Walking the Talk - VSO

the development of a drug-resistant strain of HIV. Asalready mentioned, it is therefore important thatgovernments and multilateral organisations monitor andevaluate women’s adherence to ART and designtreatment initiatives in response to the collected data.4.3. ART in resource limited settingsScaling up to universal access to treatment presents anenormous challenge for developing countries. Inresource limited settings, there may not be enoughsupplies for all patients living with HIV and AIDS whorequire treatment. Limited availability raises thornyethical questions as to how to ‘ration’ supplies and whogets priority in treatment distribution. Such issues are ofparticular concern to women and girls who may nothave the social and political power to advocate onbehalf of themselves. Recently, such issues have takeninternational prominence. UNAIDS has called for theestablishment of national ethics panels in recipientcountries, while WHO has commissioned a series ofbackground papers and a guidance document onethics, equity and access to ART. 153 Whereas decisionson resource distribution must ultimately be made atcountry level, guidance by the multilateral agenciesmust take into account the particular needs of womenand girls.As the story of Mary Bulus (see Box 4) indicates,effective treatment can make a dramatic difference tothe lives of women and girls living with HIV and AIDS.While the limited data currently available suggests thatmore women than men access public sector ART,women must overcome a distinctive set of barriers toaccess treatment and to follow the treatment regimen.Economic dependence, a lack of autonomy andconfidentiality turn accessing treatment into an ordealfor many women and girls. Donors, multilateralorganisations and country governments all have acritical role to play in addressing these barriers in theirHIV and AIDS interventions.4.4. Recommendations Donor governments1) Donor governments should ensure that theirfunding and funding processes address the barriersfaced by women and girls in accessing andadhering to treatment.2) Donor governments should provide more help tocountry governments to fund treatment literacyprogrammes and increase their funding for femalefriendlyhealth systems, including provision formobile drug distribution and treatment points.3) Donor governments should strengthen theircapacity to collect and disaggregate data on theirown treatment initiatives by gender, by developingsound indicators on gender equality and women’srights, and sharing their technical knowledge tosupport national governments to do the same.Multilateral organisations1) WHO should develop rights-based treatmentguidelines that focus upon, for example, increasingthe accessibility of treatment information, facilitiesand medications for women and girls living with HIVand AIDS.2) UNAIDS should develop and encourage thewidespread use of indicators to monitor women’sadherence to ART, including indicators on nutrition.34 Walking the talk putting women's rights at the heart of the HIV and AIDS response