OpenForum – a blog by the Health and Human Rights community

Trafficking of women for sex has long been a problem, one that has been made even worse with the spread of HIV in recent years. On August 6, 2009, women who have experienced the horrors of trafficking gathered in Bali, Indonesia, to tell their stories to the “jury” of the South East Asia (SEA) Court of Women on HIV and Human Trafficking. The participants included a young HIV-positive woman from Cambodia who was taken to Malaysia and forced into bonded sex work, a woman from Myanmar who survived trafficking, and others who shared their stories of exploitation and violence.

The Court was organized by the United Nations Development Programme (UNDP), along with the Asian Women’s Human Rights Council (AWHRC) and the Balinese NGO Yakeba, as part of the effort to raise the profile of human trafficking. During the proceedings of this symbolic court, women who have been trafficked served as witnesses and testified to a six-member jury made up of lawyers and human rights experts, including Professor Vitit Muntarbhorn, the former UN Special Rapporteur of the Commission on Human Rights on the sale of children, child prostitution and child pornography. “Expert witnesses” were also called upon to provide an analysis of trafficking in Southeast Asia.

According to Caitlin Wiesen, UNDP’s Regional HIV/AIDS Practice Leader and Programme Coordinator for the Asia & Pacific region, “the Women’s Court is both a call for action against human trafficking and HIV, and a testament to the resilience and courage of women from the region who have survived unspeakable exploitation and violence.” The call for action against human trafficking is certainly needed. The violence and exploitation that come with trafficking are among the worst human rights abuses, especially when trafficked individuals are forced into sex work, which is nothing short of rape.

The number of people trafficked every year is unknown, but estimates have ranged from 500,000 to 4 million in recent years. Accurate figures for the spread of HIV related to trafficking are even harder to obtain, as both trafficking and HIV infections are underreported.  The limited measurements and estimates that have been made are not encouraging. Jay Silverman and colleagues found a high HIV prevalence — 38% — among repatriated Nepalese women and girls who had been trafficked for sex, and Silverman’s 2006 review of case records for trafficked women and girls in Mumbai revealed that over 20% were HIV-positive. Although these studies focused only on the South Asian region, they highlight the magnitude of the HIV problem associated with trafficking. Not only will sex-trafficked individuals likely endure violence and humiliation, because of HIV, their lives may be cut short even if they manage to make it back home. Read more

[Editor's note: This is a guest post written by Stephanie Psaki.]

Last month, the World Bank published a review of its health, nutrition, and population programs from 1997 through 2007, totaling US$17 billion in support. The review found that a third of the projects in this portfolio did not meet their objectives, and that, “none of the projects with explicit fertility or population objectives achieved them.”

The Bank’s current (2007) Population Strategy does not promise much greater success. Amidst a general endorsement of past approaches, the report states that they will target high fertility countries, where total fertility rates (average number of children born to a woman over her lifetime) exceed 5.

However, this strategy does not appear to take into account the level of unmet need – the proportion of women who no longer want to have children but lack access to contraception – in these countries. From an economics perspective, this is analogous to trying to sell a product to a new market with no indication that anyone wants to purchase it.

In fact, there is reason to believe that most people in these high fertility “markets” do not currently want to use contraception.

In a 1994 paper, Dr. Lant Pritchett – a World Bank economist – famously pointed out that worldwide 90% of differences in total fertility rates could be explained by differences in desired fertility. In other words, in most cases women and couples are having children because they want to have children. While Pritchett’s conclusions have been the subject of heated debate, the distinction between wanted and unwanted fertility remains crucial. Read more