I.        Executive Summary

There are now approximately 18 million women in the world living with HIV/AIDS, a large portion of whom live in sub-Saharan Africa.[i]  2.3 million children under the age of 15 are living with HIV/AIDS; one of them dies each minute.[ii]  As the international community attempts to grapple with these staggering numbers and spends billions of dollars on essential HIV/AIDS programs, comparatively little attention is being paid to the urgent need to scale up programs that address violence against women and children (VAWC).

Establishing zero tolerance for violence is a matter of basic respect for human rights, particularly those of women, including sexual and reproductive rights.  Unless it is fully addressed with a holistic view of risk factors and consequences, the multi-billion dollar response to HIV/AIDS is bound to fail.

Violence is clearly at epidemic proportions, and it severely impacts children, with 20% of girls and another 10% of boys experiencing sexual abuse as a child.[iii]  Orphans and other vulnerable children (OVC) are at heightened risk.  Refugees and displaced persons, 80% of whom are women and children, also experience increased sexual or physical violence; this makes approximately 15 million people especially vulnerable.[iv] 

Violence is linked to HIV.  Women who have experienced violence may be up to three times more likely to acquire HIV.[v]  In addition to behavioral risk factors, there are direct consequences of unprotected forced or coerced sex, and this is compounded by global HIV/AIDS policies that fail to take seriously the realities facing women and girls.  Fear of violence can prevent women from seeking voluntary counseling and testing (VCT) for HIV, disclosing their serostatus, and receiving treatment when it is needed.

Many of the kinds of violence addressed in this paper have deep social roots.  For instance, polls show that in some countries large majorities of men and women feel men are sometimes justified in beating their wives.  These and similar views are based in traditional concepts of gender roles, which can be reinforced via religious institutions, the media and other mechanisms.  However, there are strong examples of ways in which violence against women and children can be effectively addressed.  For example:

• In rural South Africa, the IMAGE Project combined microfinance lending with participatory gender and HIV training.  The program involved over 850 women and 4,000 young people, and has already had a positive impact.

• In Egypt, NGOs have implemented the New Visions educational program, which has reached 17,000 young men and boys.  Among boys who have graduated from the program, only 26% now feel it is acceptable for a husband to hit his wife, a decline of about half.

For more than two decades, women’s advocacy organizations have been calling for action on violence against women.[vi]  The call for action to stop violence against children is more recent but is beginning to be heard.  Yet, despite clear evidence that successful strategies exist, international donor countries have been far too slow to react, multilateral funding mechanisms have been left starved of resources, and no global plan has been created.  For instance, in 2005 the United States announced an initiative to support legal and judicial reforms and improve social protection mechanisms in four African countries, but it has taken more than a year to get off the ground. The UNIFEM Trust Fund to Eliminate Violence Against Women (TF) has provided only $10 million to programs in 100 countries and faces a resource gap of at least $14 million each year.  Countries with high rates of violence against women and children, many of which also have high rates of HIV, too often fail to effectively enforce their own laws against violence and some don’t even have laws on the books.  Only 25 countries have developed national action plans on eliminating violence against women.

It is high time that the epidemic of violence be addressed with a new level of urgency—including much greater financial resources for effective, evidence-based programs.  Billions of dollars have been mobilized for an initial—albeit inadequate to date—response to HIV/AIDS, but, so far, the rising concern about the epidemic of violence has led to almost no increase in financial resources for the range of successful programmatic responses to violence.  Given the intimate connections between violence against women and children and HIV, it is clear that the international community must urgently implement a comprehensive response to stop the violence if we are to have any hope of preventing and successfully treating HIV/AIDS. 

This document describes a framework for a comprehensive response to violence against women and children, including the resources that would be needed, political and financial, for full implementation.   The following elements would be essential (for more detail, see Appendix III):

Pillar #1: Political Commitment and Resource Mobilization

Political commitment must occur at the country, international and civil society levels.  An international commitment should include creation of a Global Task Force on Violence Against Women and Children, consisting of UN agencies, donor and affected country governments, and civil-society organizations, with UNAIDS as secretariat.  Another option would be for the Task Force to become a major program of a new UN agency focused on the needs of women, an agency recently proposed by the Secretary General’s Special Envoy on HIV/AIDS in Africa, Stephen Lewis.[vii]

Effective HIV/AIDS prevention and treatment programs, such as those financed by the Global Fund, are addressing stigma, a key driver of violence.  These programs must be fully funded, and the promise of universal access to HIV/AIDS prevention and treatment by 2010 must be kept.  HIV/AIDS programs should be expanded to include funding for programs to address violence against women and children.  Beyond HIV/AIDS programs, additional resources, at the level of at least $2 billion beginning in 2007, are urgently needed for effective, evidence-based programs that address violence. 

Pillar #2: Legal and Judicial Reform

Countries should immediately enact and enforce legislation that criminalizes all forms of VAWC, and legally mandate violence recognition, prevention and response training for judicial professionals. 

Pillar #3: Health Sector Reform

Comprehensive reform of the health sector is needed to ensure that VAWC is an essential element of universal access to care and that the right to health, including sexual and reproductive health, is met. 

Pillar #4: Education Sector Reform

Countries should establish gender and violence trainings throughout the education sector for professional certification, incorporate violence into all national education strategies, and establish schools at all levels as places of safety.  Addressing the needs of OVC is especially critical.

Pillar #5: Community Mobilization for Zero Tolerance

Local leaders and change agents should be mobilized by a decentralized network of community task forces, established by the national VAWC strategy, to identify, respond to, and speak out against VAWC in their communities. 

Pillar #6: Mass Marketing for Social Change

National strategies should include plans to conduct widespread, comprehensive mass marketing campaigns aimed at eradicating tolerance of violence and modifying harmful gender norms. 

The world has already waited too long, allowing more and more women and children to be victimized because of their lower status and the systemic violence that enables governments, police, neighbors and friends to turn a blind eye.  The international community should take concerted action to bring an end to this epidemic on the basis of a coordinated and fully-financed plan.