accept proposals for Round 11 until 2013, to take effect from 2014 to 2016.

In the intervening period, unless there is a dramatic intervention, the graveyards will burgeon again.

Just listen to Bill Gates once more: “One stark way of looking at (the funding) is to consider the death toll from AIDS. It costs approximately $450 per year to treat a person for AIDS. A donation of $450 to the Global Fund, for example, keeps someone alive for a year and helps prevent the disease from spreading. Conversely, every $450 that isn’t forthcoming represents a person the world is willing to let die from a treatable disease. Sometimes it’s just a question of money.”
Precisely. Sometimes it’s just a question of money. That time is now. Thirty years into the pandemic, after 30 million deaths, we know how to subdue the virus. We know the treatment and preventive interventions that work. The carnage can cease. That’s why, just three weeks ago, Hillary Clinton spoke, for the first time, of an “AIDS-Free generation” (and then—if I may be permitted a cantankerous aside—pledged an additional paltry sum of $60 million with no indication where the money was coming from … an almost certain sign that it’s not new money, but internal financial juggling).
I’m not allowed to characterize the desolate sabotage of the Global Fund as murder, but in the private depths of my soul, I really believe it is murder. There, I’ve said it. But rather than be discarded as some rhetorical extremist, let me simply assert that we have no right, by any measure of human decency, to allow people to die, in huge numbers, unnecessarily. That’s exactly what’s at stake.

I detest the brutal cynicism and behavior of the western governments. I spent much of the last decade watching people die, and to think that it could happen again is unbearable. People living with HIV/AIDS fight with such uncommon courage, intelligence and resilience … they have no right to be faced with grotesque betrayal.

The Bard wrote that “The quality of mercy is not strained, it droppeth as the gentle rain from heaven.” I ask: what has happened to mercy, to compassion, to generosity, to justice?

Download a copy of this speech (PDF, 172KB)

Sexual Violence: An Issue of Health

Thu, 28 Oct 2010 16:07:00 -0400

Stephen Lewis addresses the Tides Foundation "Momentum" conference with the message: Sexual violence is a global health crisis. "It can safely be said that not a day goes by without some authoritative report from some country of hideous sexual violence directed at women. It has become a world-wide contagion. And it is a huge issue of public health: the health of the women, psychological, emotional and physical is torn asunder."

On July 10th, Ann Njogu, a human rights activist in Kenya, wrote as follows to friends and associates: “The last couple of days have been a nightmare for me and several other civil rights activists who were arrested in a most brutal manner after police stormed the hotel [where] we were planning to hold demonstrations over Grand Corruption (sale of the Grand Regency hotel by a cartel led by the Finance Minister — who has since resigned in disgrace over the same). But on Tuesday, 8th July, when they arrested seven of us, the police not only brutally arrested us but also sexually violated and harassed me and a male colleague. One senior officer even had the audacity to put his hand inside my trouser, fondle my private parts and my breasts, all this while the rest were busy brutalizing us. Upon arrival at the police station, my colleagues sought to know from the senior police officer why he had sexually assaulted me, and without warning, this police officer, who we have since learnt was the deputy officer commanding [the] Division (very senior position), grabbed a police baton from one of the junior officers and set upon us in a most vicious manner. Other officers joined in, hitting, kicking and insulting us and it did not matter that some of us were already bleeding … we were later taken to court, charged with participating in an illegal assembly (never mind that we were inside a hotel and it’s the police who stormed in), and released on bail. The police also refused to record our complaint over the violations at the police station.”

The Grand Regency Hotel is in Nairobi. You will recall that in the immediate aftermath of the Kenyan election, the country, in parts, was reduced to chaos induced by ethnic mayhem. At an unprecedented rate, hospitals reported a huge intake of women raped and mutilated. One can’t help but feel that that pattern of events — devastating for Kenya — may well have been the catalyst for episodes like those in the Grand Regency.

Early last week, as everyone knows, charges of genocide, crimes against humanity and war crimes were laid against President Omar Hassan al-Bashir of Sudan by the International Criminal Court. Imbedded in the charges were grotesque crimes of sexual violence. If the phrase “the killing fields” of Cambodia has entered the language, then “the raping fields” of Darfur cannot be far behind.

Later in the week the President of Indonesia was forced to express extreme regret for murder and rape committed by the Indonesian army when it was attempting to subdue East Timor.

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Stephen Lewis' remarks to ICASA 2011, Addis Ababa

Thu, 28 Oct 2010 16:07:00 -0400

Remarks by Stephen Lewis, Co-Director of AIDS-Free World, delivered at a plenary session at the 2011 International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA), in Addis Ababa, Ethiopia, December 6, 2011.

With your indulgence, I’m going to deviate from the assigned topic. I shall address the Millennium Development Goals, but not in the way that was anticipated.

There are two reasons. First, I want to speak in an unusually personal way, and from the heart, and in a fashion that leaves no room for ambiguity. Second, I consider the attack on the Global Fund to be the most serious assault it has endured in its ten-year history. I would feel utterly delinquent to let the issue slide.

I am seized by frustration and impatience. Let me explain.

I’m thrilled when UNICEF tells us of the possibility of the virtual elimination of pediatric AIDS by 2015. But I know—as knowledgeable people in this audience know—that it remains an unlikely prospect, but more important, that we lost several precious years during the last decade where we simply didn’t apply the knowledge we possessed to prevent vertical transmission. It was a terrible failure on the part of international agencies and governments. Worse, the mother barely factored into the so-called “PMTCT” equation at all. As we come to this thrilling moment of progress, I cannot forget the millions of infants who died unnecessarily and the women who were never given treatment.

I’m thrilled at the creation of UN Women, and the possibility, once they join as a formal co-sponsor of UNAIDS, that the focus on women will be given a new lease on life. But I can’t dislodge from my mind the experience of my years in the role as Envoy, and subsequently working with AIDS-Free World, when it became clear that in every aspect of the pandemic women were rendered subordinate. Gender inequality doomed their lives. Sexual violence fed and feeds the virus. The entire survival of communities and families was placed on their shoulders. Men were the social determinants of women’s health, and men simply didn’t care. As we come to this thrilling moment of potential progress, I can’t avoid the spectral faces of stigma, discrimination, isolation, and pain, and they are the faces of women. That doesn’t mean that women aren’t the core of courage and strength in this pandemic; it simply means that they have to struggle valiantly to challenge the phalanx of male privilege, of male hegemony. Just a few days ago, coincident with World AIDS Day, the Harvard School of Public Health held a symposium called AIDS@30 to assess the past and plot the future. The symposium had a Global Advisory Council of nineteen eminent experts on the pandemic: 17 men and 2 women. It is ever thus. It’s the rare woman indeed who doesn’t ultimately report to a man in the world of HIV, or who can command, ever-so-rarely, the place and presence that legions of men command automatically.

I’m thrilled when I hear animated talk of male circumcision. But I know that we didn’t need to wait for the results of the three studies in Uganda, Kenya, and South Africa. Nothing would have been lost if we’d focused immediately on making circumcision safe and available for informed parents to choose for their male babies; it’s a minor procedure that has been performed for centuries. Instead, during nearly a decade as the evidence piled up that circumcision was a defense against AIDS—evidence provided by experts in the field—we waited and waited and waited, in that self-justifying paralysis of excruciating scientific precision. As we come to this thrilling moment of progress I cannot forget the numbers of lives that might have been saved had we acted sooner.

I’m thrilled with all the talk of “Treatment as Prevention” and how it has suddenly become the mantra of the international AIDS community. But back in 2006, I sat beside Dr. Julio Montaner, about to become President of the International AIDS Society, when he first expounded the proposition at a press briefing at the International AIDS Conference in Toronto. His evidence and argument were rooted in science and common sense in equal measure. But he had to endure scorn and derision, and we had to endure a five-year delay until Treatment as Prevention was definitively authenticated by the National Institutes of Health in Washington. Julio’s theory suddenly became the 96% solution five years later, and it doesn’t—I emphasize—it doesn’t apply only to discordant couples. As we come to this thrilling moment of progress, I cannot forget the numbers of lives that might have been prolonged if we hadn’t waited nearly five years to create the momentum that now propels us.

