HELEN GAYLE, MD: - the International AIDS Society and co-chair of this International AIDS Conference and it’s with great pleasure that I am here to welcome and open this meeting. We really thought that this was an incredibly important opportunity to bring together leaders of all different types – leaders in the political realm, the community realm, leaders representing people living with HIV/AIDS, the religious and faith community and other members of civil society, governments, and leaderships at the highest level - in many ways and to focus the attention on the plight and the issues related to women and girls, we thought was extremely important as we continue to face the challenges that are represented as we look at what will it take to make a difference for young women and girls around the world in this epidemic who are increasingly affected.

So it’s my pleasure to begin by introducing Josee Verber, who was elected as a member of Parliament in 2006 of January from the region of San Luis Laurent [misspelled?]. On February 6, 2006, she was appointed as the minister of International Cooperation and minister for LaFranca Forneis [misspelled?] and official languages in Prime Minister Harper’s cabinet. Ms. Verner is deeply involved in her community and has spent a significant amount of time fund-raising for the Children’s Make a Wish Foundation and has a deep commitment to these issues. She is married and has three children and we’re very pleased to have her with us today to give us some welcoming comments on behalf of the government of Canada.

JOSEE VERNER: Ladies and gentlemen, it’s a great pleasure for me to be here today. I am pleased that Canada is hosting this important conference.

[IN FRENCH – 2:28 to 2:50]

Canada has gained an international reputation for advancing gender equality issues. Gender inequalities fuel the epidemic, the rates among women are rising more quickly than among men. Canada strongly supports the promotion and protection of gender equality and of human rights including sexual and reproductive rights. These elements are key to any effective initiative to fight HIV/AIDS.

As you know, women are at higher risk than men of getting HIV-infected and increasing in infection rates. Excuse me. Infection rates among them demonstrate how vulnerable they are. This further highlights the inequalities between women and men and between girls and boys. Generally speaking, women and girls do not benefit from the same control over their lifestyle choices, especially over decisions regarding their sex life and the use of preventive measures. Because of their precarious situation, women and girls do not have the liberty to insist for safe sexual practices nor can they refuse sexual relations. Education is key.

[IN FRENCH – 4:18 to 4:50].

All individuals have the right to complete and accurate information on how to prevent HIV infection. This is of particular importance to women as they face double discrimination when they are HIV-positive. More than just an objective, Canada is determined to put a stop on the HIV/AIDS pandemic and is committed to promoting gender equality. Those are two important objectives of our development assistance program, but achieving gender equality and fighting HIV/AIDS are far more than objectives. They are fundamental prerequisites and very closely linked. If we fail to address the gender equality issue and to stop the spreading of HIV/AIDS, there is very little hope for improvement in other development areas.

[IN FRENCH – 5:58 to 6:25]

In closing, I would like to invite you, on behalf of Canada’s Ministry of Health, the Honorable Tony Clement and the International AIDS Society, to a reception immediately following this session. Minister Clement would like to take this opportunity to welcome you to Canada and to the conference as well as discuss with you the importance of health systems in the response of HIV/AIDS. Thank you.

[APPLAUSE]

HELEN GAYLE, MD: Thank you very much, and I would be remiss in not mentioning how grateful we are to the government and the people of Canada for hosting this conference this year. We really appreciate the hospitality and all the support, financial and otherwise, that went into helping to support the conference, this session, and so many other things. So we really do thank you for all the support you’ve given us.

I’d now like to open – turn it over to Dr. Peter Piot, who is going to give us a keynote message for this session. And as most people probably know, Professor Piot is the executive director of UNAIDS. He was appointed the executive director of the Joint United Nations Program on HIV/AIDS, and assistant secretary-general of the United Nations in 1994. Dr. Piot joined UNAIDS from a position as associate director of the Global Program on AIDS of the World Health Organization. He’s an old friend of IAS, as he served as the president of the International AIDS Society from 1991 and 1994, and is a longterm friend and colleague. So without further ado, turn it over to Peter Piot.

DR. PETER PIOT: Thank you Helen, and good morning or good afternoon, everybody - your Royal Highness, Excellencies, ladies and gentlemen, dear friends. This pre-conference is really a wonderful initiative and I hope that the conference in Toronto will be billed as the women’s conference when it comes to AIDS reflecting what is actually happening with the epidemic all over the world. So it’s really a fitting way to start off the week’s deliberations with this special session and I hope it will produce some clear, action-oriented solutions that will make a real difference for women and girls because we’ve got to go beyond the rhetoric saying and fill another volume of Congress proceedings and saying that women are discriminated and that women are also an equal and fatally an equal in the face of AIDS.

This conference comes at the time of great opportunity and hope in the global response to AIDS and I think that is how we should look at the conference. Why am I saying that? In the first place, because we finally, 25 years in this epidemic – so not too late, not too soon – we finally are starting to see results. In May, UNAIDS gave out its traditional report on the global epidemic and, for the first time since I’m in this job, we could point to results on the ground – for people on the ground. By that, I mean less people becoming infected, particularly in some of the Eastern African countries, some of the Caribbean countries, some countries or big states in Asia.

And secondly, far more people than ever before in developing countries are benefiting from antiretroviral therapy. About 1 and a half million, at the moment, coming from basically only a few hundreds of thousands at the time of the conference in Bangkok, two years ago when you take that as a reference. It doesn’t mean that we can cry victory. I would never use the term “success story,” even for any of these. There are no success stories in AIDS yet but there are results and there is, to use the term, return on the investment, thanks to a formidable, a political commitment, and momentum, which has also generated significant funding last year about 8.3 billion dollars. So this is the good news.

The bad news, of course, is also there. By any definition, AIDS continues to be an emergency, a crisis with so many dying every day, so many becoming infected and the level of denial that is still there and the lack of leadership that we still find is just beyond any human comprehension or any rational comprehension – maybe human comprehension. So I would say that there’s been more progress in the past four or five years than in the previous 20 years in the fight against AIDS.

But the question is now does it also - all this for women – does this work for women? What is the relationship between women and AIDS in terms of these positive results? And I won’t bore you with statistics. You’ll be overwhelmed by them, the last – or the next several days but just two things – one is that what started and was described 25 years ago as, in a report of five gay men with a mysterious pneumonia has become now the world’s leading cause of death among both men and women, leading cause of death under the age of 60. I mean, that’s unprecedented, something that didn’t even exist 25 years ago – well, it existed but it was not known - has become the leading cause of death for men and women. And secondly, what we are seeing is an increasing feminization of the epidemic everywhere. I could say that Africa is in the lead in this macabre gender equality exercise that was 60-percent of all people living with HIV are women. But in every single region in the world, the proportion of women among those living with HIV is on the increase everywhere and particularly, among young women.

And it’s fair to say that the response to AIDS is still very far from women’s needs. And there are, I could again give you many statistics underscoring the deadly and massive gap in terms of the AIDS response meeting women’s needs. The most striking for me actually is the one where you look at HIV infection rates among young women – teenage women, women under 25, here in some countries, in some communities, as many as eight to 10 times more women, girls of that age group, are infected than boys and young men of that age group. That doesn’t happen by coincidence. That is not a result of biology, a little bit, but that is the result that reflects the power relations and particularly the sexual power relations in society. And as long as we don’t address these power relations, as long as we don’t address the drivers of this epidemic, I think we have no chance of bringing this epidemic under control And that’s, for many people, a very unpleasant message and an unpleasant reality but we have to bring it over and over again.

So why is the AIDS response still failing women? I could give you probably a list of 50 reasons and I’ll give you just a few because I believe it’s essential to understand this clearly if we are to have effective strategies for improving the response to women. One, I would say, the AIDS response in most countries is still not taken full account of the extent to which gender inequality and the low status of women are driving the epidemic. That is not recognized or it is in a preamble or in some footnote but particularly, when it comes to the budgets, it’s not in there. So in other words, it’s not taken seriously. So, that has to change and it has to be funded fully to the same extent as distributing condoms and providing antiretrovirals.

And similarly, the AIDS response has not taken account of the needs of especially vulnerable groups such as sex workers, migrants, and so on, which also are affecting women disproportionately.

Secondly, because we live in a world where girls are married off as children in many countries or are otherwise forced into sexual relationships and we know in many countries, to use the language of an epidemiologist, marriage is the greatest risk factor for being infected with HIV for a young woman. There are actually more infected with HIV than young women who are not married. That’s not the case everywhere, but it’s the case in some countries because of this – the fact that marriage is with older men who have already been infected and where there is a forced sexual relationship.

Thirdly, women and girls still have less access to education in general and particularly to knowledge about HIV and that is directly related to the vulnerability to HIV infection. Four, because we still have not gone far enough beyond ABC as the guiding model for HIV prevention not that there’s something – that there’s anything wrong with the ABC – abstinence, being faithful, and using a condom. But when you think of these three letters, none of these are under women’s control primarily. And if every woman and man could choose and did choose to follow these three principles, of course, we could stop AIDS. But the truth is that most women cannot choose any one of the three.

Fifth reason that I see is that because microbicides are still not available because there is insufficient funding we’ve made big, big progress and I see [INAUDIBLE] from my PM here but we need a doubling for the funding for AIDS so that the development of a microbicide can be accelerated. Because that’s a very realistic target and it would mean a revolution, a revolution in heterosexual transmission in the world, if that becomes available at a price that’s available and even female condoms are not universally available.

And finally, I would say that AIDS policies and programs are designed without the inclusion of women, and that’s the same story – I was at the Youth Forum this morning and it’s the same story for young people. Programs are designed for them but programs forget one detail and that is that no program will work if the people who are concerned are not consulted and are not involved in it. I would say here also, as a man, that too little has been done on the ground to encourage men and boys to embrace gender equal norms and behaviors because’ let’s face it also, this epidemic is driven by male behavior. Whether it is sexual transmission or for injecting drug use, it is male behavior that is driving it and so we should be very careful when we translate an analysis of the feminization of the epidemic in what the action is. Part of the action should be that men and boys adopt responsible sexual behavior that is gender-sensitive.

That’s why, for all these reasons, that the Global Coalition on Women and AIDS was launched a couple of years ago and that earlier this year, it launched its agenda for action. It’s something that we are fully supporting at UNAIDS and it’s good to see so many members of the Coalition’s leadership council here in this room today. But what’s even more important, I believe, is that there is more and more action on the ground in countries.

For those of you who are not familiar with the agenda, this agenda calls on national governments and the international community to do three things. One, secure women’s rights. Two, invest more money in AIDS programs that work for women. And three, increase women’s’ participation in decision-making process. And we believe that action in each of these areas is vital and particularly if UN member states, governments are to keep the promises that they made at the end of this year’s high level meeting on AIDS in the general assembly.

Let me remind you what some of these pledges were and I should underline that whereas the document is disappointing in certain areas, particularly for so-called vulnerable populations, it is a very strong document when it comes to women’s rights, to gender, and I think we should use it. It goes further than any other agreed document in the UN system when it comes to gender and women’s rights. It says, for example, okay, there are wonderful things that are being promised – eliminate gender inequalities, ensuring that women can exercise their right to have control over [INAUDIBLE] sexuality. I’m not going to read all this but eliminate all types of sexual exploitation, eliminate all forms of violence against women and girls, and so on. So far so good, but the challenge is to sustain the political commitment and make all this happen. It’s like constitutions in a country. They’re usually wonderful documents but it’s the enforcement of the law that matters and that’s, in many countries, so – so dramatic. They’re not done when it comes, for example, to sexual violence against women and including within marriage.

All this will require consistently strong and, I would say, more daring leadership at every level of society and certainly at the top, and it’s time that the women’s movement is getting engaged in AIDS. It’s one of the big disappointments in my work because it’s not the case. Mainstream women’s movement where it still exists is not engaged in it and this leadership must be sustained not for a year or two but for the next 25 years or more.

So I look to all of you to provide this, to lead the way to its concrete action that makes all those pledges a reality and not just more conference [INAUDIBLE] and coming to this conference – coming back – I would say that the agenda here is really, as I said, a long-term, sustainable response to AIDS the next 25 years and to keep the political momentum up in an exceptional way. If we drop the exceptionality of AIDS, funding for treatment of people living with HIV is going to disappear. Funding for microbicide development is going to go down. Harm reduction, sex education in schools – it will all collapse. The Global Fund will not get support anymore that it needs more and more.

