Ashley Judd

Ending AIDS? Not Without Ending Tuberculosis

2012-12-01T09:43:00-05:00

Over the course of our careers, we have both visited dozens of countries. We've been inspired by the people we've met who are living with HIV and are thriving today because they are able to get the care they need.

We still don't have a cure for AIDS, but the medicine we do have is powerful enough to transform HIV infection from a death sentence to a chronic but manageable illness for millions of people around the globe. Now, children living with HIV can expect to live a full life. Pregnant women can nearly eliminate the risk of transmitting the virus to their babies during childbirth. And this year at AIDS 2012, the International AIDS Conference, global health experts reinforced the claim that an AIDS-free generation is within reach.

But as the world's attention has been fixated on the fight against HIV and AIDS, something ironic and perverse has happened. We have failed to invest enough resources to mount an effective fight against tuberculosis (TB), the number-one killer of people living with HIV.

Many people are suffering and dying because the global community repeatedly ignores the fact that HIV is deeply intertwined with TB. These are epidemics that feed off one another. Today, as we hear calls for bold efforts to end AIDS, we must recognize that this cannot be done without increased efforts and funding to address TB.

When HIV attacks someone's immune system, adult or child, the person becomes susceptible to all sorts of other infections. The most common one is TB, a disease that is everywhere, with nearly 9 million people getting sick with it each year, and spreads through the air when someone who has it coughs, sneezes or even sings.

TB drives many HIV-related deaths. People who are living with HIV are 20 to 30 times more likely to develop TB due to a weakened immune system. Meanwhile, TB can also fuel HIV acquisition: If a pregnant woman living with HIV also has TB, the risk of the HIV virus passing on to her child more than doubles.

Coupled with HIV, TB has a devastating impact on families. There are some 10 million children in the world today who have been orphaned because of the death of a parent from TB. Even without the loss a family member, TB drives poverty because it keeps adults home from work and children out of school.

Scientists, doctors and activists around the world, who together belong to a global movement, believe that by working together they can realize two huge ambitions: zero transmission of HIV from pregnant women to their babies, and zero deaths due to HIV.

However, if we do not step up efforts to stop the spread of TB in communities affected by HIV, we cannot realize these ambitions. We know that such efforts save lives. The World Health Organization estimates that between 2005 and 2011, more than 1.3 million lives were saved through integrated HIV and TB programs. This is admirable progress, but there are still huge needs that are growing more urgent every day.

TB is curable in most people, with medicines costing as little as $25, but the disease is becoming more and more resistant to those drugs. Levels of drug-resistant TB around the world are the highest they've ever been, and 77 countries have found cases of the most dangerous and difficult-to-treat form of drug-resistant TB: extensively drug-resistant TB (XDR-TB). For people living with HIV, XDR-TB is virtually a death sentence.

We're talking about the end of AIDS today because the global community stepped up aggressive efforts to address HIV. Governments and foundations recognized the scope of the problem and poured money into solving it.

TB has remained in the shadows for too long. Each day we delay the scale-up of bold TB programs, the disease will continue to drive the HIV epidemic. The time for action has never been clearer.

Dr. Lucica Ditiu is Executive Secretary of the Stop TB Partnership in Geneva, Switzerland. Ashley Judd is a PSI Board Member, a PSI Global Health Ambassador and an actress.

Why AIDS Won't Win

2012-03-12T19:37:00-04:00

"Where is Lesotho?" my friend asked me as I was sorting through my mail.

I held the envelope in my hand, staring at the smudged postmark that read "Maseru, Lesotho." As I opened it I imagined the worst. Lesotho, a landlocked kingdom surrounded by the nation of South Africa, has faced one of the world's fiercest HIV/AIDS epidemics. Last year, more than one in five adults in Lesotho was HIV-positive, a statistic that has ravaged families and filled orphanages across the country. I imagined that the letter was from a grad school classmate or global health colleague, informing me that the situation in Lesotho was getting worse.

I couldn't have been more wrong.

The letter, written by a young woman named Limakatso Mokobocko, filled me with hope. It was a testament to why we can create an AIDS-free generation: the power and commitment of youth.

Limakatso is an on-air radio host for the Silk-ee^TM female condom program, an initiative operated by PSI, Johnson & Johnson, and the United States Agency for International Development to empower young women to protect themselves from HIV and unintended pregnancies. Her letter recounts, in painful detail, the horrors inflicted on her country by HIV, by gender inequality, and by cultural taboos that prevent young women from asking simple questions about sex that could save their lives.

