XI National AIDS Conference in Amsterdam, Holland


Sex and Trade in Struggle
for Human Rights, Women’s Rights and Fair Trade

by María Suárez Toro, FIRE
Panel:  "Working Together to Support Women's Leadership"
December 1, 2007

The HIV/AIDS pandemic reached Costa Rica by way of trade, not sex. Costa Rica is a country known by many around the world for some basic characteristics that makes it what I have called, a "species in extinction." Costa Rica is unique in being a Third World country without an army; a country with highly protective laws for “the commons,” which in Costa Rica constitute not only the environment, but telecommunications, water and electricity.  Likewise, we are a country with a human rights framework that has its basis in law, and a country in which governmental policy ensures social services and protection of natural resources. In addition, Costa Rica preserves and treasures its democratic participation and strong system of interactive sovereignty.

The country’s decades-long history has persevered because all the factors above are so closely interconnected. Our forefathers and foremothers knew that a peaceful nation would not be possible without a strong social service system, without protecting the commons, and only with democratic participation. The entire civil society since has understood and continued to support these principles. For people to live peacefully, their fundamental needs must be met. However, Costa Ricans are at a turning point: If we allow global market trends to impose their logic on our country, we endorse the escalation of  HIV/AIDS, among other things.

HIV Virus in Costa Rica

In 1985, barely two years after the naming (some call it discovery) of the HIV virus by Luc Montagner in the Pasteur Institute in France, the governmental health system in Costa Rica detected the first cases of AIDS in the country: A group of 26 hemophiliacs had received infected blood that had come through the international humanitarian trade system. It was fed into a universal health system that exists in the country  since the 1948 liberal revolution, and that created the conditions that I described above. That system has such quality control mechanisms that although AIDS was almost unknown, the health system detected the impact in the blood stream of the infected when they were being routinely tested for any sign of hepatitis.

Invisible, undetected, not yet named, the HIV virus reached the country by way of the same mechanisms that we are presently challenging in Costa Rica about the Central American Free Trade Agreements, known as CAFTA. “Free” trade barriers that will only liberate corporations of the quality controls that prevent them from dumping; patenting rights that will limit the availability of generic medicines, the privatization of a public health system that so far is still healthy but will receive a sick blow when health and health insurance – also a universal public service - in Costa Rica now, becomes a commodity.

Two years later in 1985, the first cases of HIV transmission via homosexual sexual activity were detected and the following year, AIDS appeared in the population at large. Today, AIDS spreads in Costa Rica at a rate of 128% per year.

According to a specialist in women’s health, Anna Arroba of the Association for Women’s Health in Costa Rica, the HIV/AIDS virus has a higher rate of growth among women, young and poor women. Up to to 1990, there were 21 cases of women with AIDS, which added up to 65 between 1991-5 and 153 in the period 1996-2000. Proportionally, the ratio was 13 men to 1 woman infected in 1993, which rose to 5 men to 1 woman in 1999.

From recognition of the epidemic to persecution of its victims

The first HIV/AIDS campaigns by the Costa Rican government in the early 1990s were not preventive, nor about treatment. Instead, they triggered greater persecution of gays, lesbians, transgendered and transexuals, as shown by the escalation of raids that took place in GLBT NGOs and their social spaces such as bars.

As a result, the homosexual population organized for prevention and protection far faster and better than any other, not only because of the way they were affected by the virus, but because of how they were affected by homophobia.

In  the year 1997, after a long constitutional court case headed by the GLBT community, the Costa Rican Government finally adopted The General Law about Aids 7771 and its regulation, which made it an obligation of the Public Health System to provide medicines and treatment for people with AIDS.

New organizations of gays and lesbians, of people promoting HIV/AIDS prevention efforts, and services for people with AIDS mushroomed thoughout the country.

