Women and girls need an Aids vaccine
By Janet Museveni
Five months ago here in Kampala, delegations from 32 countries gathered for the Eighth Commonwealth Women’s Affairs Ministers Meeting. “Gender inequalities lie at the heart of the HIV epidemic,” states the communiqué from that gathering. It calls for a truly comprehensive approach to HIV/Aids- not only scaling up treatment and care services, but also, and with equal urgency, investing in existing prevention techniques and newer and better technologies, such as microbicides and vaccines.
Two and half decades since the onset of the HIV/Aids epidemic, gender inequality remains one of the principal drivers of HIV. In 1998, women accounted for 41 percent of HIV-infected adults worldwide. By 2005, women made up almost 50 percent, and nearly 60 percent in sub-Saharan Africa.
The gender imbalance in sub-Saharan Africa is even more striking among young people: a woman between the ages of 15 and 24 is two and a half times more likely to be infected than her male peer. We must ask ourselves: Why are women at a higher risk of infection than men? What must we do to address this challenge and curb the epidemic? In this country, we have been using a strategy called ABC, which simply means Abstinence, Being Faithful, and Condom Use.
Early on, the A and B were given limited attention. We believe, however, that our advocacy efforts, which include multimedia campaigns all over the country, have contributed to the greatest decline in prevalence in those aged 15 to 20, due in large part to delayed sexual debut among young people. The evidence of the impact of ABC supports the current wisdom that the ABC approach should be put forward as a package: abstain or delay sexual debut for those who are not yet sexually active, seek voluntary counselling and testing with a potential sexual partner, and remain faithful or use condoms correctly and consistently.Although Uganda has registered some success at prevention, young people and adult women, especially married women, remain at the greatest risk of contracting HIV.
The most immediate cause of women’s HIV vulnerability in most settings is their limited power to negotiate safer sex, combined with the lack of female-controlled HIV prevention methods other than the female condom.
The global community needs to maximise the use of HIV prevention interventions that are available today, including widespread HIV and sexuality education, particularly for young people; efforts to shift gender norms that put women and girls at a disadvantage; and the development of newer and better prevention options.
As a proponent of the ABC strategy, I have come to the realisation that in order to ultimately end this epidemic, we need to advocate even better options, like the development of vaccines. An effective vaccine would offer women the possibility of a long-term method that can be used with or without their partners’ knowledge or cooperation.
A vaccine would be particularly important in addressing the vulnerability of adolescent girls, as they could potentially be vaccinated before the onset of sexual activity or coercive or transactional sex. I am proud that Uganda is at the forefront of the development of an Aids vaccine by hosting trials through collaboration among the government, the Uganda Virus Research Institute, the International AIDS Vaccine Initiative, the Makerere University Walter Reed Project and the Makerere University John Hopkins Research Collaboration. If an Aids vaccine is to become a reality in the near future, there is a need to significantly expand political support for Aids vaccine research globally.
My appeal to all members of the Commonwealth is that they play their part in finding an Aids vaccine. Heavily affected countries should support vaccine trials and can invest in their own research capacity, for instance, by committing to train the next generation of researchers.
Countries with established research capacity should increase and sustain their funding for research to combat HIV, TB, malaria and other neglected diseases. They should also explore incentives to stimulate greater private sector engagement.
Donor nations should help ensure adequate support for Aids vaccine research and development. Without better prevention, the costs of treating Aids will only continue to soar.
It is my hope that the commonwealth meeting will build on the many previous declarations from United Nations High Level Meetings and African Summits to previous Commonwealth Heads of Government Meetings. We must act now to save generations of women, men and children from the Aids pandemic.
The writer is the First Lady of the Republic of Uganda and Member of Parliament for Ruhama County Constituency