I’m thrilled with the turnaround in South Africa. The dramatic roll-out of treatment is nothing short of miraculous. But I remember all those years of denialism, and not a single voice at the most senior levels of the United Nations—Under-Secretaries-General, the Secretary-General himself. Not one of them said publicly to Thabo Mbeki, “You’re killing your people”. Oh, to be sure, it was said in private by everyone. They took Thabo Mbeki aside and begged him to reverse course. He didn’t budge an inch. Around him, in every community in South Africa, and in communities throughout a continent heavily influenced by South Africa, were the killing fields of AIDS. As we come to this thrilling moment of progress, I can’t forget the millions who died on Thabo Mbeki’s watch, while those who should have confronted him before the eyes of the world stood mute.

I’m thrilled by the embrace of the slogan “Know Your Epidemic; Know Your Response” and the current concentration on high-risk groups. But I note that there were many voices, over the years, not all of them eccentric, calling attention to concurrent sexual partners and discordant couples, to MSM and sex work and sexual violence, and particularly injecting drug use, and they were contemptuously dismissed. I cannot but remember that magnificent gay activist from the Caribbean, Robert Carr, who died such an untimely death … back at the pre-conference on MSM in advance of Vienna last year, Robert made one of those speeches that leaves you gasping. When you hear what the experts say, said the normally tactful Robert, it’s bullshit – and he repeated bullshit so many times in the course of thirty minutes that the crass word became a cry of mobilizing dignity. As we come to this thrilling moment of progress, I can’t forget the casual delays in responding to vulnerable groups. Experts fiddled while human rights burned.

So if you sense a certain impatience in me, you’re right. We don’t have another day to lose. Peter Piot did the arithmetic yesterday … 1,350,000 put on treatment in 2010; 2,700,000 new infections, exactly double the number in treatment in the same year. It works out to 7,397 new infections every day. And it’s 2011, for God’s sake. It’s appalling that such numbers continue to haunt us; it’s heart-breaking beyond endurance to contemplate further exponential agony. We cannot delay another minute in putting the ‘prevention combination’ to work.

And I think, judging from the mood in the corridors, that’s what seizes this conference. But right at the moment when we know, irrefutably, that we can defeat this pandemic, we’re sucker-punched at the Global Fund.

What’s a sucker punch? It’s when a boxer in the ring gets a punch below the belt that he doesn’t see coming. No one expected a complete cancellation of Round Eleven, with new money unavailable for implementation until 2014.

It’s just the latest blow in a long list of betrayals on the part of the donor countries, in this instance the Europeans in particular. I’ve heard from several people that the politics of the Global Fund meeting in Accra two weeks ago, when the decision was made, were not just complicated, but amounted to miserable internecine warfare. Certain governments on the Board of the Global Fund simply discredited themselves. They give a soiled name to the principle of international solidarity. The Chair of the Board, in a remarkably convoluted effort, tried to explain things in a press release. He would have done far better to remain silent.

The decision on the part of the donor countries is unforgiveable. In a speech a few days ago, I addressed the Global Fund predicament by talking of the moral implications of a decision that you know will result in death … death on the African continent.

I asked: “Do they regard Africa as a territorial piece of geographic obsolescence? Do they regard Africans themselves as casually expendable? Is it because the women and children of Africa are not comparable in the eyes of western governments to the women and children of Europe and North America? Is it because Africans are black and unacknowledged racism is at play? Is it because a fighter jet is worth so much more than human lives? Is it because defense budgets are more worthy of protection in an economic downturn than millions of human beings?”

These are not phrased as rhetorical questions. I mean each and every one of them.

Spare me, I beg of all the speakers … spare me the economic crisis. Everyone knows that when it comes to financing wars, or bailing out the banks, or bailing out Greece, or reinstituting corporate bonuses, or even responding to natural disasters that threaten economies, there’s always enough money. We’re drowning in crocodile tears. It’s not a matter of the financial crisis; it’s a matter of human priorities. We have a right to ask the G8: what do you sanctify as governments: profits and greed or global public health?

That’s especially true in the case of the United States. I was, like everyone else, delighted by President Obama’s endorsement of the proposition that PEPFAR could treat a total of six million people rather than four million people by 2013 with the same money. And I congratulate Ambassador Goosby for seeing that through. It’s wonderful. No one would take issue. How could you? There’s no additional money involved: it’s just greater efficiency and more targeted spending.

And then the President went on to affirm his support for the money that’s supposed to be destined for the Global Fund … $4 billion over three years, 2011-2013; $1.3 billion a year.

Now let me take you back a step. In 2010, when the three-year pledge for the Global Fund was being discussed, the activists in the United States were asking for $6 billion over three years, believing that this was a fair share for the United States and an inducement to all the other donors. They feared that the President would stay at $3 billion over the next three years … roughly the previous allocation for the Global Fund. When he endorsed $4 billion, it was considered a partial victory.

In my respectful submission, it’s time for the United States to take a hard look at $6 billion. Many American speeches glow with the words that the US is the largest donor to the Fund. Well of course they’re the largest donor; they’re the most dominant and wealthy economy in the world. I really think that apart from calling on the European governments to reverse their decision, President Obama should tell Congress he wants a full $6 billion.

I don’t expect that anyone ever listens to me. But I do point out what was emphasized at the opening of the conference: money to do battle against HIV/AIDS is the singular non-partisan issue in Congress. Even those irascible philistines who want to cut foreign aid, or global health, have shown in the past that they’re prepared to shore up funding for HIV/AIDS. It seems to me that President Obama should put his moral authority on the line, and ask Congress to raise the ceiling from $4 billion to $6 billion for the Global Fund.

It’s not a matter of comparison with other countries; it’s a matter of doing what’s right. And that means doing your fair share regardless of whether others are doing theirs. There are many commentators who agree that the salvation of George Bush’s presidency was PEPFAR. President Obama doesn’t need salvation. But I can’t imagine a greater act of statespersonship than to say to the world: I, Barack Obama, cannot stand the thought of another unnecessary death; if the United States of America has to bail out the Global Fund, we will.

Is the extra $2 billion dollars outrageous? The economist Jeffrey Sachs has answered that question. He points out that the United States defense budget amounts to $1.9 billion a day. In other words, we’re asking that HIV/AIDS receive an additional amount, over three years, that equals American military spending in one day.

It seems to me that that’s an argument that African political leaders can effectively pursue amongst the many arguments they should employ in dealing with the donor community. I agree with Michel Sidibe—who’s given significant and visionary leadership to this struggle—that there must be a high-level crisis meeting, and that Prime Minister Meles should convene it.

We’ve waited for this moment for a long time. This is an opportunity for the African political leadership to show its muscle, and to demand that the Global Fund be restored to its intended level. Remember, at the last formal replenishment in 2010, the funding came in at a dismal $11.7 billion, far short of the $20 billion that the Global Fund really needed in order to scale up to meet universal access. Now we’re being told that even the $11.7 billion is out of reach. It’s unconscionable, indefensible, outrageous. It’s murder, that’s what it is: murder. And the donor countries expect to get away with it because there’s a culture of fiscal impunity.

As I wind my way to a conclusion, let me relate an anecdote that I think is relevant.

When I left my diplomatic post at the United Nations in 1988, I took on a role as the Secretary-General’s Advisor on Africa. (I admit that seems odd, but there is an explanation that more or less justifies the appointment.) There was an Inter-Agency Task Force established, and there was a kind of executive committee of four. The Chair was the noted African economist, Professor Adebayo Adedeji of Nigeria and at the time Executive Secretary of the Economic Commission for Africa; the Vice-Chair was the remarkable, brilliant Richard Jolly, Deputy-Executive Director of UNICEF; the Rapporteur was the accomplished economist Sadig Rasheed, also with the ECA, and I was the fourth, a sort of honorary post. (Note that then, as now, men were tapped to lead the way.)

