1. Recommendations for the United Nations Demographic Change Work Group Gender-Based Solutions to the AIDS Epidemic in Africa Team Members: Mukesh Vidyasagar Patricia D’Costa Miho Komiya Masatake Yamamichi Aaron Law

2. Overview of Presentation Overview of AIDS in Africa Gender-related AIDS issues in Africa Uganda and Zambia issues of gender Comparative governmental policies Conclusions and recommendations

3. AIDS: An African Problem Africa Sub-Saharan Africa represents 2/3 of the global HIV-infected population while comprising a mere 1/10 of the global population Problematic Responses to AIDS: Fear of Admitting Problem External Blaming Slow Medical Acceptance *Sources: UN AIDS 2004 Report Richard Fredland, “Aids and Development,” Journal of Modern African Studies, 1998

4. Growing AIDS Crisis

5. AIDS: A Gendered Problem 10 out of 13 people who contract HIV in Africa are Sub-Saharan African women 60% of HIV-positive individuals in Africa are women (13.3 million) More than 75% of young people who contract HIV in South Africa, Zambia, and Zimbabwe are women *Source UN AIDS 2004 Report

6. Gender and Africa Source: UN AIDS 2004 Report

7. Similarities: Gender in Uganda and Zambia Patriarchal African Societies –Women are dependent on men for economic stability –Male-dominated leadership –Legacy of physical and sexual violence –Poverty creates female susceptibility to AIDS –Increases in “transactional sex”

8. Differing Policies: Responses to AIDS 1. High-level Political Support UGANDA Museveni became President in 1986, began AIDS fight Central government level to grass-roots level policies In 1989, enacted law of one- third female parliamentary representation ZAMBIA No high-level political commitment No HIV/AIDS gender analysis No effective HIV/AIDS programs nor large public campaigns--treated AIDS as a taboo topic (1991-2001)

9. Differing Policies: Responses to AIDS 2. Multi-sectoral approach UGANDA Established multi-sectoral organization, the Uganda AIDS Commission (UAC) in 1992 Established the national AIDS Control Programme (ACP), with Defense, Education, Gender and Social Affairs ministries in 1986 ZAMBIA No strategic and multi- sectoral management at the central level Technical and line ministry officials were the most vocal and active with regard to HIV/AIDS

10. Differing Policies: Responses to AIDS 3. Community-based approach UGANDA Used ACP Program training as a community-based, face- to-face approach to train practitioners and the general public (The Behavior Change-Based Approach) More open personal communication networks for acquiring AIDS knowledge ZAMBIA No evidence of government- led community-based approaches NGOs were ineffective, due to lack of funding and human resources

11. Differing Policies: Responses to AIDS 4. Education UGANDA Trained teachers among other community leaders to help in AIDS education Multiple channels for information dissemination School Health Education Program (SHEP) in primary schools Early Life Skills Initiative collaboration with the many NGOs ZAMBIA Lack of appropriate HIV/AIDS curriculum at school because of no high-level political commitment Limited human resources in the Ministry of Education (only 2 staff members focused on AIDS) Continued requirement of school entrance fees

12. Differing Policies: Responses to AIDS 5. Legal Aspects of Sexual Violence UGANDA In 1991, enacted laws to protect women from sexual violence; made the rape of girls under 14 a capital offence, raised the age of consent for sex from 14 to 18 ZAMBIA Even in 2000, the Ministry of Health/Central Board of Health report did not mention the problems of sexual violence

13. Differing Results Uganda –4.1% of the adult population infected –Change in AIDS population 2001-2003: -90,000 –Change in female AIDS population: -40,000 –Increase in the age at which individuals first have sex. –Increase in general condom use Zambia –16.5 % of the adult population infected –Change in AIDS Population 2001-2003: +100,000 –Change in female AIDS population: +20,000 –Rampant female teenage sexual abuse

14. Conclusions –Conclusions Policies in Uganda helped decrease women’s HIV/AIDS rate more sharply than that of men, because it realized gender undergirded much of the HIV/AIDS crisis. Recognizing that women were physiologically and socially more susceptible to HIV than men, government policies made significant steps in several areas.

15. Recommendations Focus on gender to change cultural norms Leadership initiatives Engage civil society in form of tribal leaders, traditional healers, teachers, religious and community leaders Early education of risks Increase female parliamentary representation