For other versions of this document, see http://wikileaks.org/wiki/CRS-RL34438 ------------------------------------------------------------------------------ ¢ ¢ ¢ ¢ ¢ ¢ Prepared for Members and Committees of Congress ¢ ¢ In recent years, the international community has increasingly recognized international violence against women (VAW) as a significant human rights and global health issue. VAW, which can include both random acts of violence as well as sustained abuse over time, can be physical, psychological, or sexual in nature. Studies have found that VAW occurs in all geographic regions, countries, cultures, and economic classes, with some surveys showing that women in developing countries experience higher rates of violence than those in developed countries. Many experts view VAW as a symptom of the historically unequal power relationship between men and women, and argue that over time this imbalance has led to pervasive cultural stereotypes and attitudes that perpetuate a cycle of violence. U.S. policymakers have generally focused on specific types or circumstances of VAW rather than view it as a stand-alone issue. Congress has authorized and appropriated funds for international programs that address VAW, including human trafficking and female genital cutting. In addition, past and current Administrations have supported efforts to reduce international levels of VAW-- though many of these activities are implemented as components of broader foreign aid initiatives. There is no U.S. government-wide coordination of anti-VAW efforts. Most agencies and departments do not track the cost or number of programs with VAW components. Therefore, it is unclear how much money the U.S. government, or individual agencies, spend annually on VAW- related programs. Some experts have suggested that the U.S. government should re-examine, and perhaps enhance, current U.S. anti-VAW activities. They argue that VAW should not only be treated as a stand-alone human rights issue, but also be integrated into U.S. assistance and foreign policy mechanisms. Other observers are concerned with a perceived lack of coordination among U.S. government agencies and departments that address international violence against women. This report addresses causes, prevalence, and consequences of violence against women. It provides examples of U.S. activities that address VAW directly or include anti-VAW components. It outlines possible policy considerations for the 111th Congress, including the scope and effectiveness of U.S. programs; further integrating anti-VAW programs into U.S. assistance and foreign policy mechanisms; and strengthening U.S. government coordination of anti-VAW activities. Material relating to United Nations anti-VAW activities that previously appeared in this report is now published in CRS Report RL34518, United Nations System Efforts to Address Violence Against Women, by Luisa Blanchfield. ¢ Introduction ..................................................................................................................................... 1 Defining Violence Against Women ................................................................................................. 2 Scope and Context........................................................................................................................... 2 Social and Health Consequences............................................................................................... 3 Prevalence and Circumstances .................................................................................................. 3 Types of Violence ............................................................................................................................ 5 Harmful Traditional Practices ................................................................................................... 6 George W. Bush Administration Efforts.......................................................................................... 7 Interagency Activities................................................................................................................ 8 Key Issues and Related U.S. Activities ........................................................................................... 8 Global Health ............................................................................................................................ 9 Related U.S. Activities...................................................................................................... 10 Humanitarian Assistance and Refugees ...................................................................................11 Related U.S. Activities...................................................................................................... 12 Foreign Military Training........................................................................................................ 13 Related U.S. Activities...................................................................................................... 14 Trafficking in Women and Girls.............................................................................................. 15 Related U.S. Activities...................................................................................................... 16 Legal and Political Rights ....................................................................................................... 17 Related U.S. Activities...................................................................................................... 17 Selected International Activities.................................................................................................... 18 U.N. System Efforts ................................................................................................................ 18 Other International Efforts ...................................................................................................... 19 Policy Issues for Congress............................................................................................................. 20 Scope, Effectiveness, and Funding of Current U.S. Programs................................................ 21 Integration into Foreign Assistance Programs and Additional Funding................................. 21 Coordination Among U.S. Agencies and Departments ........................................................... 22 Collaboration with International Organizations ...................................................................... 22 Possible Program Implementation Challenges........................................................................ 22 Infrastructure and Priorities .............................................................................................. 23 Most Effective Approaches? ............................................................................................. 23 Program Evaluation .......................................................................................................... 23 Lack of Comparable Data ................................................................................................. 