We met, often in Addis – where the ECA was and still is located – with many of our colleague agencies working in Africa. The World Bank was almost always in attendance, and intermittently, the International Monetary Fund.

It was the height of “structural adjustment” programs. Every meeting was a battleground, filled with heated imprecations, accusations, and malice. Our little executive cabal of four detested the international financial institutions, and they detested us.

In the midst of endless angry discussions of conditionality, we looked carefully at the financial data, and suddenly realized a staggering truth: when you took into account the interest payments and some capital payments as well, and ran the statistics carefully, it became clear that Africa was paying out far more than it was taking in … hundreds of millions more. The continent was financing the World Bank; the World Bank wasn’t financing the continent.

And it continues to this day. Again, I remind you of Peter Piot’s reference yesterday. I have a close friend who writes columns for the newspaper The Globe and Mail in Canada. Commenting on the study that Peter Piot referenced, the title of his column was, “Africa: The World’s Most Generous Foreign Aid Donor”. It confirms the fact that a study of nine African countries, Ethiopia, Kenya, Malawi, Nigeria, South Africa, Uganda, Tanzania, and Zimbabwe showed that they had exported doctors to Canada, the United States, the UK, and Australia, costing Africa between $2 billion and $13 billion in education and training, and saving the four western countries more than $4.5 billion in education and training. The nurses’ financial ratios would be even higher.

This is an AIDS conference. We talk endlessly about capacity building. Africa desperately needs its doctors and nurses. Instead, in the vital field of health professionals, Africa loses billions in exporting its human resources.

I say all this to challenge the artificial debate on dependency. From slavery to today’s extractive industries of minerals and oil, Africa is financing the world. The modern world’s economy was built on Africa’s human and natural resources, and it depends on them to this day. The money from the Global Fund and PEPFAR amount to partial reparations. Western donors are not engaged in some kind of financial philanthropy: we owe Africa what we give to Africa. And a hell of a lot more to boot.

That’s the debate that Prime Minister Meles should induce. The donor countries to the Global Fund, having ransacked the continent for six hundred years, have no right to withdraw. They must be confronted. And all of you, who make up civil society in so many countries, must press your Presidents and Prime Ministers into action.

Let me end by coming full circle to the Millennium Development Goals. Africa will never reach the MDGs if AIDS is not vanquished. AIDS adds to the desolate state of poverty. Obviously, it affects both maternal and child health. It continues to leave children parentless (though the millions of orphans whose plight seemed a priority at past AIDS gatherings, increasingly, mysteriously, disappear from view). Gender equality is a mockery in the face of AIDS. And the so-called partnership between the haves and the have-nots is rendered laughable. Even sustainable development is influenced, because climate change feasts on weakened populations.

If the MDGs are as important as everyone says, then AIDS must be subdued.

As a last parting thought, in respect of the Global Fund, I beg you to mobilize as a truly civil society and stand up to the reckless nation-states who dare to decide whether Africans will live or die.

Download a copy of this speech (PDF, 180KB)

The Diabolical Consequences of the EU-India Free Trade Agreement

Thu, 28 Oct 2010 16:07:00 -0400

Excerpt from Stephen Lewis’ remarks at the Dean’s Signature Speaker Series, Ted Rogers School of Management, Ryerson University, Toronto, February 13, 2012.
You asked me to address Corporate Social Responsibility, and I have done so with many vivid examples demonstrating that so-called CSR can often be a sham.

However, let me end with one of the most offensive current international examples of how multinational corporations can actually make a fetish of irresponsibility, regardless the potentially catastrophic human consequences.

The European Union and India are in the final throes of negotiating a Free Trade Agreement. From leaked texts, it has become clear that the European Union, serving as the shill for the pharmaceutical industry, is putting great pressure on the Indian Government to accept changes to patent policy that would straitjacket the Indian generic drug industry and guarantee the brand name industry access to wealth beyond the dreams of avarice. And that’s saying something about some of the most avaricious corporations on the planet.

It’s no minor matter. At present, Indian generics supply fully 80% of all the AIDS drugs in the developing world, keeping millions of people alive. Shortly after the generics became available, prices actually dropped by 99%! In 2008, of 100 countries requiring anti-retroviral drugs, 96 purchased the drugs from India. If the drugs or the prices are put at risk, millions of lives hang in the balance. You would think that the priorities of global public health might spawn an ounce of concern for the well-being of millions, but not when well-being conflicts with balance-sheets.

To be sure, the negotiations are carried out by the EU, and you might think that they, too, would flinch in the face of human need. But the pharmaceutical lobby is the strongest lobby there is, before which governments regularly genuflect and human rights are cavalierly jettisoned.

In this instance, if I may mercilessly simplify the arguments, the EU is demanding three major concessions. First, a change in so-called “data exclusivity,” the effect of which would be to delay, possibly for years, the registration of generic medicines, thus keeping them off the market. Second, stricter enforcement and expanded definition of intellectual property rules that would permit lawsuits to be launched by brand name drug companies, even against the Government of India in private courts, for a range of specious reasons. In the process, it could tie up generic companies and third-party suppliers and purchasers in litigation for an eternity. Third, tough and utterly unjustified border measures that would allow custom officials to seize generic drugs destined for patients in developing countries.

The Treatment Action Campaign of South Africa wrote an open letter to the Citizens of Europe under the heading “Don’t let your Governments trade away our lives.” The UN Special Rapporteur on the Right to Health, a citizen of India himself, said that it would be “a colossal mistake to introduce data exclusivity.” And Elton John, in an eloquent column in the Independent just three days ago under the headline “We must end the greed of these corporations,” wrote: “We cannot allow Europe’s greed to triumph over the needs of HIV patients around the world.”

If, for the sake of promises of increased trade, the Indian Government capitulates to the demands, then the death of countless numbers of men, women and children is the preordained result.

There are dimensions of terrible irony in all of this. The Free Trade Agreement comes at precisely the moment when we know how to defeat the pandemic of AIDS, and the defeat is entirely dependent on low-cost drugs. More, the FTA comes at precisely the moment when donor funds are drying up, so much so that the Global Fund to Fight AIDS, Tuberculosis and Malaria had to cancel its most recent round of grants.

If the Indian generic drug industry, on which almost all the world depends, is now shackled by diabolical intellectual property rules, then the assault on the poor and the vulnerable of the earth will be complete.

I have heard UN voices, I have heard activist voices — tens of thousands marching in the streets of capital cities all over the world this last week — I have heard the voices of people living with AIDS speaking in crescendo about the apocalyptic possibilities. I have not heard a single corporate voice.

That says all that needs be said about corporate social responsibility.

Download a copy of this speech (PDF, 127 KB)

For more information:

Christina Magill
TEL: +1-416-657-4458
clm@aidsfreeworld.org

VIDEO: Stephen Lewis Delivers Dartmouth College's 2010 Commencement Speech

Thu, 28 Oct 2010 16:07:00 -0400

Stephen Lewis receives an honorary degree and speaks about global citizenship.
Honorary Degree Recipient Stephen Lewis' Commencement Address to Dartmouth College Graduates,
Sunday, June 13, 2010, Hanover, New Hampshire

As you heard, I served as the UN envoy on AIDS in Africa from 2001 to 2006. The nadir of that tenure was 2003. It's impossible to convey the depths of despair and anguish that consumed the high-prevalence countries of Africa.

The specter of death and the reality of death were omnipresent, from the graveyards to the village huts to the hospital wards. There were times when entire countries felt like a charnel house, a virtual cemetery. I remember one particularly awful episode: I was visiting the pediatric ward of the University Teaching Hospital in Lusaka, Zambia, with the superintendent, moving from cot to cot, each cot filled with five or six tiny infants, bodies strangled by a combination of malnutrition and what was undoubtedly the AIDS virus.

