New Year, New Opportunities to Address an Age-Old Problem: Gender-Based Violence

Around the world, reports of gender-based violence (GBV), particularly intimate partner violence and child marriage, have spiked during the pandemic, but these issues are far from new. Women and girls make up the vast majority of those subjected to GBV with one in every three women experiencing physical or sexual violence in the course of her lifetime according to the World Health Organization. GBV can lead to negative physical and mental health outcomes for individuals, such as unintended pregnancy, transmission of sexually transmitted infections and injuries, and in aggregate, can have costly socioeconomic consequences for communities and countries.

Combating GBV is a global priority, in addition to a priority here in the United States. President Biden’s dedication to ending GBV goes back to his days as a senator. In 1990 he wrote and in 1994 championed the passage of the Violence Against Women Act, the seminal legislation which governed the U.S. federal response to the GBV epidemic in the United States. The legislation enjoyed broad bipartisan support for years and was reauthorized multiple times, until efforts to update and strengthen the bill led to it falling victim to political polarization, which resulted in the bill expiring in 2019.

Now, the Biden-Harris administration is looking to challenge GBV in a big way in 2022 with two new strategies slated for release this year. The first is the National Action to End Gender-based Violence, an initiative currently under development, and the second is an update of the 2016 United States Strategy to Prevent and Respond to Gender-based Violence Globally. Both were commitments made by the administration in its March 8, 2021 executive order.

These strategies are intended to provide a holistic, interagency and multisectoral approach to simultaneously address the impacts of violence, while also working towards the lofty goal of curtailing and ultimately preventing GBV in the future.

Doing so will require the administration to take bold steps to tackle the root causes of GBV around the world, including the inequities perpetuated by patriarchal systems, institutions and social and economic norms.

As advocates of global sexual and reproductive health and rights, PAI is deeply committed to supporting the United States in its efforts to end GBV and support survivors around the world. As such, we encourage those updating the 2016 GBV strategy to take into consideration the following recommendations:

• Ensure that U.S. programs support comprehensive post-rape care, including emergency contraception and abortion. Survivors who have experienced rape should be provided with timely access to emergency contraception to prevent pregnancy and post-exposure prophylaxis for HIV and other sexually transmitted infections. Additionally, the U.S. government should take this opportunity to clarify that the Helms amendment does not restrict the provision of abortion services with U.S. funds in cases of rape, incest or life endangerment, as these circumstances are not considered “family planning.”
• Acknowledge and address the full range of sexual and reproductive health impacts of different forms of GBV. The health care response must go beyond pregnancy and HIV prevention for survivors of rape. GBV, including intimate partner violence, is correlated with a number of negative health outcomes such as injuries, including gynecological injuries, maternal health complications, increased rates of miscarriage and unsafe abortion, premature labor and low birth weights, as well as mental health concerns such as anxiety and depression. For many individuals, the negotiation of safe sex and contraception use may also be difficult given power dynamics in a relationship. Therefore, ensuring access to the full range of contraceptive methods, particularly female-controlled and invisible contraceptives can be important tools.
• Improve the capacity of health care providers to be able to screen for GBV. Health care providers can play a significant role in identifying those who have or are experiencing abuse. This strategy should work towards improving the capacity of health care workers to competently, confidentially and efficiently screen all patients and provide survivor-centered care.
• Make GBV and reproductive health services available from the onset of any humanitarian response. In line with international standards and the Minimum Initial Service Package (MISP) for Sexual and Reproductive Health, reproductive health services to reduce maternal and newborn deaths, prevent HIV and respond to the immediate needs of GBV survivors should be in place at the start of a humanitarian response. Ensuring this should be part of the United States’ commitment to the Call to Action on Protection from GBV in Emergencies, a multistakeholder effort, in which both the U.S. government and PAI participate, to change how the humanitarian systems address GBV.
• Promote comprehensive sexuality education. Age-appropriate and evidence-based comprehensive sexuality education that emphasizes bodily autonomy and consent is critical in educating young people about their rights and breaking the cycle of GBV over the long term.
• Recognize the gendered impact of public health responses to COVID-19 and future health emergencies and ensure that GBV services are considered essential and remain accessible to those in need. Stay at home orders and the closure or reduced capacity of many GBV services during the COVID-19 pandemic created a perfect storm, in which violence increased and women and girls were left with few places to turn.

These recommendations represent only a sliver of the issues that the strategy will need to cover in order to achieve the goal of a holistic, multisectoral approach to ending GBV. The revisions to the 2016 strategy should be worthy of President Biden’s historic leadership on GBV over the past three decades. We look forward to the seeing the administration’s global strategy come together in the coming weeks and months and eagerly await its release.