United Press International - December 1, 2004
Donna Borak

It was a disease that neither she nor her medical examiners knew much about. It was a disease of death, her examiners told her. She didn't have much time left.

The medical school expelled Wagura and told her nothing could be done to help -- that she should just go home and wait to die.

"And I waited six months to die," she said. "After six months I realized I was not sick. I was not dying."

Since that time she has worked steadily on changing the stigma in her home country of Kenya, where her 14-year-old son is told on the playground, "In this team we don't want people who have mothers with AIDS."

Her voice lowers to a whisper, "Children don't want to play with my child."

Wagura is only one woman among the 13.3 million others who are living with HIV in sub-Saharan Africa. There are a total of 25.4 million cases of HIV in the region, including children.

The sub-Saharan region is only one of the vastly growing regions in the world that have seen a marked increase of female HIV/AIDS cases. Over the last two years the number of HIV cases among women increased 56 percent in East Asia and 48 percent in both Eastern Europe and Central Asia due to a resurgent epidemic in the Ukraine and Russia.

There are roughly 39.4 million people living with HIV worldwide, including many children under the age of 15. Women make up nearly 50 percent of all cases, at roughly 20 million. This year there were 4.9 million new cases in total, not including the 3.1 million individuals who died.

Fourteen years ago the face of AIDS was largely male, with only 2 million cases of women living with HIV. Today the number is as high as 20 million, excluding the 10 million women who have died of AIDS-related diseases. As a result the focus of this year's World AIDS Day, created by the World Health Organization in 1988, was on the growing epidemic among women and young girls living with HIV.

"It's a social and economic disaster," said UNAIDS Executive Director Dr. Peter Piot at a news conference Wednesday. "Women are the backbone of our society. Keeping women healthy is not just the right thing to do; it's also the smart thing to do.

"If there's one place in this epidemic to intervene, one place where our efforts will yield dramatic results, this is it. The simple truth is that empowering women and girls to protect themselves and their families from AIDS is the key to turning the tide," he said.

Piot argued that the current system in place, under President George W. Bush's AIDS relief plan, though strongly supportive, is not enough to impede the current growing pandemic among the female population. The President's Emergency Plan supports an AIDS-prevention program, called ABCs, based on abstinence, being faithful and the use of condoms.

"These programs are not being implemented in a social vacuum. They are implemented in a world where women are still in a vulnerable position," said Piot.

"We must make sure to ask, will this work for women and girls? If we can get the answer right, we will win this fight."

The hindrance of PEP is that it does not take into account a series of factors facing women in these underdeveloped countries. In most instances, women live on $2 a day, many of whom are illiterate, without their own land or home. They have little to no access to healthcare services or information, and most suffer from sexual and physical violence, making them the highest-risk group in the world.

"ABC, as a strategy for prevention is necessary, but not sufficient for most women and girls around the world," said Dr. Geeta Rao Gupta, president of the International Center for Research on Women.

Gupta recommended a supplemental program, called ABC-Plus, which would help to improve access to healthcare and information for women, provide more financial resources for female condoms and increase economic opportunities for women to own land and have jobs.

"The what and why of women's vulnerability to HIV and AIDS has been known for more than a decade, it's time now to move to a response," said Gupta.

The picture depicted on World AIDS Day was a bleak and often sobering experience, but a reality that has been prevalent for some years.

According to research conducted by ICRW between 1990 and 1997, it predicted that as a result of women's gender inequality they would be one of the highest-risk populations likely to contract HIV.

"Till there are deaths and visible illness, there is very little action," said Gupta. "This is the lesson the epidemic has taught us.

"It takes very strong leadership to put this issue center stage even before people start dieing. It's an issue that politicians don't like to deal with ... sex or death."

Wagura agreed.

"It could have been prevented. Every single day is demoralizing, is heart breaking. Sometimes you feel like you want to give up, because you don't see the results of what you have done," she said.

Wagura urged that the day of looking at statistics come to an end, saying the time for action must be immediate.

Every time she returns her home, she explained, her son asks, "What did they say?" wondering if there will be a cure or how long he will have his mother.

This time, she said, "I will tell him, I think they are going to change the way they are doing things. At least, I gave them the message."

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