Christiana Figueres, newly appointed executive secretary of the United Nations (UN) Framework Convention on Climate Change (UNFCCC), has voiced the UN’s position on the state of climate change negotiations and said that there is a constructive atmosphere and a growing sense of urgency among governments about climate change mitigation. At Cancun, Mexico, where the sixteenth Conference of the Parties will be held from 29 November–10 December 2010, governments need to go from the politically possible to the politically irreversible, she said. During the last meeting in Bonn, Germany, in June 2010, Figueres said that countries decided that the ‘text before them is now a negotiation text,’ and a ‘party text,’ which shows serious commitment, she said. In addition, comments were heard from ‘very important countries’ that their confidence and trust in the negotiation process was restored, which was not the case at the end of the 2009 conference at Copenhagen. Figueres said that she was expecting governments attending the Cancun meeting to make decisions on the relevant financing mechanism and technology for fighting global climate change, on how to push forward reduction of emissions from deforestation, on adaptation, and on monitoring, she said. At Cancun, four or five decisions could be taken to establish the operational entities that would be the basis for the next chapter of the climate regime.
Values, Policies and Rights
According to this study, there have been few studies on domestic violence and women in developing countries, including South Africa, which has one of the highest rates of intimate partner violence in the world. The study examined the association between physical intimate partner violence and physical health outcomes and behaviours among South African women. Using data from the cross-sectional, nationally representative South Africa Stress and Health Study, the study assessed exposure to intimate partner violence, health-risk behaviours, health-seeking behaviours and chronic physical illness among a sample of 1,229 married and cohabiting women. It found the prevalence of reported violence was 31%. This correlated with several health-risk behaviours (smoking, alcohol consumption, and use of non-medical sedatives, analgesics and cannabis) and health-seeking behaviours (recent visits to a medical doctor or healer). Intimate partner violence was not significantly associated with chronic physical illness, although rates of headache, heart attack and high blood pressure reached near-significance. The study recommends that public health programmes in South Africa should incorporate interventions to mitigate the impact of violence on victims and reduce the risk of negative behavioural outcomes. Further investigation of the pathways between violence exposure and health behaviours is needed to inform the design of such programming.
Opt-out testing for the human immunodeficiency virus (HIV) incorporates testing as a routine part of health care for all patients unless they refuse. The ethics of this approach to testing in sub-Saharan Africa is a source of controversy. Opt-out HIV testing is expected to improve survival by increasing case detection and thus linking more HIV-infected people to earlier treatment, provided there is effective patient follow-up and programme sustainability. At the population level, these benefits will likely outweigh the potential negative consequences of individuals experiencing HIV-related stigma, according to this article. These justifications appeal to consequentialist moral theories that the acceptability of an action depends upon its outcomes. On the other hand, liberal moral theories state that the autonomy of individuals should always be protected unless restricting autonomy is necessary to protect the welfare of others. Opt-out consent may restrict autonomy and it is unclear whether it would benefit people other than those being tested. Yet, the doctrine of libertarian paternalism proposes that it is justifiable and desirable to use unobtrusive mechanisms to help individuals make choices to maximise their own welfare. Central to this idea are the premises featured by supporters of opt-out consent that individuals will not always make the best choices for their own welfare but they may be influenced to do so in ways that will not compromise their freedom of choice. Also important is the premise that all policies inevitably exert some such influence: opt-in consent encourages test refusal just as opt-out consent encourages acceptance. Based on these premises, the article argues that opt-out testing may be an effective and ethically acceptable policy response to Africa’s HIV epidemic.
In preparation for the Millennium Development Goal (MDG) Summit, held from 20-22 September 2010, in New York, Women in Development Europe (WIDE) launched the new campaign ‘Mobilising for Gender Justice Beyond the MDGs’ to advance gender and social justice for all. WIDE’s view on the MDGs framework is that it offers too narrow and minimalist a focus for measuring development or the advancement of gender equality and women´s rights. WIDE considers that the MDGs’ shortcoming is that the indicators exclude the structural nature of poverty as well as the structural nature of gender inequality. WIDE is inviting participation in the ‘Gender Justice Beyond the MDG Campaign’ to share analysis, opinions, activities and proposals, news, processes, expectations and outcomes of the summit.