I had been in the ward for five minutes when an agonizing cry filled the room and reverberated wall to wall like some ghastly other-worldly shriek. I remember convulsively swiveling round to see what in God's name was happening, and there in the corner of the room was a young mother, on her knees by one of the cots, weeping inconsolably as the nurse came in with a white sheet and took the babe away.

What lives with me to this day was that it happened every ten minutes I was in the ward: a wail, a nurse, a sheet, a little morsel of a death.

I remember thinking to myself: has the world gone mad? How is this possible in the first decade of the 21st century? But of course, not only was it possible, but it was happening to huge percentages ... 5, 10, 20, 30, 35 per cent of the population between fifteen and forty-nine years of age, of whole countries, and in the decisive majority, to the women of those countries.

What was so appalling was the fact that by 2003, we had antiretroviral drugs available; to be specific, three drugs in one pill to be taken twice a day. It was called triple-combination therapy. It kept people alive. So powerful and effective were the drugs that they were said to cause the Lazarus effect ... people at death's door suddenly underwent a startling metamorphosis: they got better, they looked after their family, they survived!

But for some reason, the world was paralyzed in its response. It might have been racism, it might have been geography, it might have been indifference; whatever it was the treatment did not roll out, even though, by then, there were generic drug equivalents emerging that made treatment financially possible.

Millions of lives were lost, unnecessarily; millions were put at risk, unnecessarily.

And then something astonishing happened. It came in mortal form: it was called Jim Kim.

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Homophobic Ugandan Bill Demonizes People with HIV

Thu, 28 Oct 2010 11:56:00 -0400

In a speech to the Commonwealth People’s Forum, Stephen Lewis says Uganda's anti-gay bill must go.

This is a moment of truth for the Commonwealth. The anti-homosexuality Private Member’s Bill introduced into the parliament of Uganda, and now proceeding through the normal legislative process, puts the Commonwealth’s legitimacy and integrity to the test.

In a fashion unmistakable in both clarity and intent, the putative legislation declares war on homosexuality. There are deeply offensive sodomy laws and homophobic statutes on the books of many other Commonwealth countries, particularly here in the Caribbean. But nothing is as stark, punitive and redolent of hate as the Bill in Uganda; nothing comes close to such an omnibus violation of the human rights of sexual minorities. For some time now, Uganda has had offensive anti-homosexual legislation on the books, but this variant, this inflammatory redesign makes of the law a veritable charter of malice.

What is truly staggering about all of this is that not a peep of skepticism or incredulity has come from President Museveni. And President Museveni is chairing the Commonwealth Heads of Government summit. In so doing, he makes a mockery of Commonwealth principles.

One must remember that the last meeting of CHOGM was held in Uganda in 2007, and issued what is called the “Munyonyo Statement of Respect and Understanding.” It asserted that the Commonwealth “is a body well-placed to affirm the fundamental truth that diversity is one of humanity’s greatest strengths.” It went on to say that “accepting diversity, respecting the dignity of all human beings, and understanding the richness of our multiple identities have always been fundamental to the Commonwealth’s principles and approach...” President Museveni signed the document. How in the world does he reconcile the affirmation then with the defamation now?

It is noteworthy that much of the strongest opposition to the Bill is coming from the courageous Lesbian, Gay, Bisexual, and Transgender activists on the ground. LGBT activism always commands admiration, but in this instance especially so, because their very lives hang in the balance.

The proposed legislation actually mandates the death penalty for any HIV positive gay man who has sex with another man or any HIV-positive lesbian who has sex with another woman. But because it’s often hard to believe the sheer malignancy of language, let me quote directly from the Bill itself. Section 2 of the Bill is titled, “The offence of homosexuality.” It reads as follows: Clause “(1) A person commits the offence of homosexuality if — (a) he penetrates the anus or mouth of another person of the same sex with his penis or any other sexual contraption; (b) he or she uses any object or sexual contraption to penetrate or stimulate the sexual organ of a person of the same sex; (c) he or she touches another person with the intention of committing the act of homosexuality.”

Clause “(2) A person who commits an offence under this section shall be liable on conviction to imprisonment for life.

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Honor Women by Naming and Shaming Zimbabwe

Thu, 28 Oct 2010 11:56:00 -0400

On International Women's Day 2012, AIDS-Free World Co-Director Stephen Lewis participated in a panel at the United Nations Human Rights Council moderated by the UN High Commissioner for Human Rights, Navi Pillay, and featuring Maryam al-Khawaja, Head of Foreign Relations for the Bahrain Center for Human Rights, Kumi Naidoo, International Executive Director of Greenpeace, and Kim Phúc Phan Thị, UNESCO Goodwill Ambassador. The video below is an excerpt of comments made by Lewis at the panel. Remarks made by Lewis at the Meeting of Council Diplomats follows the video.

Honor Women by Naming and Shaming Zimbabwe

Remarks by Stephen Lewis, Co-Director, AIDS-Free World, at the Meeting of Council Diplomats on International Women's Day, March 8, 2012.

Here in Geneva, at the Human Rights Council, on International Women’s Day, I have a case I want to make. It’s about Zimbabwe. It should have been made by the United Nations, but it hasn’t been made by the United Nations. Frankly, that’s unforgiveable.

Let me set it out. And please bear with me for a few minutes of background, leading to a decisive revelation.

In Zimbabwe in 2008, there were two elections; the second was a run-off, held because Robert Mugabe refused to concede defeat. They were held in March and June. Between the two elections, there was a terrible campaign of political rape orchestrated by President Mugabe and his party, ZANU-PF.

The facts are not in dispute. My organization, AIDS-Free World, at the request of a group called The Girl-Child Network, decided to respond to the women who had been raped and take their stories by way of formal affidavits. On six separate occasions, accompanied by lawyers from pro bono law firms in Canada and the United States, we traveled to southern Africa and took the affidavits.

We gathered evidence from 70 women. Collectively, they were subjected to 380 separate rapes by 271 different men. In every single instance, the rapes were committed against women solely because they directly or indirectly supported the MDC, the opposition party.

The raping was diabolical, completely without conscience, merciless in its ferocity, committed by members of Mugabe’s Youth Corps and War Veterans. The pattern of rape was identical and uniform in every part of the country. It was carried out in every province. There was no doubt as to its orchestration. There was no doubt that it constituted crimes against humanity.

It was rape as a strategy of politics, no different in its execution and result than rape as a strategy of conflict. It was meant to terrorize the opposition, to destroy communities and families that harbored the opposition, to force women to vote for ZANU-PF, or to frighten women, their family members and neighbors away from the polls altogether. The fact that women might emerge as HIV-positive from such horror, mattered not at all.

It is not excessive to say that it was the plan of a madman.

AIDS-Free World meticulously documented the saga and produced a comprehensive report titled “Electing to Rape: Sexual Terror in Mugabe’s Zimbabwe.” We launched it in Johannesburg in December of 2009.

It garnered significant coverage in southern Africa, and from that day to this we’ve been telling anyone who would listen to us, within the United Nations and outside of the United Nations, that the international community must intervene because this strategy of rape is historic and it is ongoing. Women will be subject to terrifying sexual assault again during the next elections, expected to be held later this year.

We went so far as to prepare a case to be brought before the National Prosecuting Authority (NPA) in South Africa to take advantage of South Africa’s ability to use the legal principle of “universal jurisdiction” – that is, bringing those accused of crimes against humanity to justice through courts outside their own countries, because the crimes offend us all, and their own countries won’t prosecute. We were frustrated in that objective by the response to another case, also against Mugabe and Zimbabwe, alleging crimes of torture in 2007. The application of universal jurisdiction is stalled in that case, because the NPA argued that it didn’t have jurisdiction. The decision was appealed. There was no point in our proceeding until the question of the NPA’s jurisdiction was resolved.

Interestingly, the High Court of Gauteng has agreed to hear the appeal at the end of this month, so we will file our rape dossier before the NPA by May.

But while that may get some of the known perpetrators into jail should they cross into South Africa, the women who have been raped, will never receive justice, and those who most certainly will be raped in advance of the next election, will not be safe until the international community intervenes.

