ECONOMIC AND POLITICAL CONDITIONS
From an economic perspective, you need to see the full scope of women's lives. ..and health is a pivotal issue. - Peggy Antrobus, Barbados
AFFECTING THE PREVENTION AND CONTROL OF
REPRODUCTIVE TRACT INFECTIONSHealth cannot stand by itself; it has to be hacked up by other programs. - Dr. Sadia Chowdhury, Bangladesh
The woman most vulnerable [to RTIs] is the one with only one wrapper [dress] and one pot. - Dr. Adepeju Olukoya, Nigeria
The underlying factor is economic power. Women are driven to become commercial sex workers. No one thinks it is "nice." - Dr. Debrework Zewdie, Ethiopia
RTIs can be understood -- and solutions sought -- only in the larger context of economic, political, social, and cultural institutions that define relationships between women and men, determine the information that they receive, and shape the quality and quantity of health services. The global political and economic context appears increasingly hostile to actions needed to prevent and control RTIs. Conference participants emphasized two aspects of the global context: economic and social development policies, and the resurgence of conservatism.
ECONOMIC AND SOCIAL DEVELOPMENT STRATEGIES
Since the 1980s, a variety of international and domestic economic policies has substantially exacerbated differences between rich and poor countries, and between rich and poor people within most countries. Shifts in foreign-assistance strategies by Northern governments and multilateral institutions away from human development and toward economic growth have severely undercut basic social-sector services and resources. Structural adjustment policies have resulted in cuts in social services, fees for public services, or privatization of services, in addition to the removal of subsidies of basic items such as food, medicines, municipal water, and transport. Massive foreign debts have restricted the efforts of many Southern governments to move away from dependence on the North, and have impeded their provision of adequate services to their populations. Furthermore, many national governments give priority to the military and economic sectors at the expense of the social sector.The global political and economic context appears increasingly hostile to actions needed to prevent and control RTIs.
These and other policies are undermining basic health infrastructures and related services. Quantitative and qualitative deterioration in health services is obvious in most countries, including poverty-stricken areas of the United States. Declines in service quality, especially when services are already inadequate, inevitably increase iatrogenic infections. Budget cuts restrict or eliminate curative RTI services; they also curtail preventive efforts. In addition, international and national economic policies and market forces have deepened and broadened poverty in most countries. As poverty deepens, more and more girls and women are forced to sell their bodies as a means of survival or, in some countries, as a "subsidy" to pay school fees. Gender-based violence tends also to increase with poverty, bringing concomitant risks of STDs, unwanted pregnancy, and all their consequences.
The experience of the 'nineties will be even harsher. . .[as] former North-South relationships are being overtaken by North-North protectionist priorities.... A better scenario [would be] a much improved understanding of the doctrine of interdependence --between North and South, social and productive sectors, men and women -- [based on] the independence of and participating parties and on mutual respect. - Billie Miller, Barbados
THE RESURGENCE OF CONSERVATISM
Economic retrenchment has been accompanied in many parts of the world by a resurgence of conservative ideologies regarding women, their sexuality, and their rights. The sources are many and varied, including religious fundamentalism, ethnic nationalism, and social conservatism in reaction to what some see as excessive sexual and personal freedom. Some groups that hold conservative values about sexuality and gender roles have become political movements in national and international arenas. They seek to restrict the social roles of girls and women, to perpetuate their subordination, and to control their sexuality in ways that, paradoxically, make girls and women even more vulnerable to unwanted sex and to RTIs.Conservatism, along with stringent economic conditions, blocks sex education programs, contraceptive information and services for young people, and even female education and employment These conditions also prevent the adoption of a comprehensive approach to girls' and women's health that is genuinely responsive to their needs, that would enable them to manage their own health effectively, and that would ensure their ability to exercise their basic rights.
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