Limakatso's letter (transcribed below) was not a cry for help or a statement of defeat. Rather, it was a call to action, one that started when Limakatso looked in the mirror and asked, "What can I do?" It's a question I asked myself when I learned that half of all new HIV infections every year around the world are among people under 25. And it's a question that millions of young men and women across Africa -- and the world -- are answering with their actions.

Fed up with watching a disease squander their generation's future, young people are breaking down communications barriers. They are talking to their friends, their families, their boyfriends, their girlfriends, encouraging them to ask questions, protect their health, and pursue their dreams. They are saying, "Enough."

This summer the International AIDS Conference in Washington D.C. will include thousands of youth voices from around their world. If the global community is serious about creating the first HIV/AIDS-free generation by 2015, we need to listen to young people and respond to their needs.

And we need to do it now.

Please read Limakatso's letter:

Dear Ashley,

I just finished reading your book, All That Is Bitter & Sweet. Your book inspired me to share the story of my own country.

Of course, it is hard to compare Lesotho with many of the places you describe in your book. I mean, what can compete with the horrors of forced prostitution in Cambodia or sex slavery and trafficking in India? Those heartbreaking stories ultimately made me feel, perhaps naively, that we here in Lesotho have a lot to be grateful for.

Walking around Maseru, you might find it quiet and orderly. But in a country where 23% of adults are living with HIV, the third highest in the world, this calm surface only hides a pandemic that is wreaking havoc on families -- leaving behind orphans, widows and extreme poverty. Women are especially impacted by the HIV epidemic in my country. HIV prevalence jumps dramatically from about 8% to 40% as women transition from adolescence to womanhood. As a Mosotho woman, I remember the joy and optimism of my youth and it pains me to think about this next generation of young women are faced with a disease that robs them of their youth and shows no sign of retreat.

In Lesotho, it's very common for people to have multiple sexual partners -- a problem that is now one of the biggest drivers for HIV. The situation is so bad that most people do not think it is possible to be committed to just one person. At the same time, many girls in Lesotho often start having sex with older men -- who promise to help them pay for food, books, or clothes. Together, these problems have infected many young girls with HIV.

In our culture, young girls and women are powerless to insist on condom use and are forbidden to talk openly about sex. In reading your book and learning how you've used your position to confront similar issues, I came to realize that few people in Lesotho have the courage to address our issues head-on.

In your book, you talked about how the contributions of every person are important and improve all of humanity. I couldn't agree more, which is why I've recommitted myself to speaking out more about the issues that affect women in my country. I am currently the on-air radio voice for PSI/Lesotho's young women's program, which is called Silkee. I took on this role about the same time that I was reading your book and your words inspired me to use this forum to lead important discussions about sex, condom use and the rights and responsibilities of young Basotho women. In this way, I am trying to live up to your words by making my small contributions to improve all of humanity.

Sincerely yours,

Limakatso Mokobocho

To read more about other young men and women like Limakatso making a difference in the fight against HIV/AIDS, please read the latest, youth-focused issue of Impact Magazine.

Family Planning: It's Time to Welcome Men Into the Discussion

2011-07-12T14:18:58-04:00

Yesterday, on World Population Day, the United Nations Population Fund officially launched 7 Billion Actions -- a campaign to raise awareness and action around our planet's growing population, which is set to reach 7 billion later this year.

The campaign is a wake-up call to the health, environmental, and social challenges associated with rapid population growth. It is also a wake-up call to the importance of voluntary family planning.

In 2011, more than 200 million women worldwide are still denied access to desired family planning services due to unavailable resources or lack of support from their husbands and communities. As a woman, I believe it is time to make universal access to family planning a global priority. And as a woman, I believe it is essential to welcome men into the conversation.

Why Family Planning?

According to World Health Organization statistics, approximately 1,000 women die every day from preventable causes related to pregnancy and childbirth. Over 99 percent of these maternal deaths occur in the developing world, in countries where a mother's death can leave children -- and entire families -- in a perilous scenario.

Many, if not the majority, of these women want smaller families but often do not know how to prevent pregnancies. During my travel as Global Ambassador for the public health organization PSI (Population Services International), I have personally met some of these women.