AIDS-Free World had resolved to apply pressure in every possible way to forestall a repetition of election-related raping later this year. But we have frankly felt deeply frustrated and depressed by the impunity that rests like an impenetrable halo over Robert Mugabe’s head.

Why will no one take him on? The days of Zimbabwe’s role as a Front-Line state against apartheid are long, long gone. Everyone — every country on the Security Council — knows of the sexual violence; knows what is being done to the women of Zimbabwe who dare to support the opposition; knows that a brutal, insensate regime is in power in the country. It appears to make no difference.

In the councils of the United Nations — indeed, here in the affairs of the Human Rights Council, where Zimbabwe has recently undergone its Universal Periodic Review and appeared before the Treaty Body for CEDAW, the Convention on the Elimination of ALL Forms of Discrimination Against Women just last month — it is de rigueur to rail against dozens of countries for violence against women, but Zimbabwe is always exempt.

On this International Women’s Day, we have to resolve to break the pattern. Incredibly enough, the chink in the armor of Zimbabwe’s impunity has finally been exposed.

Let me explain how it plays out.

Back in December of 2010, the UN Security Council adopted Resolution 1960. It was focused entirely on sexual violence in situations of armed conflict, bemoaning the extremely slow progress made in bringing any of the perpetrators to justice. In order to attempt to correct the situation, and in response to Resolutions 1820 and 1888 also dealing explicitly with sexual violence in conflict, the Security Council asked the Secretary-General, in his annual reports on the issue, to include “detailed information on parties to armed conflict that are credibly suspected of committing or being responsible for rape or other forms of sexual violence,” and to list the parties in an annex.

It became known as the “Naming and Shaming” resolution. There’s no question: it was important progress.

In January of this year, as requested, the Secretary-General submitted his report titled “Conflict-related sexual violence”. And it named names. It went through country after country — Colombia, Cote d’Ivoire, Democratic Republic of the Congo, Libya, Myanmar, Somalia, South Sudan and Sudan (Darfur) — identifying the groups and sometimes individual assailants who were responsible for campaigns of rape between December 2010 and November 2011.

The next section predictably deals with “conflict-related sexual violence in post-conflict situations”, again naming names, or discussing the situation in detail, and citing Central African Republic, Chad, Nepal, Sri Lanka, Bosnia and Herzegovina, Liberia, Sierra Leone, Timor-Leste.

As we moved through the reading of the report, my colleagues and I were tormented by the all-consuming focus on “sexual violence in conflict” that seemed to preclude the inclusion of Zimbabwe. How could we explain to the world, and to the Secretary-General that sexual violence in conflict didn’t always require warring parties? How could we explain that sexual violence driven by political motives was simply a different kind of conflict, of similar scale and import, needing equally to be addressed.

And then we came to page 21!

The heading is “Sexual Violence in the context of elections, political strife and civil unrest.” I was stunned.

The first paragraph couldn’t have been more explicit:

“Situations of civil and political unrest or instability, including pre- and post-electoral violence, where reports suggest that sexual violence was used to serve political ends and to target opponents, are relevant for the purpose of reporting under resolution 1960. Sexual violence employed as part of the repertoire of political repression needs to be monitored as a security threat, as a context in which sexual violence amounting to a crime against humanity may occur, and as a potential conflict situation.”

This is the exact definition of Zimbabwe in 2008, and what undoubtedly will be Zimbabwe in 2012. So which countries does the report name? Guinea, Kenya, Egypt and Syria.

What in heaven’s name is going on? AIDS-Free World was appalled by the post-election rape that haunted Kenya; collectively, we’ve spent months on it; assigned an intern to gather material; helped to design a conference that addressed it; and the co-Director of AIDS-Free World and I spent a week in Nairobi interviewing between fifteen and twenty activists, mostly from women’s groups, shortly after the post-election violence.

What they reported was awful; but the scale of the raping didn’t begin to approximate Zimbabwe. The Secretary-General’s report ends the section on Kenya with these words: “Generally, Kenya remains peaceful but the political environment is expected to continue to be charged as the country heads for the next general elections in 2012. Accordingly, there is continued monitoring and peace-building initiatives … in view of the potential for repeated violence and population displacement.”

If Kenya remains ominous for the repeat of sexual violence in 2012, then Zimbabwe is many times more threatening. And as bad as things have been and are in Egypt, Guinea, and yes, even Syria, Robert Mugabe’s Zimbabwe beats them all for the scale of repression and rape throughout the 32 years he has been leading the country.

Why is Zimbabwe missing from the list? Why does the Secretariat allow it to happen, especially when a section of the Secretary-General’s own report cries out for the inclusion of Zimbabwe? The report is seen as a document that will change the course of history for women. It was debated by the Security Council for the first time just two weeks ago. Any analysis of the language of the report must conclude that Zimbabwe is the very embodiment of what’s being reviled, and is now definitively within the orbit of the actions to be taken on sexual violence by the United Nations.

So I must ask: why does the Security Council call for naming and shaming and then observe the omission of Zimbabwe without so much as a word? Nor, I might add, a word from the Human Rights Council. What hold does Robert Mugabe have on the Permanent Members of the Security Council, or on the member governments of the Human Rights Council? Does no one recognize the blow to the public credibility of the UN in both New York and Geneva when such obvious matters of principle are discarded?

It can’t be allowed to go on. Zimbabwe is now — by fact, by logic, by circumstance, by morality, by behavior — an organic extension of the Secretary-General’s report. It’s a travesty that of all the countries named, Zimbabwe is missing.

It smacks of a dreadful hypocrisy; it’s an unsettling glimpse into what might be called the collusion of camaraderie … that cozy male bonding when everyone agrees, behind closed doors, to be silent. It shows unsettling contempt for the women of Zimbabwe who have been raped by President Mugabe’s henchmen.

Someone has to correct this wrong. Neither the Secretary-General himself nor a single member of the Security Council can explain or defend it. Not after the words in the report.

Download a copy of the statement here (PDF, 70 KB)

###

For more information:
Scott Morgan
Office: +1 (718) 210-3647
Cell: +1 (973) 865-0128
Email: swm@aidsfreeworld.org

Dead wrong

Mon, 25 Oct 2010 14:52:20 -0400

An excerpt of a speech to the Third Annual Student AIDS Conference at Harvard Medical School, where Stephen Lewis confronted the question: Does too much funding go to AIDS?

Recently, there has been a spate of news stories in which scientists and academics claim that too much money is going for AIDS, leaving crumbs from the donor table for other international health imperatives. Those of us at AIDS-Free World think they’re dead wrong. And they do a great disservice to the legitimate, insistent clamor for more foreign aid.

The argument has been sharpened because of UNAIDS’ revision of the numbers of people living with the virus from nearly 40 million in the last estimate to 33 million today. Thank you UNAIDS. This embarrassing correction of epidemiological miscalculation has predictably given dissenters a hook on which to challenge the money being spent for AIDS. And when UNAIDS soon revises the financial requirements downwards — as they must, if there are between six and seven million fewer cases — then we’ll get yet another burst of controversy over what should be allocated for HIV/AIDS versus all the pressing health priorities.

The struggle for AIDS funding remains a monumental challenge. The people who beat the drums about too much for AIDS and not enough for other health priorities; who suggest reapportioning AIDS monies to other health concerns are unwittingly compromising the lives of millions.But the argument is really straightforward. On the basis of the former estimate of the number of people infected, UNAIDS calculated that we’d need $41 billion annually by 2010 to reach full universal access to treatment, prevention and care (including orphans and program costs and a pittance for violence against women) and $52 billion by 2015, coincident with the Millennium Development Goals. If you make a straight reduction in those figures to reflect the percentage reduction in the number of cases, you’d need roughly $34 billion in 2010 and $43 billion in 2015. (Those are the real and accurate figures with which I fully agree. But there were other scenarios presented to water down total costs so as not to scare off the donors. We reject them utterly. It’s time to stop bargaining over human life because donors betray their promises.) Last year, 2007, we spent, overall, a little more than $10 billion on HIV/AIDS worldwide. The shortfall this year will be enormous … in the billions. So, too, 2009; so, too, 2010; so, too, every year thereafter. The struggle for AIDS funding remains a monumental challenge. The people who beat the drums about too much for AIDS and not enough for other health priorities; who suggest reapportioning AIDS monies to other health concerns are unwittingly compromising the lives of millions.