We also need to make sure that we address the drivers of this epidemic and again, here is what the women’s agenda is important and I would say for the future and for today, we are – we have two legs to walk on – one is science and technology grounded in that. The other one is social change and if we don’t have both legs, we will not be able to make progress. So the last thing I would like to say is that we should push everybody dealing with AIDS and ask all of us that question – does this work for women? Thank you.

[APPLAUSE]

MALE SPEAKER: I thank Peter Piot for his keynote address, which has given us a direction for this special session for this high-level session on leadership, Time to Deliver for Women and Girls. It will be our task now to focus on that as we move through the program this afternoon. Following Peter Piot, we would have had two comments or statements. The first lady of Rwanda, Madame Kagame, was not able to make it due to the air traffic problems we’ve had, but we are the more pleased to have the first lady of Honduras with us and it’s my pleasure to introduce to you Madame Iris [misspelled?] Xomara Costa [misspelled?] de Zelaya [misspelled?]. She was born in Tegris [misspelled?] [INAUDIBLE]. She is the second child of five children, born to Mrs. Olga Seirmento [misspelled?] Montaya and Mr. Eran [misspelled?] Costa Reyes [misspelled?]. She attended Catholic schools during her childhood and married Jose Manuel [INAUDIBLE] Rosales in January 1976. They have four children. Her further education includes accountability and business administration.

She has accompanied her husband on various political activities focusing on social areas and we are very pleased that you are with us today and that you are willing to share your thoughts and your commitment with us. Madame.

XOMARA DE ZELAYA: Mucho gracias. Muy buenos tardes. [IN SPANISH – 25:00 to 30:30].

[APPLAUSE]

MALE SPEAKER: We want to thank the first lady of Honduras for her statement, which also shows the direction for our discussion. She has been pointing to some very vital issues that we need to develop further in our discussion. Now, I have a message, which may disappoint some. It should – there should not be a coffee break now. Somehow, in the preparation for the conference, that was in at some time but I was surprised to see it in the conference, which has been – in the program, which perhaps, has been distributed. But if you need coffee from now on and you have someone to assist you, you could have that person go out and get the coffee, which is ready outside or even leave for a moment but not too long to bring your coffee in. We’ll be very liberal about that.

I think we all our eager to continue now and to get into the discussion and it is my great pleasure to introduce the two co-chairs who will lead us through the next part of the program, both of whom are very committed leaders in their own capacity and in their own context to the struggle to stop the epidemic. And we are very pleased that they have accepted to have this role this afternoon. I introduce to you Heidemarie Wiieczorek-Zeul, minister of Economic Cooperation and Development – Germany, and professor Sheila Tllou, minister for Health, Botswana, and these two ladies will guide us through the next session, please.

HEIDEMARIE WIIECZOREK-ZEUL: Thank you. I’m happy to be with you and in the spirit of making this a discussion and not reading, you know, I decided that the text that I have prepared, I will distribute so everyone can read whatever he or she is interested in and perhaps, that is an example also to others. It’s best that we react to each other.

I want to just, at the beginning, to say I’m happy to be here with you. We are dedicated to the topics that we have been discussing and I have taken what Peter Piot said as a kind of challenge. It’s indeed true that the women’s movement have to take the question of fight against HIV/AIDS up and wherever we are, it be we’re in government or in non-governmental organizations or other initiatives, I think we have to take this as the fight, which will last over our lifetime and the sustainability is the point that has been clearly marked. And I think also congratulating you and commending you that are here because if you take other fora, sometimes, I belong to the development committee of the World Bank. I sometimes would be happy to have more women around who can indeed take positions and influence decisions.

Those will be points that we’re certainly going to discuss, but I’ve – lastly just for the first part, say Peter Piot has also, in a way, given – said – or those who have given promises should fulfill. I could say that we, as German government, will raise the funds for fighting HIV/AIDS from so far $300 million Euros to $400 million Euros for the next years per year and we show that we are willing to stay and to be sustainable in the fight against HIV/AIDS because the numbers are so shocking and specifically the numbers related to women.

That was what I just wanted to say at the beginning and then could – if you allow me, we ought to say some words on the procedure that we will have to follow for the question of the time management. The maximum time per participant should be three minutes in the debate afterwards and in the discussion and we would have the first speaker. That is Yolanda Simon – she’s regional coordinator for the Caribbean Regional Network of People Living with HIV/AIDS. And then we would have lead speakers on the five key issues that we have in the questions who will take the floor. And then afterwards, the debate is open for everyone to participate

And you will find, in some minutes before you also, a possible proposal for a call for action which, of course, would not be a consensus document but might, in the end, become the call of action and the conclusions of the co-chairs that we have discussed so far. But what is important is that during this discussion, there should be very concrete points, which could be included in such conclusions because we are here to become very concrete to implement. And once there are concrete proposals, they would be included in the conclusions of the cochairs. That, having been said, I think all the technicalities have been dealt with and could I then call – sorry yes, sorry – could I give the floor to the co-chair and afterwards, then, to Yolanda Simon.

SHEILA TLLOU: Thank you very much. Yolanda will speak – actually it is Louise [misspelled?] Binder since Yolanda is not there but I just wanted to also let you hear my voice as the co-chair. I’ll take [misspelled?] one later but I must say that I have been agenda activist more than I have been minister of health, and having participated in the UN conference, the fourth one in Beijing - this is like 21 years ago - and I must say that I have participated in the commissions on the status of women and so many years after [INAUDIBLE], women are still vulnerable to HIV and AIDS mainly because when we talk poverty, we talk discrimination. When we talk violence, the people at the receiving end are the women. I feel it is time to deliver.

On my own, I don’t know what’s going to come up but I feel the commissions are not enough. We’ve had too many that too disjointed that are under-resourced. [INAUDIBLE] is with me on this one. My lobby is for an international agency in the UN, well resourced in terms of human as well as financial, headed by an undersecretary general and whose main mandate will be to look at the human rights of women. I think that’s the only way we’re going to have governments move. I know I’ve been an activist. I’ve formed the Society for Women - AIDS in 1988 and we are still here today. We are talking the same thing and women are still increasingly disappearing. So that’s really my stance and I’m hoping a lot of people will join me in this one. Thank you.

HEIDEMARIE WIIECZOREK-ZEUL: And then could I then give the floor to Miss Binder, please?

LOUISE BINDER [misspelled?]: Thank you. Your Royal Highness, Your Excellencies, Ministers, and colleagues, thank you for the invitation to join in this session on women and girls.

First of all, I think the most important strategy that we need to employ if we’re going to make changes for women around the world is the strategy of visible leadership – national, international, and then every leader in every type of our community. So to that end, I hope that I’m going to see each and every one of you at the front of our march and rally tomorrow morning at 7 AM. I understand even CNN will be covering it so that the world can see visibly your leadership and your support for what will be a historic march. So that’s my first point. You could call it an unpaid advertisement.

The second point is that we require, in my view, country-wide strategies. Of course, international work needs to be done and I’ll speak a bit about that, but mostly what we truly, truly need are country-wide strategies. They can and they must be multistakeholder and they must have leaders from all important sectors, including political, medical, bureaucratic, religious, cultural, health care and, most importantly of all, women at the head of the table at those important strategic sessions.

And it is very important that we do not consider ourselves as women to be victims, vectors and vessels but leaders and you cannot force us to be empowered but you can create an environment where those of us who wish self empowerment can take self empowerment. This does not mean, by the way, the creation of strategies that mainstream women’s issues nor ghettoize women’s issues but, rather, they actually create integration, recognizing unique issues where they exist for women including gender inequality and socioeconomic status of women. They must be comprehensive strategies. They must be sustained strategies and well resourced.

Now, what do those strategies have to contain? They cannot just be siloed to HIV. They must, of course, be a comprehensive set of strategies related to HIV and, in each case, looking through the gender lens from prevention, care, treatment, and support, research, all the way through. But they must not be siloed and, in fact, must be contained within a broader health context of a particularly full reproductive rights and health for women, must be a part of those strategies. And they can also not be siloed from development issues, which are real gender inequality issues. So we must have education for women and if that means getting rid of school fees and other costs that get women into schools and keep them there, we must get rid of those. We must train our women. We must give them the opportunity for microfinance and other opportunities to be employed. We must ensure that they have housing because one of the other terrible pandemics in this world is the pandemic of violence against women. It stops women from getting out of situations, which would allow themselves to prevent HIV for themselves. And it also makes them frightened to take treatment, care, and support that would be available to them should they be HIV-positive.

We must ensure that every country has inheritance rights for women. We must ensure that every country has property rights for women. We must ensure that every country has laws against violence, that women are educated about their rights in all of these areas, including treatment, literacy, and that the judiciary and the police and all of these other areas as well must be educated to deal with women.

We must decriminalize the sex trade and we must have comprehensive harm reduction as part of these strategies, absolutely. We must have support for our caregivers as well, because so many women are, and my last point is this, and it’s to the donors, it’s the international point that I’d like to make – donors must absolutely remove the strings that they put on funding for people. Those strings are ropes around women’s necks and they are killing us. And you must give us the money and you must accept that these strategies that are country-wide and have all of the intelligent people in that country will know how to use that funding. And it must be used both for prevention and for treatment because neither is successful without the other and we must have a balance of both. Thank you.

HEIDEMARIE WIIECZOREK-ZEUL: I would like to call, as the lead speaker on the existing AIDS strategies, Horace Stely [misspelled?], minister of health from Jamaica. Is she around?

SHEILA TLLOU: It’s a he. He’s not around.

HEIDEMARIE WIIECZOREK-ZEUL: He’s not around. Then, I take it that we would have to call on Julio Frenk Mora, who is minister of health who would speak on the access to services – Minister of Health, Mexico.

JULIO FRENK MORA: Yes, thank you.

HEIDEMARIE WIIECZOREK-ZEUL: Just to tell – the thing, as you know, sometimes people have come who were supposed to come and some have not come and there is a change sometimes but we are happy to have you here and you have the floor.

JULIO FRENK MORA: Madame Chair – you want - The topic of access, I take it and I will be happy to do that, of Mexico. If my colleague from Jamaica has not arrived.

Her Royal Highness, Excellencies, colleagues, I would – in this very brief introduction to the topic of access to services, I would like to share some reflections on concrete experiences in my own country both in fighting HIV/AIDS and also in adopting a gender perspective into health policies and direct [misspelled?] from those some global lessons. The main point I would make in this introduction is that any comprehensive strategy to deal with HIV/AIDS must take into account the added challenges posed by gender inequities, and this is both in countries where the epidemic is rapidly becoming feminized and also in countries where it is still concentrated among men. This is so because the tendency for HIV/AIDS to disproportionately affect the socially marginalized becomes exacerbated in women and hence, the epidemic both reflects and magnifies gender inequities. A comprehensive approach to HIV/AIDS in [INAUDIBLE] must be based on three pillars as we have done in Mexico. First, prevention. Second, universal access to comprehensive quality care, including antiretroviral therapy. And third, the fight against discrimination and stigma and each of those pose special challenges in dealing with women.

On prevention, the main challenge is that many women other than commercial sex workers underestimate the risk of infection and demand detection services infrequently or too late only when they realize that their partner is infected or sick. For these reasons, a key strategy is to link prevention against HIV infection to health services that women demand with higher frequency, especially, although not exclusively, those related to reproductive and sexual health.

It is essential to take advantage of every contact with the health system to develop preventive actions against HIV/AIDS including information and opportunities for testing. Today in Mexico, we’re committed to offering rapid detection tests to every pregnant woman as a routine component to [INAUDIBLE] natal and delivery care. If tests are positive, then antiretroviral therapy is guaranteed.

Preventive and testing opportunities must also be offered to other ambulatory and hospital services for women such as family planning, cancer detection, et cetera. We are training health workers to assure that these opportunities are fully taken advantage of.

