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Notes for Press Briefing by Stephen Lewis, UN Secretary-General’s Special Envoy for HIV/AIDS in Africa,
on his February 2006 visit to Lesotho and Swaziland United Nations

17 March 2006

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Lewis comments on trip to Lesotho and Swaziland with special attention to women and girls; continues criticism of composition of High Level Panel; continues to call for international women's agency

I've been doing these media briefings, after every trip to Africa, for almost five years. They all tend to follow the same pattern: a narrative of what I've observed, a critical analysis of the issues that have been raised and my thoughts on what should then be done.

On this occasion, I'm going to break the pattern. Last month, I visited the Kingdoms of Lesotho and Swaziland from February 8th to the 15th. I intend to provide a cursory overview of the main findings, but save particular focus for women and orphans. Then I shall attempt to tie that focus directly to the current preoccupation with UN reform. In so doing, I shall not be charitable.

In the case of both Lesotho and Swaziland, the virus has the countries by their throats and they are gasping for survival. In Lesotho, the Demographic Health Survey of 2005 showed a prevalence rate of 25%. Swaziland continues to have the highest prevalence rate in the world at 42.6%. In its recent antenatal survey of pregnant women between the ages of 25 and 29, the prevalence rate was 56.3%. That's the highest prevalence I have ever seen registered in any age group anywhere. The mind fractures at the thought of it.

Both countries are making frenzied efforts to provide anti-retroviral treatment. In the case of Swaziland, remarkably, they slightly exceeded their 'three by five' target for the end of 2005. In the case of Lesotho, lamentably, they came nowhere near the target. In both countries, there is a fatal paucity of human resource capacity. In both countries, there is a desperate shortage of health professionals. In both countries, many of the professionals they do have end up in western nations, or in other countries in the sub-region such as South Africa. Both Lesotho and Swaziland are attempting to create new professional or semi-professional career lines to compensate for what's been lost. And in both countries, the emphasis on training commands an almost supernatural zeal, intensity and commitment.

In both Lesotho and Swaziland, there are special features of note. In Lesotho, the country has embarked on an undertaking unique in Africa: the government intends to offer HIV counseling and testing to every household in the land by the end of 2007 in what is called the "Know Your Status" campaign. To that end, seven thousand people are being trained to fan out across the country to implement the campaign in what is surely one of the most ambitious initiatives on the continent. Lesotho knows it is fighting for survival: words like extinction and annihilation are commonplace. The "Know Your Status" campaign is meant, unflinchingly, to confront the unthinkable. Fortunately, Lesotho has one of the most gifted and committed political cabinets in all of Southern Africa. If the country can be saved, they will save it.

In Swaziland, there is now enshrined, just last month, after years of debate, a new constitution. It confers many rights on the citizenry, amongst them the right to free primary education, a subject of immense controversy in the past. Free primary education will usher in a new era for the children of the country. Equally significant is the widespread discussion, at every level, of the meaning of "volunteerism". Swaziland, more than any other country I've encountered, is engaged in an intense debate around compensation, both direct and indirect, for the caregivers who labour valiantly to sustain communities, families and individuals in the face of the pandemic.

Moreover, Swaziland has one of the most impressive National AIDS Councils in all of Africa. If it was able to do its work unimpeded by funds, capacity and politics, Swaziland might just be able to make a miraculous recovery. At this point, the obstacles remain formidable.

Finally I must, I think, mention the King of Swaziland, who obviously exerts huge power over the country, and has been criticized by many, myself included, for his apparent failure to rally the country against the depredations of the virus. On this visit, I had a private one-on-one meeting with the King, and while I don't feel at liberty to divulge the content of a confidential conversation, I can say that we discussed, directly and openly, every controversial subject with which the King has been associated. I hope something comes of it. The United Nations family, and the Resident Coordinator in particular, stand ready to follow-up. This is of immense value because the UN is well-respected within the ranks of governmental officialdom in Swaziland.

But for the primary purpose of this press briefing, I want to turn to the situation of women and children in both countries.

In Lesotho, the government has still not passed the "Married Persons Equality Bill" which is intended to enshrine equality between men and women in marriage. It has been debated for a number of years, and is yet to be embraced by parliament. Predictably, under customary law, women are regarded as minors; married women are under the guardianship of their husbands and unmarried women are under the guardianship of their fathers, brothers or even sons. This circumstance is both untenable and intolerable. But it speaks directly to the prevailing gender inequality.

I was talking just this morning with Dr. Jim Kim of the World Health Organization, who spearheaded the "three by five" treatment campaign. He's just returned from Lesotho, carrying a remarkable piece of data: incredibly enough, the HIV prevalence rate for young girls, fifteen to seventeen years of age, stands at roughly 30 per cent. This is obviously a disaster for the country, but it reconfirms, yet gain, the wildly disproportionate vulnerability of women and girls.

In the case of Swaziland, I've already noted the terrifying HIV prevalence rate of 56.3 per cent for pregnant women 25 to 29 years of age. The meaning of gender inequality could not be more starkly expressed. The new constitution, to which I earlier referred, enshrines equality between men and women, but in a country where women are still shackled to the status of minors, that constitutional equality will mean nothing unless it is concretely embodied in legislation. That will be a gargantuan uphill struggle.

In both countries, the deluge of orphans is overwhelming. Lesotho is only now beginning to confront the numbers, and hardly knows where to begin. Swaziland is faced with the apparent inevitability that between ten and fifteen per cent of its entire population will consist of orphans by the year 2010. While I was in the country, I encountered a primary school of 350 students, 250 of whom were orphans … 70 per cent of the total. How in the world is the educational system expected to cope? How in the world is the community expected to cope? UNICEF and the World Food Programme and the government are making earnest efforts, but it does resemble Canute standing on the shore turning back the tides.

