Thursday, July 15, 2010

The UN Millennium Development Goals....for Men Only?

Consider these truths:
*Men don't get pregnant.
*Completely preventable complications of pregnancy, labor, unsafe abortion and
*AIDS-related illnesses remain the leading causes of death and disability among
*women in countries throughout the world due to lack of political will, lack of
*funding, and the politicization of sexual and reproductive health by
*fundamentalist religious and political actors.?
*Women now make up the majority of those infected with HIV worldwide and over
*two-thirds of those infected in sub-Saharan Africa.
*Women and girls continue to face profound discrimination in access to education,
*employment, and political power in virtually every country (yes, including the
*United States).? Women continue to experience high rates of sexual violence and
*coercion, high rates of child marriage, and low rates of access to basic
*reproductive and sexual health care, including safe abortion.
*The health and well-being of newborns, infants, and children rests primarily on
*women.? In communities riven by poverty, violence and discrimination, the death
*of a mother too often results in the neglect, deteriorating health, abuse, or
*death of her child(ren).
Consider also that virtually all of these issues remained invisible--or just
plain unimportant--to the largely male power structures in every country for the
past several decades, until the global women's movement gained traction in their
fight to put them on the global agenda.
Given these realities, it would seem that appointments to a recently convened
United Nations High-level Advocacy Group focused on pushing for progress on the
Millennium Development Goals would take pains to put high-level women in
charge--at least in equal numbers to their male counterparts--of advocating for
maternal health, child health, and HIV and AIDS, as well as those "other things"
like economic development, in which women, as all the development literature has
repeated ad nauseum for 40 years, are essential actors.??

Someone, somewhere, did not get the memo.

A "final" July 1 2010 list of prominent individuals circulated by the United
Nations End Poverty 2015 Millennium Campaign comprising the "Global Advocacy
Team" indicates that not one woman has been assigned to Millennium Development
Goal (MDG) 4 (to reduce child mortality), MDG 5 (to improve maternal health), or
MDG 6 (to combat HIV and AIDS and malaria).?
This is, quite simply, astounding.?

And yet, its not.? Because in the pattern of all things having to do with
women's health--whether we are talking about Utah or Nebraska, Uganda or the
United Nations--there are other truths.? Men continue to control the agenda and
to decide how much or how little money and attention will be paid to ending the
epidemic of pregnancy- and sexually-transmitted infection-related deaths and
illnesses that robs millions of women of their lives and health every year
worldwide.? Men continue to decide what priorities will be on the table when
they do "pay attention" to these issues, and when they won't, for reasons of
their own political or financial agendas or their own ideological or political
affiliations or all of the above, address honestly one of the leading and most
preventable causes of pregnancy-related death and illness, that being unsafe
abortion. Men continue to decide? whether they will, for the sake of ideology
cloaked as "common ground," push for abstinence-only-until-marriage programs
that leave women disproportionately vulnerable to HIV and AIDS, leave the issue
of safe abortion out of research and international documents, confront other
issues like stoning as "adulterers" women who've been raped, or "accept" that
ending the war in Afghanistan likely means leaving women to the "mercy" of the
Taliban.? Men decide whether we can talk about women's health writ large, or
even their sexual and reproductive health writ large, or only about the mommas
and the babies.
So when I received from a colleague the PDF file containing the list, having
been here and done this before, I knew to some extent I already knew the story.
I also knew my obligations and therefore in an effort to find out more about
this group yesterday, I called numerous colleagues in the advocacy and policy
field as well as the UN Campaign office itself.? I also emailed a contact in the
office of the UN Secretary General.? I did not hear back from any of the UN
spokespersons as of this writing, but of those colleagues I reached they were,
to a person, shocked at the composition of assignments on the list.? Most had
not yet heard that this group had been convened, and a couple suggested that the
role might largely be for public relations, as the September 2010 UN Summit on
Millenium Development Goals in New York approaches.? In other words, every one
of these colleagues had virtually the same reaction as I did on receiving this
list: A combination of "How could this happen?" "Where are the women's advocacy
leaders that have worked so hard on these issues the past 20 years?" and
"Business as usual."

Let's be clear: Every one of the people on the list of UN MDG campaign
"advocates" is a prominent person. The list includes Ted Turner, who provided
the original funding a decade ago for the establishment of the UN Foundation,
under the umbrella of which--in full disclosure--RH Reality Check now exists.?
The list includes, but is not limited to well-respected men such as Jeffrey
Sachs (all MDGs) director of the Earth Institute at Columbia University, Bill
Gates (MDGs 1, 4, 5, and 6), founder of Microsoft, and of the Bill and Melinda
Gates Foundation, Julio Frenk, Dean of the Harvard School of Public Health (MDGs
4,5,6, and 8), Akin Adesina, Vice President of the Alliance for a Green
Revolution in Africa (AGRA) (MDG 1, extreme poverty and hunger), Muhammed Yunus,
founder of the Grameen Bank (MDG 8 on poverty), Philippe Douste-Blazy (France)
UN Special Advisor on innovative financing for development (MDGs 4, 5, 6 and 8),
and Paul Kagame, President of Rwanda and a co-chair of the group.?

The women include, among others, Stine Bosse (Denmark), CEO of TrygVesta Group,
Chairman of B?rnefonden (The Childrens? Fund) (MDG 3 on gender equality and the
empowerment of women); Wangari Maathai (Kenya) Nobel Peace Prize Winner,
environmental and political activist (MDG 7 on environmental sustainability);
Dho Young-Shim (Republic of Korea) Chairperson of the UN World Tourism
Organization?s Sustainable Tourism for Eliminating Poverty (ST-EP) Foundation
(MDG 2 on universal primary education); HHS Sheikha Mozah Bint Nasser (Qatar)
First Lady, Chairperson of the Qatar Foundation for Education, Science and
Community Development (MDG 2) and Gra?a Machel (South Africa / Mozambique),
former First Lady, advocate for women?s and children?s rights (MDG 3, gender
equality and the empowerment of women).

