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I feel it is appropriate that a woman from Sub-Saharan Africa, where millions of people are infected with and affected by HIV/AIDS, should critically examine some of the socio-cultural dimensions of the epidemic.

It is even appropriate because I come from the Southern African Development Community (SADC), the region where more than three quarters of the member countries have the highest number of HIV and AIDS cases in the world per capita. SADC has only 1% of the world’s population, but nearly 40% of the world’s HIV infections are in the region, and the majority of them are young women.

The Platform for Action, resulting from the Fourth World Conference on Women and the Programme of Action,adopted at the International Conference on Population and Development, call for a holistic life cycle approach to women’s health care with emphasis on increased allocation of resources for the provision of affordable health care, health promotion and disease prevention, and prevention and treatment of sexually transmitted diseases and HIV/AIDS.

The call was again made at the 43rd Session of the Commission on the Status of Women when member states resolved to ensure greater protection of women from HIV infection, including access to female controlled methods, access to affordable antiretroviral therapy for people living with HIV and AIDS, eradication of gender based violence and harmful practices such as female genital mutilation. Southern African Development Community (SADC) sponsored a resolution on women, the girl child and HIV/AIDS which called upon Governments, NGOs, civil society and the international community to speed up efforts to prevent and reduce the horrible impact of HIV/AIDS on women and girl children in developing countries.

The twenty-third Special Session of the General Assembly entitled "Women 2000: gender equality development and peace for the twenty first century" noted some positive, but very slow, signs in the fight against HIV/AIDS and member states further resolved to intensify efforts to protect women of all ages from HIV infection and other sexually transmitted infections, including access to female controlled methods, voluntary and confidential HIV testing and counselling, and development of vaccines.

In short, the ‘talk and talk and talk’ about the gender aspects of HIV/AIDS has been with us for a considerable length of time. The question one needs to ask is: why is there so little or inadequate action when it comes to implementing these gender sensitive resolutions?

In my paper I attempt to answer this question by looking at some of the factors behind the non-implementation of these noble resolutions.

The special vulnerability of girls and young women to HIV/AIDS has been documented in many studies and discussed at the various United Nations fora. While most states agree that young people have the right to develop their capacities, to access a range of services and opportunities, to live, learn and earn a safe and supportive environment, and to participate in decisions and actions that affect them, one finds that social institutions such as schools, NGO’s, the media, the private sector, and the governments are doing very little to support these rights. For example, access to information relating to sexual health is still a controversial issue despite extensive research showing that school-based life skills education empowers youth and does not increase their sexual activity (Kirby et al., 1994).

From my observations, backed by 10 years of experience teenagers who are "kept in the dark" about matters of sexuality are at a much greater risk than those who are provided with information because when they do decide to engage in sex, it is likely to be unsafe sex which immediately results in a pregnancy and/or a sexually transmitted disease. Their ignorance and lack of planning guarantees that they cannot negotiate safer sex let alone carry a condom or even know how to use it.

In most countries, the legal systems and cultural norms reinforce gender inequality by giving men control over productive resources such as land, through marriage laws that subordinate wives to their husbands, and inheritance customs that make males the principal beneficiaries of family property. This is still happening despite the fact that most of these countries have ratified the Convention on the Elimination of all forms of Discrimination Against Women (CEDAW). Such resolutions have far reaching consequences for the rights of women, the achievement of national development, and the transmission of HIV. Furthermore, Structural Adjustment policies seem to have worsened the levels of poverty in many countries rather than improving their economic situations. As usual, women and girls have been the most affected by some of the strategies employed. The continuing retrenchments and lack of employment opportunities have resulted in women and girls resorting to both direct and indirect commercial sex work for survival, placing them at risk for HIV infection. The appropriate question to ask is: To what extent do governments have linkages between programmes targeting HIV/AIDS at community level to those targeting economic empowerment of women?  Poverty eradication among women requires gendered dimensions by dismantling the institutions and ideologies that maintain women’s subordination in all spheres of their lives. Economic empowerment and poverty reduction cannot be accomplished through anti-poverty programmes alone, but through a democratic environment and changes in economic structures giving access for all to resources and opportunities that enhance their quality of life.

For women living with HIV and AIDS, a gendered approach ensures that they have access to food, sanitation, education, housing and health care, including the provision of antiretroviral drugs. Our governments seem to hide under the cloak of "drugs are too expensive" to the point where very little is being done to procure them, but these are the same governments that spend millions of dollars on military equipment and on armed conflicts. In my own continent, Africa, about one eighth of the military budget of most countries would be enough to provide free antiretroviral drugs to all citizens living with HIV and AIDS, yet it is the drug companies that seem to be getting an unequal share of the blame for exploiting the situation. Whatever happened to state accountability to its citizens?

There is still a wide gap between the acknowledgement of HIV/AIDS as a problem and what any one political leader does about it, and the resources to be allocated for such programmes and activities. What we need are leaders who can: