Serra Sippel2013-05-19T21:43:44-04:00Serra Sippelhttp://www.huffingtonpost.com/author/index.php?author=serra-sippelCopyright 2008, HuffingtonPost.com, Inc.HuffingtonPost Blogger Feed for Serra SippelGood old fashioned elbow grease.The Right to Fight AIDStag:www.huffingtonpost.com,2013:/theblog//3.31324002013-04-22T13:35:42-04:002013-04-22T13:35:46-04:00Serra Sippelhttp://www.huffingtonpost.com/serra-sippel/Agency for International Development, Et. Al., v. Alliance for Open Society International, Inc., Et. Al.--centers on a policy that requires organizations to adopt the U.S. government's point of view as a condition of receiving U.S. global HIV/AIDS funds. Not surprisingly, it is being challenged on grounds that it violates the First Amendment.
The anti-prostitution loyalty oath (APLO) is at the center of the case. It is a provision in the 2003 United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act (the same law that authorized PEPFAR, the President's Emergency Plan for AIDS Relief) that requires organizations receiving U.S. global HIV/AIDS funds to adopt an organization-wide policy opposing prostitution. The provision remained in place when Congress reauthorized PEPFAR in 2008, and is still a part of PEPFAR today.
Since the APLO's inception, the public health community has been critical of possible ramifications it could have on HIV prevention interventions. After all, the policy didn't emerge as a public health response to HIV. It arose when some legislators saw an opportunity to enforce ideological purity about sex work when PEPFAR first emerged.
It's not just a mere inconvenience to be told what you can and cannot believe as an organization fighting HIV. Being able to find a solution to this devastating illness means being able to implement best practices in public health, to explore new approaches, to talk to anyone and everyone about risk and prevention. Freedom of speech and freedom of belief feed an effective public health response. Engaging sex workers to stem the spread of HIV requires building trust and ending stigma and discrimination--isn't it counterintuitive to force organizations to pledge opposition to one of the groups most at risk of HIV infection? Isn't it irresponsible, if not dangerous, to exclude the contributions of people affected by a pandemic?
The government of Brazil thought so. In 2005, it rejected $40 million in U.S. HIV/AIDS funding because of the APLO's potential to damage the government's partnership with sex workers in addressing Brazil's HIV epidemic. Brazil considered sex workers essential partners for the development and implementation of effective HIV prevention and treatment programs. It would rather lose $40 million than compromise what it considered to be a public health best practice in defeating HIV. And it would rather depend on its own successful policies than be compelled to adopt the U.S. government's opinion--not something one would expect from a country that defines itself as a champion of free speech.
It turns out Brazil was right to be wary. Research published in the Journal of the International AIDS Society in March 2013, found that because of the APLO, organizations have limited or eliminated HIV prevention and treatment programs targeting sex workers. Furthermore, in its 2013 Congressionally-mandated evaluation of PEPFAR, the Institute of Medicine noted that the implementation of the APLO, "...is seen by a range of stakeholders in the global health community as impeding access to HIV services for sex workers and as a missed opportunity for PEPFAR to more effectively contribute to the HIV response in partner countries and to the reduction of HIV transmission."
It is known by now that the U.S. has a flawed policy that undermines HIV prevention and treatment, in addition to flouting the First Amendment. It is the worst of what we have to offer the world: instead of the power to heal and the freedom to think independently, we aid and abet a plague, and restrict ideas that are out of line with a superficial view of morality. Our commitment to the First Amendment is proven when we allow it to stand in situations that are not to our liking, but are for the public good. This is one of those times.
Today, we need more open discussion and debate about public health, not less. Current law stands in the way of the discussion and independent thinking necessary to find an end to the HIV epidemic. Putting aside our own prejudices about sex work, the Supreme Court is being asked to give public health organizations and experts--who know better than legislators what it takes to fight HIV--the freedom they need to do their jobs effectively. In short, the justices need to grant the right to fight HIV.
Have no doubt that we need it.]]>Delivering America's Promise to Women Who Are Raped in War and Conflicttag:www.huffingtonpost.com,2013:/theblog//3.28293472013-03-07T16:34:24-05:002013-05-07T05:12:01-04:00Serra Sippelhttp://www.huffingtonpost.com/serra-sippel/
In a presidential memorandum on January 30, 2013, President Obama promised to advance the status of women and gender equality globally through implementation of U.S. foreign policies that seek to codify that promise. His leading example was the National Action Plan on Women, Peace and Security.
Now is the time to turn this promise to action.
Through the National Action Plan, the U.S. pledges to defend women from violence, to prevent conflict in the first place -- and notably -- to "provide support for survivors of conflict, torture, and sexual violence... through direct services, including sexual and reproductive healthcare." It shouldn't be surprising the plan includes access to sexual and reproductive health care. Threats to women's sexual and reproductive health are among the most dire consequences of war rape. Survivors often face HIV and other sexually transmitted infections, pregnancy, traumatic fistula, and other severe damage to internal organs.
A woman's right to dignity and bodily integrity is violated when she is raped in war and torture. Women must have access to services that may restore -- if only slightly -- her health and bodily integrity. Of particular importance is access to reproductive health services such as emergency contraception, post-exposure prophylaxis, and safe abortion -- all are critical to a woman's physical health, mental well-being, and restoration of her rights.
The Action Plan acknowledges the needs of women who have survived conflict in a way the U.S. has never done before. This could be a game-changer for women worldwide -- if it is implemented fully, with full attention to the sexual and reproductive health and rights of women and girls.
