This blog was co-authored by Marilyn Coolen, National Co-chair of the Grandmothers Advocacy Network (GRAN), Peggy Edwards, co-founder of GRAN and Pat Evans, National Co-Chair of GRAN.
The grandmothers in sub-Saharan Africa face triple jeopardy caused by gender, age and exposure to both communicable and non-communicable diseases that are associated with aging. Many are affected and infected by HIV/AIDS, malaria and TB. At the same time they are invisible in the statistics and often in the public consciousness. They are impacted on many levels by gender inequalities that are intersected by the stigma of aging.
1. Older women are systematically excluded from population health surveys determining the prevalence and indicators of HIV/AIDS. For example, UNAIDS did not even count or track the numbers of HIV-positive women after age 49 until one year ago.
2. Older women have diminished access to medicines. While the scale up of delivery of HIV/AIDS medicines has been impressive in many areas, men and women of working/child-bearing years have had priority to access. As older women and widows "should not" and "do not" engage in sex, they are deemed not to be at risk for HIV-infection. Even when HIV-positive older women are diagnosed, ageist attitudes held by health professionals can cause them to view older women as burdens, deserving of less priority for care than younger women and men.
3. Older age sometimes poses additional barriers for older women. Lack of transportation and less ability to walk long distances make it difficult for them to get to health clinics to use services. Older women are less likely to have the necessary identity papers and the money necessary for care. Lower levels of literacy can make it difficult to understand treatment options and to act upon them, and to advocate for their rights to age-friendly health care.
4. Many older women have their property and inheritance taken by their in-laws when their husbands die and they are without income. When their children die, they take on the care of their grandchildren. Dealing with grief and poverty, they assume the precarious role of caregiver without the benefit of financial support or even the social recognition of its importance. Cash transfers in the form of pensions for older people and for AIDS orphans would enable grandmothers to provide the basics for their families. Many grandmothers also serve as community care workers. They deserve to receive a stipend for this work.
"Getting to zero" requires the political will to want to get to zero, which includes full access to prevention, diagnosis and treatment of AIDS for everyone. The Canadian government has made an important step by significantly increasing it contribution to the Global Fund, but it must also restore a human rights and social justice perspective to the rationale for foreign aid. Getting to zero requires addressing both the short-term issues of access to affordable medicines, the longer term goal of sustaining communities, and taking steps to address the inequities of age and gender.
Grandmothers caring for the orphans of the AIDS pandemic in sub-Saharan Africa are ensuring the future of their countries. Grandmothers, older women, and women in general need to be a part of every level of decision-making where they will be affected.
This blog is part of a World AIDS Day series produced by the Interagency Coalition on AIDS and Development (ICAD) in recognition of World AIDS Day (Dec 1). The series runs from Dec. 1-7, 2013 and will feature a selection of blogs written by our member and partner organizations. Each day of the week will address a specific, yet broad topic area, and offer different perspectives and insight on what must be done to achieve the UNAIDS campaign of "Getting to Zero." Disclaimer: The views and opinions expressed in this blog series are those of the authors and do not necessarily reflect those of ICAD."
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