24 Current and Emerging Issues......................................................................................................... 24 The Role of Men and Boys ............................................................................................... 24 Links to HIV/AIDS........................................................................................................... 24 Discrimination and Violence............................................................................................. 25 Possible Economic Impacts .............................................................................................. 25 Table 1. Examples of Violence Against Women.............................................................................. 5 ¢ ¡ Appendix A. Additional Resources ............................................................................................... 26 Appendix B. Selected U.S. Agencies and Offices/Bureaus that Address Global Violence Against Women .......................................................................................................................... 28 Author Contact Information .......................................................................................................... 29 ¢ In the past three decades, the U.S. government and international community have increasingly recognized violence against women (hereinafter VAW) as a human rights problem with far reaching consequences.1 Prior to the 1970s, many in the international community viewed VAW as a private matter to be dealt with among individuals and not a public matter that merited a national or international response.2 In the late 1970s and 1980s, however, the international community began to focus on VAW as a global health problem and violation of human rights. This shift was driven, in part, by an increasingly effective and well-organized grassroots movement of local, national, and international women's non-governmental organizations (NGOs) that brought international attention to the plight of VAW victims and created a more public forum for discussion of the issue.3 U.S. policymakers have generally addressed VAW as a component of other international development efforts rather than as a stand-alone issue. Congress has authorized and appropriated funds for international programs that address types of VAW, including trafficking in persons and female genital cutting (FGC). Members of Congress have also addressed VAW in the context of issues such as HIV/AIDS prevention and democracy promotion. Similarly, in the last decade past and current Administrations have supported initiatives to reduce specific types and circumstances of international VAW through programs addressing humanitarian assistance and healthcare. The lack of U.S. government-wide coordination or overarching framework for addressing international VAW, however, has led some to suggest that U.S. efforts to address VAW, while important, take a piecemeal approach to addressing the problem. Further, some argue that the United States should re-examine and possibly enhance current efforts to combat violence against women. This report identifies types of VAW and the direct and indirect consequences of these acts of violence. It provides examples of U.S. government programs that--in whole or in part--work to reduce or eliminate international violence against women. It does not assess the scope of individual programs or a program's success in achieving its goal. The report also outlines possible policy considerations for the 111th Congress, including the scope and effectiveness of current U.S. programs, further integrating VAW prevention and treatment into U.S. foreign assistance programs, and coordinating among U.S. executive branch agencies and departments.4 1 This report discusses U.S. efforts to address international VAW on a global level. It does not address VAW in particular regions or countries. For an overview of domestic efforts and programs to combat VAW, see CRS Report RL30871, Violence Against Women Act: History and Federal Funding, by Garrine P. Laney. 2 International efforts to address women's issues during this time focused primarily on achieving equal legal and political protection through legal reforms. 3 For more information on the international movement to address VAW, see Overcoming Violence against Women and Girls: The International Campaign to Eradicate a Worldwide Problem, by Michael L. Penn and Rahel Nardos, Rowan & Littlefield Publishers, Inc., Lanham, MD, 2003. 4 For information on U.N. system anti-VAW efforts, see CRS Report RL34518, United Nations System Efforts to Address Violence Against Women, by Luisa Blanchfield. ¢ In 1993, the U.N. General Assembly adopted the non-binding Declaration on the Elimination of Violence Against Women (DEVAW). The Declaration, which was supported by the U.S. government, describes VAW as "any act of gender-based violence that results in, or is likely to result in, physical, sexual, or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life."5 The DEVAW definition of VAW is broad, encompassing both physical and psychological harm. It is used in this report because it is one of the most inclusive and widely agreed to international definitions. In some contexts, VAW may be used synonymously with "gender-based violence" (GBV), which describes violence perpetrated against an individual, regardless of sex, because of his or her gender.6 Despite the international adoption of DEVAW, governments, organizations, and cultures continue to define VAW in number of ways, taking into account unique factors and circumstances. How VAW is defined has implications for policymakers because the definition affects the types of violence that are measured and addressed. Some law enforcement organizations and national criminal codes, for instance, do not consider psychological abuse to be a form a VAW because, while harmful, in many cases it is legal. Others, however, advocate for a broader definition of VAW, contending that physical and psychological harm cannot be separated, and that psychological abuse can be as devastating as physical abuse.7 ¡ VAW occurs in all geographic regions, countries, cultures, and economic classes. Many experts view VAW as a symptom of the historically unequal power relationship between men and women, and argue that over time this imbalance has led to pervasive cultural stereotypes and attitudes that perpetuate a cycle of violence.8 Though the specific causes of VAW vary on a case-by-case basis, some researchers have identified community and individual risk factors that may increase rates of violence against women. Community factors can include cultural norms that support male superiority, high crime levels, poor economic conditions, and a lack of political and legal protection from governments. Individual factors that may lead to a high risk of becoming a victim of VAW include living in poverty and a previous history of abuse.9 5 U.N. document, A/RES/48/104, December 20, 1993. DEVAW was adopted without a vote at the 48th Session of the U.N. General Assembly. 6 The term "gender-based violence" is broader than VAW because it can include violence perpetrated against men and boys in addition to women and girls. 