Up until now, U.S. politics have blocked full attention to the sexual and reproductive health and rights of women and girls who are raped during war and conflict by denying them access to abortion services. There are hopeful signs that this is changing -- the Action Plan, combined with U.S. voters' rejection of restrictions on the reproductive rights of rape victims, promises a way forward. Denying access to healing services to those who have suffered so much is almost universally acknowledged as inhumane, and politics have no business standing in the way.
Now we need the political courage and will for full implementation of the Plan that includes provision of and access to the full range of sexual and reproductive health services that women raped need and deserve -- and that includes safe abortion services.
Now is the time for the administration to move from promise to action.]]>Searching for the Soul of Politics 40 Years After Roetag:www.huffingtonpost.com,2013:/theblog//3.25068772013-01-22T14:26:21-05:002013-03-24T05:12:02-04:00Serra Sippelhttp://www.huffingtonpost.com/serra-sippel/
She is an American citizen who was gang raped in a country where mass killings, disappearances, and torture were used to oppress its people. When she returned to the U.S., she faced the horrifying reality that she was pregnant from the torture she survived. She was able to secure a safe, legal abortion, unlike the women in the country she fled. Even though the U.S. was there offering foreign aid, she and other rape victims could not have secured safe abortions.
Because even though abortion has been legal in the United States for four decades now -- and in cases of rape, incest and life endangerment, it is legal for federal funds to pay for it -- the U.S. denies funding for the same abortion services to women overseas even though U.S. law allows for it. The Helms Amendment, which forbids U.S. spending on abortions overseas for the purpose of family planning, does not prohibit U.S. foreign assistance for abortion in the cases of rape, incest, or life endangerment. In actuality, and in stark violation of the Geneva Conventions -- to which the U.S. is bound -- the U.S. forbids its humanitarian aid to pay for abortion services for women who have faced war rape and torture.
Today, on the 40th anniversary of Roe v. Wade, the Center for Health and Gender Equity is calling on the United States to demonstrate the depth of its compassion as a country and allow U.S. foreign assistance to be used to provide abortion services. Congress must repeal Helms entirely, but in light of current reports of war rape in Syria and gang rape in India, there is an urgent need to comply immediately with current U.S. law, and the Geneva Conventions, and fund abortion in cases of rape, incest and life endangerment.
The U.S. is a generous country and has the capacity to respond to global violence against women and girls with compassion. Compassion to not only commit ourselves to prevent and end such violence, but compassion to provide the highest standard of care and support, to treat wounds and restore health for the women and girls who face such cruelty.
Politics has no soul when we allow political agendas to interfere with support for those who suffer. It is unconscionable to deny women and girls who have been raped, and whose lives are at risk, the support and restorative health services they need. On the anniversary of Roe v. Wade, we have to act with compassion and allow U.S. foreign assistance to fund abortion services for women and girls -- whether they live in war and conflict or a nation at peace. We can at least start by responding to the women and girls who have been raped and whose lives are at risk.]]>To the Next US Secretary of Statetag:www.huffingtonpost.com,2012:/theblog//3.22140722012-12-04T17:25:16-05:002013-02-03T05:12:01-05:00Serra Sippelhttp://www.huffingtonpost.com/serra-sippel/This post is co-authored by Pamela W. Barnes, president and CEO of Engenderhealth. Ms. Barnes has more than 30 years experience in global health. Prior to joining Engenderhealth, she served as president and CEO of the Elizabeth Glaser Pediatric AIDS Foundation.
To the next U.S. Secretary of State:
Congratulations on your appointment. You have some big shoes to fill.
Hillary Clinton has been a firm diplomat -- and a tireless champion of global health and women's rights.
On Thursday, the eve of World AIDS Day, she released a blueprint for creating an AIDS-free generation.
As a part of an expansive vision, the blueprint called for integrating family planning services and HIV prevention and treatment programs -- a linchpin for empowering women, including women living with HIV, to make their own choices about whether to have children, when to have them, and how many to have.
The story of Maimuna, a 28-year-old Tanzanian woman, illustrates why this matters. She learned that she carried HIV during a prenatal care visit to the Magugu Health Center.
If she hadn't visited the Center, she might never have had an HIV test while pregnant. Her baby might have been born with HIV. She may have remained untreated herself.
But the Center's staff, experts in both prenatal and HIV care, provided anti-retroviral treatment that allowed Maimuna to birth a healthy child. She stayed healthy, too.
Staff at Magugu also counseled her and her husband, Jumanne, in family planning - the most effective tool for preventing both mother-to-child HIV transmission and reducing maternal mortality.
"We don't plan to have any more children because now we are fighting for our own lives," said Jumanne, who is also living with HIV. "I am grateful that we don't have to travel to many different places to get all of the care we need."
Unfortunately, the integrated services at the Magugu Health Center are still uncommon, particularly in the communities hardest hit by HIV. This deprives health care workers of a crucial tool in stopping the virus, and ignores the great demand of women to safeguard their health and that of their families.
Women of childbearing age account for roughly half of the 40 million people living with HIV. Across sub-Saharan Africa, young women between the ages of 15 and 24 account for 75 percent of new HIV infections.
With proper care, these women have an excellent chance to space childbirth or delay pregnancy, or have a healthy pregnancy and birth if they choose. On the other hand, women without access to quality reproductive health care still face a substantial risk of dying during childbirth in many parts of the world, especially those most ravaged by AIDS. Given these realities, the integration of family planning, maternal health, and HIV prevention and treatment is a matter of common sense.