I remember Therese, a woman in the Democratic Republic of Congo, who was so desperate after having given birth to six children that she ingested poisonous herbs to terminate three different pregnancies -- leaving her in agonizing, life threatening pain. Her husband, Victor, watched each time in helpless fear. Like his wife, he had never been given information on family planning methods that could protect his wife and his family.

Their story is all too common and is a reminder that family planning communication must incorporate men into the equation.

Men and Family Planning

Research shows that men have a significant influence over women's reproductive health decisions in the developing world, especially in Africa. Men who receive education on sexual and reproductive health are far more likely to support their partner's decision on family planning.

Despite these facts, many family planning programs continue to follow the traditional woman-focused model, excluding men from research, service provision, and information campaigns.

A program in the Democratic Republic of Congo is addressing this problem, tailoring communication to reach men. Moreover, it uses an innovative and remarkably simple avenue to do so: the cell phone.

Approximately 24 percen of women of reproductive age in the Democratic Republic of Congo have an unmet need for modern family planning. Victor and Therese (pictured) reached out as a couple for family planning services to protect the health and well-being of their family.

Reaching Men in the DRC

In 2011, 70 percent of worldwide cellular phone users live in developing countries. The World Bank has identified mobile phones as one of the most powerful ways to deliver health services and information to people living in remote areas, particularly in largely rural countries like the DRC.

PSI and its local partner, Association de Sante Familiale, saw a unique opportunity within these statistics and, in 2005, launched a family planning hotline in the DRC called Linge Verte.

Open 5 days per week, 8.5 hours per day, Ligne Verte provides free, accurate information on family planning and refers clients to family planning clinics across a wide geographic range.

Most importantly, Ligne Verte provides a safe, confidential zone for Congolese men and women to ask sensitive questions about family planning, as well as other sexual health concerns such as HIV.

To date, 84 percent of Ligne Verte callers have been men. Parallel PSI hotlines in other countries reflect similar statistics. In Benin and Pakistan, men make up 77 percent and 78 percent of callers, respectively, to national PSI family planning hotlines.

These numbers speak for themselves.

Family planning is not a gender specific issue. Men, as much as women, are interested in learning about ways to protect the physical and economic health of their families. They are asking questions and seeking answers.

It is our responsibility to listen and respond to them.

For more information on family planning:

2011 International Conference on Family Planning, Dakar, Senegal, November 29- December 2

7 Billion Actions Campaign

A Kenyan Brothel's Lasting Impression

2011-03-08T00:00:00-05:00

This year's International Women's Day comes at a difficult time. The brutal sexual assaults and harrassments described by women at Cairo's Tahrir Square last month were a visceral reminder of the ongoing subjugation suffered by so many women and girls around the world. Abuse and humiliation of women is an outlet for rage, addiction, dominance and control and, at times, a tactic of war. As my friend and writer Nicholas Kristof recently wrote in his forward to my memoirs: "The central moral challenge of the 19th century was slavery, and in the 20th century it was totalitarianism. In this century, the equivalent moral challenge is to address the oppression that is the lot of so many women and girls around the world."

We are all guilty of discounting difficult realities. At home in the United States, we often ignore the unacceptable daily facts facing women worldwide -- the thousand women who die each day in pregnancy or childbirth, the tens of millions of girls who are kept out of school, and the millions more who are regular victims of violence and abuse. A few years ago, in my role as Global Ambassador for the health organization PSI (Population Services International), I visited a Kenyan brothel -- it was a scuzzy flea-bag flophouse on a teeming street in a broken-up, tough part of town. Rooms were rented in 15-minute intervals to exploit prostituted women who often fought over clients, so desperate were they to survive.

I met a woman there name Shola, who was not as hardened as many of the other women I've met in brothels in 13 countries. Shola was a teenager -- six-feet tall, rail thin and heartbreakingly gorgeous. She was one of seven children. Her mother died in an accident when she was 12; when she was 15 her father died of tuberculosis. Her father's relatives took their land and she was left alone, in charge of her siblings. She dropped out of school and tried to make do. At 15, she found out she was pregnant. At 18, she was pregnant again. This time, her boyfriend left her.

Two months pregnant, hungry, with no education, no skills and her health collapsing, Shola made a poor and disempowered woman's classic "choiceless choice." Every day at 9 a.m. she would take the bus to the crowded street where Imet her, and she would sell herself to strange men for sex while a neighbor watched her child. She earned a dollar on her back, two dollars on her hands and knees. Struggling to feed her growing toddler for whom her breast milk was not enough, she worked until her eighth month of pregnancy, and was having exploited sex again a month after delivering. She was innocent and fragile. And she was so ashamed of what she was doing.