An additional challenge on the prevention side relates to gender roles that limit the participation of women in decisions concerning preventive measures such as condom use by the partner. This is worse in bisexual violence within or outside the relationship with a partner. To face such challenges, my country has implemented an action program called “Women and Health,” which includes interventions to empower women, and I will just emphasize two of them that have already been mentioned. The first is, of course, the promotion of methods to prevent sexually transmitted infections that can be controlled by women, such as the female condom. I think that a priority for national and international action must be to reduce economic and other barriers to access to these methods. Also, more research and development is needed to provide women with a wider array of alternatives in this regard, including microbicides, as was mentioned already by Dr. Piot.

The second, apart from this, the second key intervention refers to specific models for reducing violence against women through, as we’ve done in Mexico, through the training of personnel in the detection of signs of violence, treatment of physical and emotional sequelae, counseling, cooperation with civil society to establish shelters, and broad intersectorial policies dealing with education and justice, again, as we have just heard. I hope we will be discussing this topic in greater depth. And I particularly would like to point out that migrant women are especially vulnerable population and that the linkage between migration and AIDS is, I believe, a critical topic of our time that I hope again we will discuss during our roundtable.

So these are some of the challenges on the first pillar of prevention and access to treatment – the second pillar…[INAUDIBLE] a cultural or [INAUDIBLE]. Women are often discriminated in access to health services generally and, more specifically, to care for AIDS. Again, there’s evidence about discrimination in the level of quality and both personal and technical quality. One of the key elements here, and it’s the topic of this introduction, is to expand access to treatment. In Mexico, we have introduced an innovative universal insurance scheme for poor persons called Popular Health Insurance or Seguro Populare, that provides accelerated universal coverage to comprehensive treatment against AIDS including ART. And this illustrates what we’ve just heard about not siloing the fight or the treatment against AIDS, but rather resolving the traditional fight between vertical and horizontal approaches through the signing - diagonal approach in which specific priorities such as treatment against AIDS becomes the driving force to introduce overall improvements in the health system.

Finally, I would like to very briefly refer to the third pillar, fight against discrimination. Clearly, HIV/AIDS compounds other sources of discrimination against women and therefore, we need action based on a human rights perspective. In Mexico, we have worked closely with civil society organizations, both in dealing with HIV/AIDS and with gender equity. As a result, Congress has approved an increase of 14 times in the budget both for prevention, treatment, and fight against discrimination, has made a constitutional amendment and a specific law to prevent and combat discrimination with a special body charged with this mandate, which has been working with our national AIDS council in an extensive award-winning campaign to combat discrimination and stigma. Mutual reinforcement among the three pillars will be, in my opinion, the only way to face this crisis and in doing so, to improve the overall condition of women worldwide. Global cooperation is essential to improve this juncture of gender and health, which are two key dimensions of the search for equity in our common world. Thank you.

[APPLAUSE]

HEIDEMARIE WIIECZOREK-ZEUL: Thank you and on women’s rights, it would be Mary Robinson, who is present and who I give the floor to. Thank you.

MARY ROBINSON: Thank you very much and I actually – I’m very happy to follow the lead from this corner already and to say, yeah, yes, we need visible women’s leadership and visible leadership on the issues. And I was reflecting that we know what a human rights approach is and it’s part of the agenda of the UN Global Coalition on Women and AIDS and the agenda on Action for Women and AIDS, which we all have. It’s about women being there, being there in the planning, being at the decision-making. It’s about addressing all of the human rights issues that we know about. And what I was thinking is if we’re going to have a call to action from this group, then we need to build in systems of accountability, not just rhetoric anymore, but actually accountability of what women leaders will do when they’re in positions of power.

We’re trying to widen that circle – Mosimbi Kenyuro [misspelled?], myself, are bringing in business women to – because business women have power in their societies and as Peter Piot pointed out, a lot of the vulnerability particularly of young girls is about power relationships and so we have to address these power relationships. We have to have women’s voices linking with those who don’t have the same power. But we also need to do the practical agenda, the Beijing agenda, as was said, about women’s rights, about property and inheritance rights, about violence against women, about discrimination, about what happens when it’s discovered that a woman is positive, a mother is positive. She gets the blame and gets thrown out of her home. Who’s there to help her?

And I have learned an awful lot from the International Community of Women Living with AIDS, about how many barriers and how much discrimination they face and also how proactive they are as not so much victims as was said but change agents, activists for change, and seeing what very poor women will do in their communities when they have nobody else to help them fall back on themselves, in groups of three or five that become local communities, local networking and the way in which that can change the local circumstances so we need visibly to show. We do need to be country-centered and there needs to be accountability mechanisms.

One suggestion I would make, because I think it might help, is to encourage governments to be prepared to have some kind of an independent oversight of what they’re doing in this area. Are they taking a gender approach? Are they bringing in legislation to combat domestic violence and are they implementing that legislation? Are they changing the property laws, the inheritance laws? Are they empowering women? Have they women at the table?

And on funding, all of the funds need to look again at whether they are sufficiently putting gender at the center. In other words, I like the tone that has been set from the chair, from the co-chairs of this meeting. We want to be practical. We want accountability. We know what will make a difference. Can we, in our call to action, maybe make a checklist of what governments should be adhering to, what donors should be adhering to, what civil societies should be putting at the – prioritizing in their agenda particularly, the women’s movement, and hold everybody accountable? That, I think, would reinforce the human rights dimension. We know that we will not combat this huge pandemic unless we take a rights approach. We know practically what that means. We need more accountability. Thank you.

HEIDEMARIE WIIECZOREK-ZEUL: I’d like to call on Elena Selgado, who’s minister of health from Spain. There she is. Please, on the question of participation.

ELENA SELGADO: Thank you very much. Buenos tardes.

[IN SPANISH – 57:54 to 1:04:14].

HEIDEMARIE WIIECZOREK-ZEUL: Next speaker is Mosimbe Kenyuro [misspelled?] who is general secretary of World Way – YWCA.

MOSIMBE KENYURO [misspelled?]: Thank you. Your Highness, your Excellencies, ladies and gentlemen. For the last 25 years, we have realized that there’s no single player who can be – who alone can make achievement in regards to HIV. We have realized that the only way we can succeed is to walk together and therefore today, I want to speak about participation. But I want to say that if we want to talk about participation of women, if we want to bring women to the table, then we also need to change the table rules.

We need to have different table manners and one of the table manners that we need to change immediately is to stop talking about women as if women were objects doing nothing and just suffering, because women are doing a lot of things. And therefore, I wanted to encourage the fast change of the table manners by telling you some of the important things that women are doing all over the world in regards to HIV.

We all know and have heard over and over, in this country made popular by Steven Louis, about the work of the grandmothers, all over the world in their caring for people that are ill, for the orphans and for the children. These are women and they are doing something. I know that the only organization that is documenting the lives of women in Africa and I dare list Africa up because it is one of the continents where it is talked about in terms of the deficit all over and yet. I know that when I look at that continent, which is also my continent, if someone who does not live on that continent is given just one day to use that day and do what the women of Africa do, I don’t think that you will survive. Women are doing something and on that continent, the only organization that is documenting the lives of women affected by war, by poverty, [INAUDIBLE] situated in Uganda and there we can find many records of what is happening to women. They are doing something.

What I want to say on participation, I see three areas that are important when you invite people to participate. First, you must realize that the people will change the nature of that table. If women come to the table, then the table will have to look different - not just by how they look, but how they think and what they bring to that table. Women are going to ask different questions from the questions that have been asked on that table. Women are going to be concerned, for example, that we don’t leave children away, that we make sure that the mothers are kept alive when we are talking about HIV, that we make sure that everyone is fed on the table - not just the women and the children, but the whole family, because women are caretakers.

Women are also going to say we have to put implementation to the words that we make. Every one of us, whatever we are, has some budgets and we can’t talk about lack of money for women if we don’t make our own budgets stick for women. An example is that when we decided, in my own organization – the YWCA, that we should use 60-percent of all our money to support what women are doing in HIV and AIDS, we have reason to [misspelled?] the work in 73 countries for HIV and AIDS, covering every part of this continent but because we made a decision that we shall back up and support those people that are working on HIV/AIDS financially and look for resources to support them.

Another small example that I would like to use for participation where we can really be able to implement is that we have other properties. We have buildings. We have churches. We have mosques. We have different things. We have synagogues. These buildings stay unused when women cannot have a place to have meetings. In the YWCA, for example, we said everywhere where we have a building, if positive women are asking for a place to meet, they will have that place free and have a meeting there. It is a resource and this is one way of participation of encouraging people to have a way of participating and yesterday, in this country, in Canada, positive women met at the Toronto YWCA because they knew that that is their place. And we can make the resources be able to do a lot more for us by using the kind of resources that we have on the ground.

And the third one that I want to use that we have found very useful is investing in young people. The future of our work depends on young people. How many young people on this table invited specifically to come and stick for themselves? When I look around, we are not very young, including myself. In the YWCA, we believe in young people. So we make policies and say we shall not meet unless we have a reasonable percentage of young people. No meeting will take place with less than 25-percent of young people and no board will be set up, internationally, with less than 50-percent of young people. These policies [APPLAUSE] ensure, for us that participation will continue.

And finally, we must teach our own communities that we work with how to work with deeper, greater involvement with people living with AIDS or people living with HIV. This does not come naturally. We have to be able to teach it to enable mistakes to be made and those mistakes corrected. But we can only do so if we show by example that every government seat, every church, every particular form of leadership – they are in that group – people who are living with HIV and they, themselves, are doing the education that is needed in our place. That is what participation is about. It’s about making ourselves accountable even before we have tools for accountability. And it is this kind of participation that I have found, as a leader, one of the leaders in the global coalition of women, that we can be able to talk of participation that helps women to participate because their human rights have been respected, to participate because there are resources that back up their work, to participate because there’s a place at the table and on that table, there are good manners on the table. Thank you.

[APPLAUSE]

HEIDEMARIE WIIECZOREK-ZEUL: Last speaker in this round of introduction is Noleen Heyzer from UNIFEM.

NOLEEN HEYZER: Thank you very much, Madame Chair. Your Royal Highness and members of the round table, it has been 25 years since you have been dealing with this pandemic and 30 years that women have put the issue of gender equality and women’s human rights on the table. We can celebrate progress, celebrate progress in terms of their winners that we have, in terms of some of the policies that we have changed, in terms of some of the laws that we have changed.

But this progress is far too slow. It is too slow when we still have data that says that women, and especially young girls, young women between the age of 16 to 24, gets infected six times more than boys in some parts of Africa and in some parts of the world. This is not accepted. It is too slow when grandmothers still have to take care of orphans and when the number of orphans have grown from 12 million to 15 million just from two years ago. It is too slow when many widows are still pushed out of their land and out of their property because they are stigmatized, when positive women and women who are affected do not have the space of shaping the policies that affect their lives and their strategies are not invested in.

Now, what are some of the things that we can do to accelerate change? Because we cannot wait for another 25 years. What needs to be put in place? I have six suggestions coming from our engagement with women. As many of you have heard, it’s time to end violence against women, not just in situations of war when rape is used as a weapon of war and women do not have any way of getting out of that cycle, but in times of peace because what we accept in times of peace indicates what we will accept in times of conflict. We have to end violence against women now and forever and I’m very happy to say that private sector is coming in to invest in this strategy with UNIFEM. And I just want to mention the support that we’ve been getting from Johnson & Johnson in the context of the Coalition of Women and AIDS.

Secondly, many countries can do this action, and this is to eliminate once and for all, all laws that discriminate against women. There is no place for any law that discriminates against women in the 21st century from poverty rights, from employment strategies, from family coats [misspelled?] and so on. We have to make that history.

Thirdly, it is not alright to have laws but not to implement them and when it comes to lives of women, to then ensure that it goes into the informal sector of customary [Inaudible] or customary practices and there are no legal - proper legal systems of implementation so laws are there but they need to be implemented. Our institutions can change and there is no excuse.

Just a few months ago, I visited the Indian Railways and I was told by the director general at that time that when some of my staff went to see him, he said, why are you here? We only have men who are employed by our railways, and we said that’s why we are here. We are here because we want you to change the way in which this system can support – support your employees who are living with HIV/AIDS and the wives of men who have died of HIV/AIDS.