And it is a crucial element in helping realize Sec. Clinton's goal of achieving an AIDS-free generation.
Integrated services reduce inefficiencies and costs while better serving millions of women. Secretary Clinton's blueprint will call for greater coordination among international donors, governments, and the U.S. agencies tasked with fighting the AIDS epidemic -- the Centers for Disease Control, the Agency for International Development, and others active under the President's Emergency Plan for AIDS Relief, or PEPFAR.
The blueprint will call on them to jointly promote the integration of family planning and HIV services around the world.
As the nation's next Secretary of State, you will play a crucial role in making sure the blueprint is translated into action. For all its laudable goals, the plan will amount to nothing if it is left to collect dust in Foggy Bottom.
This will require close coordination with governments, communities and health care providers funded through PEPFAR, which has spent hundreds of millions of dollars to make HIV treatment, care, and prevention more accessible around the globe.
Promoting the integration of family planning and HIV services will help safeguard the massive investment that PEPFAR has made to prevent the spread of the virus and improve the lives of those living with it.
As Maimuna can attest, all women -- including those living with HIV -- must be empowered to make their own decisions about the timing and spacing of their children. Those who wish to prevent pregnancy must have access to an array of contraceptive choices -- not only the male and female condoms that are critical to preventing HIV transmission, but the many other methods critical to preventing pregnancy.
Such services must be provided in a manner that respects women's rights, including the provision of information and counseling services that are free of coercion, judgment and discrimination.
This is a vision that Secretary Clinton worked hard to promote. We hope you will make this vision a reality.
Additional resources: Family Planning-Integrated HIV Services: A Framework for Integrating Family Planning and Antiretroviral Therapy Services (Engenderhealth) U.S. Global HIV Policy: Combination Prevention (CHANGE)]]>Is the GHI Dead, or Is This a Wake up Call?tag:www.huffingtonpost.com,2012:/theblog//3.19747662012-10-22T18:15:12-04:002012-12-22T05:12:01-05:00Serra Sippelhttp://www.huffingtonpost.com/serra-sippel/
The United States doesn't think about global health the way it did four years ago. Today, there is an understanding that clinics, hospitals, and health programs cannot address one health issue without tackling others. There is a greater appreciation for communities defining their own health needs and solutions. There is a recognition that the barriers to services that women and girls face are grounded in inequality and must be confronted vigorously in order to improve global health. This reframing of the U.S. approach to global health is a game changer. Unfortunately, this frame may lose definition or vanish over the next four years, and that's not something we can afford.
In July, news circulated quickly that the Global Health Initiative (GHI) office at the Department of State was closing and a new Office of Global Health Diplomacy would take its place. The agency heads that oversee U.S. global health programs -- Raj Shah, USAID; Eric Goosby, OGAC; Thomas Frieden, CDC -- joined in a statement with Lois Quam, executive director of the GHI, declaring that the three agencies will be responsible for ensuring that the GHI principles are implemented in the field to achieve global health goals.
A focus on the GHI principles--especially principles of health sector integration, equal rights for women and girls, country ownership, and health systems strengthening--is indeed necessary to ensure US global health programs are effective. The principles are the most important piece of GHI, and what has given global health advocates optimism since it was launched in 2009.
Now on the heels of a global family planning summit, the International AIDS Conference, and a UN report on commodities to save women's lives, there is hope for increased investments in family planning, more tools available to prevent and treat HIV, and increased political commitment to prevent maternal deaths. The GHI principles are more important than ever. We're armed with science and evidence, now we have to address the social drivers of maternal mortality and HIV -- gender inequality, weak health systems, poverty, and discrimination -- to ensure the science has a chance to show us what it can do. That's where the principles come in.
Although progress has been made in GHI's implementation, as our studies based on interviews in Guatemala and Ethiopia have shown, the full vision of a comprehensive approach to global health through GHI principles has not yet come to fruition. Yet the principles clearly resonate with government officials, individuals and organizations overseas we've met and worked with who are dedicated to building healthier communities where rights are guaranteed.
Their enthusiasm contrasts sharply with some who have already accepted the death of GHI. But to call something dead in Washington can be a self-fulfilling prophecy, and does no good for women, men and youth in countries that would benefit from efficient and effective programs funded by the U.S. government.
While the administration claims that it is holding on to these principles, it is in fact putting the principles at risk by shuttering the GHI. In the final months of this administration's first term, what will be done to ensure the principles stick? Who will be held accountable (and how) to making sure this new vision of our global health strategy is actually carried out?
Right now, it appears no one is accountable and there is legitimate concern that the promise of a comprehensive approach to global health may be lost.
The administration raised expectations by announcing something so bold and so important. And the first try didn't entirely work. But this second try is doomed before it begins unless leaders come up with a new and lasting vision to make sure we do not go backwards. If administration officials truly believe that these principles are the best way to save lives, they need to show they're willing to give a real second effort -- and not by occasionally referring to the principles while going back to business as usual. No matter what happens in November, we still expect the administration to keep the vision and promulgate the principles in the field. But the question will need to be answered, who is accountable for keeping GHI's promise alive?]]>Shortchanging Women's Rightstag:www.huffingtonpost.com,2012:/theblog//3.19896382012-10-22T12:45:29-04:002012-12-22T05:12:01-05:00Serra Sippelhttp://www.huffingtonpost.com/serra-sippel/
To review, this is what we know: At the International AIDS Conference in July, Secretary of State Hillary Rodham Clinton said, "Every woman should be able to decide when and whether to have children. This is true whether she is HIV-positive or not." And in guidance released last week, the U.S. agency responsible for global HIV programs (PEPFAR) stated, "Voluntary family planning should be part of comprehensive quality care for persons living with HIV." They followed that up with a reference to family planning as a human right. So far, so good for women and their families around the world.