The Asociación de Lucha Contra el SIDA (Association of Struggle Against AIDS) known later as ILPES, lesbian groups such as Las Entendidas, The Movimiento 5 de abril, GAYPOA, later known as the Asociación Triángulo Rosa, and the Asociación por el Respeto a la Diversidad Sexual, among others emerged in that context.

Some of the achievements of those initiatives are the following: The criminalization of raids against lesbian and gay bars, their advocacy in the achievement of the special law (7771) about HIV/AIDS, the recognition of the first GLBT rights, the obligation of the health system to provide medicine free of charge to HIV/AIDS patients, the creation of social organizations to render visibility and struggle for rights, cultural change and exposure in mainstream media.

Fundamentalism and AIDS

The UN organization ONUSIDA, in its studies about Costa Rica and AIDS, recognizes “bad sexual education” as the main obstacle to AIDS prevention.

To understand what this means, the first step is to see in Costa Rica a direct link between the rise of HIV/AIDS and fundamentalism.  Way back in the late 90s, the Government of Costa Rica  had designed, published and was ready to distribute throughout the universal education system a series of books on sound sex education for elementary and high school levels. For the first time in the history of the country, and due to feminist presence in government, sexual education was to be taught in holistic terms, including gender, health, biology and culture. The  booklets were to be an example for the region regarding a comprehensive approach to sex education.

However, the Catholic Church stepped in to halt the process of distribution of materials, and continues to do so today. Only god knows how many HIV cases could have been prevented among the escalating number of victims among young people who have not stopped having sex, but do not receive any education about it in the system.


Feminization of AIDS

Gender-based discrimination and violence against women also spreads HIV/AIDS. At the very beginning of feminist struggles against violence toward women and of gender-based discrimination, we said that these were “matters of life and death”. And today we can say the same about AIDS. 

I already provided some statistical data. Now I want to tell you about what women are doing.  Rosibel Zúñiga of the Asociación Mujeres PVVS (Association of Women Living With AIDS) in Costa Rica since 1995, is a woman, mother, and wife infected with HIV/AIDS. She believes that her illness has restricted her life projects due to rejection by familiy, discriminatin in work and exclusion from society.

Zúñiga's organization is the first of its kind in Costa Rica.   They struggle to help women develop new forms of livelihood through economic, health and other types of projects. A membership of 35 women with AIDS creates small enterprises with women, undertakes training in schools and communities and develops awareness and advocacy for legal change.

Last October in Panama, Costa Rican women AIDS activists took part in the First Latin American & Caribbean Congress of Women, Girls and Adolescents Living with HIV/AIDS, organized by the International Community of Women Living with HIV/AIDS.  (ICW).  At the Congress, they joined the 1,000 women from Venezuela, Uruguay, Perú, Paraguay, Panamá, Nicaragua, México, Honduras, Guatemala, República Dominicana, El Salvador, Ecuador, Cuba, Colombia, Chile, Brasil, Bolivia, Belice, Barbados y Argentina.

The women
had met earlier in the 8th International AIDS in Amsterdam in 1992. The objectives of the Panama meeting were to bring women activists and advocates about HIV/AIDS together to learn about each others’ issues and perspectives, to make their voices heard, to become spokespersons and informed advocates at the legal, medical, social and political levels, and to denounce violation of their human rights and raise their self esteem in their common struggle.


In Panama, the women talked about the internationalization of the virus, of sexual and reproductive rights, of racism, of xenophobia and global movements facing HIV/AIDS policies and agenda.  


AIDS and free trade

Combating the HIV/AIDS epidemic by advancing drugs and accessibility is what I want to focus on last, both because of what is at stake in Costa Rica, not to mention the rest of the world, but also because it is the issue that is least talked about, yet one that will shape all present and future policies.

In Costa Rica, 70% of the HIV/AIDS treatment consists of generic medicines. The cost will be higher if CAFTA is adopted, because the Chapter on Property Rigths in the agreement will favor pharmaceutical companies.

