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Ethical women's health in Africa

20 June 2006

Dr Ray Noble (UCL Elizabeth Garret Anderson Institute for Women's Health) has recently returned from South Africa, where he has been instrumental in developing academic collaboration and ethical guidelines for women's health.

In 2005 UCL, together with the University of KwaZulu-Natal and the University of Witwatersrand, embarked on a joint effort to establish a centre for collaborative research and scholarship in reproductive ethics and rights. The centre aims to provide opportunities for graduate students in these fields, and developing women-centred projects to understand factors affecting access to reproductive healthcare.

Dr Noble said: "Gender equality and empowerment are central to reproductive health, affecting not only individuals but also their families, societies and the global community. South Africa has one of the highest rates of HIV infection with a particularly devastating impact on women and women's rights - a fact highlighted by my visit to a rape crisis unit in Durban last year."

The unit has some 250 referrals each month, and more than 36 per cent of women attending a nearby antenatal clinic are HIV positive. Dr Noble added: "The vulnerability to HIV infection is particularly elevated by their economic dependence on men, lack of access to education, poverty, sexual exploitation, coercion and rape. If their HIV-status is disclosed, women face being physically abused, losing access to jobs, and face the threat of being evicted from their homes and communities. It is for this reason, in a joint paper, I argued in favour of an 'opt-in' strategy, where antenatal screening for HIV is carried out only with specific consent."

Dr Noble believes that this strategy is one small step in tackling the lack of empowerment and vulnerability in South Africa, and the impact of HIV on their lives.

Dr Noble and his African colleagues are now planning a meeting for 2007 on the theme of 'Women's Health - African Solutions' with the aim of exploring new approaches to women's health in the African context, identifying and developing projects on the ground.