Op-Ed: Health equity for priority populations: Putting women first

Yekokeb Berhan Program for Highly Vulnerable Children. The program, which began in 2011, is funded by the PEPFAR,​ and is implemented by USAID ​and Pact. Photo: Screenshot

By Dr. Aimee Rurangwa @DrNiba

Addis Abeba – On March 8, we celebrated International Women’s Day 2023, and throughout the month of March we recognize the contributions of women in history. At the same time, we reaffirm our deep commitment to eliminating biases and barriers that stand in the way of reaching gender equality and equity and achieving sustained HIV epidemic control in Ethiopia. 

Inequality is a major factor increasing women and girls’ vulnerability to HIV. The gender health gap is particularly acute for those living with HIV/AIDS and is further complicated by issues of poverty, culture, and unequal access to and quality of healthcare. Women are disproportionately affected by HIV, accounting for 58 percent of all adults living with the virus in Africa. Moreover, despite immense progress in the fight against HIV/AIDS, research consistently indicates that women have greater difficulty accessing treatment than men. 

Equal access to healthcare and health equity for women and girls is a fundamental component of the President’s Emergency Plan for AIDS Relief (PEPFAR) programs in 55 countries, including Ethiopia, which are making tremendous progress to support women and girls. In Ethiopia, PEPFAR has invested nearly $3 billion to support the HIV/AIDS response since 2003. Through this support, PEPFAR has enabled the provision of lifesaving antiretroviral therapy (ART) for over 450,000 men, women, and children, accounting for 98 percent of the treatment being offered nationally at more than 1,000 sites. Sixty-three percent of those recipients are women. 

While all women can develop cervical cancer, women living with HIV are up to six times more likely to develop invasive cervical cancer. Through the ‘Go Further’ partnership, PEPFAR is committed to reducing new cervical cancer cases by 95 percent among the estimated 11 million women across 12 African countries, including Ethiopia, which has some of the highest rates of HIV and cervical cancer co-morbidity in the world. 

PEPFAR/Ethiopia expands investments to integrate and scale up cervical cancer screening and treatment services within existing women’s health and HIV treatment platforms. As of September 2022, PEPFAR had funded over 72,000 cervical cancer screenings for women living with HIV and achieved 92 percent treatment coverage for women with pre-invasive cancerous lesions. 

To reach the most marginalized populations and ensure health equity, PEPFAR, through the GoFurther Partnership program, focuses on the social, economic, and cultural factors contributing to health disparities and prioritizes care tailored to the needs of women by increasing healthcare accessibility and encouraging flexible eligibility criteria. PEPFAR will enable stronger networks of community health providers and advocates to better identify and refer women to HIV and cancer treatment and services. Additionally, PEPFAR’s data collection will better recognize the diversity of gender identification, sexual orientation, and language to ensure a more effective approach for improving equitable care for all. 

PEPFAR will also prioritize a research- and evidence-based approach to tackle gender-based violence, which disproportionately impacts women, and strengthen efforts to equip women with the knowledge they need to demand and access to life-saving care and services. PEPFAR is committed to the global vision of ending the HIV/AIDS pandemic as a public health threat by 2030 and assisting countries and communities to confront health threats that impact people living with and affected by HIV/AIDS. Ultimately, reinforcing the commitment to health equity for women and advocating for their rights in the fight against HIV/AIDS will strengthen the efforts of the PEPFAR program. By actively working to reduce the underlying gender-based risk factors that exacerbate vulnerability to HIV/AIDS, PEPFAR will be better able to achieve its goal of achieving an AIDS-free generation. AS


Editor’s Note: The writer Dr. Aimee Rurangwa is PEPFAR/Ethiopia Country Coordinator

Incepted in 2003, The United States President’s Emergency Plan For AIDS Relief (PEPFAR) is a United States governmental program to fight the global HIV/AIDS epidemic and help save the lives of those suffering from the diseas

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