What they should be saying is “Where is the additional money for everything from water to sanitation to nutrition to education to health systems to human resources to neglected diseases to everything that is needed to ameliorate the human condition?”

The American contribution to foreign AID for developing countries remains abysmal. The Administration spends, conservatively, up to $108 billion a year on the war in Iraq, and perhaps $5 billion in an entire year on HIV/AIDS. Those priorities are so skewed as to be obscene. And now that the United States is in economic crisis, you can be sure that foreign aid will again emerge the beggar when future appropriations are made.

We should never forget that as a percentage of GNP, the United States occupies virtually the bottom rung of the ladder amongst all the industrial nations, let alone the G8. In 2006, the last year for which figures are available, the Development Assistance Committee of the OECD reported that only Greece was below the United States of the 23 countries listed. Greece spends 0.17% of GNP on foreign aid; the United States spends 0.18%. The average for all countries is 0.31% of GNP … virtually double the expenditure of the United States. The target, of course, is 0.7%, almost quadruple the US current contribution.

The scientists and academics who argue for redistribution of HIV/AIDS monies simply capitulate, ignobly, to the dreadful levels of ODA (official development assistance). They rationalize this position by arguing that we must be pragmatic: there’s no more money forthcoming or available. Of course, that’s a counsel of despair. We don’t need detractors; we need advocates who will hammer away at government until the pendulum swings and the resources are extracted.

To make HIV/AIDS pay the price for governmental negligence is the ultimate irony. Talk about robbing Peter to pay Paul. Peter and Paul are both in life and death struggles. Those who would sacrifice one on the altar of the other have been reading Milton Friedman, not the Bible.

Stephen Lewis' Keynote Address at the Closing Session of the XVI International AIDS Conference

Mon, 25 Oct 2010 13:24:44 -0400

This is the last speech I shall make at any of these international conferences in my role as United Nations Envoy. I'm glad, for obvious Canadian reasons, that it comes in Toronto. But I'm equally pleased because this has been a good conference, covering an extraordinary range of ground, and I therefore feel confident in asking you to join with me in giving force to the oft-repeated mantra: "Time To Deliver."

Of what would that meaning consist? Allow me to set out a number of items.

Number 1: Abstinence-only programs don't work. Ideological rigidity almost never works when applied to the human condition. Moreover, it's an antiquated throwback to the conditionality of yesteryear to tell any government how to allocate its money for prevention. That approach has a name: it's called neo-colonialism.

Number 2: Harm reduction programs do work. Needle exchange and methadone treatment save lives. More, it would be positively perverse to close the "Insite" safe injection facility in Vancouver when it has been positively evaluated in a number of studies; in fact there should be several more such facilities in Canada and around the world. Russia, Central Asia, parts of India are all struggling with transmission through injecting drug use. To shut 'Insite' down is to invite HIV infection and death. One has to wonder about the minds of those who would so readily punish injecting drug users rather than understanding the problem for what it is: a matter of public health.

Number 3: Circumcision, as a preventive intervention, should not be subject to bureaucratic contemplation forever. We have enough information now to know that it is an intervention worth pursuing. What remains is a single-minded effort to get the word out, respect cultural sensitivities, and then for those who want to proceed, make certain that we have well-trained personnel to do the operating.

The men are lining up for the procedure in Swaziland. And when I was in the Zambian copper belt, just a couple of weeks ago, at an animated meeting with the District Commissioner, he indicated that he was a part of an ethnic group which was circumcised. I then revealed that I was circumcised, and there followed a joyous frenzy of male bonding amongst all the circumcisees. The fact of the matter is that even in the remotest parts of Africa there is now an awareness of the issue; it's important to act on it.

Number 4: The growing excitement around a microbicide is entirely warranted. This is a preventive technology whose time has come. To be sure, there can be no flagging in the dogged quest for a vaccine, but it would appear that where preventive technologies are concerned, the microbicide is first in line. Now is the time to make certain, in advance, that when the discovery is made, it is instantly accessible and acceptable to the women of the world, wherever they may live.

Number 5: In the hierarchy of preventive measures, the Prevention of Mother To Child Transmission is very near the top. It is a bitter indictment that so few HIV-positive pregnant women have access to PMTCT. But that's just the half of it. It is inexcusable that in Africa and other parts of the developing world we continue to use single-dose Nevirapine, rather than full triple therapy during pregnancy, as we do in western countries like Canada. This means that hundreds of thousands of babies continue to be born HIV-positive, rather than reducing the transmission rate virtually to zero. I ask: what kind of a world do we live in where the life of an African child or an Asian child is worth so much less than the life of a Canadian child?

Number 6: It is now accepted as unassailable truth that people in treatment need nutritious food supplements to maintain and tolerate their treatment. And yet, there is a growing clamor from People Living with AIDS that decent nutrition simply isn't available, leaving them in a desperate predicament. The World Food Programme released a study at this conference calculating the cost of food supplementation at 66 cents a day for an entire family; what madness is it that denies the World Food Programme the necessary money?

Number 7: One of the issues that received an insufficient airing at this conference is sexual violence against women. Just a few months ago, I was visiting the local hospital in Thika, Kenya, which houses the one rape counseling center in that part of the country. The rise in sexual violence has meant that there are over thirty reported cases every month, with multiples of that number never of course reported.

In April of this year there were forty-six reported cases. Twenty-two were under the age of eighteen; half of those were under the age of twelve. Horrific you say? Without question. But how would you characterize an emerging pattern of the sexual assault of women between the ages of sixty-five and eighty, the rapists confident that they can rape with impunity without fear of transmission?

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UNAIDS corrects global stats: AIDS-Free World responds

Mon, 25 Oct 2010 13:04:24 -0400

Imperial College, London: Excerpt from a speech by Stephen Lewis, Co-Director of AIDS-Free World, to the World Health Editors Network charging that “the UN was stubborn and it was sloppy” when entrusted with the job of measuring the growth of the AIDS pandemic.

It’s fair to say that any speech designed to address leadership and AIDS must start with the events of this week: the publication of the UNAIDS Epidemic Update, 2007.

Let me get two matters out of the way at the outset. I think the new set of numbers is much closer to the truth of the pandemic, although I’m inclined to believe that they’re still too high and that another awkward revision lies ahead. Second, I don’t believe for a moment that UNAIDS inflated the figures for the purpose of extracting money. That seems to me too conspiratorial by half. If by some bizarre happenstance, Machiavelli’s apprentices were involved, they make lousy fund-raisers: we’re billions of dollars short of where we should be, old estimates or new.

I take issue with the report on different grounds. For years, knowledgeable epidemiologists have been telling the UN that the figures were too high. They didn’t whisper their criticisms: they wrote books and articles. No one paid them heed. It doesn’t take a Nobel prize statistician to guess that prevalence rates based on urban antenatal clinics should not be extrapolated to the entire country and presented as holy writ.

But the UN chose to turn a blind eye. And then, finally and abruptly, came the come-uppance: the result is an annual prevalence rate that is lower by almost seven million than last year’s estimate.

Sure, it can be rationalized by arguing that it’s just a methodological adjustment, rooted in superior statistical-gathering techniques. And that might even be persuasive if there hadn’t been academicians and epidemiologists clamoring for revision for years. The UNAIDS explanation sounds good; the fine print has the ring of arcane scientific authority. But down here, in the mortal universe, where people aren’t easily taken in, it doesn’t wash.

The UN was stubborn and it was sloppy. In the process, it undermined public confidence in the reliability of the figures, introducing completely unnecessary levels of doubt, contention and confusion.

