During the past six years the public health crisis in the developing world has been getting remarkable attention. In 2000, 189 nations came together at the UN to pledge their support for eight “Millennium Development Goals” including the eradication of extreme poverty and hunger, the reduction of child mortality, and the control of AIDS. Since then, several new public health foundations with billions of dollars to spend have emerged, including the Bill and Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria, as well as the less well endowed but no less ambitious William J. Clinton Foundation.
Opinion polls show that voters in the US and Europe are far more willing to support foreign aid programs than they were just a decade ago; and some corporations, such as Gap Inc., Coca-Cola, and De Beers have discovered that associating their brands with philanthropic activities helps sell T-shirts, soft drinks, and diamond rings. Most heartening of all is that, at last, some of these groups are finally beginning to grasp the fundamental reality that they aren’t going to get anywhere near the public health goals they have set themselves unless they deal with the human rights issues, and particularly the rights of women, that underlie most health problems in developing countries.1
The causes of poor health in the developing world are often pathetically simple: lack of access to safe water, vaccines, mosquito nets, antibiotics, oral rehydration salts for diarrhea, and other cheap commodities. Many international health agencies specialize in distributing these items to developing countries and in sponsoring research on new ones, including vaccines for AIDS and malaria that so far do not exist. But there is growing recognition that the key to improving the health of the world’s poor may lie not only in technology but also in politics—and in encouraging poor people to develop the collective will and take the social action necessary to enable them to protect their own health.
One way to do that is to improve the status of women. Empowering women has long been seen as an important public health goal.2 Where women are more educated and independent, societies tend to be much healthier than would otherwise be expected, at least partly because it is usually women who fight for better services and living conditions for their families. Unfortunately, there is no commonly accepted method for giving more power to women. A variety of programs, each with strengths and shortcomings, have been attempted, including press and radio campaigns to raise awareness of women’s rights issues; programs to increase the number of girls enrolled in school or the number of women in paid employment; and programs to improve the distribution and development of contraceptives and “microbicides”—as yet nonexistent vaginal gels that could, potentially, block HIV infection.
However, new research from South Africa suggests that it may be possible to dramatically change the status of women in a very short time, even in the poorest, most troubled communities, at relatively low…
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