Zambia Country Presentation Role of the Women’s Movement: protecting the equality, equity and rights of women and children Regional Videoconference: Addressing Stigma and Discrimination of HIV/AIDS in Africa April 2, 2009

HIV Prevalence Ages 15 to 49 =16-14% from 2002 and 2007 Luapula Northern Eastern North-Western Central Copperbelt Lusaka 13-15% Western Southern 18-15% 22-21% 9-7% 20-17% 11-13% 8-7% 14-10% 15-18% Male 13-12%, Female 18-16% Urban 25-20% Rural 13-10% Heterosexual sex -78%; MTCT -21% of infections

Coverage & scale remain low - Zambia

Contextual causation and Key drivers of HIV Environmental Drivers Structural Drivers Individual Drivers Education is a factor –those with higher education almost twice as likely to be infected as those with no education! Unbalanced distribution of resources Women continue to bear the burden of HBC and care for OVCs (with associated exposure to S&D). Reproductive purposes Gender dynamics: Lack of access to health care; gender inequality; common practices of MCP and “sugar daddies”; high levels of migrant labour Domestic violence problem for women (HRW Report) Difficulties in talking openly about sex in schools Some groups experience “double discrimination” e.g. women; people with disabilities High risk behaviour groups: FSW and their clients; MSM and those engaging in CHS with low levels of consistent condom use- difficult to negotiate for women;

2. Policy Framework for Responding to Stigma and Discrimination u Zambia is a signatory to a number of regional and international declarations relating to HIV and AIDS (incl. S&D) and gender e.g. Maseru Declaration on HIV/AIDS and CEDAW. u Key national policies/plans addressing S&D include: FNDP, NASF , National HIV/AIDS/STI/TB Policy u Relevant gender policies/plans include: Gender Sector Program, the National Gender Policy and its implementation plan 2006, Population Policy 2007, HIV/AIDS Work place policies, the Women, Girls and HIV/AIDS Action Plan and the Gender Based Violence Action Plan

Programmes to address Stigma and Discrimination Zambia

International HIV/AIDS Alliance Zambia: Regional Stigma Training Programme: u Training trainers across Africa- mainly PLHIV- to use the Toolkit ‘Understanding and Challenging HIV Stigma: Toolkit for action (ICRW/Alliance) u Supports the roll-out of anti-stigma activities at national, district, organizational and community level u Develops new tools to tackle changes in stigma u Training support group members to be treatment support workers and anti-stigma agents (104 trainers trained in 13 districts in 2008) u PLHIV are open about living with HIV and act as role- models and community consultants.

Positive Women’s Network, Kabwe u Targets women in urban and rural- aims to empower women and men to live positively; challenge conventional image of women with HIV as victims u Voice of nurses living with HIV in relation to service delivery and needs u Runs workplace programmes in clinics and hospitals u Group of nurses trained as anti-stigma trainers through PWN

A Safer Zambia (ASAZA) u Decrease GBV through increased knowledge and attitude changes toward gender inequities u Give GBV survivors access to comprehensive services to meet medical, psychological, and legal needs at one-stop multi-agency u Form men’s networks to change male behaviour and attitudes toward GBV u Work with traditional leaders to address negative gender norms that privilege men’s rights over those of women u Provide youth life skills training to address abuse of girls, including child marriage and prostitution

Achievements & Successes u Stigma reduction and other positive changes identified at individual and community level u DPOs and other vulnerable groups now addressing HIV (including S&D) among women and children u Increased interfaith dialogue-ZINGO-leading to more open discussion of HIV, S&D and gender issues u Increased number of Positive Living Support Groups focusing on S&D and women’s empowerment u Increasing number of antenatal clinics focusing on couple counseling

Challenges and Gaps Consistent messaging; HIV message “fatigue”; S&D among children & young people, economic/social dependence of women; few programmes address values of men; issues of “double discrimination”. Lack of capacity -esp. gender analysis and mainstreaming skills; failure to understand link between gender and HIV; gender and S&D not a priority in most planning, implementation, M&E. Slow domestication of international declarations; weak implementation of policies and plans many policies/plans and workplace programmes still not HIV/gender sensitive; inadequate M&E/lack of evidence.

Key Lessons Learnt u Gender and S&D need to be at the heart of HIV programming –with appropriate investments in surveillance, quantitative and qualitative data collection and analysis u Strengthen linkages –to overall development processes; between HIV and gender mainstreaming. u Move beyond polices and plans to effective implementation; u Extend gender based programming to address the values and attitudes of men. u Children and young people can be agents of change for HIV/gender S&D –we need to invest appropriately!

The Way Forward u Support actions to address challenges/gaps and build on lessons learnt. u Ensure a particular focus on: –Scaling-up and predictable financing for effective programmes. –Improved programme design for weaker programmes (incl. development of appropriate indicators for M&E systems) –Accountability for implementation of relevant national policies and plans –Critical engagement in development of new legislation (e.g. the “Gender Bill”), policies and plans. –Domestication of relevant international declarations.