Author:
Dr Manzoor Ahmed Butt
Family Physician, Researcher & Trainer,
Maqbool Clinic, Research & Training Centre,
Dhoke Kala Khan, Shamsabad,
Rawalpindi-46300, Pakistan

Dated: 22-09-2004.

International Women's Day is celebrated every year on 8th of March. It provides an opportunity to:

	assess 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
	celebrate the gains made in these areas.

This year the theme is "Women and HIV/AIDS". According to WHO, combating gender inequality is crucial in the fight against HIV/AIDS. Women's vulnerability to the epidemic is increasing throughout the world. In 2002, out of 38.6 million adults living with HIV/AIDS globally, almost 50% were women. 58% of adult infections in sub-Saharan Africa, 30% in South East Asia, and 20% in Europe and USA were women. Women now account for almost 50% of HIV/AIDS cases worldwide. This is because women are biologically, economically, socially and culturally more vulnerable to infection than men. Factors such as financial dependence on men, physical and sexual abuse from partners, and the fact that it is acceptable for men to have multiple partners are gender issues that need to be considered in responding to the epidemic. This inequality frequently prevents women and girls from obtaining treatment for HIV/AIDS when sick, and from protecting themselves against infection. To overcome this injustice, a first requirement is equitable access to information, treatment, care and support. The "3 by 5" initiative of WHO gives us the opportunity not only to bridge the treatment gap but to overcome gender-based inequities.

The Human Rights Commission for Pakistan (HRCP) launched its annual report titled "State of Human Rights in 2003" on 19/03/2004 in Islamabad. It says that violence against women continues and there is no evidence of a decrease in it, with a reported 600 losing their lives to honor killings. In Pakistan, women face gender-specific barriers. They have to get permission from another household member (such as husband, mother-in-law, brother, or her son) to go to the doctor. They often cannot avail of health services on their own because they do not have control over household resources. They are always more stigmatized than men for being HIV-positive; and suffer more discrimination and more violence within the home because of it.

According to the Federal Health Administration, 1998 cases of HIV/AIDS were registered till December 31, 2002. These figures are incorrect because according to a WHO estimate, there are more than 78,000 persons affected by HIV/AIDS in Pakistan. HIV/AIDS is regarded as curse of God rather than a disease. The sufferers are not given the status of a patient but of criminals and sinners. Their families disown them and people hate them. They are thrown out of jobs and schools.

We have been trying to create awareness about STDs through our Family Health Program for the past 4 years. On March 8th, our team launched an initiative which consisted of dissemination of the following information through hand bills and regular meetings of various groups of men and women for brainstorming.

1)	HIV/AIDS is a disease and not a crime or sin. Unprotected sexual act is the major but not the sole cause of spread of this infection. Anyone can get it through the following:
	infected blood
	infected mother to newborn
	milk of HIV (+) mother
	multiple use of infected syringes
	infected dental instruments
	infected instruments for piercing of ears and nose
	infected blades

3)	As a human being, we have a moral obligation not to:
	hate them.
	disown them
	throw them out of home
	throw them out of jobs and schools

Ours is a definitely a male-dominant society. I have undertaken the most difficult job of informing women about their rights and men about their obligations as heads of family. I have been striving since 1993 in collaboration with my local and international friends but our work has been limited to our immediate community. The Global Family Doctor Award has given me more opportunities. People have started listening to us with interest and respect. It has helped me to get access to useful persons and institutions in the country. This has really opened new dimensions for my work. I am getting a lot of invitations throughout Pakistan, especially the remote areas, to visit and work with them.

Our present parliament has more women coming in than ever before. Their presence has generated more discussions on important matters related to women: for instance, a bill against domestic violence has been introduced; child sexual abuse has been discussed.

I have no hesitation to admit that WONCA has been the most useful institution in furthering our cause. Last but not least, I owe a lot to Dr. Lesley Pocock who has provided me with tremendous help and guidance. She is a truly inspiring personality.