Stephen Lewis: Women's rights and Africa's pandemic
April 30, 2006
Canadian Government Executive Magazine (April 2006), by Paul Crookall
You recently proposed that the United Nations establish a new international agency for women.
I have felt increasingly over the 20 years I’ve been involved in the international community that it’s scandalous that in the UN system there is no powerful force or agency speaking for and promoting the rights and needs of women. A handful of agencies do stuff for women but they’re all very small or very narrow in mandate. There is nothing that approximates UNICEF for children. For example, the women’s agency in the UN, UNIFEM, has about 75 core employees and a budget of $50 million. UNICEF has $2 billion a year and 8,000 core employees. Yet UNIFEM is expected to deal with the needs of half the world’s population. I don’t begrudge for a moment what UNICEF has or is doing but I feel that it’s unconscionable, just indefensible, that we do not have a powerful international women’s agency.
The need is there to support getting girls into school, to reduce sexual violence, to reduce maternal mortality. But I’ve never felt this more clearly than in the situation of HIV/AIDS where women are so disproportionately infected and are dying in such terrifying numbers. It is just heartbreaking beyond belief because they’re overwhelmingly in their late teens, twenties. We are losing the young women of Africa. They need an agency to advocate for them, to pummel governments into submission or into sanity, to be really tough about the interests, needs and rights of women and to help women organize, network and put pressure on their own governments and to get the rest of the world engaged.
Yesterday morning at the Canadian mission, with Alan Rock in the chair, gender equality experts gathered from a number of missions. I made an opening presentation and we had a most fascinating and intense discussion of the possibility of a women’s agency. We looked at using a panel on UN reform, recently appointed by the Secretary General to study the cohesion of development and humanitarian assistance, to see whether it could be the vehicle through which we can make the case.
Ambassador Rock was superb, so clear in the way he framed issues. I was frankly proud that it was Canada taking the lead on this, not committing to any particular design, just saying the situation of women is so fraught with hazard and discrimination that we really have to sit down and figure out a better design for the UN system. I think what started yesterday morning if carried ahead will pick up traction. I was amazed and heartened.
You are the UN Special Envoy for HIV/AIDS in Africa. But you are also personally involved. How did you get started with the Foundation that supports communities suffering from AIDS?
The Foundation was born out of despair, despair at seeing the toll that the AIDS pandemic was taking in Africa. Women seemed most vulnerable and the number of orphan kids was increasing exponentially. The women needed treatment, support and care. The children needed food and money to pay for school and shelter. People living with AIDS were so often stigmatized and isolated, but were actually very brave and courageous and really were the experts on the pandemic because they knew all of the data. Yet they were so isolated in society. They didn’t have access to health care and lacked computers and cell phones and anything to keep in touch with each other.
A friend told me to stop whining and do something. So I did. Canadians have been astonishingly generous and responsive to the Foundation. We have raised between $10 and $11 million simply because of the willingness of Canadians to contribute – we haven’t really solicited. We now have over 100 projects in 14 countries. We are careful to have people in Africa who are able to visit the projects, monitor them, evaluate them, build their capacity and also take a look at the proposals, which are sent to us to assess.
Then, we suddenly realized, based on what we were seeing, that the unsung heroes of the continent were the grandmothers who were sustaining communities and looking after the orphan children, going through this agonizing ordeal of burying their own adult kids and looking after their orphan grandchildren; starting to parent again at the age of 50, 60 or 70, without money to send the kids to school, without adequate shelter, just scraping together but with an enormous resilience and joie de vivre. It is extraordinary how feisty and strong the grandmothers are.
Then in Canada, spontaneously, groups of grandmothers were springing up in Nanaimo, Kamloops, Wakefield, Saskatoon, Quebec and Toronto, groups wanting to support the efforts in Africa. My daughter, who runs the Foundation, suddenly realized we should be doing a grandmothers-to-grandmothers campaign.
This fits very well with Canada's aging demographic, and the leading edge of the Baby Boom who are now retiring and seeking to make a contribution. How does it work?
The grandmothers-to-grandmothers works in two ways. First, we funnel money directly to grandmothers’ projects in Africa. We have identified 30 to 40 projects with a significant grandmother component. The grandmothers are so desperate for the basics and for some training around psycho-social support to be able to nurture these kids psychologically. They are in very, very fragile circumstances.
Second, we want the grandmothers to be able to dictate the terms. We want the African grandmothers to be able to say, "this is what we need and want," and then the Canadian grandmothers to be able to respond and say, "this is what we think we can reasonably do." This differs from what is so often the instinct in the western world to just tell people what we think they need and provide it.
