The major health concerns come from young brides being forced to engage in sexual activity before they are fully developed. They are also often expected to bear children while very young, and early childbrith leaves them at high risk for serious health complications like obstetric fistula. Sexual activity with their older, experienced spouses puts them at higher risk for HIV infection than unmarried girls. These girls are also removed from any ongoing education, leaving them at a disadvantage for earning income, caring for their children, or surviving on their own if their marriages might end.

Here's to the fact that some policy makers are recognizing that to have success in US development assistance, some cultural practices and gender inequities have to be confronted for any of the prescriptive programming that comes out of Washington to work.

We have seen Rep. Barbara Lee (D-CA) and colleagues step up in addressing the underlying inequities between women and men in many parts of the world in order to be able to seriously address HIV prevention. Sen. Dick Durbin has also brought to his colleagues an informed approach to achieving the lofty goals of access to education, good health, and a life free of violence by addressing one of the cultural practices — rejected in international agreements — that limit girls' abilities to acheive those goals.

The International Child Marriage Prevention and Assistance Act calls for an integrated and community-based approach to end the practice of child marriage. We hope this kind of leadership helps others better understand that some different approaches need to be adopted to meet the intended goals of our foreign assistance.