Then, in bold type, they punctuated it with, "PEPFAR funds may not be used to purchase family planning commodities."
They take it a step further with a caveat that before anyone decides they'd like their program to have anything to do with family planning, they had best consult relevant U.S. legal counsel first. Just in case.
Don't worry; you're not losing your mind. They really did just say that voluntary family planning is essential, that it saves lives and is a human right, and then forbid their own funds from paying for it. And make a vague reference to legal problems. To be fair, they do say that PEPFAR programs can just refer women to a different program that offers family planning, maybe something that the U.S. Agency for International Development is funding. Besides being a woefully insufficient alternative, there's also the fact that USAID family planning programs don't always exist in PEPFAR countries. So the suggestion is flawed from the start.
What's going on? We could speculate a mountain of reasons, but they all come back to the same dirty word: politics. Family planning is no stranger to political bargaining. It's happening yet again, and women's lives are yet again being treated like expendable assets.
There is an opportunity to fix this and push PEPFAR over the finish line. The State Department is working on a blueprint that will set the parameters for creating the AIDS-free generation that Sec. Clinton called for a year ago. At the moment, the blueprint says that family planning is essential to HIV prevention, treatment and care, just like the PEPFAR guidance did. Now they need to pick up where PEPFAR left off and call for HIV funds to pay for family planning as part of HIV prevention and treatment. If we're sincere about this, we'll fund it. If not, we've just revealed a very ugly side of ourselves.
What does the U.S. really care about? Do we really value women's lives? Do we really want to create an AIDS-free generation? We're dangerously close to demonstrating that we value politics above all. It's time for the State Department to cross the finish line and prove otherwise.
Every single woman who benefits from U.S. HIV programs should be able to expect nothing less.]]>AIDS-free Generation? Not Without Womentag:www.huffingtonpost.com,2012:/theblog//3.16575532012-07-11T14:17:14-04:002012-09-10T05:12:03-04:00Serra Sippelhttp://www.huffingtonpost.com/serra-sippel/
Five years ago, women overtook men as the majority of people in the world living with HIV. They've held on to that majority and started to take over other areas as well: Young women ages 15-24 account for 75 percent of all new infections in sub-Saharan Africa. HIV is the number one killer of women in their childbearing years, and HIV was responsible for 60,000 maternal deaths in 2008. In the last two years, HIV infections have nearly doubled among African American women in Washington, D.C. Something in the world's current response to HIV has left women, especially women of color, behind, and now we're seeing the consequences of our blind spots.
The XIX International AIDS Conference is coming to Washington, D.C., in two weeks and it must be different from its predecessors for one reason: HIV is now a woman's plague. Our HIV policies and interventions have to respond accordingly or we will never create the AIDS-free generation that Sec. Hillary Clinton and the Obama administration have committed to build -- where vertical transmission of HIV from a woman to her child is significantly reduced, where HIV-free girls and boys grow up with all the prevention options they need, and those who do acquire HIV have access to treatment.
The vision is grand, and will require the world to think big. That's what Sec. Clinton challenged us to do when she stated that the effectiveness of interventions like voluntary medical male circumcision, treatment as prevention, and prevention of mother-to-child transmission depend on a combination approach that includes access to condoms and social changes that will end the stigma, discrimination, and violence that put women at increased risk of HIV.
Take voluntary medical male circumcision for example. It is a critical and necessary piece of addressing HIV, but it's just one piece -- when unaccompanied by other interventions, like female and male condoms, and prevention of gender-based violence, it can only live up to a fraction of its potential. We can't afford to be myopic in our responses anymore. We have to focus on the whole package, or we're willingly putting an entire generation of women at risk.
Combination prevention isn't difficult. It's logical: Give everyone affordable access to medical interventions, tools and information, and respect human rights. It's also our only option if we're sincere about creating an AIDS-free generation, because it targets everyone, including women. And we can't even begin to address HIV if we don't address the majority of the pandemic.
If you're in Washington, D.C. for the conference, pay attention to what's around you -- in some select bus shelters, on stickers, in print, and on Facebook cover photos, you'll see the message that this AIDS conference must pay attention to:
AIDS-free generation? Not without women.]]>The U.S. Global Health Initiative and Diplomacytag:www.huffingtonpost.com,2012:/theblog//3.16512132012-07-06T13:23:16-04:002012-09-05T05:12:07-04:00Serra Sippelhttp://www.huffingtonpost.com/serra-sippel/Office of Global Health Diplomacy. It will implement the principles of the Global Health Initiative that make economic and humanitarian sense, namely a woman-centered approach, country ownership, and health sector integration. The GHI's principles have the potential to make real progress against the world's greatest health challenges, and we have to pay meticulous attention to ensuring they are put into action.
We have already seen the benefits of the GHI principles in some of its target countries.
Last week, the Center for Health and Gender Equity (CHANGE) released two reports examining progress of GHI in Ethiopia and Guatemala, with a third report on Nigeria to be issued by the end of the year. The reports find that GHI's key principles of a focus on women and girls and health sector integration are already making a positive difference.
For example, in Guatemala, the GHI country strategy demonstrates a keen awareness of the discrimination that prevents indigenous women from accessing maternal health and family planning programs. In Ethiopia, where health sector integration predates the GHI, the GHI has opened the door for more emphasis on women's health and rights.
