Any reflections on the XVI International Conference on AIDS are necessarily subjective, as each person reporting attended different sessions, had different goals and talked to different people at different times. Nevertheless, taking the various perspectives into account can give us a more comprehensive view of what transpired in Toronto.
Advocates for women’s and rights issues can rightly take pride in having focused at least some attention on topics that were relatively neglected, such as female-controlled (at least to some extent!) barrier methods (female condoms, microbicides, diaphragms and cervical caps) and violence against women.
A recent New York Times article confirmed what most of us know already: condoms are effective at preventing pregnancy and sexually transmitted infections. One doctor in the article even goes so far as to nominate the condom for "the greatest technological invention of the past 2,000 years." Why? They don't need a prescription, they don't have an age limit, they're affordable, they can fit in your pocket, they're not messy, they save lives... the list goes on and on. So why is this news?
Because despite all of the progress in sexuality education and in preventing pregnancy and disease, there are still many misconceptions floating around about condoms.
Here in Nicaragua, advocates for women's reproductive health and rights are up in arms about a recent anti-abortion statement by left-wing presidential candidate Daniel Ortega, narrowly favored to win elections this coming November. Ortega, who was President of Nicaragua from 1979 to 1990, is the head of the Sandinista party (Americans may recall the U.S.-backed Contra war against the Sandinistas, who originally came into power in 1979 when they overthrew the forty-year-old U.S.-backed Somoza dictatorship) and a traditional opponent of Nicaragua's conservative Catholic hierarchy. During his 1979-1990 presidency, Ortega never took an official position on abortion, which has been illegal in Nicaragua under almost all circumstances for the past several decades. Throughout the 1980s, when pressed by the women's movement to do something about the growing number of Nicaraguan women regularly killed or sterilized by complications from illegal abortion, he chose instead to remind women of their reproductive responsibilities. Women were the mothers of revolutionaries, after all, and if women stopped having babies, who would fight the revolution? (Never mind that women themselves were fighting the revolution and that if a woman died or was sterilized during an illegal abortion, that made at least TWO fewer revolutionaries.) Despite the rhetoric, however, the Sandinista position on abortion always carried an air of ambiguity.
If I were President Bush, the world would be a better place.No, no, no that’s not what I meant to say.If I were President Bush and had just pissed off my social conservative base with Plan B, I would be looking for something to appease them. What could be easier than the other whipping child issue – UNFPA, the United Nations Population Fund.Look for the Administration’s coming decision to once again block the funds that Congress intended for UNFPA– funds for contraception, HIV prevention and safe deliveries to the world’s poorest countries. Look, too, for the decision to be based on the need to create political cushion rather than any sort of substance.
Thanks to Bill Gates, microbicides may soon become a household word. At the International AIDS Conference (IAC) last week, calls for “women’s rights” and “gender equality” were issued not just by the Gates, but also Stephen Lewis, Bill Clinton, and others. Even a few women made the news.
The Toronto meeting was my first IAC. I’d expected overwhelming chaos, but I’d underestimated the richness of the dialogue taking place. For me, the most powerful lessons actually emerged not from the major newsmakers, but other channels behind the scenes.
A gal finds herself pregnant, looking for some advice. She finds a pregnancy counseling center, thinking they will give her accurate, nonjudgmental advice about her options. She has a tough decision to make and she wants some facts and medical referrals. Imagine her surprise when the "counselor" calls her a murderer for considering abortion and gives her inaccurate information intended to intimidate and scare her into continuing her pregnancy.
Sounds familiar, doesn't it? Sounds an awful lot like what Congressman Waxman discovered about crisis pregnancy centers in the United States - that they accept federal funds and then give biased, inaccurate advice. Only, this scenario and others like it are happening in Australia.
A report released by the South Australia Government's Pregnancy Advisory Centre says that "various bodies and agencies, both private and public, have given women false information on the physical and mental health risks of abortions." But that's no big deal, right? I mean, it's not like pregnancy is a decision that can completely change a woman's whole life. No, wait... it is.
Acting FDA Commissioner Andrew von Eschenbach's decision, supported by President Bush, to approve Plan B for over-the-counter (OTC) status for women over 18 was a political decision. The question is not whether it was politically motivated, but what kind of political motivations were at play here.
I don't think this decision should be too quickly underestimated as political caving toward either direction. With today's decision, the FDA has crafted a unique policy that will for the first time permit a drug to be distributed with separate rules for different age groups. It's a decision that neither side of the debate is excited about: social conservatives don't like that it was approved at all, and reproductive health advocates are upset that the approval was made arbitrarily for a certain age group, irrespective of the science. Both sides are upset. In the search for an answer about motives, aren't we supposed to first discern who benefits?
The progression of getting to today's decision to make Plan B available from pharmacists without a prescription is somewhat circular - in many ways ending up where it began. It goes something like this:
In the battle of ideology v. reality, check one victory box for reality, the FDA today approved Plan B Emergency Contraception for over-the-counter distribution to women 18 and older with a valid government issued identification to prove age.
Socially conservative ideologues showed their true colors on this issue, delaying and disparaging scientific evidence showing Plan B's efficacy for more than three years. But even the staunchest of ideologues could not buttress the Bush Administration against the overwhelming tide of scientifc evidence, and public opinion, that showed Plan B should be available to women and families wishing to avoid an unplanned pregnancy, and thus further reducing the rate of abortion.