I’m very happy to say that the railway system, employing 1.3 million people today, have broken stigma and silence to reach out to 1.3 million employees, and many of the men are now receiving free drugs and many of the widows are now brought in and employed. Change can happen, but they need to be upscale and they need to be invested in and I’m very happy to say that the Chinese Railway had decided to learn from the Indian Railways.

There are things that need – that can happen but we need to put the energy and the investment behind it. There has to be change of the behavior and attitudinal level, at the community level where things happen. And I was very happy when I visited a community in Zimbabwe when I saw how happy the men were when they wore a T-shirt receiving me - “We are caregivers.” It is not all right anymore for women to have the burden of care. The men can come in, and I was very happy to see the discussions that they have had and that the positive women are, in fact, running the HIV/AIDS communities and many of the action plans have their voices and strategies.

We have to invest in space and in participation, the people who carry the burden of care. The people who are infected should be the ones to shape the policies and the plans. And I was very happy to partner with a positive women’s network to make sure that they had a space at every table.

Finally, it is not all right to know strategies that work because we do know – I don’t think we can go around today to say that we do not know what strategies work. We do know what strategies work but what is it? What is holding us back so that our strategies cannot keep pace with the spread of the pandemic? It is still the fear of upscaling the resources and the investment to make sure that those strategies are large enough and deep enough for the transformation that needs to happen, the legal policy framework in our institutions, in our attitudes, in our behavior, and in our pockets. There are not enough resources going to where it should go. Money matters and money, at the end of the day, is what we have to make sure – reach the people who make the strategies work and finally, accountability mechanisms. We need to have the right data, the indicators, the monitoring, and the tracking systems and none better than to have positive women and affected women tracking what is happening at the community level. We can make things happen. We cannot wait another 25 years and I know that with your leadership and commitment, this will happen today. Thank you.

[APPLAUSE]

SHEILA TLLOU: Thank you very much. I must thank all the presenters. We are now getting into a different patch [misspelled?] of this session where we are going to have people volunteer to speak. If they don’t volunteer, I have a nice list where I’ll be able to call up on them, but I’m sure we’re all here to come and share. We want to share our experiences and to really share especially what works. How can strategies be adapted to be more effective? How can women be more involved in fora [misspelled?], in AIDS policies decided and, of course, measures taken to empower women as well as how do we scale up. PMTCT and natal care, education, and giving health education and giving health information, et cetera.

So I’m going to open the floor so that people can give us, in two minutes, what you think and what – and I will be very strict – people, I am a professor. When I say two, I mean two. So it will be that. I will be able to thank you for participating so with that, I’m hoping then that there will be no read statements. We want a statement from the bottom of your hearts not something that was written for you. So lets be more spontaneous and share with each other. So with that, I’m opening the floor but I’ll open it up by calling on my own sister, Honorable Minister for HIV/AIDS and the Presidency of Burundi, Dr. [INAUDIBLE]. So then you start the floor and then I’ll also volunteer. Thank you very much.

FEMALE SPEAKER: [IN FRENCH – 20:31 to 24:05].

SHEILA TLLOU: [IN FRENCH – 24:05 to 24:15]. Okay. Our next speaker is from the International Community of Women Living with HIV/AIDS, Marie Jose Vazquez.

MARIE JOSE VAZQUEZ: Thank you, Madame Chair. Good afternoon, ladies and gentlemen. I am the chair of the International Community of Women Living with HIV and AIDS, which is the only global network run by and for HIV-positive women. Our main objective is to give support to HIV-positive women worldwide and to raise the women’s voices and make them heard in decision making places. At this conference, the International Community of Women Living with HIV and AIDS want to challenge all delegates to think about the meaning behind words by proposing five key challenges that you will be hearing about in the next five days.

And it is also what we are going to try to do here, by asking you to look at how the five areas proposed here for discussion can take us to oversimplifying the issues we are trying to address by not taking into account the diverse reality of women all over the world and especially those of women living with HIV and AIDS. We feel that all five areas are very broad and should be [INAUDIBLE] and probed more deeply in a way that they will meet more adequately addressed living the [INAUDIBLE] traditionally [INAUDIBLE] assumptions that showed of no use in the past.

Let’s take, for instance, women’s sexual rights. We consider it is absolutely necessary that it’s [INAUDIBLE] acknowledged, that it’s not possible to limit our vision to safety issues, pregnancy, delivery, STD prevention, and treatment. It is foremost important, importance that we focus in the right of women to have knowledge about their own bodies and the search for pleasure. Pleasure has been left aside in dealing with prevention and health, in most cases, although we consider that it should be recognized as crucial for women to live their lives to the fullest. When talking about scaling up services, again, it is necessary that this talk is not limited to access in terms of statistics reducing women to numbers. We need to think of creating enabling environments for women and explore ways in which these environments facilitate both within and without – and outside health services, the achievement of women’s health and health rights. You ask how can women be involved where AIDS policies are decided, and you will get a first piece of information that you can reflect upon by looking at who is around this table.

The last report UNAIDS had just launched, informs about the little advance that has been done in the reduction of stigma and discrimination and these can be easily seen in this meeting. How many openly HIV-positive women have been invited to this meeting? How much time will we dedicate to learn about women’s realities as told by themselves? Where are women IV injecting drug users or sexual workers or prisoners? Where are they represented? HIV-positive women are actively working in their communities, their churches, working places, et cetera. So we are far from hidden, far from silence. We are doing our individual and collective work wherever it’s needed.

So we want to ask you how many of the very sessions where HIV-positive women are talking about themselves and the work they do have you included in your agenda? Have you planned to share with us, with HIV positive women, the multiple activities that are going to take place in the global village? There is where you can listen to us in the first place because participation is not just a one-way road.

So making ours the theme of the conference, we invite you all to our meetings where you will not find the same restrictions that most women find when having to share with you here in these high level meetings. ICW has been invited to this table and we had to ask for the word because we were not accorded a time in the presentations. So thank you very much to you all.

[APPLAUSE]

SHEILA TLLOU: Thank you very much. The next person we’re hearing from is Jan Wei Jing [misspelled?], the Minister of National Population and Family Planning from China.

JAN WEI JING [misspelled?]: Thank you, Chair. [IN CHINESE – 1:30:11 to 1:35:01].

SHEILA TLLOU: Excuse me? Can you try to sum up because we have to get the other [INAUDIBLE].

JAN WEI JING [misspelled?]: Thank you. [IN CHINESE – 1:35:08 to 1:36:43]. Thank you.

SHEILA TLLOU: [INAUDIBLE] I was already just about to die Minister, thank you very much. [INAUDIBLE]. Okay. To make this better, it looks like everyone wants to speak, so I’m going to tell you the next six speakers. That way, I’ll ask them to put down their signs and then we can have an idea who else is left. So – okay. First on the list, Dr. Caiman [misspelled?], minister of health, Namibia. Then HIV/AIDS Ambassador – Netherlands, Paul Beckers. Then Dr. [INAUDIBLE], minister of health, Zimbabwe. Then HIV/AIDS Ambassador – Sweden, Lennart Hjelmaker. Then Mrs. Joy [INAUDIBLE] – assistant director general, WHO. And last, African Development Bank [INAUDIBLE] Johnson – So we’ll have those six first and then we’ll have the others and yes, I will interrupt you so please keep to the time. As you can see, everyone wants to say something. Okay, Dr. [INAUDIBLE]. You’re on.

MALE SPEAKER: Yeah. Thank you, Co-Chairperson. I wish to make a contribution on this very important subject – time to deliver for women and girls, and to share our own experience as a country.

Namibia, just like many other countries, has a long history of gender inequalities. Discrimination has been hindering the progress of women in economic, social, and political areas. The Namibian constitution explicitly discourages any form of discrimination on the basis of gender. Thus, since 1990, the Namibian government has been committed to addressing the gender inequality and this led to the establishment of the Ministry of Women Affairs and Child Welfare in 2000.

Unfortunately, men had to complain. Thus, as we talk now, we now have a Ministry of Gender Equality and Child Welfare addressing all. Namibia is committed to the goals of the International Conference on Population and Development principles on reproductive health. Co-Chairperson, clearly my country – HIV prevalence rates among pregnant women stands at 19.7-percent and that, in the whole country, 51-percent of those who are infected are indeed women. Now what are we doing to address this problem?

The Namibian government has introduced a number of programs for women and girls including the prevention of mother-to-child transmission in all public and private hospitals. Female condoms and sex education are in place and that, during 2005, we had up to 4,710 HIV-positive women received prophylaxis. In 2003, Namibia rolled out antiretroviral treatments and that currently we have up to 22,000 people are on ART of which, 64-percent are our women folk.

It is important, yes, I want to share with other colleagues that those in legislation are indeed important in addressing this problem. Thus, Namibia has signed and ratified several regional and international instruments such as the Convention on the Elimination of Discrimination against Women. The Beijing Declaration and Platform, obviously, is in place. The African Regional Platform for action and the African chapter on women’s rights signed a declaration on gender and development and AIDS addendum on prevention and eradication of violence against women and children, all of which upholds the principles of gender equality.

At the national level, laws and policies that have been enacted to address gender inequality are married persons in 1996 combating of Rape Act of 2000, combating of Domestic Violence Act of 2003, Maintenance Act of 2003, affirmative action are all in place and we are making it a point that these laws are respected, to address gender-based violence in the country that affects women and children. The government has created a number of women and child protection units in all our 18 regions. For this program to succeed, it calls for behavioral change among men folk.

Co-chairperson, in the area of education, which is equally important, great progress is being made by making education free and accessible for all boys and girls at primary level. The effectiveness of Namibia’s primer schooling system has also improved over the past decade. Girls continue to outnumber boys in secondary education. That, for every 100 boys as we talk now, in secondary school, there are now 113. Co-chairperson, it’s important to know that women folks are assisting and are contributions to make sure our women folks are indeed in the system. Finally, while acknowledging progress made in addressing gender inequality, challenges to empower women and girls and funding for programs related to the increasing numbers of orphans and vulnerable children remains. Thank you, Co-chairperson. It’s important to mention some of these things.

[APPLAUSE]

SHEILA TLLOU: Thank you very much General [INAUDIBLE]. Challenges do still remain in there. My next presenter is Paul Beckers, HIV/AIDS Ambassador – Netherlands.

PAUL BECKERS: Thank you very much, Madame Chair. Thank you to the government of Canada for hosting us. Madame Chair, I’ll be brief. I have one remark. As usual, it was very enlightening to listen to Dr. Piot’s introduction earlier this afternoon. When he was talking about the drivers of the epidemic, the inequal positioning of women, I think one of the first reasons we mentioned for us not being able to solve it is that the world community is not taking financing of the AIDS response serious enough as far as the gender issue’s concerned.

I’m afraid Dr. Piot’s was using an understatement here. As we all know, sexual and reproductive health and rights play a pivotal role in addressing the gender issue vis-à-vis the AIDS response and while we see luckily that there’s a vast increase of funding for HIV/AIDS, we’ll actually see a decline in funding for sexual and reproductive health and rights. Madame Chair, women have the rights to be informed and to have access to safe, effective, affordable, acceptable methods of family planning, have the right access to appropriate health care services. So, in response to the question on the table, my plea is simple – we just need much more funding for sexual reproductive health and rights. Thank you Madame Chair.

[APPLAUSE]

SHEILA TLLOU: I have to clap to that because I’m hoping other people follow your lead. Exact to the point, thank you very much. My next presenter is my own brother, who I will stop if he tries. Honorable Minister [INAUDIBLE] from Zimbabwe.

MALE SPEAKER: Thank you, Co-chair. Yes, I think this is a very important conference for us and I really would like to appreciate and thank the government of Canada for calling us here. It is important for us because in Africa, and particularly in Southern Africa, the epicenter of the epidemic is in Southern Africa and I think, to us, it’s critical.
Our governments in that region have shown a lot of commitment and we are pleased that we still continue to fight the challenges in our countries and these challenges include, of course, the issue of poverty among our people and food security, which relates to nutrition that goes very well at fighting HIV and AIDS but gender inequalities in Zimbabwe are reflected. This is that 59-percent of our women, of those who are positive, 59-percent are women and that again to me, is a big challenge and as a Minister of Health and Child Welfare in Zimbabwe, we also continue to fight the issue of stigma and the issue that we need resources and those resources reflect in the poverty that we have talked about but as we fight HIV and AIDS.

