Following the recent United Nations summit on sustainable development, there are encouraging signs for women and girls — welcome news given that women have often been overlooked in discussions of global priorities.
The new Sustainable Development Goals adopted by the U.N. General Assembly include targets to secure the health and well-being of women. U.N. Secretary-General Ban Ki-moon is personally making women and girls a top priority and named the 21st century the “century of women.”
It is our shared moral and public health imperative to make that pledge a reality for women everywhere so that they can reach their potential and realize their goals. Time and again, evidence has shown that healthy, empowered women are also the foundation of strong families, communities and nations. Women feed and educate their children, lift their families out of poverty and are a backbone of the workforce in productive economies.
Greater attention to women and girls is arriving at an auspicious time, when there are positive developments on one of the gravest threats to women’s health and well-being: HIV and AIDS. More women than ever are receiving lifesaving and life-extending HIV treatment. Even as infections among young women continue at alarming rates, promising clinical trials nearing completion on a vaginal ring for HIV prevention could give women the first long-acting, self-initiated product designed specifically for them.
These advances toward stemming the epidemic among women are real, but also fragile. To ensure recent gains bear fruit in the long term, continued investment is critical.
Protecting women and girls from HIV, and improving their sexual and reproductive health broadly, has tremendous payoff for sustainable development because it removes a major barrier to women’s ability to achieve their full potential. More than half of adults living with HIV worldwide are women. HIV and AIDS are a leading cause of death among pregnant women, and nearly one-quarter of all pregnancy-related deaths in sub-Saharan Africa can be linked to HIV.
So what does the sustainable development agenda mean for young women living in an area like Ladysmith, a small community on South Africa’s east coast, where new HIV diagnoses are delivered to their friends daily? Here, as in many communities across the African continent, young women and adolescent girls are especially vulnerable to HIV infection and account for the vast majority of new HIV diagnoses. In fact, adolescent girls in South Africa are eight times as likely to have HIV as boys their age.
If we translate the SDGs from aspirations to outcomes, young women will have a brighter future: one that is free of HIV, enabling them to complete their education and pursue careers. Fulfilling this vision depends on international commitment across public and private sectors to two areas: making existing prevention methods such as treatment-as-prevention, oral pre-exposure prophylaxis and condoms available to women, and supporting urgently needed research to develop new technologies that offer the options women need to protect themselves and stay healthy.
Tools to stem the tide of HIV can only be as powerful as the resources invested to deliver them. New partnerships focused on reaching more women and girls with HIV prevention and care, such as the DREAMS initiative launched by the U.S. government and the Bill & Melinda Gates Foundation, are a step in the right direction.
At the same time, one of the most important HIV investments for women is scientific innovation. Women are particularly vulnerable to HIV because of a combination of biology and gender inequities that are not sufficiently addressed by the tools currently available to protect against HIV.
That could change as early as next year, when first efficacy results are expected on a monthly vaginal HIV prevention ring. The ring, developed by the International Partnership for Microbicides, would address a major gap in current HIV prevention strategies by offering women an easy-to-use and discreet way to protect themselves. The ring delivers the antiretroviral drug dapivirine slowly over the course of a month at the site of potential infection. If the results show that the ring works, realizing its lifesaving potential will require making it affordable and accessible, particularly in sub-Saharan Africa.
Regardless of the results on the ring, research on new technologies for women’s health and well-being must carry on. No one product will suit all women — or stop the epidemic. Other products in development include a three-month multipurpose ring that simultaneously prevents HIV and offers a contraceptive.
Any genuine effort to promote sustainable growth must have a vision for shaping an HIV-free future for women and girls which requires sustained investment in scaling up current technologies and developing new prevention methods. By investing in women’s sexual and reproductive health, we not only ensure that they are able to live healthy and productive lives, we help build a more equitable and sustainable world.