Over 500 physicians call on WHO to support a global treaty to end VAW
Every Woman Treaty is thrilled to support hundreds of committed physicians from across the world who have signed this strong call for a new global treaty to end violence against women and girls. We salute you! Will WHO put its weight behind this call, as women suffer the violence pandemic within the COVID pandemic?
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As the COVID-19 pandemic rages on, reports of domestic violence are increasing around the world. Violence against women and girls had already assumed pandemic proportions prior to the COVID-19 crisis, with one in three women globally experiencing violence over their lifetimes. That is 1.3 billion women—more than the combined total cases of other public health crises, including COVID-19, people living with HIV/AIDS, and cases of malaria (2018) and Ebola (2014 and 2016). Now, the United Nations estimates that continued lockdowns will lead to an additional 31 million cases of gender-based violence worldwide.
As global public health and human rights policymakers well know, violence against women has devastating health consequences for women and families. Women experience acute and chronic issues including broken bones, fractures, suicidal thoughts, PTSD, and depression. These and other physical and mental health issues can persist across her life course and can reduce a healthy life expectancy. UN Women estimates that violence against women is as serious a cause of death and incapacity among women of reproductive age as cancer, and a greater cause of poor health than traffic accidents and malaria combined.
The mental and physical health effects of violence are intergenerational. Children of mothers who experienced violence can have poorer physical health and a greater number of emotional, psychological, and behavioral problems, including self-harm, aggressive and antisocial behaviors, depression, and anxiety. Mental and emotional health problems can follow children into adulthood, leading to alcohol and drug abuse, self-harm, and other issues, including: an increased likelihood of becoming a perpetrator of violence (more common in men), or a victim of violence (more common in women).
Poor access to health care exacerbates the problem for many women, particularly those in low- and middle-income nations. These nations report higher rates of violence against women, but access to healthcare is less available. For example, the World Health Organization estimates that 45 percent of women in sub-Saharan Africa experience violence, while a recent study found that access to quality care was the lowest in sub-Saharan African countries.
Violence against women erodes the prospect of living healthy lives for billions of women and children worldwide and it has social and economic costs that affect all communities and all nations. Violence against women and girls stresses health systems, education systems, and social services. As of February 2020, it cost the world an estimated 5.5 percent of the global economy or US$4.7 trillion, nearly three (3) times the size of Canada’s economy. Nation by nation, across the globe, violence against women, in short, has long proven an existential threat to human potential and human flourishing.
Yet, violence against women is not being responded to with the sense of urgency required to address a global pandemic of these proportions. Not only is violence against women and girls not being treated with urgency, it is also not being recognized by some of our colleague healthcare providers.
In a study at Yale University Hospital, Stark and Flitcraft found that nearly one in five women experiencing domestic violence had presented at least 11 times with trauma; another 23 percent had brought 6 to 10 abuse-related injuries to the attention of clinicians. In most of these cases, the healthcare provider never identified the history of abuse underlying the injuries.
The right to be free from violence is a universal human right. Unfortunately, violence against women is not comprehensively covered in international law. Although references to violence against women in international and regional treaties are numerous, they differ in substantive scope and nature. Some international norms address specific aspects of this global problem, including violence in armed conflicts or workplace violence, for example. And some international norms address how women experience specific forms of violence due to social forces that create additional disadvantages and risks, including women with disabilities, indigenous women, and older women. But no international treaty adequately or comprehensively addresses all aspects of a State’s duty to respect, protect, and fulfill every woman’s right to live free from violence. Therefore, a new holistic treaty focused solely on violence against women and girls will provide much-needed normative specificity, while removing lack of clarity over definitions and responsibilities.
To help find answers to prevent violence against women and girls, for the past seven years, frontline advocates from every corner of the planet have been advancing a global norm to eradicate violence against women and girls. Designed to be complementary to the Convention on the Elimination of All Forms of Discrimination (CEDAW), the treaty aims for a norm that combines the best of public health and human rights frameworks. We, the undersigned physicians and public health professionals, support this call. We urge you to do the same.
A treaty specific to ending violence against women and girls has the potential to change the course of human history—to a healthier one, physically, socially, and economically. A binding global norm will mandate that nations implement evidence-based interventions, using a multi-sectoral approach. It will set norms and standards on women’s health, including access to health and the availability of life-saving services. It will protect women across their life course, and includes specific protection of vulnerable groups, such as refugees, indigenous people, people experiencing disability, and people with various sexual orientations and gender identities, leaving no one behind.
A treaty specific to ending violence against women and girls also supports the fulfillment of Sustainable Development Goal Number 5 by mainstreaming a whole-of-government, whole-of-society approach to eliminating violence and harmful practices.
A key component of the proposed treaty in ensuring a strong health system response through the implementation of the WHO’s Global Plan of Action to strengthen the role of the health systems within a national multisectoral response to address interpersonal violence, in particular against women and girls, and against children. Experience has shown that public health approaches to violence make a significant difference. The health sector has unique potential to deal with violence against women. Yet too often, they are not given the training and resources necessary to recognize intimate-partner violence, trafficking, and other forms of violence.
With standards and associated funding in place across the globe, proactive, evidence-based interventions will cause rates of violence and costs associated with violence to drop, delivering triple dividends: healthier populations, improved social dynamics and norms, and stronger economies.
As healthcare practitioners and public health professionals, our leadership has been pivotal to the movement for a treaty to end violence against women and girls. Therefore, this letter is a clarion call to all global policymakers and United Nations Member States. We are writing to you as physicians who in our medical practices have had personal experience with survivors of domestic violence. We are writing to you as leaders of institutions committed to promoting health and defending human rights. We are writing to you as public health physicians who respond to evidence-based data from proven strategies to take the next step to address this global, but largely not discussed pandemic. We do call on you, dear colleagues, to join us in a call for a global treaty to end all forms of violation on women and girls of all ages. A new legally binding international instrument will generate the momentum necessary to innovate while developing stronger frameworks for domestic plans of action, funds and budget commitments, and enforcement mechanisms, all of which should be clear and measurable, as required by SDG 5 indicators.
We are physicians from around the world who have responded to this call on the premise that physicians and health professionals, because of our privileged relationship with our patients, our moral role, responsibility, and duty in the society, can help get this treaty to the finish line. We pray that the pain that women and girls suffer daily around the world due to domestic and sexualized violence will awaken the collective consciousness of the world to act. And you will be at the forefront of this response.
Thank you for your leadership in this important area.