7 For further discussions on VAW definitions, see Ending Violence Against Women: A Challenge for Development and Humanitarian Work, by Francine Pickup, Oxfam GB, Information Press, Eynsham, 2001, pp. 11-14, and "Defining and Measuring Violence Against Women: Background, Issues, and Recommendations," by Patricia Tjaden, Expert Group Meeting of the U.N. Division for the Advancement of Women, April 11-14, 2005. 8 For further discussion, see U.N. document, A/61/122/Add.1, In-depth Study on all Forms of Violence Against Women: Report of the Secretary-General, July 6, 2007, pp. 28-30, available at http://www.un.org/womenwatch/daw/vaw/ SGstudyvaw.htm. 9 For more information on VAW risk factors, see World Report on Violence and Health, edited by E.G. Krug et al., World Health Organization, Geneva, Switzerland, October 3, 2002, pp. 96-100 and 157-161, at http://www.who.int/ violence_injury_prevention/violence/world_report/en/. ¢ A wide range of research highlights the serious social and civil consequences of violence against women. In many societies, women provide emotional and financial support for families and communities. Studies have shown that violence and the social stigma of violence negatively affect the ability of women and girls to participate fully in and contribute to their communities. Research has also found that women who experience violence are less likely to hold jobs and are more likely to live in poverty than those who do not experience violence.10 Violence and the fear of violence may cause some women to avoid public places such as schools and the workplace. Some research has also found that women may also be less likely to participate in political activities or development projects because of the threat of physical violence.11 Moreover, some studies have found that harassment and sexual abuse contributes to low female enrollment rates and high dropout rates from secondary schools.12 The health consequences of VAW are significant, with many victims suffering from severe physical and mental health consequences--both immediate and long-term. Numerous studies have found that women and girls who experience violence have an increased risk of poor physical and reproductive health.13 The physical health impacts of VAW can be divided into two categories--immediate and functional. Immediate consequences directly result from acts of violence, and may include fractures, gunshot wounds, bruises and lacerations, and death. Functional consequences, also referred to as "functional disorders,"14 include long-term health consequences. Researchers have linked these functional impacts to long-term physical or sexual abuse. They include gastrointestinal disorders, chronic pain (including pelvic pain), chronic urinary tract infections, and irritable bowel syndrome. (For more information on the health consequences of VAW, see the "Global Health" section.) World Health Organization (WHO) multi-country surveys estimate that between 10% and 69% of women have been physically hit or harmed by a male partner at some point in their lives.15 The WHO surveys found that levels of violence tend to vary by country, and that women in developing countries may experience higher rates of violence than those in developed countries.16 10 Eleanor Lyon, "Welfare and Domestic Violence Against Women: Lessons from Research, National Online Resource Center on Violence Against Women, August 2002, pp. 49, 50. 11 U.N. document, A/61/122/Add.1, July 6, 2007. 12 These findings resulted from a qualitative study in Ethiopia. For more information, see Unsafe Schools: A Literature Review of School-Related Gender-Based Violence in Developing Countries, Wellesley Centers for Research on Women (with the support of USAID), September 2003. 13 See, for example, U.N. document, A/61/122/Add.1, In-depth Study on all Forms of Violence Against Women: Report of the Secretary-General, July 6, 2007, and Summary Report: WHO Multi-Country Study on Women's Health and Domestic Violence Against Women, Initial Results on Prevalence, Health Outcomes and Women's Responses, World Health Organization, 2005. 14 For further information on the functional health consequences of VAW, see "Researching Violence Against Women: A Practical Guide for Researchers and Activists," by Mary Ellsberg and Lori Heise, World Health Organization, 2005, pp. 18-24. 15 These data are based on 48 international population-based surveys conducted between 1982 and 1999. For more information, see World Report on Violence and Health, WHO, 2002, pp. 89-90. 16 Ibid. In Japan, for example, data indicated that women were less likely to have experienced physical or sexual abuse. Surveyed women with the greatest risk of violence were from rural areas in Bangladesh, Ethiopia, Peru, and Tanzania. (continued...) ¢ Some research indicates that approximately one in five women experiences rape or attempted rape during her lifetime.17 Surveys in some Asian and sub-Saharan African countries have found high female mortality rates due to female infanticide and nutritional neglect of young girls.18 Many incidences of violence are not reported because of the shame and fear associated with being a victim. Experts generally agree that current levels of violence reported through studies and national and local law enforcement records represent a minimum of actual VAW cases. Rates of sex trafficking, sexual violence in armed conflict situations, female infanticide, and violence in schools and the workplace, for example, are thought to be significantly under-documented, particularly in developing countries.19 Underreporting may occur because victims view violence as normal or expected behavior. Additionally, in certain circumstances it is difficult for researchers to collect data on VAW prevalence. In conflict situations, for example, potentially dangerous and fluid conditions may affect the ability of researchers to gain access or create conditions conducive to victims coming forward. In addition, some communities, particularly those in developing countries, lack adequate law enforcement infrastructure and reporting services, which may discourage women from reporting abuse.20 VAW can occur in the home as well as in public and private institutions, including the workplace, schools, universities, and state institutions. Custodial VAW, which includes violence in prisons, immigration detention centers, social welfare institutions, and jails, is reported in many areas of the world--though there is not enough to data to quantify its prevalence globally.21 Moreover, VAW in schools, which can be perpetrated by teachers, administrators, and students, is prevalent in developing countries, particularly those in Africa, the Middle East, South Asia, and Latin America.22 In Ecuador, for example, a World Bank study found that approximately 22% of women reported being sexually abused in school.23 A qualitative study in Ethiopia found that harassment and sexual abuse contributed to low female enrollment rates and high dropout rates from secondary school.24 (...continued) See Summary Report: WHO Multi-Country Study on Women's Health and Domestic Violence Against Women, Initial Results on Prevalence, Health Outcomes and Women's Responses, World Health Organization, 2005, pp. 5-7. 