In order to achieve that partnership, we’re holding a grandmothers gathering, at the International AIDS Conference in August in Toronto. We’re trying to bring up to 100 grandmothers and the coordinators of their projects to Toronto. We hope to have 200 or 300 Canadian grandmothers, I suspect, we’ll be hard pressed to keep it to that number because they all want to come already. Both George Brown College and Ryerson University have agreed to help and have resources, so there’ll be no drain on the Foundation’s finances. In the two-day session the African grandmothers will set out what they need and want and the Canadian grandmothers will respond. We hope to build a close solidarity between the two and make it real so that there is a sense of friendship and affection and relationship between them. The Canadian and international support is really taking off, it’s encouraging.
What can our readers be doing, through their work, to contribute to the initiatives you are championing, and to international development generally?
Public service executives have the knowledge and capacity to fill the gaps and to replenish the capacity on a continent like Africa. They can also, of course, as individuals, support various major NGOs, for example: Save The Children, CARE, World Vision, Plan International, Doctors Without Borders, UNICEF, these extraordinary groups that are doing magnificent work. They often need people to help them with policy, with advocacy, to raise money, to occasionally visit the continent and work with them on projects on the ground. There are a lot of ‘twinning’ projects where governments support fellow governments.
Are there any systemic government issues that need to be addressed?
The only systemic issue is political will. The previous government gave good support around HIV/AIDS, which I will readily admit is my preoccupation. The $100 million it gave to the World Health Organization to start the famous Three by Five Program, putting three million people into treatment by the end of 2005, was tremendous. They didn’t reach the goal but they got momentum going.
Canada's contribution to the AIDS vaccine initiative, to the Microbicide Partnership, to the Global Fund, was exemplary. Where we fell down lamentably, inexcusably, was our refusal to set a timetable to reach the target of 0.7% of gross national product as foreign aid. We were viewed increasingly as hypocrites by the international community because we suggested the target and then refused to set a timetable.
But the fascinating thing we did, which no other country in the world has yet done, is to pass legislation, originally Bill C-9, to allow for the manufacturer of generic drugs in Canada for export to the developing world, using an amendment to the intellectual property rights clause of the World Trade Organization. And we’ve started the process, and there is now a drug that has been produced, in response to a request from MSF (Doctors Without Borders). It is an anti-retroviral generic drug, a fixed dose combination – 3 drugs in one pill – and it may well compete on the market with the cost of the drugs from India, which is quite phenomenal, really, if that turns out to be true.
What is needed here is fast tracking with a vengeance. It’s taking an unconscionable time to get it done. If you ask what can executives do – well, I do not mean to be presumptuous, and I mean this respectfully, but the executives of the Ministry of Health can consider this to be one of the single most important imperatives they have initiated, because if they’re successful, we save lives. If they’re not successful, we lose lives. And there’s no question in my mind that we can be successful. Canada can be a model for the industrial world.
I would also like to encourage CIDA to look more sympathetically at initiatives in which Canadians are involved and give them some real support. CIDA has had to cut back a lot. They reduced their number of countries, which I think is sensible, but you should not be arbitrarily rigid about it and you should be able to see the advantage of supporting really good projects that Canadians are engaged in. For example, in Malawi, there is an integrated community-based health project – the spirit behind it is Dr. James Orbinski, a magnificent fellow – it’s exactly what Canada always talks about. It’s community-based, not top down, not a series of vertical silos where you separate one disease from another. I’ve spoken to government officials in Malawi and they love it. We've said to CIDA, "this is a project that does Canada proud. Why in heavens name can’t you give them some funding?" In Lesotho, the AIDS infection rate is 25%. There’s an excellent Ontario Hospital Association treatment project in the community of Leribe, saving hundreds of lives: Why can’t CIDA find a little money to help them? Well, Lesotho isn’t on our list of 25 countries, CIDA says. Fair enough. But don’t be so dogmatic that you can’t make the occasional exception in order to give support to Canadian initiatives. I’m not asking you to support American initiatives; this is driven by Canada.
I like CIDA. CIDA has a fine reputation, it’s a great place and people work very hard. But I’m worried about what’s happening to the public perception of CIDA when it’s so hard to find a few dollars to do these things.
I’m hoping that the new government will have more sympathy towards understanding what Canadians are doing. One of the great things about CIDA, before they were cut so savagely financially, is that they had a tremendous reputation for collaborating with Canadian NGOs and Canadian projects. That reputation has declined; it should be restored. Dignitas and Leribe are two excellent opportunities. The current Prime Minister has promised CIDA more money, and they’re getting 8% increases each year now as part of the Chretien legacy. I’m hoping that CIDA will see its way clear to helping these projects because it will bring honour to Canada and to CIDA.
It is my experience that, increasingly, Canadians want to get involved personally, either through their organizations, their governments or as individuals.
Stephen Lewis's book, Race Against Time, published November 2005, is available online and in bookstores. More on Stephen's work is available at www.stephenlewisfoundation.org.