GHI is also exposing program weaknesses that will hinder U.S. development efforts without proper attention, namely if they are not restructured to align with key GHI principles. While USAID in Guatemala has made progress in integration of maternal health and family planning programs, they have not integrated HIV prevention into those programs. The U.S. HIV prevention efforts in Guatemala focus on migrant workers, but not on their partners. Low-cost HIV prevention could be integrated into existing family planning and maternal health programs to reach many of these women.
Guatemala's GHI Country Strategy also does not include a plan to address its rate of adolescent pregnancy, which is the highest in the region. Yet in 2011, 21 infants were born to 10-year-olds. Girls under the age of 15 whose bodies are not prepared for childbirth are more likely to die as a result. GHI targets on maternal mortality won't be reached without an honest, multi-sector approach to this issue.
In Ethiopia, many U.S. partners target adolescents, but many young people reached still do not receive information about and access to female and male condoms to prevent unintended pregnancy and HIV transmission. Ethiopia's GHI country strategy does not detail a plan to combat early marriage -- which U.S. officials acknowledge as a serious threat to adolescent girls' health in Ethiopia.
Full and sustained implementation of GHI's principles is the best way to ensure that U.S. global health programs make a real, measurable difference in the lives of those served by U.S. foreign assistance, and that U.S. dollars are spent effectively. We've seen that its principles have a positive impact that resonates with the efforts of other donors and civil society working in these countries. The Office of Global Health Diplomacy is the first step toward expanding that impact.]]>Creating an AIDS-free Generation for Women at Home and Abroadtag:www.huffingtonpost.com,2012:/theblog//3.13726062012-03-23T12:26:30-04:002012-05-23T05:12:01-04:00Serra Sippelhttp://www.huffingtonpost.com/serra-sippel/announced two weeks ago a working group that will address the intersection of HIV/AIDS, violence against women and girls, and gender-related disparities. The Presidential Advisory Council on HIV/AIDS (PACHA) recently met to address the intersection of women and violence and HIV. Given that at least 12 percent of HIV/AIDS infections among women in romantic relationships are a result of intimate partner violence (IPV), yet fewer than 10 percent of all HIV service providers routinely screen for intimate partner violence, both events mark a major strike against the HIV epidemic.
The White House also appointed Dr. Grant Colfax as the new director of the Office of National AIDS Policy (ONAP). Dr. Colfax has already stated his concern that women account for 25 percent of new HIV infections, and that African American and Latina women are upwards of 30 times more likely to contract HIV than other women. His acknowledgment of the unacceptable health disparities among women of color is reassuring.
The challenge now is to move this working group and Dr. Colfax's words forward in a meaningful way.
With the upcoming International AIDS Conference (AIDS 2012) in Washington, D.C., the U.S. is poised to make a difference for women at home. We have been working toward integrating HIV, sexual and reproductive health, and gender-based violence services for women overseas. It's time we did the same at home. The administration has already stated it will take lessons learned from global AIDS programs to enhance our programs in the U.S.
And what better time to walk the talk and move forward with this course of action than this July, when women living with HIV from the U.S. and around the world will be in the nation's capital for AIDS 2012. Advocates are hoping President Obama will speak to the conference. I hope he does, and I hope he uses it as an opportunity to speak directly to women living with HIV from the Global South and the U.S. I hope he commits to putting women's human rights at the center of the U.S. agenda to create an AIDS-free generation at home and abroad. I also hope he will come to the conference and listen to women. Yes, we need promises of human rights. But this administration's commitment will only be authentic if it is informed by the voices of women most impacted by this epidemic.
Listen to women. We can't create an AIDS-free generation without them.]]>An Affordable HIV Intervention: Because Women Are Worth Ittag:www.huffingtonpost.com,2012:/theblog//3.13275842012-03-08T10:40:47-05:002012-05-08T05:12:02-04:00Serra Sippelhttp://www.huffingtonpost.com/serra-sippel/
Last fall, USAID released for the first time ever guidance on including female condoms in HIV interventions. It highlights the major selling points of the female condom: it is safe and effective, it is a cost effective HIV prevention intervention, it increases protected sex, and it is a largely untapped resource for HIV prevention. It calls for U.S. global HIV programs to build upon PEPFAR's legislative mandate to endorse women-initiated means of protection against HIV/AIDS and promote the female condom as a safe and effective HIV prevention intervention.
Two weeks ago, the World Health Organization issued guidance in response to questions linking increased HIV risk and hormonal contraceptives. It concluded that there isn't enough evidence yet to support that conclusion, but continued to say that the best way to prevent HIV is by doing what we should be doing anyway: providing women access to female and male condoms for HIV prevention and to a wide range of contraceptive options for family planning.
The bottom line is, female condoms are absolutely essential to any and all HIV interventions, as well as to efforts to prevent unintended pregnancy especially among women living with HIV, but they are still grossly underfunded and in short supply. There is quite a demand, and now, the groundwork in the form of guidance and evidence has been laid.
If WHO recommends that all women living with HIV receiving hormonal contraceptives also be counseled about and given female and male condoms -- and USAID recommending that women be "advised" about male and female condoms -- how do these recommendations become meaningful in light of the lack of political will and financial commitment to make male and female condoms available and accessible and ensure uptake and use.