17 State of the Wold Population--2005, U.N. Population Fund (UNFPA), p. 67, available at http://www.unfpa.org/swp/ 2005/english/ch7/index.htm, and U.N. Violence Against Women Fact Sheet, February 2008, available at http://endviolence.un.org/docs/VAW.pdf. 18 See, for example, Amartyna Sen, "Many Faces of Gender Inequality," Frontline (India's National Magazine from the Publishers of The Hindu), vol. 18, issue 22, October 27-November 9, 2007, available at http://www.globalpolicy.org/ socecon/inequal/gender/2001/11sengender.pdf. 19 U.N. document, A/61/122/Add.1, July 6, 2007, pp. 66-67. 20 "Violence Against Women: A Statistical Overview, Challenges and Gaps in Data Collection and Methodology and Approaches for Overcoming Them," by Sharmeen A. Farouk, Expert Group Meeting of the U.N. Division for the Advancement of Women, April 11-14, 2005. 21 See U.N. document, A/61/122/Add.1, July 6, 2007, p. 44. 22 See Unsafe Schools: A Literature Review of School-Related Gender-Based Violence in Developing Countries, Wellesley Centers for Research on Women (with the support of U.S. Agency for International Development), September 2003. 23 Ibid. 24 Ibid. ¢ ¢ Violence against women can include both random acts as well as sustained abuse over time, which can be physical, psychological, or sexual in nature (see Table 1).25 Some studies have found that women are most likely to experience violence at the hands of someone they know, including authority figures, parents, sons, husbands, and male partners. Studies conclude that one of the most common forms of VAW is intimate partner violence, which can include forced sex, physical violence, and psychological abuse, such as isolation from family and friends.26 nemoW tsniagA ecneloiV fo selpmaxE .1 elbaT egatS efiL selpmaxE erac lacidem dna doof ot ssecca laitnereffid ;esuba lacisyhp dna lacigolohcysp ;edicitnafnI ycnafnI ,doof ot ssecca laitnereffid ;esuba lacigolohcysp ;esuba lauxes dna tsecni ;gnittuc latineg elameF doohdlihC ecneloiv desab-redneg detaler-loohcs ;gnikciffart ;noitutitsorp ;noitacude dna ,erac lacidem lauxes ;epar ;ecalpkrow eht ni esuba lauxes ;xes decreoc yllacimonoce ;ecneloiv pihstruoc dna gnitaD ecnecselodA ;esuba yrwod ;egairram decrof ;esuba lacigolohcysp ;gnikciffart ;noitutitsorp decrof ;tnemssarah srehto fo semirc eht rof noitubirter lacigolohcysp ;edicimoh rentrap ;sgnillik ronoh ;esuba yrwod ;epar latiram ;esuba rentrap etamitnI evitcudorpeR gnikciffart ;noitutitsorp decrof ;seitilibasid htiw nemow fo esuba ;ecalpkrow eht ni esuba lauxes ;esuba tcelgen ;epar ;esuba ylredle ;esuba wodiW ega dlO ,repaP noissucsiD knaB dlroW ,esieH .L yb ,nedruB htlaeH neddiH ehT :nemoW tsniagA ecneloiV :ecruoS .ecivreS hcraeseR lanoissergnoC eht yb deifidom ,4991 ,CD ,notgnihsaW There are many different types of violence against women. Honor killings, for example, occur when women are stoned, burned, or beaten to death, often by their own family members, in order to preserve the family honor.27 The practice is most common in Middle Eastern and South Asian countries, though it has been reported in other parts of the world, such as Latin America and Africa.28 Dowry-related violence, where victims might be attacked or killed by in-laws for not bringing a large enough dowry to the marriage, is also prevalent in South Asian countries such as Pakistan, India, and Bangladesh.29 Female genital cutting (FGC), which has also been referred to as female genital mutilation (FGM) or female circumcision, is common in some African and Middle Eastern countries. The World Health Organization estimates that between 100 and 140 million women and girls have undergone a form of the procedure, and that about 3 million girls 25 Examples of random acts of VAW include isolated incidents such as a stranger attacking a woman because of her gender, or isolated acts of abuse within the family. An example of VAW as sustained abuse over time includes repeated physical and psychological abuse of a woman during the course of an intimate partner relationship, or a family relationship (i.e., father-daughter, mother-son, sister-brother). 26 Charlotte Watts, Cathy Zimmerman, "Violence Against Women: Global Scope and Magnitude," The Lancet, vol. 359, issue 9313, April 6, 2002, p. 1232. 27 Suspicions that a woman has been raped, is pregnant by a man other than her partner, or has had an extramarital or pre-marital affair may lead to such killings. 28 "Culture of Discrimination: A Fact Sheet on Honor Killings,"Amnesty International, July 25, 2005, available at http://www.amnestyusa.org/women/pdf/honorkillings.pdf. 29 As is the case with honor killings, it is difficult to estimate the incidences of dowry-related violence because many of the deaths are labeled as accidental. Though India has passed (and twice amended) a Dowry Prohibition Law, many say that the problem continues. For more information, see page 91 of Ending Violence Against Women: A Challenge for Development and Humanitarian Work, by Francine Pickup, Oxfam GB, 2001. ¢ are at risk each year.30 Some consider child and adolescent marriage, which is particularly prevalent in parts of the Middle East and Africa, to be a form of violence against women. In such cases, girls as young as 10 and 12 years old may be married to older men, often with the approval of their parents.31 Some research indicates that these child brides may face a greater risk of violence.32 Traditional practices are part of local cultures and are generally considered socially acceptable; in some cases, they are encouraged by family members and the community. Many experts maintain that some of these practices are damaging to women. They argue that these "harmful traditional practices," including FGC, intimate partner violence, and child marriage, perpetuate unbalanced sex stereotypes and a cycle of violence. What constitutes a harmful traditional practice, however, is a matter of perspective. In some cultures, for instance, both men and women may view violence as a legitimate punishment for female disobedience and as a traditional part of male- female relationships.33 Moreover, some women may not view forced marital sex as rape, or may endure frequent beatings from their husbands, fathers, sons or boyfriends because of cultural or familial legacies. In addition, some do not view child marriage as a harmful traditional practice-- instead they see it as a cultural tradition that should be respected. In recent years, some international advocates have increasingly argued that harmful traditional practices should be addressed through anti-VAW programs.34 They maintain that anti-VAW efforts should focus not only on treatment and services for victims of violence, but also on eliminating harmful traditional practices. Because some of these practices are often a part of a community's culture, however, programs that introduce treatment and services may meet resistance. Some experts argue that harmful traditional practices cannot be significantly altered without sustained, long-term efforts on the local level with national and international support. Finding the most appropriate balance and means of intervention is a challenge that highlights a broader debate-- with human rights and individual freedom on the one hand, and the right to preserve culture, group identity, and tradition on the other. 