It's easy to distance ourselves from Shola's agonizing lot in life and to ignore her story on a day like today. But we must remember that her life is not so different from our own. She is a woman with incredible potential, dreams and hopes. My own mother was a high school senior when she found out she was pregnant. She took money out of her piggy bank to secretly hire a cab to visit our family doctor and confirm the pregnancy. When the doctor found out she was pregnant he wept; when my grandmother found out, she screamed. Like Shola, my mother had to drop out of school and was forced to move out of her family's home.

Fortunately for my mother, she was born here in the United States, And unlike Shola, my mother had grandparents who, despite the dramas, pitched in to help, and a boyfriend -- my father -- who adored and helped care for his girls.

Thanks to these important blessings, in spite of her own considerable hardships, my mother was able to raise a healthy, productive family. Shola doesn't have those same opportunities, and her situation puts her life and her family's at risk. Every day, she's exposed to lethal sexually transmitted diseases like HIV and further unintended pregnancies. And when she is not healthy and strong, her children can't be either. Children who lose their mothers at a young age are 10 times more likely to die prematurely than those who have not. For Shola and millions like her, the onus lies on us to help as much as we can to create opportunities for her and her family to live healthy and happy lives. If we want peace, we must.

As a start, I encourage all of you to honor and remember Shola today by educating yourselves and those around you. I read a perplexing poll that said that the majority of Americans believe that 25 percent of our federal budget goes to foreign aid. Actually, the United States Agency for International Development (USAID) receives only one half of 1 percent of the federal budget for foreign aid. I hope you'll take some time to learn where that money goes and how USAID and all Americans are improving the health of millions of people in the developing world in HIV/AIDS, malaria, child, maternal, reproductive health, and tuberculosis. I also hope you'll focus on what more still needs to be done to help women like Shola. Even if all you can do is spread the word, it's something. Eli Weisel said to fail to transmit an experience is to betray it. In a world of difficult problems, that is a challenge that you can meet. The time is now, and our sisters across the world are waiting.

Ashley Judd is an actor and philanthropist currently serving on the board of directors for the global health organization PSI (Population Services International, as well as other NGOs). Read more about Shola and Ashley Judd's other travels in her upcoming memoir All That is Bitter and Sweet.

Costs of Convenience

2010-11-26T11:24:18-05:00

People steal, they cheat and lie
For the wealth and worth
It will buy
But don't they know
On Judgment Day
Gold and Silver
Will melt away

~ Hank Williams

Quite literally dripping with electronics, I walk through Dulles airport to my gate. I am holding my iPad, downloading books from Kindle to have to read while on my journey. So far, I've chosen Kentuckian Barbara Kingsolver's Animal, Vegetable, Miracle; she came to mind, of course, because her spectacular book, Poisonwood Bible, is set in Zaire (now DRC). I've been meaning to read this one, and the amazing Blackberry Farm, over in east TN in the Great Smokey Mountain National Park, was featuring it in their gift shop. It felt like a good fit, a distracting, companionable counter point to the aim of my trip. I've also downloaded something I hadn't known existed, an Elizabeth Cady Stanton Bible, as well as Dietrich Bohnhoeffer's Psalms: The Prayer Book of the Bible. I have been studying the 104th. It about says it all, as far as I can tell. I wanted it on my iPad.

I am also carrying my iPhone. Charging it in the lounge, I nearly forget it, and scoop it up hastily. It dangles like a fashionable necklace as I juggle everything: bag, elevator buttons, doors to pull, passport to display, boarding pass.

My iPod is in my bag. I decide I want my full music library, not just the partial one (spiritual, recovery) I have loaded on to my phone. The size is convenient. Goodness gracious, I don't want to have to have my MacBook Air out just to listen to music, when I could have instead something that fits in the palm of my hand.

Also in my bag is that MacBook Air. I was determined to bring only the iPad, and had loaded classic movies on it, thinking I may want occasionally to take my mind off the matters at hand in DRC, for some lightheartedness, self care, a reminder the whole world is not woe, and that art and movies help with what woe there is. (I have recently adopted an older feller to be a grandfather figure to me, and at lunch the other day he was saying I should be proud to be an actor. "The Germans, God, in the Depression, all they had to turn to was Hitler. We had the movies! What would we have done without them?") But I am not yet comfortable writing lengthily on the iPad, and have had some scary episodes losing significant chunks of work, and not being able to work with timely, deadlined documents others send me.

