September 24, 2014
Written by Dr. Mark Dybul, Executive Director, Global Fund to Fight AIDS, Tuberculosis and Malaria
This post originally appeared on The Huffington Post here.
The circumstances of our lives begin the moment we enter the world. They start with who our parents are, what part of the world we are in, how many brothers and sisters we have, the environment that surrounds us — and if we were born a girl or a boy. Even before we speak our first words, life begins shaping the opportunities and challenges we will face.
These socio-economic factors and levels of risk for diseases like HIV are intrinsically connected, especially for young women. In sub-Saharan Africa, HIV prevalence amongst adolescent women is double that of their male peers — in some countries, girls can be 5-times more likely to be HIV-positive than boys. This sobering reality is a byproduct of the challenges and lack of opportunity many of these adolescent girls and young women face, like having to drop out of school or stay in school but exchange sex for money to support themselves and their families, a significant risk of gender-based violence and abuse, or needing to marry and have children at a young age.
However, we now know that by supporting these women through financial assistance and giving them the chance to make healthier decisions at a young age may just be the entry point in the fight to prevent new HIV infections and eventually end HIV as a public health threat, while advancing equal opportunity for all and creating a better world.
Recent data suggests that when we view the opportunities and challenges that face adolescent girls more holistically, we create a new dynamic and serve a person not a disease or specific development issue. In the end, it is education and health that will determine if an adolescent girl becomes a woman with equal opportunity. And now we have data to help us to shift to a holistic approach to bring the two together in development programs. Strong and promising evidence shows that providing cash transfers to low-income adolescents has a direct correlation in preventing new HIV infections and achieving other important health and development objectives. In Malawi, 1,200 young women (and their parents) aged 13-22 years were provided with US$1 to US$15 per month and their school fees paid. Teenage pregnancies and early marriage fell by 29 percent and 32 percent. Those who received the cash transfers had 64 percent fewer HIV infections and sexually transmitted infection prevalence was lower by 76 percent. We’ve seen similar promising results in Kenya, Lesotho, and South Africa as well.
In a study in Tanzania, when US$20 cash was given to young adults aged 18-30 conditional on being free from sexually transmitted infections, including HIV, there was a 20 percent reduction in curable sexually transmitted infections at 12 months.
What is most exciting about these outcomes, beyond the promise of HIV prevention, is the long-term effects it can have on young women’s lives, which in turn can create catalytic positive effects on their communities and countries. By bringing health and education together, opportunities will drastically improve during the important years of adolescence. This can mean reaching secondary school rather than dropping out to earn money for themselves and their families, learning skills that can lead to job and career opportunities rather than marrying and having children at a young age, and being empowered to create a happy and healthy environment for themselves, their families, and, therefore, their community and country.
Sarah Brown, President at Theirworld and Executive Chair of the Global Business Coalition for Education, is leading an effort to make development policy reflect real life. We are co-hosting an event during the UN General Assembly to look at concrete ways to accomplish this and Sarah recently wrote a Linkedin post on the subject.
Let’s all join this important movement to focus on people rather than diseases and development issues. By doing so, we can collectively achieve something far greater than the sum of its parts and create a world of equal opportunity for all. That’s something worth fighting for.