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On International Women Human Rights Defenders Day, a coalition of human rights organizations are launching a new set of guidelines for governments to protect frontline abortion rights defenders, including healthcare providers. Amnesty International, the International Planned Parenthood Federation (IPPF), Ipas, MSI Reproductive Choices, the Organisation Pour Le Dialogue Pour L’Avortement Sécurisé (ODAS Centre) and the International Confederation of Midwives (ICM) published the Key principles and actions to safeguard abortion care providers as human rights defenders. The document provides a set of concrete recommendations for governments to guarantee that health professionals and other human rights defenders of the right to abortion care for women, girls and pregnant people, can do so without fear of attacks and intimidation. “Despite the global progress we have seen on sexual and reproductive health and rights over recent years, including steps to decriminalize abortion in many countries, defending abortion rights, which includes the provision of abortion by healthcare providers, remains a dangerous job,” said Fernanda Doz Costa, Gender, Racial Justice, Migrants & Refugees Programme Director at Amnesty International. “Abortion rights defenders are failed by many States. On the one hand, States are negligent in their obligation to protect them while, on the other hand, abortion continues to be restricted and criminalized. As such defenders are deemed less ‘deserving’ of support and protection and are actively targeted. The Key Principles show governments how to break this cycle,” said Melissa Cockroft, Global Lead on Abortion, IPPF. “Democracy, human rights, and abortion rights are under attack, and so too are the frontline defenders of these rights. They risk physical and verbal attacks, threats, smears and intimidation to ensure people have access to abortion – a critical and essential health care service. We stand with them today and every day in the fight for human rights, and call on the global community to do the same,” said Dr. Anu Kumar, President and CEO of Ipas. The Key Principles include practical recommendations to: Prevent violations by implementing specific protection protocols and establishing channels to report harassment and receive support;   Enable defenders to exercise their rights without fear by ensuring universal access to comprehensive sexual and reproductive health, and decriminalizing abortion – as reinforced by the WHO’s Abortion guidelines; Safeguard defenders’ rights by protecting civic space and tackling abortion stigma; Provide redress, by stopping the criminalization of abortion defenders, and by bringing to justice those who attack them; “As the organized rollback of reproductive rights continues, the attacks being directed at healthcare providers are getting worse. It's time for States to uphold their duty and defend those who are risking everything to provide lifesaving care. We look forward to working alongside and together with governments, professional associations, donors, health facility managers, and civil society organisations to ensure frontline healthcare providers are given the support they deserve,” said Simon Cooke, MSI Reproductive Choices’ CEO. "Comprehensive abortion care is an essential health service. Midwives who provide these services are often subjected to discrimination, intimidation, and in some cases, even violence. In order to uphold women's right to safe abortion care, we need to protect and enable the midwives and health professionals who provide these services. To do this, professional associations, civil society, policy makers and governments need to implement the Key principles and actions to safeguard abortion care providers as human rights defenders," said Sandra Oyarzo Torres, ICM President. “We refuse to stay silent in the face of constant attempts to restrict and criminalize abortion and its defenders, and we commit to stand firmly with this fundamental human right,” said Kadidiatou SOW, Director of the ODAS Centre. An Amnesty International report in 2023 detailed the danger and difficulties faced by those who defend abortion rights and provide access to services, often in challenging circumstances, including midwives, doctors, nurses, doulas, activists and all those who help pregnant people manage their own abortions with medication. The report evidenced how many people working in healthcare settings are exposed to hostility and abuse from colleagues, employers, patients and others who oppose abortion.  Those working outside health facilities are also exposed to physical and verbal attacks, threats, smears and intimidation. Some are criminalized through prosecutions, investigations and arrests. The report also documents cases of stigmatization, isolation and ostracization, and restrictions on rights to freedom of expression, association and assembly. Attacks are more common in countries where abortion is stigmatized, restricted or criminalised. “Abortion is essential healthcare. Yet, as healthcare providers we are routinely faced with discrimination and violence for simply doing our jobs. Restrictive abortion laws and attitudes cause harm. They create hostile environments that feed abortion-related stigma that smears healthcare providers and those that seek abortion care as criminals. We all know colleagues, unfortunately, who have battled with stigma, career blocking, intimidation, physical attack, imprisonment, and even in the most extreme cases health care providers have been murdered,” said Dr Anne-Beatrice Kihara, President of the International Federation of Gynecology and Obstetrics (FIGO). For more information or to organize an interview, please contact: press@amnesty.org or media@ippf.org

Eswatini (27 August 2024) - IPPF’s Member Association in Eswatini, the Family Life Association of Eswatini (FLAS), is soon to roll out the first women-controlled HIV prevention product, the dapivirine vaginal ring (DVR). FLAS will be among the first organisations to offer the DVR outside implementation or pilot studies anywhere in the world. Made of flexible silicone, the ring is inserted into the vagina by a woman and slowly releases the antiretroviral drug dapivirine in the vagina over a one-month period, helping to reduce a woman’s risk of acquiring HIV. In 2023, in sub-Saharan Africa, women and girls accounted for 62% of all new HIV infections and every week, 3,100 adolescent girls and young women aged 15–24 years became infected with HIV. Therefore, there continues to be an urgent need for HIV prevention methods that females can use to protect themselves. The DVR is a product women can control themselves and use without the knowledge or consent of their partners, unlike condoms, which men often refuse to use. The DVR is inserted into the vagina and left for a one-month period, where it can then be replaced each month for continued protection. Unlike daily oral PrEP, the DVR does not rely on remembering to take a pill each day and is also discreet as it stays inside the vagina throughout the month. The DVR does not prevent pregnancy or other sexually transmitted infections (STIs), so women choosing to use the ring may want to consider combining it with condoms and methods of contraception. The availability of the DVR is an exciting step in supporting women’s autonomy and choice in HIV prevention. This need for women-controlled HIV prevention products has long been advocated for, with the African Women Prevention Community Accountability Board launching the HIV Prevention Choice Manifesto in early 2023. The Choice Manifesto prioritises the principle of choice to ensure that women and girls have the right to choose which HIV prevention methods work for them. Currently the ring is available at selected facilities through implementation studies across six countries in East and Southern Africa; South Africa, Kenya, Zimbabwe, Lesotho, Eswatini, and Uganda.  