[procaare] Politics, Money and Reproductive Health

[AIDS2002 <procaare@usa.healthnet.org>]

Politics, Money and Reproductive Health
AIDS2002 Conference
Barcelona, July 7-12, 2002
****************

Advocacy, empowerment and prevention: these are three fundamental concepts driving much of
the fight against the HIV pandemic. They are also principles that underpin the activity of
the International Planned Parenthood Federation (IPPF). This organisation has suffered
severely from the recent attempts by President George Bush to court the "moral majority"
in the US by invoking the "Global Gag" - withdrawing of US funds from organisations that
support abortion.

The result? A severe restriction on the international work of the IPPF as it seeks to
increase the choice of women in deciding their reproductive and sexual health. At this
conference, the IPPF stand is relatively small (as compared with, say, the GSK
pantechnicon), but what they and similar NGOs represent is more crucial, far outweighing
the size of their stand - the centrality of sexual and reproductive rights in the battle
against HIV.

On Monday, in the oral presentations of the social sciences theme, the conference
addressed in some detail how HIV intersects with the lives of women and children across
the globe, and will focus on such issues as discordant couples making choices about
parenthood, and gender inequalities reducing the power of women over their reproductive
health. It is easy to see the paradox. The IPPF funding problem illustrates how this
highly important focus can be potentially eclipsed by the overarching issues of resources
and political will.

This is further evidenced in the press conference held by Médecins Sans Frontières on
Sunday. Here, the question of distributing anti-retroviral treatments to HIV-positive
women in South Africa was presented as human rights issue, as well as one relating to
gender and prevention. Choice to be treated helps a woman regain control, and potentially
prevents a second tranche of HIV positive children.

In both of the cases above - funding for the IPPF, and provision of cheap antiviral
medication - it is money that provides the engine for positive action, and political will
that can (and does) work for or against both. This is not new, but what is needed,
especially with regard to national politics, is a greater awareness of the potential for
cultural opposition and conflict. Ideas about HIV, and what is right and what is wrong,
are preset by local belief systems, and this applies to both the developed and developing
world.

This underpins, for example, the conflict with the Catholic church over the use of
condoms, and (perhaps even more controversially) Thabo Mbeki's controversial views on the
links (or not) between HIV and AIDS.

To each group or person, their approach makes perfect sense, at least to them - it is
everyone else who is wrong. To accept this cultural relativism would be tinged with
danger, but it does provide a degree of insight into why people, groups and governments
sometimes act as they do.

This should also encourage a degree of self examination - should the scientific discourse
of the developed world really dominate as much as it does? How do other people see those
of us involved in the field of HIV? How can we communicate with them more effectively?

Politics and money will remain at the very epicentre of HIV prevention and the provision
of care. As we turn to face another potential area of controversy - the provision of
vaccines - there can be little doubt that the challenge to find an approach that is both
fiscally and politically effective will continue.

Key Correspondent
Health & Development Networks
AIDS2002 Conference

Email: correspondents@hdnet.org
Web: http://www.hdnet.org

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