VIII. INTERNATIONAL RESPONSE

With the growing HIV/AIDS crisis in Zambia, significant bilateral and multilateral donor attention has been directed at HIV/AIDS programs there. However, there is very little focus among donors on abuses against girls as part of their HIV/AIDS programs. A notable exception is the plan of the European Commission (E.C.), announced in September 2002, to provide U.S.$22 million to Zambia for HIV/AIDS programs. The E.C. said it hoped activities funded by this grant would improve care and treatment for persons already infected but also noted that it would entertain projects addressing the needs of young women vulnerable to infection.²²⁰

Global AIDS Fund Grant to Zambia

In May 2002, the Global Fund for HIV/AIDS, Tuberculosis and Malaria²²¹ dispersed its first round of grants totaling U.S.$1.6 billion over five years for forty countries. Zambia received the second largest grant, after South Africa, a total of U.S.$92,847,000 over five years (only the first two years being assured), with U.S.$19,858,000 for HIV/AIDS the first year.²²² The proposal describes the disproportionate impact of HIV/AIDS on women and girls.²²³ It also notes the problems of orphans and vulnerable children-including the rise in child-headed households, child labor, child abuse and inability to access education-but does not single out specific ways in which girls who are orphaned are at particular risk. Gender is identified as a cross-cutting issue, and eliminating sexual violence against women and children and promoting equal rights for men and women is discussed, but no particular interventions to address this problem are noted. With respect to education, funds will be targeted to community and "girl-friendly" schools, especially with the aim of retaining orphans and vulnerable children in school and developing income-generating activities for their families. Further activities to support community-based programs, including protecting and enforcing children's rights, are expected but not outlined.

Other Donors

In July 2002, Zambia's bilateral and multilateral donors met formally and pledged U.S.$1.3 billion in budgetary and project support over the next two years. This support was based on donor satisfaction with the country's economic programs, but donors linked continued support with a continued commitment to fight corruption. The World Bank country director for Zambia and Zimbabwe, Yaw Ansu, explained that the donor community was satisfied with the current government's reforms, especially on corruption and HIV/AIDS.²²⁴

Zambia has an external debt of approximately U.S.$6.5 billion. The government hopes to qualify by 2003 for significant debt relief under the program for so-called Highly Indebted Poor Countries (HIPC) of the Bretton Woods institutions. In order to do so, the government has to meet benchmarks such as implementing a Poverty Reduction Strategy, making progress in fighting the HIV/AIDS pandemic, increasing primary school enrolment, and making continued progress on increasing privatization and decreasing corruption. The Bank also urged the Zambian Parliament to approve the National Strategic Framework for HIV/AIDS.²²⁵ The Zambian government has cited HIV/AIDS programs among priority areas for consideration for use of funds that may result from debt reduction.²²⁶

United States

USAID is a leading donor for HIV/AIDS programs in Zambia, providing U.S.$18.5 in 2002, up from U.S.$12.9 million in fiscal year 2001 and U.S.$9.1 million in fiscal year 2000.²²⁷ The main projects from this assistance include support for the Zambian Integrated Health Program (ZIHP); voluntary counseling and testing (VCT); a youth mass media campaign, the HEART (Helping Each Other to Act Responsibly Together) youth mass media campaign; a program targeting truck drivers and sex workers at several border sites; the SCOPE/orphans and vulnerable children program; a workplace initiative for work sites in Lusaka and the Copperbelt; and social marketing of condoms.

Given its efforts on HIV/AIDS, orphans and vulnerable children, mother-to-child transmission (MTCT), and additional programs being developed on education for girls, the U.S. could be a more effective player by integrating the issues of abuses against girls that underlie these other programs and make girls more vulnerable to HIV transmission. Part of that could include a more active effort to highlight publicly the intersection between human rights abuses against girls and their vulnerability to HIV/AIDS, and part could involve a more active engagement with the Zambian government to implement its own commitments to provide protection for girls. The U.S. should consider funding training for justice system officials in the handling of cases of sexual assault of girls. The U.S. should use every opportunity to stress that the urgency of HIV/AIDS and the demands of the rule of law should compel a stronger response from the Zambian government.

United Kingdom

The U.K.'s Department for International Development (DFID) is currently designing a five-year, U.S.$30 million program for HIV/AIDS in Zambia. The program has four components: strengthening the National AIDS Council; supporting two key social sector investments, health and education, with the bulk of the new money going toward education; supporting private sector efforts to address AIDS in the workplace; and funding capacity building programs within civil society, with a focus on stigma and discrimination.²²⁸ There is no specific focus on girls, other than supporting proposals from the National AIDS Council or the civil society groups. However, DFID expects that some of the civil society groups will propose programs on promoting and protecting girls' rights. Given the U.K.'s extensive involvement in the country, it should add a focus on these human rights issues to its programs in Zambia and its dialogue with the Zambian government. DFID programs do not currently support capacity building in the police force or justice systems related to sexual assault cases.

World Bank

In Zambia, the World Bank has been slow to integrate AIDS and gender issues into its programs. In May 2002, the World Bank pledged U.S.$42 million to Zambia's AIDS program.²²⁹ This assistance would be 60 percent grant and 40 percent loan, and the loan would have to be repaid but at concessionary terms, essentially without interest. The project has been in the works for some time and is predicated on the passage of legislation, an HIV/AIDS bill (see above). At this writing, the bill has not been passed.

It is planned that the project funded by this credit will have several components, focusing on capacity building and support to the National AIDS Council. The largest part will comprise U.S.$21.3 million in support of several ministries. The Ministry of Health is expected to get about one third of that money to purchase antiretroviral drugs for mother-to-child transmission (MTCT) programs. Support for community response to HIV/AIDS will comprise U.S.$14.7 million, including home-based care and voluntary counseling and testing. The idea is that community groups will be able to apply for funding, although the mechanisms as to how and to whom they would apply have not been fully worked out. The Bank intends to work largely through district AIDS task forces under the Ministry of Health, as well as local government and district development coordinating committees responsible for development activities.²³⁰ Support for the National AIDS Council will be approximately U.S.$2.5 million. Although the Project Appraisal Document states that "it will mainstream gender considerations into all its components" and that "reducing the HIV prevalence in the teenage girls population will receive high priority,"²³¹ it remains to be seen if any programs by the line ministries, the National AIDS Council, or the community-based organizations will include a focus on protecting girls.

United Nations

The UNICEF program in Zambia is focused on water, sanitation, and hygiene education; health, including MTCT and education for new mothers; child protection, legal reform, and upgrading child care; the Program for the Advancement of Girls' Education (PAGE), which includes an AIDS component; and advocacy and communication.²³²

The UNICEF representative in Zambia told Human Rights Watch that there is a new focus on HIV/AIDS in UNICEF.²³³ UNICEF programs relating to HIV/AIDS target health, education, and child protection, and more broadly UNICEF supports Zambian NGOs that include a focus on HIV/AIDS issues.²³⁴ UNICEF supports youth-friendly health services in six districts that promote young people's access to health care and also supports an STD/HIV/AIDS component to the mother-to-child transmission programs. With respect to education, UNICEF supports NGOs involved in advocacy and community outreach, including a group of teachers against HIV/AIDS that focuses on awareness among teachers and in the communities. UNICEF also supports a "life skills" program that it hopes to make part of the primary school curriculum. Finally, the child protection component of the country program supports NGOs targeting orphans and vulnerable children, many of whom are in difficult circumstances because of HIV/AIDS. In the near future, UNICEF expects to be assisting with the establishment of child rights clubs throughout the country, which will include an HIV/AIDS component. There are currently no UNICEF programs that focus specifically on girls' vulnerability to abuses and HIV/AIDS.

220 United Nations PLUSNEWS, "Zambia: EC increases funding to fight AIDS," September 25, 2002.

221 The Global Fund to Fight AIDS, Tuberculosis and Malaria was formed at the initiative of the U.N. secretary-general and began its work in January 2002. It is a multilateral body with NGO and private sector representation that is meant to attract and disburse public and private resources with the aim of reducing infection, illness and death, and mitigating the impact of the three diseases. At this writing, the Fund has received about U.S.$2 billion in pledges from governments and private contributions.

222 The Global Fund to Fight AIDS, Tuberculosis and Malaria: http://www.globalfundatm.org/files/Proposalslist_40.doc (retrieved July 10, 2002).

223 The Global Fund to Fight AIDS, Tuberculosis and Malaria Interim Secretariat, Zambia's Proposal to GFATM (GFATM/B1/6A), March 7, 2002.

224 ZNBC Radio 2, Lusaka, July 11, 2002.

225 "World Bank Calls on Govt to Reduce Fiscal Deficit," The Post/All Africa Global Media, July 10, 2002.

226 See, e.g., National AIDS Council Strategic Framework, p. iii.

227 Human Rights Watch interview with Robert Blair, regional advisor for Africa and the Western Hemisphere to the Deputy Assistant Secretary of State for Health and Science, Office of International Health Affairs,, U.S. Department of State, July 17, 2002.

228 Human Rights Watch interview with Sam Gibson, Social Development Advisor, DFID, Lusaka, May 30, 2002.

229 IRIN, "Zambia: World Bank to support HIV/AIDS programme," May 3, 2002.

230 Human Rights Watch interview with Helen Mbao, Social Development Specialist, World Bank, Lusaka, May 29, 2002.

231 World Bank, "Project Appraisal "Document: Zambia National Response to HIV/AIDS," April 30, 2002.

232 Human Rights Watch interview with Stella Goings, May 31, 2002.

233 Ibid.

234 Human Rights Watch telephone interview with Gabriel Fernandez, Child Protection Officer, UNICEF-Lusaka, July 31, 2002.