Where HIV/AIDS is concerned, there is no room for the jolting of confidence. The new estimates confirm a continuing apocalypse for sub-Saharan Africa: 22.5 million infections, 61% of them women, 68% of world-wide infections, 76% of all deaths, 11.4 million orphans … this is where the focus should be, this is where it should always have been; not a report cluttered by mathematical adjustments so that virtually every story that’s written begins with the news of a statistical volte-face. If the recording of data had been more scrupulous all along, we could have welcomed this report as the latest instalment in a record of declining numbers, showing some strong hints of progress, and plausibly leading to universal access for treatment, prevention and care by 2010.

Instead, all of us have to run to the trenches to remind the world that more money is still desperately needed and that the situation, in many places, remains grim, bleak, funereal.

As a matter of fact, at the risk of knocking the nail through the wall, allow me to add that I earlier used the word "sloppy" advisedly. For a number of years in the 1990’s, I was the Deputy at UNICEF and oversaw a raft of publications. I would never have permitted the Epidemic Update to go out as is.

Let me explain by way of example.

In one of the dense explanatory notes, there’s a statistical adjustment described that attracted little notice, but seems to me to be of enormous import. If I may attempt a soothing simplification, the report seems to be saying that, on average, the population-based random household surveys in countries with generalized HIV epidemics produced estimates that were 20% lower than the estimates produced by antenatal surveys. Therefore, says the report, for all those countries that have not yet done random surveys, we’re applying a reduction factor of 0.8 … that is to say, the new figures will be 80% of the old figures.

That’s quite a reduction! Don’t you think it might have been useful to produce a table (there were, after all, tables galore) to show what it might mean, in practice, country by affected country? No such luck.

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Remarks at the 10th Annual V-Day Celebrations

Mon, 25 Oct 2010 12:51:39 -0400

Remarks by Stephen Lewis, delivered at the 10th Annual V-Day Celebrations, New Orleans, LA.

Today is a day that has largely — and rightly — been given over to Dr. Mukwege and his astonishing and heroic work in the Congo. (For those who may have missed his panel, he is, of course, the internationally famed doctor who heads the resolute and magnificent staff of the Panzi Hospital in Eastern Congo.)

Driving the work is the endlessly grim and despairing litany of rape and sexual violence. All of us assembled in the Superdome, talk of V-Day and the Vagina Monologues; in the Congo there’s a medical term of art called ‘vaginal destruction.’ I need not elaborate; most of you have heard Dr. Mukwege. But suffice to say that in the vast historical panorama of violence against women, there is a level of demonic dementia plumbed in the Congo that has seldom, if ever been reached before.

That’s the peg on which I want to hang these remarks. I want to set out an argument that essentially says that what’s happening in the Congo is an act of criminal international misogyny, sustained by the indifference of nation states and by the delinquency of the United Nations.

Dr. Mukwege and others have said time and time again that the current saga of the Congo has been going on for more than a decade. It’s important to remember that it’s a direct result of the escape of thousands of mass murderers who eluded capture after the Rwandan genocide - thanks to the Governments of France and the United States - by fleeing into what was then called Zaire, now the Democratic Republic of the Congo. The wars and the horror that followed have been chronicled by journalists, by human rights organizations, by senior representatives of the United Nations Secretary-General, by agencies, by NGOs internationally and NGOs on the ground, by the UN Office of Humanitarian Affairs, by the Security Council, and in the process, accentuated and punctuated by the cries and the pain and the carnage of over five million deaths.

The sordid saga ebbs and flows. But it was brought back into sudden, vivid public notoriety by Eve Ensler’s trip to the Congo in July/August of last year, her visit to the Panzi Hospital, her interviews with the women survivors of rape, and her visceral piece of writing in Glamour magazine which began with the words “I have just returned from Hell.” Eve set off an extraordinary chain reaction: her visit was followed by a fact-finding mission by the current UN Under-Secretary General for Humanitarian Affairs who, upon his return, wrote an op-ed for the Los Angeles Times in which he said that the Congo was the worst place in the world for women. Those views were then echoed everywhere (including by the EU Parliament), triggering front page stories in the New York Times, the Washington Post, the Los Angeles Times and a lengthy segment on 60 Minutes by Anderson Cooper of CNN.

Largely as a result of this growing clamor against the war on women in the Congo, and the fact that Eve Ensler herself testified before the Security Council, the United Nations resolution that renewed the mandate for the UN Peacekeeping force in the Congo (MONUC as it’s called) contained some of the strongest language condemning rape and sexual violence ever to appear in a Security Council resolution, and obliged MONUC, in no uncertain terms, to protect the women of the Congo. The resolution was passed at the end of December last year.

In January of this year, scarce one month later, there was an “Act of Engagement” — a so-called peace commitment signed amongst the warring parties. I use ‘so-called’ advisedly because evidence of peace is hard to find. But that’s not the point: the point is much more revelatory and much more damning.

The peace commitment is a fairly lengthy document. Unbelievably, from beginning to end, the word "rape" never appears. Unbelievably, from beginning to end, the phrase ‘sexual violence’ never appears. Unbelievably, “women” are mentioned but once, lumped in with children, the elderly and the disabled. It’s as if the organizers of the peace conference had never heard of the Security Council resolution.

But it gets worse. The peace document actually grants amnesty — I repeat, amnesty — to those who have participated in the fighting. To be sure, it makes a deliberate legal distinction, stating that war crimes or crimes against humanity will not be excused. But who’s kidding whom? This arcane legal dancing on the head of a pin is not likely to weigh heavily on the troops in the field, who have now been given every reason to believe that since the rapes they committed up to now have been officially forgiven and forgotten, they can rape with impunity again. And indeed, as Dr. Mukwege testified before Congress just last week, the raping and sexual violence continues.

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Peacekeepers Must Protect Women

Mon, 25 Oct 2010 12:09:36 -0400

Stephen Lewis warns UN military commanders who gathered on May 27th 2008 at Wilton Park in West Sussex, England to discuss their role in protecting women targeted or affected by armed conflict: peace is a mere illusion wherever bullets have stopped, but rape continues.

Photo by Paula Allen / vday.org

At the heart of this conference there lies an unassailable truth: if sexual violence is not addressed during the course of a conflict, then sexual violence will haunt the post-conflict period, and make of the ostensible peace a mockery for half the population.

Three days ago, I returned from Liberia. While in the country, I met with President Ellen Johnson-Sirleaf, with senior officials of the Ministry of Health, with the Minister of Gender, with the leadership of the Clinton Foundation, with the consultant who drafted the legislation for the special court to try sexual offences, with the UNICEF Representative and significant numbers of the UNICEF staff. Unfortunately, I did not have the opportunity to meet with UNMIL, but the UN Mission in Liberia and its peacekeeping forces were inevitably a part of every conversation.

The context of my discussions is encapsulated in the words of the Deputy UN Envoy for the Rule of Law in Liberia when she said, as recently as May 20th: “We cannot expect the future leaders of Liberia, the doctors, nurses, and engineers of Liberia to be brought up amongst men who are rapists and women who are angry, degraded, frightened, depressed, embarrassed and confused.”

She was speaking about the contagion of sexual violence that currently engulfs the country and causes such intense concern. The statistics are horrifying: a recent study by UNICEF indicated that more than fifty per cent of all reported rapes are brutal assaults on young girls between the ages of ten and fourteen. The gender advisor in UNICEF felt that the percentage was probably on the rise, and it’s feared that increases in the HIV rates among female youth will not be far behind. The Minister of Gender showed me figures for March, 2008, indicating that the majority of reported rapes in that month were committed against girls under the age of twelve, some under the age of five, and she narrated stories of gang rape so insensate and so depraved that it reminded me of exhibits in a Holocaust museum. A further survey, of all fifteen counties in the country, found that girls and boys were united in their conviction that young girls were the most endangered group in Liberia, and incredibly enough, that there was no place and no time of day or night where adolescent girls could be considered safe.