In 1998, the United States accounted for 39.6 percent of all global pharmaceutical sales, and 13 out of 17 antiretroviral AIDS drugs were developed in U.S.-based laboratories.[1]

The sales of HIV/AIDS drugs has since created multimillion dollar revenues for U.S. companies such as GlaxoSmithKline (GSK), Bristol-Meyers Squibb, and Merck & Co., maintaining them as some of the most influential players in the debate over accessibility of antiretroviral drug therapy. In the late 90’s, triple drug antiretroviral therapy under U.S. patents cost approximately $10,000 per patient per year.

Pharmaceutical companies have legal protection to ban free or cheap medicine based on drug patents. These have become a defining factor for access or denial to the drug. Under the WTO rules,  patents are protected for up to 20 years, creating decades of monopoly by U.S. pharmaceutical companies.

Since its recognition in the early 80’s, AIDS has taken the lives of millions worldwide. In 2006, UNAIDS (Joint United Nations Programme on HIV/AIDS) estimated that there were 39.5 million people living with HIV on the planet, and that approximately 2.9 million had died from AIDS.[3] UNAIDS has also estimated that 95 percent of people living with HIV/AIDS are in developing countries.[4]



Evidently what has been done about HIV/AIDS has not only not been enough, but it is not working! 

Costa Rican microbiologist, Libia Herrero, one of the characters in the book
[5] that I am about to publish in Costa Rica, the book which is also the basis of the theatre show that  has brought me here to the Netherlands, has made it very clear that this and the SARS virus epidemic are evidence of the  decadence of fragmented or excessively specialized policy and vision (or the lack if it) regarding health or anything else.

“It is clear now with both those viruses, that in order to control any pandemic, it would be necessary to touch everything: veterinarian, wild, doctor, forests, prevention, and promotion. Viruses – [Herrero says to me in the book] - are the beings that are keeping the scientific community in a state of emergency due to public health concerns about the threat of pandemics, because of their successful capacity to adapt and because their different survival mechanisms makes one question whether science is taking the whole picture into account.   Nowadays, the only way to solve things thus is when a society integrally organizes to understand and face what happens to it in its entirety.”


AIDS education and prevention strategies about all the ways we can get infected have not been enough to control or mitigate the spread of the disease, and yet they are necessary.

Sex education only has not worked, yet is necessary for more than one illness in our societies, including AIDS.

An end to gender-based violence and discrimination against women has not worked, yet is also needed to prevent HIV/AIDS and all kinds of deaths.

Secular States are not very successful at remaining secular, yet separation of Church and State is urgently needed in this and women’s rights cases.

Homophobia is rampant, yet it casts a shadow that obscures how  all in society are affected by discrimination based on difference and dichotomization of sex and gender roles that we have created to humanity’s disadvantage… and I mean all of us.

Social and civic organizations have been devalued and even persecuted with the rise of government policy and its links to fundamentalism, yet those very same organizations are the ones that are pushing government to protect rights.

Accepting and taking an activist stance to implement the feminist principle that the "personal is political" is urgent. When was the last time you were tested for HIV? When was the last time you requested a test from a sexual partner or a condom for that matter?

A shift in paradigm is also necessary. HIV/AIDS cannot be stopped with the same fragmented strategies as other illnesses. When was the last time you connected women’s rights to the struggles against neoliberalism?





[1] Frederick Harris, Charles R. Kennedy and Michael Lord, “Integrating Public Policy and Public Affairs in a Pharmaceutical Marketing Program: The AIDS Pandemic,” Journal of Public Policy and Marketing 23, no. 2 (2004): 132.

[2] Barnard, 163.

[3] Joint United Nations, “UNAIDS: Joint United Nations Programme on HIV/AIDS,” UNAIDS http://www.unaids.org (accessed November 11, 2007).

[4] Barnard, 159.

[5] Women: Metamorphosis of the Butterfly Effect, by María Suárez Toro.  In press by Farben/Norma, Costa Rica.




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