We also look at the traditional norms that we fight, that militate, that sometimes promote HIV and AIDS particularly wife inheritance and we’ve fought against that in Zimbabwe. Child sexual abuse has become a pandemic the world over but we also continue to fight that. Although we’ve got a high literacy rate in Zimbabwe of 93-percent among our population but we need to strengthen reproductive health education in our schools and we have started at grade 4. We now teach reproductive health including HIV and AIDS.

But also I wanted to just mention that often in Africa, we are underestimated. People underestimate what Africa can do and I think this is important to us. In Zimbabwe, we have embraced the [INAUDIBLE] ones where we have said national governments should lead the fight against HIV and AIDS with one strategy, with one coordinating system, and indeed with one monitoring and evaluation system and we have worked very well with our own NGOs in the country.

In spite of what we hear about Zimbabwe, sometimes very vicious press about Zimbabwe, I tell you that we continue to steadily and very confidently fight HIV and AIDS. That is why we have registered a decline in the prevalence between the ages of 15 and 49. The prevalence was as high as 31-percent in 1999. It came down to 24.6 in 2003 and as I speak, it is now 20.1-percent. So in spite of the very bad publicity that we get, we are still the only country that is [INAUDIBLE] nationally as [INAUDIBLE] where we know that we have not received many resources from outside Zimbabwe and we, therefore, created our own resources by taxing everyone who works at 3-percent and that money has helped us to fight HIV and AIDS.

We therefore continue to empower people strongly and we have said we do not politicize in Zimbabwe the issue of HIV and AIDS. And because we are aware that HIV and AIDS is a political, we’ve strengthened the issue of fighting behavior to promote behavioral change and people have changed their behavior significantly. But we continue, therefore, to thank the Global Fund to fight HIV and AIDS and malaria and TB and although we only got the first round in Zimbabwe, we did not get the second round, the third round, fourth round. We have got the fifth round – we are grateful to that. We hope that we can also get the sixth round.

The Clinton Foundation has assisted us greatly. They have come in and looked at the pediatric availability of drugs and that goes to address also the issue of gender. So pediatric – 1,000 children have been accessed ARVs through the Clinton Foundation, and of course, Zimbabwe’s extremely grateful to that. So we must continue to increase the resources that are used to fight HIV and AIDS and I must add that let us not [INAUDIBLE] HIV and AIDS too much in our developing countries. Let us integrate it to other challenging conditions so that resources are efficiently used. Thank you, Madame Chair.

[APPLAUSE]

SHEILA TLLOU: Thank you very much, Honorable Minister. I think we are coming along. The next person is Lennart Hjelmaker – I hope I haven’t made up that name, HIV/AIDS Ambassador – Sweden.

LENNART HJELMAKER: Thank you, Madame Chair. You did it very well – Lennart Hjelmaker. Since my Dutch colleague, Paul Beckers, only spoke for one minute, I think I can use one of his minutes but I’ll be very brief. But I have a couple of points. Your Royal Highness, Ministers, participants in this round table, eight very, very quick points.

Number one, to win this fight, I think we must do that with open eyes and open minds not simplify things, not make things easier than they are. It’s complex matters and we must be prepared to realize that. My Minister always says that this is nothing we will solve through instant slogans and acronyms. This is something we must realize, that it is about sexuality, it’s about gender, it’s about violence, it’s about trafficking human beings, it’s about drug use, it’s about selling sex and we must be prepared to address all these complex matters, that was number one.

Number two, leadership – we need leaders – that has been said by many. I think it’s very clear also that those leaders must dare to speak up on the different things. We don’t always see that so the link to the first point, leaders that dare to speak up.

Number three – the young people. The minister from Burundi, I think, mentioned the young people and the link to prevention – very critical. Access to information, to knowledge, to services for young people – very, very critical. It’s very clear that increased information and knowledge does not lead to increased promiscuity. It does not lead to more teenage abortions. It leads to responsible decisions and well informed decisions so lets be very clear on that we train and inform our young people and before rights, rights for condoms and other affordable commodities Paul mentioned, rights not to be subject to stigma and discrimination as we mentioned. And I would underline right to one’s own body and sexuality that we’re also very clear on that, a broad perspective on human rights.

Number five, not only about women – Peter Piot, in his opening remarks talked about boys and men and I think that is critical that for very many men, both beliefs and behavior of many men must, in a dramatic way, change. So we talk a lot about women here but let’s not forget the boys and men and I think that’s critical.

Number six, I also agree with Peter Piot that the outcome of the New York meeting was quite a success. We moved a lot on difficult things, but we didn’t go all the way along. The documents that were presented at the meeting was actually much stronger than what we would agree on that table, so there is some way to go and I was surprised, sitting there together with many of you late in the nights, that still we had to spend time before we could agree on text on empowerment of women. There were representatives that did and want to say that women should be empowered and that was this year, a couple of months back, and we did not manage to include sexual education. We talked about HIV education, so there is some way to go. We should be happy about the meeting but let’s continue the fight.

Number seven, this meeting, I think this meeting is a very important signal to the outside world. We are sitting and talking in a very open way about difficult things. It’s a very important signal and it should be very clear signal and I hope that the co-chair’s text [misspelled?] could be – I mean we’re not going to negotiate that one but that one really reflects that we dare to speak up about the difficult things. Business as usual is not an option and let’s be very clear on that. The introductors to the different subjects in a very good way, showed us that we have a long way to go on strategies, on services, on women’s rights, on participation, on the empowerment of women. We have a long way to go on all these headings and we should be prepared to do that.

And that leads me to my last and eighth point, the follow-up to the meeting - transform words into deeds. We have heard very many good proposals already on how do we do that. How do we show that we mean reality, that we are serious, that we mean something?

I will just pick up three of them and that was what we heard from UNIFEM – money matters, I think that is critical. We also heard from Paul Beckers about we need more money for sexual and reproductive health and rights and Sweden very much supports that, but both national budgets and development budgets – it must be very clear if we are serious, we allocate money. Money is the best and budget is the best instrument. National legislation is my second point. How do we transform global commitments into national legislation? And my third and last point here is that we need a system for accountability. It has been said by many. I think it’s very clear that we need to stay accountable. Decision makers, politicians need to stay accountable. Thank you very much.

[APPLAUSE]

SHEILA TLLOU: Thank you very much. After what he just said, I feel I should explain about the summary. This is the summary that some of you have read. It’s the summary of [INAUDIBLE]. It’s not a consensus document. However, it needs to be strengthened so that those who, once we have input into it, will be able to have the chance to do so, yeah. Thank you very much. So with that, I’ll call up on Mrs. [INAUDIBLE], assistant director general – let me see – Family and Community Health and also a representative on gender equality [INAUDIBLE].

FEMALE SPEAKER: Thank you, Madame Chairperson. I would like to pay my respects to the Excellencies and distinguished participants who are present.

Very briefly, Madame Chair, we believe that there is a huge gap between the virus and the evidence that is available to combat it. I think we are all in agreement on that but there’s an even greater gap between the evidence that is currently available that can help us to combat it. And what has currently been done and this is where we are particularly concerned.

Whilst we shall continue, as WHO, to pursue the science aggressively, we [INAUDIBLE] and believe that more solutions can be found more rapidly than they are currently. We believe there is a full need to fully apply the existing evidence and that – that need is extremely urgent. We believe that the best hopes of women and girls is in the adoption of a public health approach, which will ensure the protection of individuals and therefore, women and girls through addressing directly their rights and needs. We believe that this approach must ensure a continuum of care approach, which ensures that you link prevention, treatment, and care so that a mother who gets prevention of HIV transmission must also get treatment for herself and her partner and she must also get support for caring for the sick. And if it is an elderly grandmother, she must also get support for the orphans she cares for.

We also believe that this continuum must ensure that young girls who are taught about sex education at school, because of the power games between themselves and the young boys, must also have access – easy access to youth-friendly health services that can build on this education that they get in after-school programs and at school.

We believe that this continuum must ensure that health care services [INAUDIBLE] in the home, in the household by addressing the needs that exist in each household, whether they are driven by violence, by the power dynamics, by economic and financial deprivation, by literacy or alcohol abuse, and therefore, we’d like to associate ourselves with a call for a women’s body that will ensure that these are addressed.

We also would like to advocate for integration of services in all countries so that reproductive health services such as STI clinics and [INAUDIBLE] care clinics also address the needs of women in HIV/AIDS and we would also like to advocate for uniform of application of programs so that these programs are not only provided in the public sector but in the private sector and by NGOs that provide public health services. We would like to advocate for the efficient use of the limited resources that are currently available in health and therefore, advocating for better management systems and decentralization of services and includes financial resources and infrastructure resources to enable this. To help facilitate this, we have developed standardized and simplified protocols. We have defined a central package and we recommend a clinical team for a clinical approach to treatment so that a woman is not told that you are going to get PMTCT in this clinic, you are going to get treatment in clinic X and you are going to get antenatal care services in clinic Y.

And we believe, Madame Chair, that this type of approach should bring us closer to at least making better – full utilization of the existing evidence than we currently are. I thank you, Madame Chair.

SHEILA TLLOU: Thank you very much. I particularly like the call for a UN body because we want – whatever it is that UNICEF did for children, we want somebody to do for women, only then can we progress. So with that, I’ll call up on Hilge Johnson [misspelled?] from the African Development Bank, the mining people.

HILGE JOHNSON: Thank you, Sheila Tllou and Chair. Your Royal Highness, Ministers, and friends, we were called by you to talk about what works, what delivers, and concentrate on that. I think we also need to talk about what does not deliver, at least not enough, and I’m now going to talk about the alphabet, the ABC strategy. It has helped many but it is not enough and it is far from enough in helping women and girls. Actually, most of us know that the most dangerous woman – the dangerous thing a woman can do is to be married in many parts of Africa or, indeed, just to be young is a major risk. That means that ABC is not enough. It is not working for women and girls and not on the continent where I’m and we are working in the African Development Bank.

Now, I suggest we have to talk about more letters in the alphabet and I would add several. I would add “D” – A,B,C, and D for development of new tools for women and for girls, tools that can be under their control. We’re talking about microbicides. We’re talking about new and better female condoms and we’re talking about the vaccine. The vaccine could actually be the most important gender tool that could be provided for girls and women. And I think we know that if the virus was hitting white, rich men with briefcases in the Western Hemisphere, he would have had the vaccine now and all the other tools as well. But because it is hitting mostly, or to a larger degree, poor, black African women indeed, we don’t have them and we don’t have the resources to get them. That has to be addressed and it has to be addressed now.

I would also add an “E” and that has been said by many around the table, and I don’t want to repeat everything they said, but “E,” among others, for education of girls and women, education as education but also sex education. And “E” for equality in social economic fields in development of their own potential and legislation and rights – “E.” Most of you have talked about this and I won’t repeat what you have said, just say I do agree. We need to add more, because ABC is not enough.

So as we fight for universal access of ARVs for all and for all girls and women, we need to get the alphabet right. The overall strategy must be right to be able to protect women and girls from being infected because that is when the catastrophe starts. We have to prevent them from being infected and that would be maybe the most important action coming out of this session. If they are, they are entitled to every right to get an equal treatment but let us try to protect them from getting there. Thank you.

[APPLAUSE]

SHEILA TLLOU: Thank you very much. That ends my partone list. The next group of presenters – I’ll start with [INAUDIBLE], minister of health, [INAUDIBLE], then I’ll have UNICEF [INAUDIBLE], Zeda Rosenberg [misspelled?], International Partnership for Microbicides, and I have the [INAUDIBLE] Minister of Health, [INAUDIBLE], Richard [INAUDIBLE] – the Global Fund [INAUDIBLE] and then [INAUDIBLE], Minister of Health in that order. Okay, may I start with the Minister of Health of Mali [misspelled?] please.

FEMALE SPEAKER: [IN FRENCH – 2:03 – 2:08:21]

[APPLAUSE]

SHEILA TLLOU: Merci beaucoup. Now, hear from UNICEF Director [INAUDIBLE].