Predictably, President Johnson-Sirleaf is thunderstruck by the force of the sexual violence. In a very real sense she is staking the integrity of her tenure on her ability to confront and subdue the war on women.

But how did it come to this? UNMIL has been in the country since 2003 … it has a large contingent of women peacekeepers: it has an Office of the Gender Advisor and of the Advisor on HIV/AIDS; it has gender mainstreaming built into the mandate; both the UN Envoy and the Deputy UN Envoy are women; and the resolution of 2003 which constituted UNMIL incorporated Security Council Resolution 1325 which — you will agree — was supposed to guarantee the involvement of women in the peace-keeping processes, but more important, guarantee women protection and security from gender-based violence and violations of human rights.

Clearly all that hasn’t worked in Liberia, where things for women and girls are getting worse. Where did we go wrong?

My own view, and the view of the organization to which I belong — AIDS-Free World — is that peacekeepers and force commanders alike have to take sexual violence much more seriously. It is simply untenable to argue that the responsibility to keep the warring parties at bay transcends every other human imperative. It doesn’t. You may succeed in manufacturing a semblance of peace, but for the women of the country, the conflict continues in the most painful and eviscerating of ways.

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Beyond Barriers: Disability and AIDS

Wed, 20 Oct 2010 13:17:59 -0400

Myroslava Tataryn, AIDS-Free World's Advisor on Disability and HIV/AIDS, presenting at the 'Beyond Barriers: Disability and AIDS' session at the XVII International AIDS Conference in Mexico City.

We at AIDS-Free World would like to bring to light the need for a comprehensive and sustainable response to the needs of persons with disabilities by the international AIDS community. There are excellent, creative innovations taking place on the ground but we need a coordinated global response to support these initiatives and allow them to grow.

We applaud that for the first time this international AIDS conference has included disability issues into its formal program. But, we have yet to see the coordinated integration of persons with disabilities (PWD) and disability issues into UNAIDS, the IAS and other high level international structures.

First of all, let me take a moment to briefly outline some of the particular concerns of women with disabilities in the face of HIV/AIDS.

We are being excluded from HIV/AIDS education initiatives and clinical services. There are widespread ideas that, somehow, because we have a disability we don’t fall in love, that we can’t find partners and that there is no way that we would have sex. Needless to say, these are erroneous misperceptions. Not only are women with disabilities sexually active we are also often at a much higher risk of sexual abuse from caregivers, partners and strangers who may see us as defenseless. Even if such abuse is reported, most often the reports are not taken seriously. Worse still, there’s the idea that we should just be grateful for whatever sex we can get. I think you can see how these issues closely intertwine with HIV/AIDS risk factors.

Gender inequality is not only driving the feminization of the AIDS pandemic but also leaving women and girls with disabilities more vulnerable to and more affected by physical and mental disabilities. Women and girls currently comprise 74% of PWDs in low and middle income countries yet they only receive 20% of rehabilitation assistance worldwide. The UN reports that “the combination of male preference in many countries and the universal devaluation of disability can be deadly for disabled females.”

Women with disabilities are less likely to be educated and employed than their male counterparts and are less likely to access and receive medical care. Disabled women’s exclusion from healthcare services is rampant worldwide and is not only a question of having wheelchair ramps and Braille. Perhaps the most painful discrimination come in the form of prejudices held by health care workers.

Imagine for a moment that I am a pregnant and going to access prenatal services at my local health care clinic for the first time. I have a loving and caring partner and we are both overjoyed with the pregnancy but when I reach the clinic I am only met with disdain and pity from the nursing staff. “Shame!” they say… “Sorry!” “She’s disabled herself and now this…how will she manage?” they whisper…or even worse… “to think that someone should do this to her in her condition?”… With these degrading attitudes we begin to see how easy it is for a young disabled woman to loose confidence in her local health care providers and to be discouraged from returning.

But I digress. There are many challenges we face but there are also numerous examples of exciting programs sprouting up that bring together people with disabilities and AIDS activists and service providers to combat stigma and make services more accessible to all.

Let me share with you three examples of initiatives currently being implemented in East Africa where I have spent the bulk of my time this year, with my AIDS-Free World colleague, Shonali Shome. These examples illustrate the creativity and the vast potential of partnerships between AIDS service organizations and groups of persons with disabilities.

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A Tribute to AIDS-Free World's Late Advisory Board Chair

Wed, 20 Oct 2010 13:17:00 -0400

AIDS-Free World co-director Stephen Lewis’ keynote remarks at An Evening to Honor and Advance the Legacy of Allan Rosenfield, former Dean of the Mailman School of Public Health Columbia University, New York. A video of his remarks can be viewed here.

All the plaudits and tributes for Allan, genuine and heartfelt from all of us, can never quite capture the essence of the man. So many of his friends and colleagues here knew him far better than did I; but for me, there was a quality that surpassed even the gentle innocence, the astonishing intelligence, the insatiable curiosity, the encyclopedic life experience: Allan cared so very deeply about important issues in a way I had rarely encountered before.

I felt it first, as so many felt it, when — as you’ve heard — at a critical moment in the AIDS pandemic, he fashioned and led the initiative to add the "Plus" to "Vertical Transmission" or, as it’s better known but inappropriately-styled, "Prevention of Mother-to-Child Transmission."

It was, when you think of it, an organic extension of "Where is the M in MCH?", reaffirming what preoccupied Allan always: how are mothers treated, how are women treated in the grand panorama of global health? He understood immediately that in PMTCT, the emphasis was always on the child, with the health of the mothers an afterthought.

Would that Allan were alive today. Little has changed. The preoccupation with ending “Pediatric AIDS” by 2015 is still measured in the numbers of children born HIV-positive or HIV-negative … interest in the health and life of the mother is still as much rhetorical fetishism as it is genuine concern. Admittedly, happily, Columbia is different: Columbia, true to Allan, as a matter of policy and principle, nurtures the entire family through the ravages of HIV/AIDS, but alas, Columbia is a very small part of the whole.

And it gets worse. Many jurisdictions, addressing the pandemic, still use single-dose nevirapine, rather than double- or triple-combination therapy, whatever the guidelines from WHO. But we now know, from irrefutable studies, that single-dose nevirapine can develop resistance in the mother and her infant to future antiretroviral treatment, putting both at great risk.

The mother is rarely given a choice; the principle of informed consent is rarely, if ever, to be seen.

We don’t hear from WHO or UNAIDS the outrage that should be expressed at this gross violation of human rights. And why don’t we hear? Because as ever, the over-riding focus remains on improving the chances for the child … the desperate need to tell the world, come 2015, that 80% coverage has been reached in PMTCT.

My co-Director of AIDS-Free World, Paula Donovan, known to many of you, is even now writing an uncompromising monograph, documenting this violation of the rights of pregnant HIV-positive women. I know that Allan would have approved.

Is it self-centered to introduce AIDS-Free World at this point? Not at all. Allan was Chair of our advisory board and in that position, with unfailing tenacity, he championed the rights of women and feminist causes.

As I survey the landscape today, I think there are four other matters, amongst many, that would have commanded Allan’s attention and built on his legacy.

First, the way in which the Millennium Development Goals have given priority to reducing maternal mortality. The heightened awareness, the huge increases in funding, all of it suggests that the world will no longer tolerate the death in childbirth of between 350 thousand and half a million women every year. The extraordinary film we’ve just viewed captures, in a most evocative and poignant way, the struggles of giving birth in impoverished countries.

Allan would have been thrilled to think that the world is beginning to care.

On the other hand, Allan would have been vigilant.

What are we going to do with all the money, and who makes the decisions? My government, the government of Canada announced, as host nation, that maternal and child health was to be the centerpiece of the G8 this year. Ironically, the money Canada contributed to a five-year plan equaled, almost exactly, the money they spent on three days of police security for the G8 and G20 meetings. And when they announced the plan, they had no initial idea of what they would contribute, or where it would go, or whether family planning would be a part of it, or whether the right to abortion had to be included.

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