By Judy Aita
Washington File United Nations Correspondent

United Nations -- World leaders joined local health workers in observing International Women's Day March 8 by focusing on women and HIV/AIDS.

The alarming growth in the number of women infected and the importance of women in the fight to end the pandemic are matters of special concern, according to U.N. officials.

"This year on International Women's Day, women are coming together to make themselves heard on HIV/AIDS," said Noeleen Heyzer, executive director of the U.N. Development Fund for Women (UNIFEM). "The reason for this is the strong feeling among many women and girls that, based on the data, HIV/AIDS prevention and protection efforts are still failing women and girls."

Ten years ago women were at the periphery of the epidemic but today they are at its epicenter, Heyzer said. The situation is particularly alarming for young women in the developing world. These women now outnumber young men by two to one among newly infected 15- to 24-year-olds.

"The figures are startling. Today, globally 50 percent of those infected with HIV/AIDS are women -- up from 41 percent just six years ago. In sub-Saharan Africa alone, 58 percent are women and in the Caribbean [it is] 52 percent," Heyzer said during a panel discussion that was the centerpiece of the International Women's Day program at U.N. headquarters.

"In fact, male to female transmission is estimated to be twice as likely as female to male. At the same time, the factors that make women more susceptible to HIV/AIDS can be changed . . .. What is very clear is that HIV/AIDS as a disease is a health issue; it is a epidemic; it is a gender issue; and in this issue, gender inequality is fatal and therefore very critical action needs to be taken," said the UNIFEM director.

The U.N. program, entitled "Women and HIV/AIDS," included Secretary General Kofi Annan; Queen Noor of Jordan; Dr. George Alleyne, special envoy of the secretary general for HIV/AIDS in the Caribbean; Noerine Kaleeba of UNAIDS; Dean Peacock of EngenderHeath, South Africa; and Dr. Linda Distlerather, vice-president of global health policy at Merck and Co.

The United Nations in 1977 established March 8 as International Women's Day. The day is intended to provide an opportunity to reflect on the advances in women's equality, assess the challenges women face in different social-cultural contexts, consider future steps to enhance the status of women, and celebrate the gains made in these areas.

Heyzer said that six areas need work: basing HIV/AIDS prevention efforts on the realities of women's life; reducing violence against women; protecting women's property rights and access to education; providing equal care and treatment; mobilization of leadership to end the stigma of HIV/AIDS; and allocating the appropriate level of resources.
 
In the Middle East and throughout the world, HIV/AIDS is not simply a public health crisis but a human rights issue, especially a women's rights issue, Queen Noor said.

"In the Middle East and North Africa we have so far escaped the worst of this tragic pandemic, but not entirely. Recent reports suggest an estimated 600,000 people are living with the virus in our region. Tragically, about 45,000 people died of AIDS last year," she said.

"These numbers -- although considered modest in other regions -- are still unacceptable," Queen Noor continued.
 
The challenges women face, especially in the developing world, are as monumental as their potential contributions, the queen stated. "They cope daily with political, social, sexual and legal discrimination that strangles their potential and that hurts us all. In every area, women do more and are acknowledged less."

That situation is particularly evident in the Middle East, where, despite an infection rate among the lowest in the world, women comprise 55 percent of the total infected, a rate that is higher than anywhere except sub-Saharan Africa, Queen Noor said. She attributed the situation to geography, economics, "and especially to social and cultural norms concerning women, men, sexuality and family."

Those social norms may inhibit the high-risk behavior that spreads the virus in other regions, but they also can heighten the stigma that works against testing and treatment,
Queen Noor explained.

"With the widespread stigma attached to the disease, many of those who carry the HIV virus would rather die than risk encouraging rejection -- or worse -- from family, friends and community. In a culture where, tragically, women in particular can sometimes be at risk from their own families at any suggestion of impropriety, the risks are magnified," she said.

Overcoming the stigma and cultural taboos that can prevent diagnosis and cause further spread of the disease is the biggest challenge in the Middle East, Queen Noor said.

Her majesty cited efforts in Middle Eastern nations to prevent the spread of disease: sexual health hotlines in Egypt, Palestine, and Lebanon; confidential counseling centers for young people in Tunisia; national action plans in Algeria and Lebanon; a vigorous taboo-breaking public awareness campaign in Iran; and programs to help out-of-school girls in Egypt.

"The relatively low level of HIV/AIDS in the Middle East right now presents a risk or an opportunity: a risk to underestimate the potential danger of the pandemic and delay action, or the opportunity to mobilize the political and social will to act forcefully to reverse the spread," Queen Noor said.

Secretary General Kofi Annan said "real, positive change that will give more power and confidence to women and girls and transform relations between women and men at all levels of society" is needed.

Mainstream prevention strategies such as the ABC approach (abstain, be faithful, use a condom) are "untenable," in situations where sexual abuse or violence are common, nor does marriage always provide the answer to preventing the spread of HIV/AIDS, he added.

AIDS strikes at the lifeline of society that women represent, Annan said, developing a vicious cycle, and undermining development efforts.

"Society pays many times over the deadly price of HIV/AIDS' impact on women," Annan observed. "Poor women are becoming even less economically secure as a result of AIDS. They are often deprived of rights to housing, property or inheritance or even adequate health services . . . As AIDS forces girls to drop out of school -- whether they are forced to take care of a sick relative, run the household, or help support the family -- they fall deeper into poverty. Their own children, in turn, are less likely to attend school and more likely to become infected."