FEMALE SPEAKER: Thank you. Thank you, Madame Chair, Her Royal Highness, Excellencies, ladies and gentlemen. My point this afternoon is to emphasize that our leadership today must ensure that children are able to assume leadership in the future.

As many of you know, in October last year, UNICEF and many other agencies issued a global call for action to put the missing face of children, both boys and girls, closer to the center of the HIV/AIDS agenda. Since then, we have been campaigning vigorously to increase the skill and impact of four interventions that can make a real difference in the lives of children and adolescents. We have dubbed these interventions as the four Ps – prevention of mother-to-child transmission, pediatric AIDS treatment, primary prevention among adolescents and protection, care, and support for children affected by HIV and AIDS.

These are not new interventions. They have been tried in different ways over recent years, but now it’s time to deliver. That time is now and is urgent. We must act now together to make a real difference to the lives of millions of children, both boys and girls.

As we know, children are tomorrow’s adults and it is they who will inherit the burden of revering the spread of HIV and AIDS. It’s so important to empower girls. Tomorrow, we have a special session on education and AIDS – girls’ education and AIDS, but it is so important to empower girls with education and with information because they are the leaders of tomorrow’s world. They should have the power to make sure that existing AIDS strategies work for women. They need to be able to insist on access to the services to which they are entitled. They will be stronger now to take advantage of legislation that affirms and protects their rights.

If we neglect girls and women’s potential to lead, we will not advance towards the millennium development goals quickly enough. Now is the time to deliver and the women and girls of this world deserve nothing less. So my appeal to you is to empower children to be the future leaders in the future. Thank you very much.

[APPLAUSE]

SHEILA TLLOU: As usual, I give you a 100-percent for time. The next presentation is from Minister of Health of Ethiopia, Dr. [INAUDIBLE].

MALE SPEAKER: Madame Chairperson, thank you very much. I didn’t actually expect because I was not on their list of those countries selected. So if I am taking anyone’s chance, I can maybe take the chance later on because I was not in the list you read.

SHEILA TLLOU: Thank you, my brother. I’ll give you the chance later on. Yeah.

MALE SPEAKER: Do you still want to give me or…

SHEILA TLLOU: No, I’ll give you the chance later on. You are coming back [misspelled?] because I want someone who can go right away. Okay, so I’ll have Zeda Rosenberg, International Partnership for Microbicides.

ZEDA ROSENBERG: Thank you very much. Your Royal Highness, Ministers, and distinguished colleagues, I would like to talk about one specific approach to empowering women in the fight against HIV and AIDS, and that is microbicides. These are products that women can use vaginally to protect themselves against HIV infection. We’ve heard a number of speakers talk about it today and I really want to thank Hilge Johnson [misspelled?] for bringing it up in her context and also add that in addition to vaccines and female condoms, we may also see other prevention modalities that we will need to incorporate along with microbicides.

And that is perhaps, male circumcision, pre-exposure prophylaxis, the diaphragm, herpes suppression – there are many different kinds of prevention approaches and we’re going to need them all if we are going to make a dent in this epidemic and really prevent infection for women. But of course, my organization works on microbicides and that is what is nearest and dearest to me. With the increasing support from many donor governments and from foundations over the last five years, microbicide research and development is moving ahead rapidly. There are many products that are in the last stages of clinical testing, mostly in Sub-Saharan Africa, some in India and the next generation of microbicides that are based on the advances that we’ve had in therapeutics, the highly active antiretrovirals are now being formulated as microbicides and we’re investing a lot in novel delivery systems so that the gels may not need to be used only with sex. They can be used once a day.

There can be intravaginal rings that can distribute drug for a month at a time or even longer. They’re currently on the market for contraception and for hormone replacement, so why can’t they be used for HIV prevention? And these are already being tested for safety and we’ll be talking about that here in the conference. I think we need to applaud the pharmaceutical industry for stepping up recently to the plate for microbicides. We’ve gotten drugs from Johnson & Johnson, TevoTec [misspelled?], from Merck, from Bristol Myers Squibb and, at a meeting last month, Kofi Annan got a pledge from the pharmaceutical industry to keep on delivering drugs and giving drugs that we can formulate as microbicides.

And I call upon this group to keep the pressure up, to encourage the pharmaceutical companies to give us their best drugs, not just for treatment but also for prevention, because we need them for both. And I think that we need to talk about the risks of drug development. It is very difficult to develop drugs. We need patients. We need support. We need consistency in support and we need, above all, your advocacy. It takes a lot of work, a lot of drugs in the pipeline, a lot of new approaches, a lot of money, and a lot of political will to get this done and so this group can play a huge role in advocating for microbicides and keeping the pressure on until we do have an effective one for women. Thank you very much.

[APPLAUSE]

SHEILA TLLOU: Thank you. Thank you Zeda. We now hear from the [INAUDIBLE] Minister of Health, Honorable [INAUDIBLE].

FEMALE SPEAKER: Merci Madame La President. [IN FRENCH 2:15:23 – 2:20:11]

SHEILA TLLOU: Excuse e moi, your time is up.

FEMALE SPEAKER: [INAUDIBLE]

SHEILA TLLOU: Yeah.

FEMALE SPEAKER: Merci.

[APPLAUSE]

SHEILA TLLOU: Merci beaucoup. Honorable Ministers, you’ll have to forgive me and everybody else because we still have more than 17 people who want to speak and we can only do so if we really limit our comments. That’s why I was saying rather than read, because I’m finding that people who read take a longer time, say it from the bottom of your heart, you take a shorter time. So my next presenter is Richard – Richard, I’m calling up on you to be brief and I know you will be. Thank you.

DR. RICHARD FECHAM [misspelled?]: Well, thank you very much, Sheila, and good afternoon, ladies and gentlemen.

SHEILA TLLOU: I haven’t introduced you properly, yeah. Dr. Richard Fecham [misspelled?] from the Global Fund to fight HIV, TB and malaria. I have to introduce him nicely because he’s the guy [INAUDIBLE] a lot of money, yeah. Thank you.

DR. RICHARD FECHAM [misspelled?]: Well, thank you again, Sheila, and good afternoon, ladies and gentlemen. Since money matters, I’ve been asking myself, during these passionate and committed speeches, how well is the Global Fund doing in regard to delivering for women and girls?

And I’ve thought of four criteria and four questions to examine the Global Fund’s performance. The first one is, is our board gender-balanced? The second question is, are our CCMs gender-balanced? The third question is, do the programs emphasize gender and the situation of women and girls sufficiently? And the fourth question is, are we learning systematically from our investments in these programs? Let me just briefly attempt an answer to those questions.

The first question – is our board gender-balanced? There are 20 voting members on our board, of whom nine are currently women including the chair of the board, Dr. Carol Jacobs, who’s with us this afternoon, and the vice chair of the board, Dr. Leva Francin [misspelled?]. And, of course, professor Sheila herself is also a member of our board. So we score nine out of 20 in terms of gender-balance on our board. I suggest that the correct number is somewhere between 11 and 12, given the gender balance of the HIV pandemic. So I give ourselves an okay on that question.

The second question is, are our CCMs gender-balanced? And the situation there is that we encourage gender balance. We do not require it and when we pose that question, the answer is we don’t know. We don’t have data on the gender balance of our CCMs. And that’s not good enough and I give ourselves a poor score on that question.

The third question is, do our programs emphasize gender and the situation of women and girls sufficiently? As people here this afternoon will know, we’re funding 386 programs in 132 countries already. And again, the answer to that question is we don’t know. We don’t have, at the moment, any systematic way of tracking our investment in relation to gender. And in relation to the situation for women and girls and again, I would give a poor score on that criteria. And fourthly, are we learning systematically from our investments in gender-related issues, especially in the field of prevention? And there, the answer is a resounding no. We’re not learning systematically from these large investments.

So out of the four questions, I gave ourselves one okay, two poors, in fact three poors, and one okay and all of that adds up to not enough. The Global Fund can do more in this arena. I think the Global Fund must do more in this arena and as everybody here knows, the search for my successor is under way and I’m sure that Carol and Sheila and others on the board will ensure that she is someone who will do more. Thank you very much.

[APPLAUSE]

SHEILA TLLOU: Thank you very muc,h Richard. I don’t think your next successor has a shoe size to match yours. So as you will not be able to fit into your shoes definitely, but anyway, we shall make sure he or she does. Okay, the next presentation is by Sri Lanka Minister of Health Care and Nutrition.

MALE SPEAKER: Madame Chair, your Royal Highness, dear colleagues. While thanking the Canadian government for hosting this important conference and the elaborate arrangements they have made, I would like to share the Sri Lankan experience on the topic, which we are discussing today.

The Sri Lankan experience – the lowest prevalence in the Southeast Asian region in HIV is due to their factor that we have invested in education and health. We considered education and health as an investment and not as an expense. Though we had a lot of resistance from the Western [INAUDIBLE] models criticizing that there must be [INAUDIBLE] charges, et cetera. So far back in 1938, even prior to the independence, our women in our country enjoyed the universal franchise and we produced the first woman prime minister in the world. So that shows the priority we have given to the women in the political arena. And in the area of health and education we are equal opportunity and education is free from kindergarten to that of the PhD level.

So therefore, we had impressive educational background for the women of our country. Therefore, I think the Sri Lankan experience is such that the P factor for the women’s empowerment is that of education and health. Therefore, all the respective countries and the political leaders should ensure this perspective of women not totally the smaller – the narrow aspect of HIV only, but we must look into the broader perspective.

Then of course, we talked so much about the political leadership, high level political commitment so therefore, it is the duty of the politician not only to talk about HIV but to ensure that we create a society, which would be conducive for the rights the rights, which respect the rights of the women and rights of the girls and make a holistic approach for motherhood and women while saying concluding, Sri Lanka will host 8ICAP in August 2007 in Columbus [misspelled?], Sri Lanka, and invite all of you to come to Sri Lanka and share [INAUDIBLE] too. Thank you very much.

[APPLAUSE]

SHEILA TLLOU: Thank you very much. Now, go back to my Honorable Minister of Health of Ethiopia to take the floor.

MALE SPEAKER: Thank you very much, Madame Chairperson, and Royal Highness, Excellencies. When I came to this meeting actually, I didn’t expect that it would be another country-bycountry presentation. I was hoping that the presenters would follow Madame Chairperson’s advice that dropping the statements whatever they wrote and focus on the issues that were raised by the regional presenters.

Many important issues were raised, actually, but we haven’t actually followed and discussed at length based on these issues so I’m actually trying to express, I don’t want to hide my feelings, my disappointment because we could have really revised or developed the proposed action points starting from action 1 to action 5 if we focused on the regional ideas that were proposed by the presenters. Many good ideas were presented, like the accountability issue, how do we address it, the money matters, for instance – how do we address it because there was a good suggestion – predictable financing, for instance even Global Fund needs predictable financing and whatever we said about the health system when we talk about HIV/AIDS and reproductive health, do we see it in relation to overall health system, which is gender-focused and, you know, whatever we do on gender to make it part of the overall development plan of the country, I think we could have used that time wisely and we could have focused but it’s like another probably – sorry to say but in an [misspelled?] assembly meeting – report after report from countries so I don’t see what we have actually benefited from this. I wanted us to engage into real discussion and come up with some resolutions that can really develop what was proposed this action – the 5 action points so I don’t know with the remaining time if it’s possible to…

SHEILA TLLOU: Excuse me, Honorable Minister, we did say that those action points are not – this is not a consensus document. That’s why you are on the right track - pick up something that you want to focus on from the previous speakers, do that, and actually I left you two minutes to do that.

MALE SPEAKER: Yeah. So what I’m saying is we could have benefited if we focused on those and contributed based on that. Open discussion and candid discussion, that’s what I’m saying.

So having said this, I would agree with what Miss Mary Robinson said – it’s related, the checklist issue is actually related to accountability. If we can develop a checklist of what specifically we should address with regard to gender, the social, political, and economic issues – I think that’s a very important issue.

And the other thing is the health systems. When we say HIV, we shouldn’t see it in isolation. We should see it in relation to the overall reproductive health done in relation to the overall health system and overall development plan of the country. So I think we should really see it in its sense [INAUDIBLE] or a bigger sense rather than go into specifics. That’s also very good [INAUDIBLE]. Thank you, Madame Chairperson.