So who comes to the rescue? As everywhere else in Africa, it's the grandmothers. But the grandmothers only survive for so long, and they manifest, yet again, the excruciating reality of gender inequality.

What we're fundamentally dealing with, then, is a legacy of inequality which drives the virus and leads to the devastation of the women and girls of the continent. The legacy is an omnibus catalogue of women's vulnerability: rape and sexual violence, including marital rape; domestic violence; no sexual autonomy; early marriage of girls to older men; forced marriage; harmful traditional practices, including wife inheritance, widow cleansing, polygamy and female genital mutilation; maternal mortality rates as high as they've ever been; sugar Daddies; illiteracy; lack of educational access (the MDG on gender parity in primary schools has already been missed); designation as legal minors; lack of economic and earning power; lack of rights to own and inherit land or property; lack of representation in parliaments and other elected and appointed bodies … the litany never ends.

And that brings me to the central point of this press briefing. It is my contention --- as it has ever been my contention and ever will be my contention --- that if there was a powerful international force for women, we would not be in this galling predicament. If there were equality among agencies, if there was an international agency for women, not only would the women of Lesotho and Swaziland now be far better off, but we could at this point mount an unbridled campaign to demand that gender equality be legislated and enforced in those two countries.

What has to be understood --- and seems never to be understood --- is that we're fundamentally talking about saving millions of lives.

On three separate occasions in the relatively recent past --- commencing at the University of Pennsylvania, later elaborated upon at Harvard, and re-asserted on International Women's Day less than two weeks ago --- I have argued the need for a new, dominant, strongly-resourced and strongly-staffed multilateral women's agency. This is not a piker's proposition: I mean an agency for women on the scale of UNICEF.

To be sure, there is a natural aversion to creating new multilateral entities, with new multilateral bureaucracies. That's understandable. But this is a singular need in the modern world: there is no item more urgent on the international development agenda. What has happened to women is such a gross and palpable violation of human rights that the funding must be found, whether from Official Development Assistance or new 'innovative financing,' or a combination of both. We must right the wrong.

I have argued, and it is an argument shared by many others in the women's movement, that what we now have in place --- whether it's UNFPA or UNIFEM or the Division for the Advancement of Women --- cannot do the job that needs to be done. This is not to disparage their good work; this is only to say that it has to be combined and then enhanced a hundred-fold.

A powerful women's agency was never more urgently needed within the United Nations than it is at this historical moment. The HIV/AIDS pandemic is the litmus. It is impossible to traverse the continent of Africa, it is impossible to visit countries like Lesotho and Swaziland, without an enveloping sense of horror and despair at the carnage amongst women. And in very large part, this carnage took root and has been allowed to rage because the voice of women is the voice that is still not heard.

You will forgive me, but I have to say that the United Nations doesn't seem to understand this truth. And there is dramatic evidence of that. We have just had appointed, for the specific purpose of UN reform, a high-level panel of fifteen people to rework the landscape of development, humanitarian assistance and environment within the United Nations. Development and humanitarian assistance? What job description could have more to do with the lives of women, that is to say, with the lives of more than half the world's population?

Yet, of the fifteen members of the panel, when the appointments were made, only three were women. BUT HEAR THIS: one of the women on the panel has now been replaced by a man, so the ratio is now thirteen to two! And as if that weren't sufficiently preposterous, the two members of the secretariat, thus far appointed to work for the panel are both men. So the ratio between men and women appointed so far to this crucial task is now fifteen to two. What in the world is going on? Tragically, nothing new. Nothing that would hint that the gender equity and equality promulgated in all the declarations that emerge from international conferences, and in the Millennium Development Goals for 2015, are to be taken seriously.

We've just emerged from the 2006 session of the Commission on the Status of Women where the central theme was the need for absolute equality of men and women on all decision-making bodies. It was a theme vigorously endorsed by the Secretary-General and the then Deputy Secretary-General, and by every senior member of the secretariat. I would respectfully suggest that there isn't a legal scholar in this world, no matter how versed in the arcane minutiae of contracts, who could find a way of reconciling the promises with the performance.

At this point, since the panel is obviously in place, the only thing that can be done is to tip the ratio by expanding the panel's membership, and to have absolute transparency in its proceedings. Everything must be open to monitoring by women's groups, which are struggling so valiantly to achieve the Millennium Development Goals, including the one specifically aimed at gender equality and the empowerment of women by 2015. More, the panel must be open for submissions from women's groups. If the panel is not prepared, in the spirit of UN reform, to make dramatic changes to the way women are addressed within multilateralism, then the panel must be required to explain on what basis it determined that the present arrangements serve the needs and rights of women everywhere. The panel must be required to explain how the pandemic of AIDS, the escalating violence against women, the contagion of conflict and rape, the absence of empowerment, the lack of legislation on equality … the panel must be required to explain how the present international circumstance serves the interests and upholds the human rights of the women of the world.

Why do I go on in this fashion? Because I'm frantic. Things are changing on the ground so incrementally --- Lesotho and Swaziland are but symbols for the greater whole --- that we're losing millions of young women in Africa. In the process, we're creating a generation of orphans whose lives are lives of torment.

How will we ever explain what we have wrought? What a universe this is. We came out of the Holocaust asking ourselves how we could ever live with the recognition that much of the world knew what was in those trains rumbling down the tracks to Auschwitz. We came out of Rwanda asking ourselves how it was possible that the world was inert in the face of a hideous genocide that everyone knew was taking place. It is my contention that years from now, historians will ask how it was possible that the world allowed AIDS to throttle and eviscerate a continent, and overwhelmingly the women of that continent, and watch the tragedy unfold, in real time, while we toyed with the game of reform.

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