30 "Eliminating Female Genital Mutilation: An Interagency Statement," World Health Organization, 2008, p. 4, available at http://www.who.int/reproductive-health/publications/fgm/fgm_statement_2008.pdf. For more information, see CRS Report RS21923, Female Genital Mutilation (FGM): Background Information and Issues for Congress, by Tiaji Salaam-Blyther, Erin D. Williams, and Ruth Ellen Wasem, and CRS Report RS22810, Asylum Law and Female Genital Mutilation: Recent Developments, by Yule Kim. 31 Some have estimated that 163 million girls in developing countries between the ages of 10 and 19 will be married by their 20th birthday (excluding China). For more information, see "International Women's Health Coalition Fact Sheet," October 31, 2005, available at http://www.iwhc.org/docUploads/ChildMarriageFactsheet.pdf. 32 For more information, see "A World Apart: The Disadvantage and Social Isolation of Married Adolescent Girls," by Nicole Haberland, Erica Chong, Hillary Bracken, The Population Council, July 2004, p. 5. 33 Violence Against Women: A Priority Health Issue, July 1997, available at http://www.who.int/gender/violence/en/ v5.pdf. 34 See "Taking A Stand Against Practices that Harm Women," U.N. Population Fund, available at http://www.unfpa.org/gender/practices.htm; U.N. document EGM/DVGC/2006/EP.4, The Impact of Harmful Traditional Practices on the Girl Child, prepared by Berhane Ras-Work, U.N. Division for the Advancement of Women, September 2006; and "Harmful Traditional and Cultural Practices Related to Violence Against Women and Successful Strategies to Eliminate Such Practices--Working with Men," by Dr. Michael Flood, U.N. Economic and Social Commission for Asia and the Pacific Expert Group Meeting, April 26-27, 2006. ¢ The George W. Bush Administration expressed its support for programs addressing international VAW. In 2007, then-Secretary of State Condoleezza Rice stated that combating VAW was a foreign policy priority.35 The Administration did not pursue an overall policy focused on VAW alone, although it initiated several government-wide programs with VAW prevention, treatment, and protection components.36 These components existed primarily in the context of a program's broader mission and often represented a small fraction of the budgets for these programs. This was particularly true for the President's Plan for HIV/AIDS Relief (PEPFAR), and the Middle East Partnership Initiative (MEPI). Other Bush Administration initiatives with VAW components included the Women's Justice and Empowerment Initiative (WJEI), and an initiative to respond to ongoing and widespread violence against women and girls in Darfur, Sudan.37 Most agencies do not track the cost or number of current anti-VAW programs; therefore, it is unclear how much money the U.S. government, or individual agencies, spends annually on anti- VAW programs. The U.S. Agency for International Development (USAID) and the Department of State (DOS) are the primary U.S. entities that implement U.S. international anti-VAW programs.38 Other agencies and departments that support some programs with anti-VAW components include the Departments of Defense (DOD), Health and Human Services (HHS), Justice (DOJ), and Labor (DOL). The Department of Homeland Security (DHS) and the Peace Corps also address aspects of violence against women.39 (See 0 for a list of selected U.S. offices and bureaus that have anti-VAW programs.) In March 2007, U.S. agencies and departments provided information to CRS on programs that address international VAW either in whole or in part. Approximately 350 U.S. government programs with VAW components across eight agencies have been identified.40 Capturing the overall U.S. government response to VAW is complicated by the number of programs, the degree 35 Department of State cable from the Secretary of State to all diplomatic and consular posts (unclassified 142614), "Message from the Secretary--Taking Action on Violence Against Women," October 7, 2007. 36 In some instances, the Bush Administration sought to address specific aspects of VAW through international organizations such as the United Nations. The Administration did not, however, request funding for U.N. mechanisms that address VAW, including the U.N. Trust Fund in Support of Actions to Eliminate Violence Against Women. From FY2005 to FY2008, Congress appropriated funding to the Trust Fund without an Administration request. 37 For more information on PEPFAR activities related to VAW, see the "Global Health" section. For information on WJEI and MEPI, see the "Legal and Political Rights" section. For further information on the Sudan initiative, see the "Humanitarian Assistance and Refugees" section. The Bush Administration also expressed support for international efforts to combat VAW, including an International Day for the Elimination of Violence Against Women (November 25), and 16 Days of Activities on Gender-Based Violence (November 25-December 10). 38 Both of these entities support offices that work to coordinate women's issues. The USAID Bureau for Economic Growth, Agriculture, and Trade includes the Office of Women in Development; see http://www.usaid.gov/our_work/ cross-cutting_programs/wid/. The State Department Office of the Under Secretary for Democracy and Global Affairs includes the Office of International Women's Issues; see http://www.state.gov/g/wi/. 39 DHS, for example, trains its asylum officers on gender issues. Trainees receive a 42-page lesson plan entitled "Female Asylum Applicants and Gender-Related Claims." The lesson addresses guidelines and policies for several VAW issues, including rape, FGC, domestic violence, and forced marriage. In addition, Peace Corps volunteers may be involved in violence prevention efforts related to domestic violence, trafficking, rape, and familial relations. The Peace Corps supports these activities in over 35 countries. 40 This number includes international anti-trafficking projects obligated in FY2006. The results are based on the first set of agency/departments submissions. Agencies and departments surveyed by CRS include DOS, USAID, DOL, DOJ, HHS, DOD, DHS, and Peace Corps. ¢ to which they focus on VAW or are part of a larger initiative, and overlaps in program budget allocations. Thus, it is possible to generate only a snapshot of activities rather than an all- inclusive list. The information provided to CRS indicated that funding levels for individuals programs in FY2006 and FY2007 ranged from $10,000 to $15 million; in many cases, the anti- VAW component included only a small portion of total program funding. Of these reported programs, approximately 10% operated globally, 22% in Africa, 21% in Europe/Eurasia, 17% in the Western Hemisphere, 14% in South/Central Asia, 14% in East Asia/the Pacific, and 2% in the Near East.41 ¢ U.S. agencies and departments participate in formal and informal intra- and interagency working groups that address aspects of international violence against women. The State Department/USAID informal Women's