TfG started with the singular focus on adolescent girls because of their inherent vulnerability to sexual violence and the devastating consequences that often follow. Much to my surprise, the gender-based violence programs that I identified at the time were focused on women, not girls. Furthermore, most of the service offerings for victims were only oriented towards women, despite the fact that over half of all incidents of sexual violence were being committed against girls aged 15 and younger. This struck me as a major gap that needed to be filled.
We now know that among girls in countries that have completed the Violence Against Children and Youth Surveys, between 24% and 52% of girls’ first sexual intercourse was forced or coerced, and depending on the country, between 10% and 41% of these girls were 11 to 13 years old. To me, it is simply unacceptable to allow this type of egregious violation of human rights to continue.
Typically, when the world responds to problems, it first focuses on treating the symptoms. For HIV & AIDS, it is essential to broadly extend treatment access, and the world is doing this at a cost of around $10 billion per year.
Next, focus usually shifts to establishing or improving the systems that inhibit or enhance the ability to treat the problem. For HIV & AIDS, this means strengthening healthcare delivery systems, laboratory systems, supply chain systems, procurement systems, and training systems; requiring a wide number of initiatives to facilitate access and delivery of treatment. This is all very important, but it doesn’t truly address the root of problem. It isn’t sufficient to focus only on symptoms and systems, the underlying causes must be addressed as well.
I call this third area of intervention social causes. All three of these “S’s” are essential: symptoms, systems and social causes. Ideally, we would address the social causes first, because doing so would substantially reduce the burden and the cost of improving systems and extending treatment for symptoms. But the world doesn’t work that way. We usually respond to crises, and HIV & AIDS wasn’t addressed until it was a full-blown crisis.
Back in 2009 when I founded TfG, very few people were talking about the health needs of adolescents, specifically about HIV prevalence rates in girls, in the health policy halls of Geneva, New York, Washington, D.C. or Seattle. Yet when I was meeting with people in villages in Africa, this problem was being talked about. We have come a long way. Today, adolescent health and HIV infection rates among girls and young women are in the center of the global health and development agenda. I guess I was a bit ahead of the curve on this issue.
The TfG model was built up from a simple concept from day one: if we can collaborate to plan and unite the individual efforts of different organizations working in this space, we can make the whole greater than the sum of the parts and end up with far greater impact.
At TfG, we are incredibly privileged to have many of the world’s most important and proficient agencies as partners–CDC, PEPFAR, USAID, UNICEF, UNAIDS, UNFPA, UN Women, and WHO–which allows us to have incredible reach and capability. If all these agencies work independently on this issue, the impact will be fragmented. TfG became the convener and orchestrator, and this enabled our work to extend from one to 23 countries in just ten years. That is what allows us to partner with national governments in all these countries and gain their commitment to combat violence against children, particularly sexual violence against girls.
Huge credit goes to the partners: to CDC for coordinating and leading the VACS surveys, to UNICEF for facilitating the in-country relationships, and to PEPFAR and Foreign Affairs Canada for their funding and evaluation support just to name a few. But the mobilization of our methodology and expansion to 23 countries would not have happened without the advocacy, fundraising and orchestration efforts of the TfG partnership as a whole.
This issue, girls being abused and raped by men, isn’t going away anytime soon. It hasn’t existed only for the last ten years; it’s existed as long as human beings have existed and it will take a long time to change behaviors and mindsets. One of the biggest opportunities is the general awareness on this issue has shifted substantially over the past few years. The #MeToo movement has elevated awareness of sexual abuse, harassment and violence against women and girls. Girls are more empowered than they ever have been, and are much better positioned to defend their rights than anytime in the past.
Regarding challenges, well, I don’t think the world is in a particularly good place right now. The refugee crisis has triggered an explosion in the number of people who are living in vulnerable situations. Certain countries, particularly in the Latin American region where TfG is now working, have horrifically high rates of violence against children and gender-based violence. Unspeakable crimes are being committed, and girls who are among refugee populations are incredibly vulnerable, and so many countries are affected by this. I knew when I started TfG that this wasn’t a short-term issue. We will need to stay focused on it for many decades to come. And as such, one of the challenges is to ensure that the leadership and momentum of this effort remains strong. This is far too important to stop to take a breath; it requires continuous vigilance.
Yet after ten years of continuous effort, we can see so many things that have gone well, within a very diverse array of countries and cultures. That must give us the impetus and motivation to continue this essential work.