The African Union (AU) Summit in Kampala August 2010 adopted an action plan for the improvement of maternal, infant and child health and development and made a commitment to spending 15% of national budgets in an effort to reach the Millennium Development Goals in this area. An AU task force will track progress to ensure implementation. On the partnership for the eradication of mother-child transmission of HIV (PMTCT), the Assembly invited all Member States to intensify efforts relating to antiretroviral treatment and PMTCT and to extend such efforts to primary health centres. The Assembly underscored the need for programmes for the total eradication of PMTCT and called for all African actors concerned to act immediately to make eradication a realisable outcome. An initiative on agriculture and food security was also launched. Economic growth, job creation and investment are the preferred focus for the Africa-Europe Summit in November and the next AU Summit in 2011 will focus on the Pan-African Governance Architecture.
The Kenyan government is drafting new regulations to stop fraudulent herbalists claiming to be able to treat diseases, including HIV, from practising. Anybody found selling untested herbal products will face legal action for ‘endangering people's lives,’ said Jayesh Pandit, head of pharmacovigilance at the Pharmacy and Poisons Board. The Pharmacy and Poisons Board has registered 300 legitimate herbalists, but thousands more are practising outside the law, often selling useless or even harmful products to desperate patients. According to the World Health Organization, up to 80% of Africans use traditional medicine. The government is planning to introduce a ‘Traditional Medicines Practitioners Bill’, which will regulate the use of herbal medicines and define the punishment to be handed down to herbalists practising illegally.
In his address to the Eighteenth International AIDS Conference in Vienna, Mark Heywood of the Treatment Action Campaign (TAC) has warned that South Africa’s campaign to test 15 million people for HIV in one year risks being implemented in a way that undermines people’s human rights. Incidents of coercive testing have been recorded but the lack of effective monitoring procedures means that it’s impossible to know whether those incidents are widespread or not. The testing campaign is a means to an end, and not of value in itself, he said. Unless the campaign delivers on its promise to link newly diagnosed people into treatment services, then the means to achieve this end will be unjustifiable. He noted human rights concerns about a lack of monitoring of ‘adverse events’, such as whether a person who is diagnosed with HIV then suffers discrimination, suffers violence or gains access to treatment. Incidents of refusing HIV-positive patients access to health services have been recorded by the TAC in South Africa. Heywood said it was unclear whether such incidents were rare or widespread, but that any violations of basic principles should be taken seriously.
The AIDS 2010 conference theme emphasises the central importance of protecting and promoting human rights as a prerequisite to a successful response to HIV. The right to dignity and self-determination for key affected populations, to equal access to health care and life-saving prevention and treatment programmes, and the right to evidence-based interventions based on evidence rather than ideology are all incorporated in this urgent demand for action. Rights Here, Rights Now, a campaign launched by the International Lesbian, Gay, Bisexual, Trans and Intersex Association, emphasises that concrete human rights measures need to be in place to protect those most vulnerable to and affected by HIV, especially women and girls, people who use drugs, migrants, prisoners, sex workers, men who have sex with men and transgender persons.
This book is a collection of 16 critical essays by leading scholars and practitioners in the field of sexual and reproductive health and rights. Each author analyses the legacy of the International Conference on Population and Development (ICPD) from a different perspective or focuses on a particular topic. They examine strengths, weaknesses and whether and how the ICPD mandate can still be used to improve sexual and reproductive health. Given the complexities and challenges of implementing and continuing to take forward the ICPD agenda after more than fifteen years, the undertaking in this volume is laudable. The essays all contain some dimension that should be of interest to a variety of readers. Some provide historical background which might otherwise be forgotten. Several other authors point out that the absence of reproductive health in the initial targets for the Millennium Development Goals was a serious setback. While the target of ‘universal access to reproductive health’ has since been added, one of the essays, ‘Mobilising resources for reproductive health’, points out that a strong evidence base is needed to demonstrate that poor reproductive health outcomes do, in fact, undermine the chances of the poor to escape poverty.
The aim of this paper is to examine young women's motivations to exchange sex for gifts or money, the way in which they negotiate transactional sex throughout their relationships, and the implications of these negotiations for the HIV epidemic. An ethnographic research design was used, with information collected primarily using participant observation and in-depth interviews in a rural community in North Western Tanzania. The qualitative approach was complemented by an assisted self-completion questionnaire. The study found that transactional sex underlay most non-marital relationships and was not, per se, perceived as immoral. However, women's motivations varied, for instance: escaping intense poverty, seeking beauty products or accumulating business capital. There was also strong pressure from peers to engage in transactional sex, in particular to consume like others and avoid ridicule for inadequate remuneration. Young women actively used their sexuality as an economic resource, often entering into relationships primarily for economic gain. In conclusion, transactional sex is likely to increase the risk of HIV by providing a dynamic for partner change, making more affluent, higher-risk men more desirable, and creating further barriers to condom use. Behavioural interventions should directly address how embedded transactional sex is in sexual culture.