Justice Issues Working Group, for example, has focused on GBV as part of its activities.42 The USAID Bureau of Global Health collaborates with a network of NGOs through the Interagency Gender Working Group (IGWG), which identifies GBV as a priority.43 The PEPFAR interagency Gender Technical Working Group addresses the links between HIV/AIDS and gender.44 Moreover, U.S. anti-trafficking efforts are coordinated at the cabinet level by the President's Interagency Task Force to Monitor and Combat Trafficking (PITF), which is chaired by the Secretary of State. The PITF meets annually to coordinate broad U.S. anti-trafficking in persons (TIP) policy. The interagency Senior Policy Operating Group (SPOG) meets quarterly to carry out PITF initiatives and to discuss TIP policy and programming issues.45 ¢ This section describes key VAW issues and discusses examples of related U.S. activities across agencies and departments.46 Because the U.S. government does not track anti-VAW programs and funding, it is difficult to determine the extent to which a U.S. initiative, program, or project addresses violence against women. Therefore, the descriptions of U.S. anti-VAW activities in this section are largely anecdotal and, in many cases, implemented only in the context of broader development efforts. This section does not assess the scope of individual programs, or a 41 These programs represent only a portion of U.S. programs addressing VAW overseas. CRS relied on U.S. agencies and departments to provide information on programs, and continues to receive input from agency representatives. This regional breakdown is based on the State Department regional guides, available at http://state.gov/countries. 42 This group is led by the State Department Office of International Women's Issues and functions mainly as an internal State/USAID information sharing mechanism. The group was created in April 2007 and has met twice. It has no regular meeting schedule. 43 More information the IGWG's gender-based violence activities is available at http://www.igwg.org/priorityareas/ violence.htm. 44 For more information on the Working Group, see The President's Emergency Plan for AIDS Relief, Report on Gender-Based Violence and HIV/AIDS, November 2006, available at http://www.state.gov/documents/organization/ 76447.pdf. 45 Both SPOG and PITF are required by the Trafficking Victims Protection Act of 2000 (P.L. 106-386; Division A). For more information, see the "Trafficking in Women and Girls" section. 46 These U.S. activities are based on information shared with CRS by U.S. government entities. ¢ program's success in achieving its goal. (For more information, see the "Policy Considerations for Congress" section.) The physical and psychological health impacts of VAW are wide-ranging. VAW may lead to miscarriage or the transmission of sexually transmitted diseases, including HIV/AIDS. Women who become pregnant as a result of rape may be more likely to undergo unsafe abortions, attempt suicide, or be beaten or killed by their partner.47 In some cultures, an unmarried woman's unintended pregnancy may trigger social isolation from family and friends. Women may also be killed by their spouses or other family members--though there is limited data on the frequency of this phenomenon.48 Moreover, when young girls are forced to marry and become sexually active and pregnant, often through coercion, they may experience complications during pregnancy that can result in death or long-term health problems such as obstetric fistula.49 VAW can cause psychological issues that may manifest physically. Women who are abused are more likely to use drugs and alcohol, attempt suicide, and suffer from nervous system disorders and post-traumatic stress syndrome.50 A 2007 study found that 59% of women who were abused in the previous year suffered from psychological problems, compared with 20% of women who did not experience any abuse.51 Moreover, victims of rape, intimate partner violence, and child sex abuse were found to experience a higher level of post-traumatic stress than victims of other types of violence.52 According to the U.N. Population Fund (UNFPA), rape victims were nine times more likely to attempt suicide than non-victims.53 47 It has been suggested that a woman's fear of experiencing violence at the hand of her sexual partner may make her less likely to discuss or request contraceptives. A study in Colombia found that women who suffered from intimate partner violence were more likely to have unintended pregnancies. See "Relationship Between Intimate Partner Violence and Unintended Pregnancy: Analysis of a National Sample from Colombia," International Family Planning Perspectives, vol. 30, no. 4, December 2004, pp. 165-173. 48 The prevalence of women who are killed by their families is unknown because in many cases their deaths are considered accidental or not reported. In addition, data on female deaths due to violence might be misreported because of indirect factors. A victim of rape might contract HIV/AIDS, for example, but in the event of her death, the cause would likely be attributed to AIDS rather than violence. 49 Obstetric fistula, a hole between the vagina and bladder or rectum through which urine or feces continually leaks, is often caused by prolonged labor. Fistula survivors are constantly soiled and can be paralyzed from nerve damage. The condition occurs mostly in Africa and Asia because of limited availability of birth attendants. For more information, see CRS Report RS21773, Reproductive Health Problems in the World: Obstetric Fistula: Background Information and Responses, by Tiaji Salaam-Blyther. 50 "Researching Violence Against Women: A Practical Guide for Researchers and Activists," by Mary Ellsberg and Lori Heise, World Health Organization, 2005, pp. 18-24. Also see "Intimate Partner Violence Prevention Scientific Information: Consequences" from the Department of Health and Human Services website, available at http://www.cdc.gov/ncipc/dvp/IPV/ipv-consequences.htm. 51 U.N. document, A/61/122/Add.1, July 6, 2007, p. 48. This study was undertaken in Michigan, United States. 