I didn't even want all this stuff. My iPod was in gift basket from an event, about eight years ago (yeah, still rockin' the classic). My iPad was a gift from a generous producer. My perfectly good previous iPhone was stolen, and Baton Rouge had plenty of the new ones, so, movie star whatever excitement in the store, and I somehow ended up with one. This is typical of the Saturation of Stuff that characterizes much of our society.

And that is how I, on my way to Democratic Republic of Congo to educate myself first hand about conflict minerals and advocate for a clean supply chain, am at the same time utterly complicit. My electronics, received as gifts or purchased, profit armed militias and support slavery. I am financing mass rape as I enjoy these ridiculously Global North ultra-efficiencies and conveniences, for large scale rape is the preferred predation mining interests use to humiliate and terrify local populations, in order to control resource areas. The UN notes that virtually every mine in DRC is militarized. This means little to no tin, tantalum, and tungsten is mined free of brutal exploitation, extortion, violence, rape, rape, rape.

My phone vibrates (thanks, tungsten). My music plays, using stored electricity, thanks to tantalum. My laptop screen lights up and hums, thanks to the tin used to solder its circuit boards, and the gold used as an electronics component. I e-mail my human rights traveling partner, Enough Project Co-founder John Prendergast, and compose letters to the Congolese sister I sponsor through Women for Women International. I hurt, even as I try to help, via the very actions and tools I use to try to make a difference.

What good is gold

And silver, too

If your heart's not good and true

Sinner, hear me when I say

Fall down on your knees

And pray

AppIe is known for the clean lines of their products, the alluring simplicity of their designs. Dare I....go so far....as to suggest...this signature cleanness is stained by the shit and urine of raped women's leaking fistulas?

I dream of the day when Apple and other electronics companies fully commit to tracing, auditing, and certifying the minerals they use in their products, and rape minerals are successfully excluded from the marketplace. We no longer have lead in our paint. Companies report with full transparency contents and manufacturing processes in order to assure public health and gain consumer confidence. This is no different. It is a minimum standard of conduct.

I dream of the day when North Americans recoil in horror at the introduction of an otherwise revolutionary and exciting electronic product that lacks TAC....when the queues are expressions of solidarity for 11-year-old mine slaves, women whose vaginas have been perforated by object insertion rape, and families forced to eat one another in each other's presence.

In fact, I have just decided what I want for Christmas, which will be here before I know it.

What do you want, this holiday season?

I board my flight.

I turn on my iPad.

I write this diary.

I hurt, even as my life is dedicated to helping.

For I'd rather be

In a deep dark grave

And know that my first soul was saved

Than live in this world

In a house of gold

Than deny my kind

And doom my soul

I rest on the flight to Brussels, but I do not sleep. I recall something I have been thinking about lately, aspiring to apply it to genocidaires, to FDRL, to Congolese military, to all armed militias, even the ones who make people eat each other.

My friend Victor Chan recounts in his book with the His Holiness the Dali Lama an exchange between HH DL and a fellow Lama, who had been tortured by the Chinese.

"Were you ever afraid?" HH DL asks his brother.

"No," replies the man.

"Really? You never felt fear?" presses the great spiritual leader.

Pause.

"Yes. I was afraid I would lose compassion for Chinese," is his surprising concession.

I have this book on my (yes) iPod. If I get a massage, I listen to it, or Archbishop Tutu's wonderful book, which has the added benefit of being in his own irresistible voice. When I heard this line, "Yes. I was afraid I would lose compassion for Chinese," it took my breath away.

My spiritual growth cannot afford the convenience of hate. The cost is too great. It makes me no better than they. I am asked to examine the violence in my own thoughts, where all violence starts. I am asked to regard even "justified anger" as a dubious luxury. I am asked to remember, I have no idea what I am capable of, under such circumstances. I am asked to love my enemies.

What is this grace, that allows me to feel mercy for the murderer?

This essay is excerpted from a trip diary by actress and humanitarian Ashley Judd. She traveled to eastern Congo with John Prendergast, Co-founder of the Enough Project at the Center for American Progress (www.enoughproject.org), to raise awareness of how the global trade in conflict minerals fuels rape and sexual violence as a war weapon. For more information on the campaign against conflict minerals, visit www.raisehopeforcongo.org.