So why is it that Bob Geldof, the Irish singer and political advocate is being
assigned to advocate for "all MDGs"--including those addressing maternal and
child health and HIV and AIDS, when Michelle Bachelet, the former president of
Chile whograppled directly with high rates of unintended pregnancy and unsafe
abortion in her own country, is assigned only to the MDG focused on gender
equality and empowerment? (The MDG, by the way, which everyone agrees is the
lowest priority in terms of funding and which also can't be separated from the
others.) Geldof and his colleague Bono--no matter how well-intentioned--both are
associated with the ONE campaign, which, while it advocates for ending poverty
in Africa, has also advocated for abstinence-only-until marriage programs in
PEPFAR, to deny HIV-positive women access to family planning services, and
against efforts to address safe abortion as an integral aspect of women's health
and rights.

Why is it that Sachs is covering all MDGs including all of those of greatest
concern to women's health, but Gra?a Machel, Sheikha Mozah Bint Nasser, Bachelet
and Young-Shim are not?? Machel and Maathai both actually live in and are from
sub-Saharan Africa, the region in which pregnancy-related death and illness,
complications of unsafe abortion, HIV infections and deaths among women from
AIDS-related illnesses, violence and all the rest are perhaps more pervasive
than anywhere else. To whom does this make sense?

Why is it that Bill Gates is covering all the MDGs of greatest concern to women,
but real women leaders, including those who fought to put these issues on the
global agenda and have studied, worked on, and staffed actual health facilities
working to promote both prevention and treatment are not?? It is true that the
Gates foundation is providing $1.5 billion for maternal and child health
programs over the next five years, a laudable contribution. It is however one
that will almost certainly fail to make real headway on reducing the toll on
women, families, communities, and economies of pregnancy-related illness and
death in part because the Gates Foundation will not--whether out of political or
religious or other concerns--address or apparently even speak about unsafe
abortion, which in some countries accounts for a third or a half of all maternal
deaths.? Moreover, the representation of funders in this group creates an
immediate conflict of interest, reducing the likelihood that any uncomfortable
issues will be raised.? The Gates Foundation funds Sachs' Earth Institute, for
example. The ONE Campaign and the Gates Foundation partner on the "Living Proof"
Campaign to highlight successful global health initiatives; yet as a colleague
pointed out the original materials made no mention of the role of increased
access to voluntary family planning, recognized worldwide as one of the single
most successful health interventions in the past four decades. And a recent
study of maternal mortality funded by the Gates Foundation and published by the
Lancet made no mention--not one--of the toll on women of unsafe abortion.? [The
UN Foundation does not censor content ofRH Reality Check in any way.]

The bottom line is this: We can not solve problems if we can not talk about real
life.? And we can't continue to fool ourselves that we are just "following the
lead of what country governments want," when so much of what they want is
determined by the funding available to them, and so many of them remain
pathologically undemocratic, especially when it comes to the representation of
women and their rights.

Why is it that there are only six women in a group of 19? Where are the amazing
female physicians, researchers, advocates, youth organizers who work, write,
speak, and organize on these issues every day, often with few or no resources?
Of the many who are prominently known and have deep legitimacy in the women's
movement, could more of those not have been included?? What about someone
representing the devastating disparities in maternal and infant health outcomes
by race and ethnic status in the United States, the part of the "most powerful
country" that most resembles a poverty-stricken nation?

What gives? Is someone concerned that a woman like say, Michelle Bachelet, will
speak truth to power on issues of greatest concern to women that funders and
politicians want otherwise to avoid?

It is clear to me that if women with legitimacy in the women's movement and as
social justice and health advocates were leading this effort, many more salient
issues would be on the table, including but not limited to safe abortion
services and maternal mortality. But that would change the entire power dynamic.

I believe all these people have the best intentions.? I also believe the time
has long passed when the UN, the U.S., and any and all other political bodies
can continue to talk about the importance of women, and keep putting men in
charge. It is long past time to confront the "advocacy" groups that continue to
put more stock in the concerns of fundamentalist religious groups and far-right
politicians than in the lives of real women. Does anyone see the gross irony in
talking about "the empowerment of women" when we can't even get equitable
distribution on a UN "high-level" advocacy group?

Does anyone else see the even greater irony, asStephen Lewis, founder of
AIDS-Free World and formerly the first UN Special Envoy on HIV/AIDS in Africa,
underscored to me "that the better than two-to-one ratio of men to women
advocates comes within one week of [the U.N.'s announcement] creating UN Women
(the United Nations Entity for Gender Equality and the Empowerment of Women),
the new international agency for women, while boasting about gender equality"?

Thomas Paine is said to have originated one of my favorite quotes often used by
colleagues in the global AIDS movement: "Lead, follow or 'get out the way.'"? In
other words, if you are not interested in the real problems and the real issues,
let others lead.

It's time for women to take the reins on these issues and lead, without
apology.? It is time for us to confront more directly the power structures that
result in the discussion time and again of the same issues with relatively
little progress made. And it is time to hold the leadership of the UN and others
accountable for putting their own rhetoric into practice.

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Violence against women is a worldwide yet still hidden problem. Freedom from the threat of harassment, battering, and sexual assault is a concept that most of us have a hard time imagining because violence is such a deep part of our cultures and lives.