52 Ibid. 53 Lynne Stevens, "A Practical Approach to Gender-Based Violence: A Programme Guide for Health Care Providers and Managers," U.N. Population Fund, 2001, New York, p. 4. ¢ USAID and HHS support the majority of U.S. health-related VAW prevention and treatment programs abroad, though other agencies or departments, particularly the State Department, support and provide health services.54 The President's Emergency Plan for AIDS Relief (PEPFAR), a five-year, $15 billion government-wide initiative to address HIV/AIDS globally, allocates some resources to mitigating the health consequences of violence against women. According to The President's Emergency Plan for AIDS Relief Report on Gender-Based Violence and HIV/AIDS, $104 million in PEPFAR funds supported 243 activities with a GBV component in FY2006. The report did not explain what constituted a GBV component.55 The U.S. President's Emergency Plan for AIDS Relief 2009 Annual Report to Congress does not address how much funding is specifically allocated to combating GBV. It states, however, that in FY2008 PEPFAR spent $1 billion on activities that included a gender focus. According to the report, 407 of these activities addressed violence and coercion.56 Many of USAID's health programs that address aspects of VAW prevention and response are supported by the Bureau of Global Health (GH) and implemented by regional and country missions.57 GH includes the Office of Population and Reproductive Health (PRH) and the Office of HIV/AIDS (OHA). PRH offers strategies to raise awareness about intimate partner violence and its impact on maternal and reproductive health. Several OHA activities educate audiences on how sexual violence and coercion can spread HIV/AIDS. According to USAID, OHA programs also advocate against sexual abuse, provide access to services for rape survivors, and teach women how to negotiate safe sex. Moreover, USAID addresses FGC prevention, awareness, and treatment at a variety of levels. USAID missions in Ethiopia, Egypt, Kenya, and Guinea, for example, support female genital cutting (FGC) prevention activities. In 2004, GH adopted a strategy to deter FGC that targets countries for continued and future support.58 USAID also focuses on strengthening prevention and treatment services for obstetric fistula.59 HHS supports some international programs that facilitate the collection and analysis of data and demographic surveys that measure the impact of violence on health--particularly reproductive health. The Centers for Disease Control's (CDC's) Monitoring and Evaluation to Assess and Use Results (MEASURE) program, for example, works with USAID country and regional missions to develop, implement, and analyze national reproductive health surveys that provide population- based data on reproductive health indicators, including the prevalence of violence against 54 The State Department Bureau of Population, Refugees, and Migration (PRM), for example, offers physical and psychological health services to some refugees and internally displaced persons. 55 See The President's Emergency Plan for AIDS Relief, Report on Gender-Based Violence and HIV/AIDS, November 2006, available at http://www.state.gov/documents/organization/76447.pdf. 56 U.S. President's Emergency Plan for AIDS Relief 2009 Annual Report to Congress, available at http://www.pepfar.gov/documents/organization/113827.pdf. 57 For a list of USAID missions, see http://www.usaid.gov/locations/missiondirectory.html. 58 Egypt, Ethiopia, Eritrea, Guinea, Kenya, Mali, and Sudan have been identified for future support. The USAID FGC Strategy adopted by GH is available at http://www.usaid.gov/our_work/global_health/pop/techareas/fgc/ fgc_strategy.pdf. For more information on USAID efforts to combat FGC, see http://www.usaid.gov/our_work/ global_health/pop/techareas/fgc/. 59 The USAID Fistula Care program is a five-year, $70 million initiative to strengthen the capacity of hospital centers to provide fistula repair, raise community awareness, and enhance research efforts to improve fistula services. For more information, see http://www.usaid.gov/our_work/global_health/mch/mh/news/fistula_award07.html. ¢ women.60 CDC's National Center for Injury Prevention and Control (NCIPC) works with partners, including the U.N. Children's Fund (UNICEF), to provide technical assistance on data collection, assess patterns of VAW and children, and examine possible prevention strategies and policies to address violence.61 HHS has also worked with WHO to build regional frameworks in three countries for VAW prevention.62 Furthermore, as a PEPFAR implementing partner, CDC's Global AIDS Program supports prevention and response programs to address the relationship between VAW and HIV. The programs include HIV post-exposure prophylaxis (PEP) in clinical settings for survivors of sexual violence;63 strengthening linkages among health, community, and legal services that provide protection and care for victims; and HIV prevention programs that focus on VAW prevention.64 During humanitarian crises and armed conflict (or occupation), populations become vulnerable to an array of threats--including VAW--and often lack protection from their governments, communities, and families. This underscores reports that levels of VAW increase during conflict and remain a large risk in the aftermath of upheaval in post-conflict areas or during the emergency phase following a natural disaster.65 Rape and other forms of sexual abuse reported during periods of armed conflict are common and in some cases may be systematic.66 Those who are displaced--IDPs and those attempting to return home (returnees)--often lack protection and remain vulnerable, sometimes for years.67 The U.N. High Commissioner for Refugees (UNHCR) estimates that in the majority of refugee situations worldwide, close to 50% of the displaced are women and girls and that sexual violence is one of the most common crimes committed against refugees.68 60 Some countries use MEASURE data to evaluate current health programs and interventions, assess reproductive health status, inform policy, and build national research capacity. CDC's Division of Reproductive Health is currently implementing MEASURE in Paraguay, Ecuador, Nicaragua, Georgia, and Jamaica. For more information, see http://www.cdc.gov/reproductivehealth/Surveys/SurveyTechAssist.htm. 61 The data are used to assess sexual violence patterns and identify areas for further research. 62 The CDC/NCIPC Division of Violence Prevention, for example, entered into a cooperative agreement with the WHO to launch a framework through pilot programs in three low and middle-income countries. For more information, see http://www.cdc.gov/ncipc/dvp/international.htm. 63 PEP, as defined by the WHO, is a short-term antiretroviral treatment to reduce the likelihood of HIV infection after potential exposure, either occupationally or through sexual intercourse. For more information, see http://www.who.int/ hiv/topics/prophylaxis/en/. 64 Some programs also include couples counseling and HIV testing, as well as support for community and faith-based organizations to change social norms that perpetuate male violence against women. 65 Guidelines for Gender-Based Violence Intervention in Humanitarian Settings: Focus on Prevention of and Response to Sexual Violence in Emergencies, U.N. Interagency Standing Committee (IASC), September 2005. 66 Available data on the prevalence of such cases are unreliable because of constantly shifting populations, unstable circumstances in conflict zones, and social stigmas associated with rape. For a discussion of sexual violence and armed conflict, see briefing paper by Jeanne Ward and Mendy Marsh, "Sexual Violence Against Women and Girls in War and its Aftermath: Realities, Responses, and Required Resources," June 2006. 67 Care for refugees and internally displaced persons is needed in all phases of the refugee and displacement cycle-- during conflict, during flight from conflict, in the country of asylum or location of displacement, and during repatriation and reintegration. Durable solutions usually involve one of three options: voluntary return, local integration, or resettlement. 