Women and girls are counting on us!
Enforce the right to accessible, safe and legal abortion now
Windhoek, Namibia, 28 September 2017 – On International Safe Abortion Day, marked on 28 September, the AIDS and Rights Alliance for Southern Africa (ARASA), the Alliance of Women Advocating for Change (AWAC), SAfAIDS and the Southern Africa Litigation Centre (SALC) call on African governments to ensure universal access to safe abortion by decriminalising abortion and amending or repealing laws that prevent women and girls from accessing abortions or post abortion care.
Abortion is not permitted for any reason in 11 out of 54 African countries: this equates to 93% of women of childbearing age in Africa living in countries with restrictive abortion laws, which only allow for abortions in situations where continued pregnancy poses a health risk to the pregnant woman or to the foetus and in the case of rape or incest. Only four countries (Cape Verde, Mozambique, South Africa and Tunisia) allow for the termination of pregnancy without restriction of any kind, but with limits according to the period of gestation; while Zambia permits abortion on socioeconomic grounds.
“Laws that criminalise abortion do not prevent women and girls from having abortions: they only make them unsafe,” explained Michaela Clayton, Director of ARASA. “This contributes to significantly high maternal mortality rates in Africa: according to the World Health Organisation, 9% of maternal deaths (16 000) were caused by unsafe abortion in Africa in 2014. In addition, Africa accounts for 29% of all unsafe abortions, whilst globally 62% of all unsafe abortions result in death.”
The high demand for abortions is linked to poor access to contraception and improving access to contraception would therefore significantly reduce the number of unintended pregnancies and therefore abortions.
Although the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) does not explicitly mention abortion, the CEDAW Committee has consistently criticised restrictive abortion laws on the basis that these laws, particularly those that criminalise abortion in all circumstances, violate women’s right to health. The Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa (the Maputo Protocol), makes explicit reference to a human right to abortion, albeit in limited circumstances - where the pregnancy is the result of the sexual assault, rape or incest, or where the continued pregnancy would endanger the physical or mental health of the women or the life of the woman or foetus.
In 2016, the African Commission on Human and People’s Rights and the Special Rapporteur of the Rights of Women in Africa launched a campaign to decriminalise abortion in Africa. At the launch of the campaign, the Special Rapporteur emphasised that “criminalising abortion violates many basic human rights, including the right to life, liberty, security, health, and freedom from torture. Criminal abortion laws discriminate on the basis of sex—they penalise a health service only women need.”
In the context of HIV, women living with HIV who become pregnant often face judgmental and stigmatising attitudes from health care workers and cannot access information about their options. There have been reports from women living with HIV about being denied safe abortion care or having been “asked” to agree to sterilisation in order to access abortion services. Women who use drugs or engage in sex work are stigmatised and face additional barriers to accessing information and services related to termination of pregnancy. “Enabling women and girls living with HIV and those who use drugs or do sex work to avoid the complications of unsafe abortions is a vital component of ensuring they have access to comprehensive reproductive health care. Health care providers must be able to discuss pregnancy termination in a non-directive and non-judgmental way and be able to refer women to safe legal abortion services,” said Kyomya Macklean, Executive Director of AWAC.
Even where abortion is available in limited circumstances, women and girls struggle to access information about where and how they can access safe and legal abortions, leading to delays and often a failure to access abortion timeously. The criminalisation of abortion along with religious resistance to abortion also contribute to a high level of stigma, which negatively affects women’s willingness to ask for information about abortion, access legal abortion and seek post abortion care, even where abortion is legal.
In addition to the societal, legal and policy barriers to safe and legal abortions in Africa, the recent reinstatement and expansion of the Mexico City Policy (also known as the Global Gag Rule) by the United States of America poses new challenges, by eliminating any US global health assistance for organisations that offer abortion services and/or information about abortion options or even advocate for legislative change in this regard, even if it is done so with other non-US funds.
“Given that the US is the biggest funder of HIV-related programmes globally and US global health assistance amounted to more than $8 billion in the 2017 financial year, the impact of this on reproductive health care, HIV prevention and treatment, maternal health care, and other vital services as well as on effectively silencing the voices of African activists and healthcare providers on abortion-related issues is unforgiveable,” explained Clayton.
“The Sustainable Development Goals call on us to leave no one behind and seek universal health coverage for all. This includes increasing life expectancy and reducing the causes of maternal mortality. How will we achieve this when we continue to be guided by moral, religious or other prejudices at the expense of our lives? We need to do the right thing and provide universal access to safe, legal and accessible abortion for women and adolescent girls,” Lois Chingandu, Executive Director of SAfAIDS.
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About the AIDS and Rights Alliance for Southern Africa
Established in 2002, the AIDS and Rights Alliance for Southern Africa (ARASA) is a regional partnership of 115 non-governmental organisations working together to promote a human rights approach to HIV and TB in Southern and East Africa through capacity building and advocacy. ARASA partners comprise a diverse mix of more and less well-established organisations including networks of people living with HIV, legal aid organisations, women’s organisations, youth organisations and other AIDS service organisations. The basis of the partnership is solidarity and shared responsibility for advancing social justice in the region, with a focus on the realisation of the right to health. For more information, visit: http://www.arasa.info/
About the Alliance of Women Advocating for Change (AWAC)
The Alliance of Women Advocating for Change (AWAC) is a female sex worker led initiative established in 2015, by champions of the sex worker movement in Uganda to promote & coordinate the role of underserved female sex workers’ communities working around landing sites, transit routes, boarder areas and major towns through their Drop-in Centres (DiCs)/CBOs in driving the response to programs that support their efforts to overcome all forms of vulnerabilities fuelled by criminalisation and cultural norms attached to sex work. The alliance’s mission is “to strengthen a unified, vibrant national and sustainable sex workers’ movement calling for an enabling environment and scale up of access to health, social and economic wellbeing for female sex workers in Uganda”. AWAC particularly focuses on addressing the root causes of vulnerability and marginalisation, such as sexual gender-based violence, criminalization, poverty, stigma, discrimination, other human rights violations and harmful cultural norms at individual, community and national levels. For more information, visit: https://awacuganda.wordpress.com/
Established in 1994, SAfAIDS is a regional non-profit organisation based in Harare, (Zimbabwe), with country offices in Pretoria (South Africa), Lusaka (Zambia) and Manzini (Swaziland). For the last 20 years, SAfAIDS has implemented programmes in Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Tanzania, Zambia, and Zimbabwe. SAfAIDS is recognised for its capacity to bring national lessons and experiences to regional advocacy and knowledge - sharing platforms. SAfAIDS mission is to be a centre of excellence that promotes effective and ethical development responses to SRH, HIV and TB integrated with livelihood strategies; through advocacy, communication and social mobilization (ACSM). Its vision is to ensure that ALL people in Africa realize their sexual and reproductive health and rights (SRHR) and are free from the burden of HIV, GBV and TB, and their inter-linkages with other health and developmental issues. For more information visit: www.safaids.net
About the Southern Africa Litigation Centre
The Southern Africa Litigation Centre (SALC) promotes and advances human rights and the rule of law in southern Africa, primarily through strategic litigation support and capacity building. SALC provides technical and monetary support to local and regional lawyers and organisations in litigating human rights and rule of law cases in the region. SALC also provides training in human rights and rule of law issues and facilitates networks of human rights lawyers and organisations throughout southern Africa. For more information, visit: http://www.southernafricalitigationcentre.org