When I was in college, I thought "women's issues" was a soft political science -- post-conflict reconciliation and diplomacy, poverty alleviation, and democratization were the tough issues that required the most attention on the global stage. Years later through my work on BSR's HERproject and global research on gender inequality, I now understand that in fact women's empowerment lies at the heart of solving (or failing to solve) most global development challenges -- including the fight against HIV/AIDS.
Consider these statistics from a UNAIDS Fact Sheet on Women, Girls, and HIV:
- HIV is the leading cause of death and disease among women aged 15 to 49 years worldwide.
- In Sub-Saharan Africa, 60 percent of the people living with HIV are female.
When I visited Kenya last year, I heard firsthand some of the stories behind these statistics. For example, one woman shared with me how the spread and stigma of HIV are inextricably linked to gender inequality within her tribe in western Kenya. In her culture, most women contract HIV from their husbands, and sometimes only learn about their own infections after their husbands die from the virus. Then, if a woman shares her positive status with her family, her husband's brother or other male relative -- who otherwise would take her into his family -- will often reject her. If this happens, she is likely to lose her husband's property and even custody of her children, thereby pushing her into poverty and making her an outcast within her village. If she hides her HIV status, on the other hand, she risks infecting her new husband and any of his other sexual partners.
It's clear that we can't make meaningful progress in the fight against HIV/AIDS unless gender inequity and women's empowerment are also addressed. Women with higher education levels and independent income are more likely to have greater negotiating power within their household, making it easier for them to insist on safe sex practices and make medical spending and treatment decisions for themselves. Women who are more educated and have freedom to seek their own treatment are also more likely to do so before or during pregnancy, which could help prevent mother-to-child transmission (MTCT). By contrast, violence or fear of violence can reduce women's ability to request safe sex or HIV testing, and may have a negative impact on MTCT prevention. Additionally, HIV infection rates are particularly high for sex workers. If women and girls were provided with better opportunities to earn an income -- such as through completion of their secondary education -- they may be able to avoid becoming sex workers or may be able to leave the profession and seek medical treatment.
In 2008, $15.6 billion were spent on HIV/AIDS prevention, and yet the fight continues and experts argue more money is needed. Perhaps part of the problem is that reproductive health, safety from violence, and gender equality receive comparatively little funding, and these areas are often not effectively integrated into HIV/AIDS prevention and treatment programs.
The business case for preventing HIV/AIDS for employee wellness and retention has been made among the private sector, leading companies to make significant investments in HIV prevention and treatment around the world. Most investments focus on workforce education, testing, and treatment for HIV as well as diseases that commonly progress the infection to AIDS such as tuberculosis and malaria. Very few directly target women, other than MTCT prevention programs, and preventative measures against infection factors such as violence against women and gender inequality in the household and community are rarely addressed.
More recently, we are also hearing about the business case for investing in women's empowerment: companies such as Walmart, Goldman Sachs, and ExxonMobil have commitments to improve women's economic opportunities and support women's leadership. While these investments are commendable, they also gloss over or ignore the prevalence of violence against women and the link to HIV/AIDS, issues that will ultimately limit the potential of their efforts. Studies show that up to 70 percent of women experience violence in their lifetime, and this may triple women's risk of contracting the HIV virus. The UNAIDS fact sheet points out that in South Africa, a woman is raped every minute, and the country also has the world's largest number of people living with HIV: 5.5 million in a population of 48 million.
Today, on World AIDS Day, I challenge companies committed to fighting HIV and AIDS to better embed women's empowerment, health, and protection from violence into their commitments. Likewise, I challenge companies committed to women's empowerment to better incorporate the prevention of violence against women and prevention and treatment of HIV/AIDS into their investments.
We can't ignore one or the other -- no challenge as big and as clearly interrelated as these two can be solved independently. Holistic, collaborative solutions -- targeting men as well as women -- are required. Thoughtful partnerships among business, civil society, and government can help realize them.