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No Wealth without Health, Especially for Kenyan and Ethiopian Women

Analysis Haley Nicholson, Legislative Analyst

Entrepreneurship in Africa was a key focus of President Obama’s trip to Kenya and Ethiopia. At a Saturday press conference, the President highlighted U.S. policies and investments, including an extension of the African Growth and Opportunity Act, Power Africa, and Feed the Future all designed to help Africa innovate and grow.

On Sunday, in a rousing speech in Nairobi, President Obama declared that there is “no excuse’ for sexual assault, domestic violence, forced marriage, or other traditions that treat women as second-class citizens.” The president argued these were not just issues of right and wrong, but also of “success and failure.” Any nation, he emphasized, “that refuses to educate its girls, or employ its women, allowing them to maximize their potential, is doomed to fall behind in the global economy.”

He is correct, of course. One of the greatest factors affecting a girls’ ability to complete her education, or a woman’s ability to enter the workforce—especially the formal sector—is her access to quality sexual and reproductive health information and services. We know for example, that a young woman who can avoid an unintended pregnancy is more likely to stay in school and to later command higher wages. A woman with 17 years of education –roughly through college—makes four times the income of a woman with no formal schooling.

For women and girls, the link between health and long-term economic prosperity is irrefutable.

Unfortunately, President Obama’s tough words failed to match his actions. There is a large area of U.S. investment given short shrift during the President’s travels: health programming. For years, the U.S. government has led the way in investing in global health initiatives in Africa—one of the largest being in HIV and AIDS through the PEFPAR initiative. A key component to ensuring the economic success that the President wants to champion, especially for women and girls, is full access to sexual and reproductive health services including HIV and AIDS prevention and treatment.

The NGO community has made a concerted effort to push the Obama administration to strengthen the connection between family planning services and HIV services. We have been successful in securing guidance from PEPFAR making it clear that linkages between these two areas are essential to achieve effective programming with measureable results. Despite these successes, women and girls are still one of the most vulnerable populations for contracting HIV, and HIV positive pregnant women are suffering from discriminatory health services. On the global scale, “young women aged 15-24, have HIV infection rates twice as high as in young men.” Additionally, HIV positive pregnant women will face discriminatory health care, and are often pressured into sterilization as the best option for contraception.

One of the greatest factors affecting a girls’ ability to complete her education, or a woman’s ability to enter the workforce—especially the formal sector—is her access to quality sexual and reproductive health information and services.

Integrated programming can reduce these practices, and the work of U.S. agencies like PEPFAR and USAID has helped millions of HIV positive women in developing countries to safely deliver HIV free children. The work of these agencies and their partners has supported HIV testing and counseling for more than 14.2 million pregnant women worldwide. Within these 14.2 million women, 749,313 tested positive and received medications to prevent mother-to-child transmission or more commonly known as PMTCT. The result of this PEPFAR supported work was 95 percent of these women’s babies being born HIV-free.

In the continued push to scale up integrated services, the U.S. government needs to recognize a core part of this work must include PMTCT. The benefits it provides for HIV positive pregnant women are too great to ignore. Women and girls living in Africa represent the most vulnerable population for contracting HIV. As of 2013, there were 820,000 women in Kenya aged 15 and older living with HIV, and 190,000 children aged 0 to 14 living with HIV. In Ethiopia there were 370,000 women aged 15 and older living with HIV and 200,000 children aged 0 to 14 living with HIV. President Obama missed a key opportunity to see how far U.S. investments have come in PMTCT and integrated programming, and to also see first-hand the remaining work to be done.

Women’s and girls’ involvement are crucial for future innovation investments, but they won’t fully thrive in their economies unless they have access to a full range of reproductive health services. The U.S. is at an important turning point in the HIV and AIDS epidemic. It’s too bad President Obama did not see the benefits we’ve yielded, especially for women, pregnant women, and mothers in Africa.

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