Diantha Pillay, Associate Director for Product Access for IPM South Africa NPC (an affiliate of the Population Council), said:  “It is encouraging to see the efforts made by FLAS and IPPF to support the choice agenda for HIV prevention for women and make effective HIV prevention methods, like the DVR, more widely accessible in a real-world setting. We hope this can pave the way for introduction of future pipeline products that speak to the needs of women.” The Population Council is currently developing a longer duration DVR that women would use for three months versus one month to significantly lower annual product costs and offer women a more convenient option to protect themselves. Thabo Lizwe Masuku, Programs Manager for FLAS, said: “Women have been telling us for a long time that  there is a need for a variety of methods for HIV prevention, since they are highly exposed. For women and girls to truly have choice about what works for them as they navigate different stages and circumstances of their lives, policy makers, donors, governments and implementers must ensure the mix of HIV prevention methods are available, accessible, and affordable. Access to the ring through our clinics in Eswatini now gives women choice and options to protect themselves against HIV.” IPPF is committed to ensuring that choice in HIV prevention is a reality for women and girls and aims to roll out the dapivirine vaginal rings at as many Member Associations as possible, as well as offer other HIV-prevention choices, as we work alongside our partners towards a future free of HIV in Africa and beyond. For more information and to speak to staff in Eswatini, please email media@ippf.org   Notes: The dapivirine vaginal ring has been recommended by the WHO since January 2021. (25) In clinical trials, the  ring was shown to reduce HIV infection by 35% in The Ring Study (26,27) and 27% in the ASPIRE Study. (28,29) Recent open-label studies show greater adherence to the ring, and modelling data suggest that HIV risk could be reduced by about 50%. (30) The dapivirine ring has received regulatory approval from the European Medicines Agency (EMA), as well as from local medicines regulators in Namibia, South Africa, Kenya, Zimbabwe, Uganda, Zambia, Malawi, Rwanda, Eswatini, Lesotho, Botswana and is currently under regulatory review in a number of other countries Our Member Associations (MAs) that provide clinical services are required to provide comprehensive SRH services through our Integrated Package of Essential Services (IPES) which include services for sexual health and well-being, contraception, abortion care, sexually transmitted infections (STIs)/reproductive tract infections (RTIs), HIV, obstetrics and gynaecology, fertility support, and sexual and gender-based violence. IPPF’s new five-year strategy, Come Together, focuses on expanding choice. In support of this, we recently launched a special programme to expand our HIV prevention options, which aims to integrate the newest HIV prevention methods – the vaginal ring and injectable PrEP - into our comprehensive sexual and reproductive health services.  IPPF’s IMAP Statement on Biomedical HIV Prevention can be found here. About the Family Life Association of Eswatini (FLAS)  For over 30 years, the Family Life Association of Eswatini (FLAS) has provided sexual and reproductive health (SRH) services to the people of Eswatini (formally Swaziland). While family planning, antenatal, post-natal and post-abortion care form a key part of FLAS services, there’s a significant focus on HIV and AIDS programmes. Eswatini has some of the highest HIV and AIDS prevalence rates in the world. As a result, the prevention and management of HIV and AIDS, the provision of voluntary counselling and testing (VCT), and the prevention of mother to child transmission (PMTCT) are central to FLAS’s work. FLAS has 15 service points, including three permanent clinics and three mobile facilities, staffed by a permanent team of 40 staff backed by 230 volunteers, 180 Youth Action Movement members and 29 peer educators. About the International Planned Parenthood Federation (IPPF) IPPF is a global healthcare provider and a leading advocate of sexual and reproductive health and rights (SRHR) for all. Led by a courageous and determined group of women, IPPF was founded in 1952 at the Third International Planned Parenthood Conference. Today, we are a movement of 150 Member Associations and Collaborative Partners with a presence in over 146 countries.Our work is wide-ranging, including comprehensive sex education, provision of contraceptives, safe abortion, and maternal care and responding to humanitarian crises.  We pride ourselves on being local through our members and global through our network. At the heart of our mission is the provision of – and advocacy in support of – integrated healthcare to anyone who needs it regardless of race, gender, sex, income, and crucially no matter how remote. Our services are available to all, and reach the most marginalised groups in societies, including key and priority populations, youth, and people with disabilities. Most of our MAs have special programs to engage youth (10-24) inside and outside of school settings. Because our clinics offer comprehensive services, attending our clinics is non-stigmatizing and does not label people as having a particular disease or membership to a particular group. This model of services that are integrated and open to all, embedded in indigenous, locally owned organisations, is ideal for ensuring that the most vulnerable and marginalised groups can access the HIV prevention services they need. About the Population Council The Population Council is a leading research organization dedicated to building an equitable and sustainable world that enhances the health and well-being of current and future generations. The Council transforms global thinking on critical health and development issues through social science, public health, and biomedical research. We generate ideas, produce evidence, and design solutions to improve the lives of underserved populations around the world.