Walking the Talk - VSO

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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
3) The Global Fund to Fight AIDS, Tuberculosis andMalaria, WHO and other multilateral organisationsshould strengthen their capacity to collect anddisaggregate data on their own treatmentinitiatives by gender, use the data to supportnational AIDS treatment plans and budgets fordeveloping countries, and tailor their treatmentprogrammes accordingly.Developing country governments2) National governments should develop and strengthentheir capacity to disaggregate national data onaccess to ART. In particular, they must disaggregateaccess to ART by age as well as gender and monitorwomen and girls’ adherence to treatment.3) National governments should develop, fund andimplement national treatment plans and budgetswith a strong emphasis on women and girls inorder to achieve universal treatment.1) National governments should ensure that treatmentis accessible at the local level by making sure thatART and other HIV-related treatments are availableto women and girls living with HIV and AIDSthrough mobile and decentralised treatmentcentres, and by ensuring a wide range ofdistribution points. These centres and distributionpoints must provide nutritional support for womenand girls living with HIV and AIDS, and provideaccessible treatment information.Walking the talk putting women's rights at the heart of the HIV and AIDS response 35
Page 1 and 2: Walkingthe talkPutting women's righ
Page 3 and 4: ContentsContents 1Glossary 2Definit
Page 5 and 6: DefinitionsUniversal Universal acce
Page 7 and 8: Gideon Mendel/Corbis/ActionAidAdero
Page 9 and 10: Prevention, treatment and care and
Page 11 and 12: Gideon Mendel/Corbis/ActionAidStree
Page 13: Figure 1: Number of women and men l
Page 17 and 18: marriage, harassment or other socie
Page 19 and 20: childcare arrangements or to take t
Page 21 and 22: Multilateral organisations1) The Jo
Page 23 and 24: and testing. A few of the strategie
Page 25 and 26: Box 2. The Climbing to Manhood Proj
Page 27 and 28: some of the problems facing women a
Page 29 and 30: Box 3. The Gender Violence Recovery
Page 31 and 32: 3.5. Recommendations Donor governme
Page 33 and 34: non-discrimination. Failure to do s
Page 35: Box 4. The power of ART in Nigeria:
Page 39 and 40: support. While their efforts suppor
Page 41 and 42: first point of contact for any illn
Page 43 and 44: ‘care provider’, rather than th
Page 45 and 46: In some circumstances, the cost of
Page 47 and 48: The stipends can also be hard to ac
Page 49 and 50: ecause they do not have access to t
Page 51 and 52: HIV rally, Nairobi, Kenya.Jess Hurd
Page 53 and 54: 2) The Global Fund to Fight AIDS, T
Page 55 and 56: 39Women’s rights and universal ac
Page 57 and 58: 114www.who.int/hiv/topics/prophylax
Page 59 and 60: 191USAID/UNICEF/UNAIDS/World FoodPr

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