Now is the perfect time for the U.S. to step up funding and policy support for female condoms. The bi-annual International AIDS Conference will be held here in Washington, D.C., in July. A public display of support for female condoms on an international stage signals to the world that 1) female condoms are essential, and 2) the women they protect are valued. The "woman-centered" characteristic is what makes female condoms so necessary. With more than 50 percent of the world's population living with HIV, women are at the center of the HIV pandemic. Providing them with interventions they can initiate themselves, and that they are asking for, makes perfect sense.
On World AIDS Day 2011, the White House recognized the critical role of male and female condoms in any prevention intervention. It seems like political will may be with us now. The building blocks are all there -- we have the evidence, and the demand. All we have to do now is step up.
]]>What Does an Election Year Mean for Women's Health and Rights?tag:www.huffingtonpost.com,2012:/theblog//3.12020782012-01-12T17:42:58-05:002012-03-13T05:12:01-04:00Serra Sippelhttp://www.huffingtonpost.com/serra-sippel/
In 2011, Congress' cup runneth over with attempts to limit or restrict completely women's health and rights, both at home and abroad. In 2012, there is a presidency at stake -- so what does that mean for women's health and rights in the coming year? How will political posturing and the race for votes affect what really matters? Here's our take on what to anticipate:
More attacks on women's health and rights, especially legal, affordable access to birth control and abortion services both at home and abroad: This time, we expect they'll come in the form of attack ads or debate topics, accompanied by the usual false and distorted information. In an election year, it's part of a strategy to demonize women's health and rights, and the candidates that support them. Voter beware: Women's health and rights are a lightning rod for controversy, and they are easy to ignore or betray for the sake of votes. We saw it last year with the Affordable Care Act, when the administration sacrificed abortion coverage for the sake of getting the act passed. Our health and rights are in a tenuous position right now, more so than in other years, and we can't afford to let politicians abandon us just because sticking with us might seem politically inconvenient.
And keep in mind that supporting women's health and rights is not only the right thing to do, it's the politically savvy thing to do: Eight in 10 American voters say that when it comes to policies around family planning, the debate focuses too much on abortion. They believe we can find common ground on providing access to contraceptives and want Congress to move forward on a broader set of issues like reducing unintended pregnancies by increasing access to birth control and information about reproductive health.
Stalled, compromised, or anti-woman legislation: It's likely that otherwise friendly legislators will want to avoid polarizing topics, so we're anticipating that things like the Helms and Hyde amendments, which restrict federal funding for abortion overseas and at home respectively, are likely to be ignored this year. That means they will not be challenged, and could be attached to other pieces of legislation without any opposition -- so we could lose an entire year of potential progress. We're also anticipating that attempts to defund Planned Parenthood and international family planning, or write the Global Gag Rule into law could make encore appearances, if politicians think taking a hard line against women's health and rights will garner votes.
We can't afford to take a year off, and we can't afford to sit back while politicians treat women's health and rights as expendable depending on the political climate. Because the noise of the political races can be deafening to our issues, our unified voices are needed this year more than ever.
Smoke and mirrors: Through all the noise, it's our job to keep focused on what matters. It can be hard to discern what's important from what shows up on the front page. Some things we know that matter, but may not reach the headlines:
Women's health and rights includes legal, affordable access to voluntary family planning and safe abortion services both at home and abroad. The ability to make important decisions about the number, timing and spacing of one's children, and to access the information and means needed to exercise voluntary choice, is one of the most basic human rights for individuals.
Supporting voluntary family planning programs in developing countries would have dramatic results: a quarter of a million maternal deaths would be averted, unintended pregnancies would drop by 53 million, and 1.7 million newborns would be saved.
Family planning is essential to HIV prevention and treatment: Barrier methods, such as female and male condoms, are the only tools that protect against HIV transmission and allow women to plan and space their children. Attacks on family planning are attacks on HIV programs, and we can't compromise the U.S. response to a global pandemic to save a politician's skin.
An election year means that women's health and rights are even more vulnerable to political exploitation than in previous years. Our job as advocates is to be aware, and listen for what matters. There is an office to win, but there are also rights to lose.]]>Ribbons Without Rights Don't Save Livestag:www.huffingtonpost.com,2011:/theblog//3.10640192011-10-31T12:16:43-04:002011-12-31T05:12:01-05:00Serra Sippelhttp://www.huffingtonpost.com/serra-sippel/Pink Ribbon Red Ribbon" campaign, an initiative that integrates cervical and breast cancer education, screening, and treatment with HIV services. It's a move that has the potential to reduce the number of cancer deaths among women living with HIV and improve their overall health. Given that women living with HIV are at an increased risk of developing cervical cancer, it makes sense. It's a logical and critical part of what PEPFAR is calling care and support services.
What doesn't make sense is that planning a family and preventing further HIV transmission is not part of what PEPFAR is calling care and support. HIV was responsible for 60,000 maternal deaths in 2008, and pregnancy alone could put women at higher risk of transmitting and acquiring HIV. Integrating and linking voluntary family planning, HIV, and cervical cancer prevention saves lives, improves access to quality care and promotes human rights. Including family planning in Pink Ribbon Red Ribbon would help women manage childbearing and protect themselves and their partners from infection or re-infection (think female condoms) and should be automatic.
UNAIDS has stated as much. "We must take AIDS out of isolation and provide young girls with opportunities to negotiate their sexual relationships and receive sexuality education so that they can protect themselves from infection," said UNAIDS Executive Director Michel Sidibé at this year's Commission on the Status of Women. "If we don't do this, our vision of zero new infections will remain a dream."
