Place women’s Health at the core of Regional priorities in the post-2015 agenda


Place women’s Health at the core of Regional priorities in the post-2015 agenda  


01 December 2014


Kingston, Jamaica-- Giving the keynote address at the Jamaica National Family Planning Conference in Jamaica, Dr. Edward Greene, UN Secretary General Special Envoy for HIV in the Caribbean, urged that the health of women and girls be placed at the centre of “closing the gap” to end the AIDS epidemic  in the post-2015 agenda.



He noted that sexual and reproductive health and HIV and AIDS targets are among those that will not be met by the end of the Millennium Development Goal period. While the Caribbean is in a good position to be the first region in the world to eliminate mother-to-child transmission of HIV, he states that governments need to accelerate their obligations to guarantee and to take responsibility for women’s timely and nondiscriminatory access to maternal health services. This involves universal access to quality, integrated sexual and reproductive health information, education and services with special reference to women, girls and adolescents. 


Stark realities

Dr. Greene justified this pronouncement by presenting the stark realities from a series of studies which concluded that globally, the incidence of sexually transmitted infections among women increased from 333 million cases per year in 1995 to 499 million by 2012; 21 percent of ten million girls under the age of 18 years who entered womanhood prematurely in 2009 lived in Latin America and the Caribbean; and in nine Caribbean countries, 48 percent adolescents identify sexual initiation as forced. In addition, three Caribbean countries are among the top ten for reported rape; one in three women on average will experience domestic violence; and all Caribbean countries where data has been available have higher than the global average of rape.  These persistent trends vividly demonstrate the structural inequalities between men and women.   


What role can the church and education play?

In the case of the education system, the challenges are compounded by the findings of studies undertaken between the late 1990s and 2008, which reveal sexually active students less than 15 years of age ranged from 10-16 years for boys and 14-17 years for girls; and 80 percent boys and 67 percent girls reported having more than one life time partners. These trends are no doubt among the reasons why AIDS is the major cause of death for the age range of 15-39 years, and why there are indications of a spike in new infections among young women.

Under these circumstances, Dr. Greene appealed to both education and church administrators to play a much more active role in preventing young people from becoming HIV infected and for drastically reducing teen pregnancies. “Girls under 15 years are five times more likely to die in child birth than women in their 20s and those under 18 are at much higher risk of pregnancy related injuries,” he said.

Dr. Greene pointed out that religion’s greatest challenge is sex. Despite widespread breaches to their theological prescripts by members, and even among some church officials that fall into sexual indiscriminate categories, these rules are “still presented as if they were relevant, reasonable and realistic.” The Synod of Bishops held recently  in Rome grappled with these issues of relevance, reason and realism in family life.

The Jamaica Government is commended for bringing some of these same concerns to the fore in its engagement with a cross section of stakeholders including faith leaders and the Joint Parliamentary Select Committee on reforms to the Sexual offences Act (2009). Among the issues highlighted are the use of gender-neutral language, the inclusion of rape inflicted on men and boys, marital rape and access of adolescents to health services without parental consent.



Justice for All, the 90-90-90 goal and the future

Dr.  Greene stated that a second round of discussions on the PANCAP Justice for All programme approved by the CARICOM Council of Human and Social Development is an appropriate bridge towards the end of AIDS in the post-2015 era. Its major aims are to reduce HIV stigma and discrimination, the cinders that feed the flames of the disease. The elements involved also have direct relevance for connecting sexual and reproductive health to closing the gap and for including the ambitious 90-90-90 goals aimed at getting 90 percent of people tested; 90 percent of those who are HIV positive on treatment; and 90 percent of those on treatment with viral loads low enough as not to transmit the virus.

He believes that the consolidation of functional cooperation in health and related areas like climate change and food security that impact on health are essential. So too is establishing the national and regional systems in step with the emerging post-2015 global health architecture. That architecture will apparently break down the disease specific silos of HIV, TB, malaria, NCDs and now, Ebola, while targeting disease specific measures to control the burdens and spread, and to avoid the emergence of epidemics. This means too that a new funding model is required. Hence, the proposal for the establishment of a Caribbean Sustainable Health and Equity Fund needs to be pursued in an effort to reduce the high-level of dependency of most Caribbean countries on external sources for support.    

As we in the Caribbean negotiate the post-2015 agenda in the coming year, “setting the stage for a viable and sustainable approach will require leadership with the courage to do things differently.  Hopefully, placing trust in young leaders will trigger more realistic, reasonable and relevant outcomes. Sexual and reproductive health embedded in the nation of justice for all provides hope for the future”, Dr. Greene added.  


Dr Edward Greene is the UN Secretary General Special Envoy for HIV in the Caribbean He gave the keynote at the opening session of The Jamaica National Planning Board Conference 28-30 November, 2013 at the Conference Centre Jamaica on the theme repositioning sexual and reproductive health and rights