[APPLAUSE]

SHEILA TLLOU: Thank you very much. I’ll now hear from the Thailand Deputy Minister of Health, Dr. [INAUDIBLE] and to be followed by the Vice Minister of Health of Angola and then Dr. [INAUDIBLE] from Barbados, then I give up.

MALE SPEAKER: Thank you, Madame Chair. Your Royal Highness, Excellencies, distinguished participants. I believe you are all aware that Thailand was the host of the 15th International AIDS Conference held in Bangkok two years ago and at that time, we had the theme “access for all.” So today, we are under the theme of “time to deliver for women and girls.” I have to commend that it is a very good topic [misspelled?] from the last meeting. I will humbly concur to the chairman’s request that I should put the note away because I should speak out from the heart. I won’t waste your time to say that we have significantly reduced the number of prevalence rates during these past few years and you may obtain the copy of what I would have said after the meeting if you would like to. I agree with many of my preceding speakers that, at this time, we concentrated much on women and child and I would like to express my feeling that having worked in this Ministry of Public Health of Thailand and not being a medical doctor of myself, I have experienced seeing the children in the hospitals that have been through other countries, seeing them suffering from not only being an orphan but also got transmitted from their parents. And I have seen them pass away on and on and I kept asking to myself, how many times I have to go through this grieving moment?

And I would like to tell you that Thailand is now concentrating on focusing on children more and women who got transmitted from mother-and-child transmission. With that in mind, I would like to confirm that we also established a destigmatization program as the lady from UNIFEM had mentioned before – that not only we will do the destigmatize the psychic disorder itself but also we destigmatize the people who got AIDS infected and this program is working very efficiently and in closing, I would like to – since the lady before me had given the alphabetical strategy – ABCD and E, I think she finished at E – education, I would like to add three more – F, G, and H will be focused.

G is generosity, we can not do this – solve these problems without being generous and H is not health, but heart. I think this will be very crucial for us to focus and I hope by the next meeting, we will become more successful in tackling this deadly disease. Thank you very much.

[APPLAUSE]

SHEILA TLLOU: Thank you very much. I now call up on Dr. Carol Jacobs from the National HIV Commission of Barbados but she’s also the chair of the Global Fund to fight HIV/AIDS, TB and malaria.

DR. CAROL JACOBS: Thank you very much, Madame Chair. Madame Chair, I come from a region where the girls, between 15 and 24, are predominantly affected in this epidemic. It is also a region, which I will remind people is a region with the second highest HIV problems in the world. In my own country in Barbados, the ratio of females in that age group is three to one and yet, as we talk about education being a solution, in Barbados, we have 100-percent education. Our girls are educated. We have a significant number of women in Parliament and in positions of leadership.

And therefore, Madame Chair, I’m reflecting that this is probably not just about education. I think as it was said by Peter Piot earlier, it is about sexual power relations. It’s grounded in social change and therefore, I just would like us to reflect a little bit and share with you but I think probably, one of the key things we need to do is see how do we address this social change. We are advocates. We have been doing advocacy for a long time but I think we need the next step. And I think one of the critical areas, certainly in my country and my region, is engaging the faith-based organizations so that we can deal with the stigma and discrimination, which causes problems when we’re dealing with commercial sex workers, when we’re dealing with vulnerable groups. And I think that therefore, the engagement of the faith-based organizations has to be an important area. It goes without saying, of course, that our NGOs have to be engaged. We need to engage those who define our culture – our artists, our sports people, people that our young women are listening to. We need to engage our young men. We need to look at, as has several speakers before have been saying, how can we enact legislation? How can we have declarations – signed declarations?

But I think those kind of issues are critical to the resolution and to the next step forward if we’re going to meaningfully do something about delivering for all women and girls. And of course, finally, funding. I would just like to make a plea too that we move to a different level of delivery, that we look at things like behavior change campaigns. We look at emotional intelligence. We look at ways of engaging our populations, our youth, our young people who are affected so that they can lead this fight along with those of us who sit here on this table. Thank you very much, Madame Chair.

SHEILA TLLOU: Thank you very much, Dr. Jacobs. I now call up on the Vice Minister of Health of Mozambique, Ivo Garrido.

IVO GARRIDO: Thank you, Madame Chair. First of all, I’d like to thank you very much to the government of Canada for having inviting us to come to this very important meeting. I would like to go into details [INAUDIBLE] the colleagues and talk about the causes for this feminization of HIV/AIDS. But also I would like to say it is in my country, Mozambique, 60-percent of people living with the HIV/AIDS are women and the most identified factors that contributing for that is the [INAUDIBLE] marriage – women whose partners are engaged in unprotected extramarital affairs, immigration - both for men and also for women because women also are moving to towns for [INAUDIBLE] or to get jobs. Also was the poverty and unemployment of women.

I would like also to tell that in our country, we have integrated activities, all of those activities related to HIV/AIDS. HIV/AIDS is highly in our agenda – national agenda. It is a priority in our five-year program, or government program and also in the [INAUDIBLE] paper for a reduction of poverty in our country. We have decided to strengthen our institutions especially health in the – all public institutions, to improve the capacity of human resources – not only by training but also for in-service training, to improve management capacity to deal with HIV/AIDS, to also improve infrastructure. Also, we defend pretty much the integration of our services of our interventions involving several institution-like health education and social affairs – women and social affairs and all other departments like the private partners and the public service.

We consider it’s very important to take into consideration the cultural aspects when we are conceptualizing the message that you want to pass to the public but similar to community level because we have the challenge of – association of cultural aspects to HIV/AIDS because it’s related to sexual activity and that also we have to deal very carefully – with the same [misspelled?] message we are passing to our people. We want to promote and accelerate education of the girls - that’s what we are doing now in our country, also to accelerate the literacy of adults especially women. And also we’re implementing project to improve the economic condition of women especially in the area of agriculture or [INAUDIBLE] activities. We have created youth-friendly services to address the youth and the adolescent at school and also at the rural areas in the cities or where the people are living and also we are strengthening the prevention and treatment of STIs because those have been neglected because of HIV/AIDS. That’s why now we are giving more importance to treatment of STIs. We are promoting all sexual and reproductive and health services in an integrated way.

Finally, I would like to inform that from the 20th to 21st September this year, a special session of health ministers of African Union on sexual and reproductive will take place in Maputo and the feminization of HIV/AIDS will be discussed and Africa is called upon to action and to deliver. Thank you very much.

SHEILA TLLOU: Thank you very much. Yeah, we all look forward to going to Maputo and the next – I think we now have remarks from Michelle Kazakstein [misspelled?] – Ambassador for HIV/AIDS and transmittal of diseases followed by…

[END RECORDING – TAPE 1]

[START RECORDING – TAPE 2]

MALE SPEAKER: [IN FRENCH 00:24 to 2:48]

[APPLAUSE]

SHEILA TLLOU: Thank you very much. In the next 15 minutes, before we close this session, I can only have five speakers and I can have six if all of them can be brief and to the point. So since [INAUDIBLE] I’ll ask Dr. [INAUDIBLE], Minister of Health, Cameroon if he has something to say.

MALE SPEAKER: Thank you Madame Chair. I wanted to speak in English, that’s if you permit me. Okay, I can speak briefly in French. Madame Chair, [IN FRENCH 3:32 to 6:01]

[APPLAUSE]

SHEILA TLLOU: Merci beaucoup for your brevity. Now I have Joanna Tange [misspelled?], Global Business Coalition on HIV/AIDS.

JOANNA TANGE [misspelled?]: Thank you, Madame Chair. Ladies and gentlemen, our speakers today have made it very clear that time has come to invest in women and girls, and especially adolescent girls and not just the childbearing women, and to revisit our approaches to prevention, treatment, and care – recognizing that the gender imbalances are – have fueled the epidemic as well as slowed down the response. So it is with this perspective in mind that the Global Business Coalition and its members have committed to support a variety of initiatives that aim to link private sector with other stakeholders, many of you are in the room around the table – some of them are not around the table like the International Women’s Health Coalition and a variety of community groups of living people – of people living with AIDS on the ground. But we believe that the private sector has a unique role to play as an employer, as an investor, and as an influencer in the communities. They are a handful or maybe a dozen initiatives that one could mention from the private sector that are going directly in the direction of supporting women and girls and restoring the emphasis on women and girls in HIV programming.

But these are far few between and we definitely need, over the next three years, to scale up the business practices, and we’ve identified a number of direction. The first one is to enhance the employee program so we extend coverage to spouse and often more than one spouse and dependents. The second one is to support girls’ education as studies show that even one additional year of schooling allows to decrease the chances of girls to contract HIV. The third is to support microenterprise and economic empowerment of women and girls. This is something right in the area of competency of businesses and we have hopes to expand this dramatically. There’s already quite a few best practices there.

The fourth one is to develop greater access and integration of testing, treatment, and reproductive healthcare services. They are real issues here, which need to be addressed. Another important point is to think of applying businesses core competencies and not only the exemplary contribution of pharmaceutical industry to, for example, Zeda’s initiative – the microbicide research but also to think of the marketing and messaging power of business, marketing for social changes, developing an agenda dynamic and facilitating the introduction of those prevention technologies.

Last but not least, we have every hope to see expended engagements of port collaborations between businesses and national AIDS control programs as well as the key institutions like the Global Fund to fight AIDS, TB and malaria and UNAIDS. So in other words, with your support, let us transform business response to prioritize the components that target women and girls and compensate for what is a systemic ignorance of the women’s perspective. We also think that this will yield to then the next step is an ability to leverage business engagement to transform the societies then and shore up a new stronger collective defense addressing the vulnerabilities of women and girls so I look forward to the conversations that we’ll develop at IAS and at the whole conference this week between the private sector representatives that are here as well as the agencies and governments represented here to help shape this up. Thank you. [APPLAUSE]

SHEILA TLLOU: Thank you very much. In the next 10 minutes, since we have more than 10 speakers still there, we’ve had to discriminate so if you come from the Global Business Coalition, you are no longer there. If you are from the UN family, you are no longer there. So I have like four presenters, one Islamic Relief, the Holy See [inaudible], International Federation of Trade Unions, and then the last political advisor to the Minister of International Development of [INAUDIBLE]. So I’ll start with the Islamic Relief for two minutes, [INAUDIBLE].

FEMALE SPEAKER: Okay. I’ll try to make my comments within two minutes. Madame Chair, your Royal Highness, distinguished colleagues - I’m speaking on behalf of Islamic Relief. Gone are the days when HIV/AIDS was known to be within the gay community, a disease of the gay community and drug users’ community. Gone are also the days when the disease was known to be within the Western society and non-Muslim disease. Today, the reality is that HIV/AIDS is increasing at a rapid rate in Muslim communities the world over. Pakistan, Sudan, Egypt are living examples of increase in rates of the HIV/AIDS in Muslim communities. The question is, what are Muslim communities doing in terms of its prevention of the disease, the spread of the disease?

And the common response of many Muslim organizations and many Muslim communities is abstinence and faithfulness. The C [misspelled?], in this case, where my colleague mentioned – it doesn’t even exist in many Muslim communities. Is this approach pragmatic? Is it realistic? Does it work in terms of preventing the spread of the disease and the answer is no, it’s not. We – the question is, is their approach working? And then I agree with my colleagues that – that approach is not working. The question that we ask ourselves – we should pause and ask ourselves is that with women bearing the brunt of the disease in many communities and with existing power structures and gender inequalities, how would women negotiate sex in patriarchal societies with the [misspelled?] [INAUDIBLE] power to negotiate in [INAUDIBLE] and also, how do women abstain from sex when they steal food to eat? These are some of the practical questions that we should reflect and think upon when we look at HIV/AIDS particularly within Muslim communities and -

SHEILA TLLOU: So your time is up.

FEMALE SPEAKER: Okay.

SHEILA TLLOU: Thank you very much.

FEMALE SPEAKER: Okay.

[APPLAUSE]

SHEILA TLLOU: I’ll now hear from the Holy See from Robert Frido [misspelled?] Special Advisor on HIV/AIDS.