Furthermore, in June 2011 at the United Nations General Assembly High Level Meeting on HIV/AIDS, member governments -- including the U.S. -- pledged to increase the capacity of women and adolescent girls to protect themselves from the risk of HIV infection through access to sexual and reproductive health programs and services. They also committed to strengthen the link between HIV services and sexual and reproductive health care, and eliminate the redundant systems that come about when programs are not integrated.
So what doesn't make sense now is that the U.S. government and UNAIDS are supporting a sexual and reproductive health program that intentionally excludes family planning.
It's counter-intuitive and counter-productive.
U.S. foreign policy, through the Global Health Initiative and starting with PEPFAR, needs to integrate family planning; maternal health; and HIV prevention, treatment, and care services on the ground. Pink Ribbon Red Ribbon is a stellar example of how integrating a range of sexual and reproductive health services has the potential to save so many lives -- and evidence points to integrating family planning as well.
We cannot pick and choose to address only the health issues we are comfortable addressing. We must develop and implement services and programs that are based on the health needs and human rights of clients, not what is politically expedient for policy makers or convenient to service providers. Women deserve the highest quality sexual and reproductive health services available: HIV prevention, treatment, and care; cancer screening and treatment; maternal health care; and family planning services. When the U.S. government starts integrating sexual and reproductive health interventions, it cannot be piecemeal--the full range of reproductive health matters must be addressed.
Access to such services is not only a right. It's the best thing for everyone.
]]>Why Women Leaders Must Be Authentic and Fearlesstag:www.huffingtonpost.com,2011:/theblog//3.10067752011-10-12T15:45:54-04:002011-12-12T05:12:02-05:00Serra Sippelhttp://www.huffingtonpost.com/serra-sippel/ Diversity Women's Business Leadership Conference followed the announcement of three women from West Africa and the Middle East being awarded the Nobel Peace Prize. Both events are reminders that women in positions of leadership are making a difference.
The events also remind us that it matters that women of all races, cultures, and backgrounds are in positions of leadership. Throughout the world, including in the U.S., we find laws and cultural practices that prevent women from reaching their full potential and equal place in society. Yet, we also see women step up and out of their cultural constraints and into leadership roles, engaging in courageous acts of social change.
Women take different paths to leadership. For some it is through hard work or academic excellence, for others it is through mentorship programs and for others the lesson of perseverance from a mother opens the pathway to lead. While we celebrate the female leaders of today, we know that there are still too few women leaders at the highest levels of governments, corporations and nonprofits. There is an urgent need to fill this leadership gap to ensure women are included in the decision-making that shapes societies and impacts our lives. Women must be in leadership roles not just because women are good decision makers, but because society benefits when diverse perspectives and expertise of women are included in the decision-making process.
I had the honor of chairing the opening panel at the Diversity Women's Business Leadership Conference that took on the challenge of defining models of leadership that can create pathways for women to lead. The panelists -- women leaders from diverse backgrounds and professional fields -- explored issues of authenticity, culture, mentorship and fearlessness.
On the matter of culture and women's leadership, Miriam Yeung of the National Asian Pacific American Women's Forum described cultural constraints that many Asian and Pacific Islander women face that conflict with what society expects from leaders. For many women, she noted, to be a leader of today and tomorrow requires breaking rules and breaking down barriers within one's own culture in addition to the dominant work place culture.
When it comes to creating an office culture that promotes a diversified workplace, Kierra Johnson of ChoiceUSA stated it well. Even with policies and structures in place to increase diversity and women's leadership, organizations and companies must define the value of diversity for the organization and its work. This takes authentic engagement in conversations about culture, leadership and the business implications of diversity.
Taking on the challenge of creating opportunities for other women to lead, Maria Tildon, a senior vice president at CareFirst BlueCross BlueShield, shared her observation that the best, most effective leaders are authentic and true to who they are, and that as leaders, we can and should reach out to other women to help lift others into leadership roles. Mentorship, an important tool to reach out to girls and women of color, is critical, said panelist Dr. Shireen Lewis, executive director of SisterMentors. Dr. Lewis pointed out essential leadership skills that are missing from current leadership models--social skills, emotional intelligence, and self-care. And we as leaders must model self development for others.
To break barriers and to step up as leaders, women must be fearless, stated Sara Manzano-Diaz, director of the women's bureau at the Department of Labor. Manzano-Diaz explained that to develop future women leaders we must teach girls to be fearless and the best way to do that is for those of us in leadership positions to also be fearless, to challenge the methods of recruiting diverse workplaces, and to be ourselves even when questioning the status quo. We must not be afraid to reach out and lift others up for fear of competition or scrutiny of "playing favorites."
One of our roles as women in the workplace is to redefine leadership by virtue of our roles. We have both the luxury and the obligation to begin redefining leadership according to terms that enhance our work, our workplaces and our personal lives. It is through the increased representation of women from all races, cultures and backgrounds in positions of leadership that we are poised to make the biggest impact in defining leadership with new terms that reflect our values and that will make our society and communities better.
As long as being a woman in a position of leadership is the exception and not the rule, women leaders have an obligation to mentor and create new leadership models. We must lead with compassion and generosity, be fearless, and, most crucially, be authentic. While we are not inherently better-suited to be leaders than our male counterparts, we do have a distinct responsibility. www.genderhealth.org]]>As Congress Returns, Women Will Need Courageous Leaderstag:www.huffingtonpost.com,2011:/theblog//3.9505022011-09-06T13:25:55-04:002011-11-06T05:12:02-05:00Serra Sippelhttp://www.huffingtonpost.com/serra-sippel/
(If you who think we have enough battles here at home, pay attention. The Global Gag Rule and policies like it are just a way to perfect attacks on women before bringing them home.)
