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Accelerating action for women empowerment and gender equality in the area of HIV and sexual & reproductive health & rights: Getting to zero in Africa
Eric Goosby, US Embassy
May 24, 2012

The United States applauds the efforts of the Global Power Women Network Africa, the African Union, and UNAIDS for organizing this meeting.

Addressing gender norms and inequities is essential to reducing HIV risk and increasing access to HIV prevention, care and treatment services for women and men. Your commitment and vision are critical to making a difference in the lives of women and girls throughout the continent.

The U.S. Government, through the President's Emergency Plan for AIDS Relief, or PEPFAR, proactively confronts the changing demographics of the HIV/AIDS epidemic, integrating gender throughout prevention, care, and treatment programs. We do so by focusing on five areas, all of which will be addressed in one way or another during this meeting:

• Increasing gender equity in HIV/AIDS programs and services, including access to reproductive health services
• Reducing violence and coercion
• Engaging men and boys to address norms and behaviors
• Increasing women and girls' legal protection
• Increasing women and girls' access to income and productive resources, including education

In addition, a central principle of the Global Health Initiative is a focus on Women, Girls and Gender Equality. PEPFAR is a key partner in implementing this principle which aims to redress gender imbalances related to health, including empowering women and girls, to improve health outcomes for individuals, families, and communities.

As part of our engagement, there are a few areas that, together with key partners such as National Governments, UNAIDS, and civil society, the USG has prioritized. The first is gender-based violence, or GBV. GBV fosters the spread of HIV/AIDS by limiting one's ability to negotiate safe sexual practices, disclose HIV status and access services due to fear of GBV. Sexual violence can also directly lead to HIV infection. Country studies indicate that the risk of HIV among women who have experienced violence may be up to three times higher than among those who have not. Sexual violence among adolescents and pre-adolescents is alarmingly high. In 2010, the first nationally representative survey of violence against children in Tanzania found that nearly three in ten females and one in seven males experienced sexual violence prior to the age of 18.

In fact, as way of addressing this particular issue, PEPFAR has joined the Together for Girls. This unique partnership brings together public, private, United Nations and U.S. Government agencies to address sexual violence against children, particularly girls. Working with governments and civil society, Together for Girls is taking practical steps to tackle sexual violence against children. Current work is underway in Tanzania, Kenya, Swaziland, Zimbabwe, and Haiti with future work planned for Cambodia, Malawi, and Philippines.

PEPFAR supports significant work in the field to mainstream GBV into existing HIV programs. Over the last two years, PEPFAR has invested a total of $155 million in GBV-related programming, making PEPFAR one of the largest investors worldwide. In FY2011, PEPFAR supported post-exposure prophylaxis (PEP) to prevent HIV infection for survivors of sexual violence to almost 47,061 people, nearly 34% more than the year before. We commend UNAIDS for making zero tolerance for GBV part of their 2015 goals.

The second is the prevention of mother-to-child transmission of HIV, or PMTCT. Last year, PEPFAR delivered antiretroviral drugs for the prevention of mother-to-child transmission (PMTCT) to 660,000 women, averting over 200,000 infant infections. As part of President Obama's 2011 World AIDS Day targets, an additional 1.5 million pregnant women will be reached with antiretroviral drugs to prevent mother-to-child transmission of HIV by 2013.

Through the PMTCT Acceleration Initiative, PEPFAR is scaling up its PMTCT efforts in the highest burden countries and together with UNAIDS is co-chairing the Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping Their Mothers Alive. Significant progress in the virtual elimination of new pediatric HIV infections has been achieved as programs are scaled up and more efficacious drug regimens are rolled out. Twenty-two high burden counties signed on to the Global Plan, committing to work towards virtual elimination of MTCT of HIV and a 50% reduction in AIDS-related maternal mortality by 2015.

Finally, we believe that getting to zero in Africa is not possible without effective prevention—particularly for girls and young women. Encouraging scientific advances have created an exciting moment for global AIDS, with an opportunity to use existing tools to push the rate of new infections downward dramatically. In each country, PEPFAR is prioritizing combinations of activities based on sound scientific evidence that will have the maximum impact on reducing new HIV infections and saving lives. In addition to the interventions already mentioned, these also include treatment as prevention, HIV testing and counseling, condoms, voluntary medical male circumcision, and prevention for key populations-including women living with HIV and those engaged in sex work. Female controlled technologies are an important part of combination prevention efforts. Therefore, we have invested significantly in new possibilities for such technologies, including over $90 million in microbicides research last year. PEPFAR is also one of the largest global procurers of female condoms.

The United States will continue to work together with all of you, partner governments, multilateral organizations, civil society, people living with HIV and other vulnerable populations in order to effectively accelerate action for women and girls' empowerment and gender equality across Africa. We are with you at this pivotal moment in history, and very much looking forward to the Harare Call to Action and its implementation plan.

In closing, we wish to express particular gratitude and admiration for the many courageous leaders who are present here today, and who have prioritized the health of their citizens and have taken a stand against gender inequality in their countries.

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