ROBERT FRIDO [misspelled?]: Thank you, Madame Chair. We’ve arranged to distribute the statement that we prepared so out of respect for the power of the Chair, I’ll just make two short points that I think may deserve more attention in the final document.

First of all, in his message to the Fourth World Conference on Women in Beijing, the late Pope John Paul the II committed the 300,000 health care, social service, and education institutions of the Catholic Church to give priority attention to women and girls. And we believe that more leaders would benefit from doing the same, especially in those areas where women and girls do not now have equitable access to healthcare education and social services.

The second point that I wanted to make is that increasingly, leaders in the Catholic Church are targeting men and boys to engage them in the response to HIV and AIDS and to involve them in learning about the ways that they can be respectful in their relationships with women and also to help them understand that they can abstain from sex outside marriage and be mutually faithful during a lifelong marriage. And once again, we believe that these are strategies that do work. They have worked. They’re evidence-based in terms of the behavior change that has taken place in many of the countries where the infection rate has been lowered and we would like to encourage that attention to these strategies also, beginning especially in targeting men and boys in this process. Thank you.

SHEILA TLLOU: Thank you so much, Reverend. Male involvement is really very important. So we’ll now hear from the International Federation of Fair Trade Unions, Mr. [INAUDIBLE].

MALE SPEAKER: Thank you, Madame Chair. We consider HIV/AIDS as a workplace issue whether women and men work in formal or informal – or in an informal economy – environment. It is related to decent work or absence of work and poverty. We consider HIV/AIDS as both a consequence and as a cause of poverty and the importance of work is therefore important for us and also in relation to the treatment, prevention defense of the rights of workers at the workplace.

We have now been able to have an understanding and agreement with the International Organization of Employers and we have called upon governments also to join this workplace initiative. We have an international program on HIV/AIDS with a special focus on women, youth and migrant workers. We work through our organizations at the regional and national level, through our work, teacher organizations, public sector organizations. Our organization for sex workers, for instance, in Brazil. We are reaching out also to civil society organizations. We are forming alliances with civil society organizations, community-based organizations. We want to remove the stigma and prejudice related to HIV and AIDS and to bring about an elimination of discourage [misspelled?] for all people. Thank you very much.

SHEILA TLLOU: Thank you very much. Our very last presenter is Mr. Tobian [misspelled?] Fell from – Political Advisor of the Minister of International Development of Norway.

TOBIAN FELL [misspelled?]: Thank you, Madame Chair.

SHEILA TLLOU: All the other presenters, you will forgive us.

TOBIAN FELL [misspelled?]: Thank you, Madame Chair, your Royal Highness, Excellencies, ladies and gentlemen. To end the discussion, I would like to comment on participation and rights because I’m surrounded by strong women today making a difference and we know that decision making, in general, is dominated by men. At the same time, we see that those fighting HIV every day is mostly women and gay men. They are the ones doing the job and therefore, I previously have called for greater involvement by heterosexual men.

Male leaders need to be more visible in the fight against AIDS and for women’s rights. The work of women and gay men is extremely important, but straight men need to take more responsibility for their brothers’ behavior and make them change. To make women get power of their own body and to decide of their own sexuality and what they actually enjoy, we need a number of different tools and methods that I will not mention here but some of us needs to act a bit more revolutionary than we do today and Norway is ready to take it [INAUDIBLE]. Thank you.

SHEILA TLLOU: Thank you very much. So we are now going to the last session, the closing of this. Let me just thank you all for your patience with my guillotining and fortunately, I’m helping to break disease and continue doing it because currently, I’m the chair of the African Union Ministers of Health, all 53 of them. So I have no choice but to break disease. Thank you very much.

HEIDEMARIE WIIECZOREK-ZEUL: Yeah, thank you to all the speakers and to all the participants who have gone on with us during this discussion and we have twice mentioned during this meeting that the call for action is the conclusions of the cochairs here but what we have done is, of course, to listen very carefully whether there are concrete possibilities and actions that could be taken on board, we will do so and we will put the paper with all the concrete proposals also onto the Web so that there can be a concrete follow up by those who are interested in doing so.

And could I also say that I think, I mean at least that was the spirit in which I participated here. One always learns in all these meetings because their experiences, you know which, you can also have from other countries, from other institutions, and I think everyone has realized that in his or her capacity, there will be a follow-up. That is at least what I intend to do and it has been very concrete what had been given as an impulse by Richard Fecham [misspelled?] on the Global Fund and everyone who is also a donor in the Global Fund or also receiving can express their own initiatives in the next future.

And certainly what I can say for our country, for Germany, is that within our presidency of next year in the G8 and also in the presidency of the European Union, which is the first half of the next year, we will take up those questions and specifically take up the questions of the situation of women in the fight against HIV/AIDS. You can rely on this. I wanted to make that sure because nothing that has been said is forgotten, not any impulse and please let us stay engaged. That is what I think has come from this meeting of today and could I lastly give the floor to her Royal Highness Crown Princess [INAUDIBLE] Margaret [misspelled?] of Norway and I am honored and we are all honored that she listened carefully to us and all the speeches and discussions and she has generously offered to provide us with closing remarks.

Could I just say some words? Her Royal Highness has been engaged in the HIV and AIDS issues for several years. Her studies at the school of Oriental and African studies in London as well as her work with the Norwegian Directorate of Development Corporation [INAUDIBLE] in 2003, raised her interest in and concern for HIV and AIDS issues and in April 2006, Her Royal Highness accepted the appointment as Special Representative for the Joint United Nations Program on HIV and AIDS, a position she intends to use to fight stigmatization and discrimination of people living with and affected by HIV and AIDS. Her Royal Highness is particularly engaged in young people as we have also mentioned today and the importance of empowering so that they can protect themselves from HIV and its consequences. I am pleased to give the floor to you and thank you for very much for participating, having participated in this meeting. Thank you very much.

CROWN PRINCESS [INAUDIBLE] MARGARET: Your Excellencies, ladies and gentlemen, thank you for this opportunity to reflect on some key points from this high-level session. The focus on the increasing feminization of HIV/AIDS is a highly suitable way of entering into this 16th International AIDS Conference. To address the vulnerability of women, and particularly young women, is a central pledge in the declaration of the Special Session of the United Nation less than three months ago.

This session has made it clear to all of us that it is possible to make women and girls less vulnerable to AIDS. It is unacceptable that young girls are six times more vulnerable than their peer boys. It is unacceptable that women are made vulnerable through sexual abuse, domestic violence, or hurtful traditional practices. It is unacceptable that women are not in charge of their own sexuality and health. Girls and women must be allowed access to information and means to protect their own lives and the lives of their future children.

In Bangkok two years ago, Nelson Mandela said history will surely judge us harshly if we do not respond with all the energy and resources that we can bring to bare in the fight against HIV/AIDS. It was said again in [INAUDIBLE] in New York. Our generation will be measured against how we respond to the global catastrophe of women and AIDS.

The discussion we’ve had here today make me hopeful for the future. Presently, our leaders are willing to deliver by taking the measures needed to reverse the pandemic and rectify some of the striking imbalances that hit women and girls the hardest. Today’s discussion reflected feminization of the HIV pandemic is caused by a complex mixture of underlying factors and even societal structures and power relations, lack of sexual and reproductive health for youth and also lack of comprehensive health and AIDS services tailor-made for women’s needs, customary laws and practices that do not empower women and put young girls at risk, legislation that does not ensure the basic right of women and girls, widespread use of sexual violence and abuse, and major gender inequalities, for example, in terms of access to education and employment as a cause and a consequence of HIV.

All of us in this room are different in terms of background, roles and expertise, but we have one thing in common. We are all in the fortunate position of being able to make positive change. By attending this session, I think we have all taken on a responsibility. We will be held accountable for how we respond to it. It is time for leadership and I think it’s the kind of leadership, visible leadership, that Mary Robinson called for. Delivery must reflect reality and much the real needs not what we suspect people need or what we wish was the reality.

This is about real people, about young girls who are more and more likely to contract a life-threatening virus the older they get, but HIV-positive women are facing devastating and heartbreaking realities on a daily basis. Most of us need to listen more in order to capture that reality. Flying through statistics and counting facts and figures may give some information but the only way to find the real answers is to ask those concerned to give women and girls a choice. Let them express their reality in their own words and define what their needs are but this is not enough. We need more women at the table when decisions are made and strategies laid out. HIV-positive women are probably the strongest tools we have in building sustainable prevention programs for women and girls. Positive women know what made them vulnerable to HIV. They know which structures and tradition that need to be changed to protect future generations. We heard the challenge from the International Community of Women Living with HIV and AIDS calling us not to pay lip service but be real about their essential role.

Let us, therefore, give opportunity and voice to positive women not as tokens and symbols but as highly competent people. Let us celebrate and learn from what women are already doing as Mozambique and Europe and the world, YWCA called for. Let us use our roles and networks to empower these women and to engage together with them. I encourage you all to walk out of this room today promising to follow up on today’s call for action and to make a real difference for real people. Thank you.

[APPLAUSE]

MALE SPEAKER: On behalf of the organizing committee, the leadership committee of the International AIDS Society’s 16th Conference, it is my great pleasure to thank Her Royal Highness for her concluding remarks, to give thanks to all the presenters and all the participants in the discussions, to our eminent co-chairs and to the Canadian government and the staff, which have devoted so much time, energy, and imagination to bring about this gathering we’ve had today. I also want to simply say to you that, as a person of the Church, I have enjoyed three days of pre-conferences – two for Christian churches, and the third one, an interfaith conference. And I want to say to the Muslim, the Buddhist, the Church representatives here that the challenges that we’ve heard in terms of leadership, needed leadership to deliver for women and girls is one that rests very heavily upon church leaders, upon religious leaders because in many ways, we come very late out in that struggle.

So I will leave this room with a sense of commitment on behalf of all of us that what we have said shall be translated into words. It is time to deliver for all of us those who have spoken and those who were unfortunate not to have been given the floor due to time constraints. Thank you to all of you who have honored the invitation from the Canadian government and from the leadership committee of IAS to come here, to spend this afternoon on this important topic and now, we’ll leave this room and attend the reception outside here and during the next few days, we will translate into actions what we have been sharing with each other in words. Thank you, all.

[END RECORDING – TAPE 2]

Source: kaisernetwork.org -- a free service of the Kaiser Family Foundation

View Video:

Part 1 (2:44:00)

Part 2 (30:37)

Speakers for this session:

Welcome

• Helene Gayle, M.D.
  Co-Chair, AIDS 2006
  President, International AIDS Society
  President and CEO, CARE USA
• Josee Verner
  Minister for Development Cooperation
  Canada

Keynote

• Ellen Johnson-Sirleaf (TBA)
  President
  Liberia
• Peter Piot
  Executive Director
  Joint United Nations Programme on HIV/AIDS

Introductions

• Peter Piot
  Executive Director
  Joint United Nations Programme on HIV/AIDS
• Jeanette Kagame
  First Lady of Rwanda
• Xomara de Zelaya
  First Lady of Honduras

The Round Table

Co-Chairs:

• Heidemarie Wiieczorek-Zeul
  Minister for Development Coop
  Germany
• Sheila Tllou
  Minister of Health
  Botswana

  Ministerial participation

  Heads of agencies

  HIV/AIDS-ambassadors
  
  

Lead speakers on 5 key issues:

Existing AIDS Strategies

• Ivo Garrido
  Minister of Health
  Mozambique
• Lennart Hjelmaker
  HIV/AIDS-ambassador
  Sweden

Access to Services

• Julio Frenk Mora
  Minister of Health
  Mexico
• Maria Jose Vazquez/Ale Troserro
  International Community of Women living with HIV/AIDS

Women's Rights

• Charity Ngilu
  Minister of Health
  Kenya
• Mary Robinson
  Ireland
  President
  Realizing Rights: the Ethical Globalization Initiative

Participation

• Elena Salgado
  Minister of Health
  Spain
• Yolanda Simon
  YWCA

Empowerment

• Anbumani Ramadoss
  Minister of Health
  India
• Noleen Heyzer
  UNIFEM & Malaysia

Concluding Session

• Call For Action
• Concluding Remarks
• Crown Princess Mette-Marit of Norway
  

 

 

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