The Global Gag Rule is a presidential order that declares that U.S. international family planning funds cannot go to organizations that use non-U.S. funds for abortion services, counseling, or referrals. It translates into less support for women and men to plan the size of their families and space childbearing, because it diverts funds for contraception and family planning services away from effective organizations. Contraception and family planning services save lives of women and children; we know that. That's not a debatable point, it's a fact. Actively denying access to contraception also violates a woman's fundamental right to plan a family, but if that doesn't seem like an adequate reason to permanently stamp out the Global Gag Rule, women dying should certainly suffice.
Access to contraception means fewer women die or suffer permanent injury in childbirth, fewer victims of early marriage are forced to bear children before the age 15, more infants born healthy. Even conservative pundit Michael Gerson--not exactly a friend to reproductive rights--has acknowledged the cruelty of denying access to contraception and family planning services.
The Global Gag Rule has been kicked back and forth between presidents since Ronald Reagan introduced it in 1984. As an executive order, Congress doesn't have anything to do with its status--presidents can sign it in or out of existence with a pen click. It has come and gone four times in the last two decades. Congress is doing its best to intervene. Members on both sides of the aisles have introduced legislation in more than one session to either permanently repeal or permanently codify the rule as U.S. law.
In reality, the Global Gag Rule could never be applied in the United States, because it is unconstitutional. Withholding federal funds from an organization because they talk about a legal medical procedure--remember, the Global Gag Rule doesn't have anything to do with U.S. funding for actual abortion services, only funding for organizations that discuss abortion, or use non-U.S. money to provide services--doesn't work with the First Amendment.
Not that anti-family-planning forces haven't tried to impose it here.
Planned Parenthood has been fighting a U.S. version of the Global Gag Rule all year. The threat of losing U.S. funds because it provides a legal service with non-U.S. funds. Sound familiar?
The fact is that legislators who oppose family planning aren't terribly creative. Foreign policy is often their testing ground for policies too heinous for domestic constituents. But as has become clear in this past year, the Global Gag Rule is just a symbolic division between domestic and international women's rights. We are all being attacked, and we can't be divided. Opponents to family planning are ruthless and our supporters could bargain it away at any political moment.
We could, however, use a sign from our leadership that we're making progress. The White House, State Department, or Congress must have the courage to say that the Global Gag Rule has to go for good. Someone at the highest levels of government must clearly state that women's lives, and therefore family planning programs , are no longer bargaining chips for policies or budgets. As a nation, we believe (at least we act like we do) that women and men have a right to access basic services to plan families. The nation's leadership needs to start acting that way.]]>30 Years is Enough: An HIV Strategy for Women Nowtag:www.huffingtonpost.com,2011:/theblog//3.8755692011-06-13T09:05:59-04:002011-08-13T05:12:01-04:00Serra Sippelhttp://www.huffingtonpost.com/serra-sippel/
In recent years, the U.S. has been a leader in the fight against HIV globally, commendable in their funding for treatment but unforgivable in their denying women access to tools and information to prevent HIV and unintended pregnancy, perpetuating a dangerous fallacy that marriage is reliable protection against HIV infection.
Here at home, women have fared no better. In the U.S., women account for nearly 30 percent of those living with HIV.* Yet the U.S. National HIV/AIDS Strategy issued in July 2010 has no gender strategy. In fact, women barely appear in the U.S. National HIV/AIDS Strategy and its implementation plan. This is striking given national strategic plans on HIV and AIDS in southern and eastern African countries highlight women, girls and gender equality as key to the fight.
However, this is not to say simply adopting a gender strategy will ensure women receive the prevention, treatment and care they need. In a recent analysis of 20 African national strategic plans for HIV and AIDS where women, girls and gender equality feature prominently, most strategies focused not on women's health, but on prevention of vertical transmission of HIV to newborns. The majority failed to provide an effective approach to tackling gender inequalities, to meaningfully advance women's rights, and to link HIV with other sexual and reproductive health services. The same shortcomings are true for the gender strategy of the US. global AIDS strategy in PEPFAR (President's Emergency Plan for AIDS Relief).
With such deficiencies in the PEPFAR gender strategy and national strategies of these African countries, why then bother with a gender strategy for the U.S. National AIDS Policy?
For decades, global agreements, political declarations, and national plans and strategies have given women throughout the world tools to fight for our rights. Without a written document outlining a government's commitment to women, words are mere rhetoric. We need tools for advocacy, to hold our governments accountable. Right now, women in the U.S. do not have a stated commitment from our government for women and HIV. No strategy for how the government is going to slow the infection rate among women -- especially among women of color and women who are living in poverty. We need a strategy to hold this administration (and future administrations), members of Congress, governors and local leaders accountable.
The Obama administration should commit to do right by women and put them at the center of its HIV/AIDS agenda at home and overseas. It should go beyond prevention of HIV transmission to newborns to preventing new infections among women and treating and caring for the women who are infected. And at the heart of it all, the U.S. must focus on the central roles that gender inequality, denial of reproductive rights, poverty and violence play in fueling the epidemic. This commitment must be demonstrated through bold gender strategies and robust funding for women.
HIV is global. We have to take what we have learned from PEPFAR and the global community and apply it to the U.S. That's what will make the response to HIV as global as the epidemic.
*This blog was updated on June 16, 2011 to reflect the most current statistics.
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