68 Sexual Violence Against Refugees: Guidelines on Prevention and Response, UNHCR, 1995, available at http://www.unhcr.org/publ/PUBL/3b9cc26c4.pdf. ¢ Other forms of VAW, such as sexual exploitation and "survival sex" (when a person engages in sex in exchange for money or material assistance as a means of survival), domestic violence, and traditional practices that prove harmful, occur with frequency. In addition, long periods of displacement and frustration can lead to VAW within families and communities. In such insecure environments, the high degree of fear, lawlessness, and lack of judicial procedure and enforcement means that many perpetrators are not prosecuted or punished. Often, survivors are left with little recourse and suffer related problems such as emotional and physical health risks, unwanted pregnancies, HIV infection, and rejection by family. In some cases, humanitarian and peacekeeping workers themselves are perpetrators, not the deterrent force, of violence against women.69 VAW is also a documented problem in conflict settings such as Darfur, Sudan, Chad, and the Democratic Republic of the Congo (DRC).70 Members of the international community--including governments, international organizations, NGOs, and others--work on collaborative and separate initiatives to develop prevention and response strategies to protect vulnerable populations, particularly women and girls.71 These projects are undertaken with an eye toward strengthening the protection of displaced women and promoting gender equality.72 Many experts view increasing the capacity of states and host communities as a priority for implementing sustained, effective measures. U.S. activities addressing VAW in humanitarian and refugee settings are often incorporated into other refugee programs and activities, including basic humanitarian services, treatment, and education. Because of this, it is a challenge to determine the total number and scope of U.S. activities that address VAW in refugee settings. As the issue has gained attention, however, VAW has in some instances become the main focus of specific programs.73 In the humanitarian sector, the U.S. government's response to VAW comes from the State Department's Bureau for Population, Refugees and Migration (PRM), and USAID's Bureau for Democracy, Conflict, and Humanitarian Assistance through its Office of Foreign Disaster Assistance (OFDA) and Office of Transition Initiatives (OTI).74 USAID missions may also be involved at the regional and country level.75Implementing partners include several actors, including U.N. agencies, such as UNHCR, 69 See U.N. documents: A/59/782, October 11, 2002, Investigation into Sexual Exploitation of Refugees by Aid Workers in West Africa, and A/60/861, May 24, 2006, Special Measures for Protection from Sexual Exploitation and Sexual Abuse. 70 In the Democratic Republic of the Congo, the International Committee for the Red Cross provide support to victims of sexual violence perpetrated by armed groups. 71 FY2006 PRM funding for Prevention and Response to Gender-Based Violence, and CRS discussions with PRM, October 2007. Also see Department of State, Migration and Refugee Assistance, Emergency Refugee and Migration Assistance, FY2009, Congressional Presentation Document. 72 Ibid. 73 In FY2006, for example, PRM supported a program in Thailand that worked to improve community-based services addressing gender-based violence among refugees in the Mae Hong Song province (FY2006 funding: $283,501). PRM also supported a sexual abuse and exploitation prevention program in Liberia (FY2006 funding: $167,156) and a program in Tanzania that provides legal, medical, counseling, and other services to gender-based violence survivors (FY2006 funding: $103,668). Both of these programs were funded under the Migration and Refugee Assistance (MR) account. 74 For more information, see CRS Report RL33769, International Crises and Disasters: U.S. Humanitarian Assistance, Budget Trends, and Issues for Congress, by Rhoda Margesson. 75 See also USAID's "Internally Displaced Persons (IDPs) and Protection Programs," Fact Sheet #1, FY2007, November 2006. ¢ and international organizations, such as the International Organization for Migration (IOM), and many NGOs, including the American Refugee Committee and the International Rescue Committee. PRM began addressing VAW through its refugee assistance programs in FY2000. Since then, it has provided nearly $28 million toward programming for refugee and IDP populations. In FY2006, it provided approximately $4.4 million to support VAW-related activities. (This represents roughly .5% of total Migration and Refugee Assistance account actual funding in FY2006, which was $858.79 million.)76According to PRM, the 2006 projects built local capacity among Afghan refugee populations in Pakistan, reduced incidences of sexual violence among returnees in Burundi, prevented sexual exploitation and abuse in the Kenya and Liberia refugee programs, and supported programs for VAW survivors in Tanzania.77 PRM has more recently been discussing VAW preventive measures in the context of the massive Iraqi population displacement.78 In FY2007 and FY2008, USAID supported a number of programs, including projects in Liberia to address and raise awareness about sexual exploitation and violence; technical evaluations of energy efficient stoves in Uganda and Darfur to help reduce women's exposure to sexual abuse while traveling long distances to find firewood; and support for health and livelihood recovery programs in the Democratic Republic of the Congo, Sri Lanka, and Kenya. In addition, a $15 million initiative in Darfur, Sudan, focused on improving the physical safety of vulnerable populations, some of which benefited women.79 Other reported activities include establishing emergency protection-sensitive shelter in IDP camps and schools, educational activities, counseling, and case management. Most projects were funded through small grants to local community-based organizations and larger humanitarian assistance programs implemented by international NGOs. ¢ The issue of VAW awareness training and education for foreign military and peacekeeping troops was brought to the fore by events in the Democratic Republic of the Congo in 2004. Cases of sexual exploitation and abuse (SEA) by U.N. peacekeepers had been documented in the 1990s and early 2000s in Bosnia and Herzegovina, Kosovo, Cambodia, East Timor, and West Africa.80 After a special review of the situation, then-U.N. Secretary General Kofi Annan recommended 76 CRS requested FY2008 funding information on PRM VAW-related activities. The information has not yet been received, and will be added to this report as it becomes available. 77 For more information on Afghan Refugees, see CRS Report RL33851, Afghan Refugees: Current Status and Future Prospects, by Rhoda Margesson. 78 For more information, see CRS Report RL33936, Iraqi Refugees and Internally Displaced Persons: A Deepening Humanitarian Crisis? by Rhoda Margesson, Jeremy M. Sharp, and Andorra Bruno. 79 USAID OTI leads this initiative to enhance the safety and basic rights of vulnerable civilians, particularly women, affected by conflict in Darfur. According to USAID, this initiative works to minimize women's exposure to violence, monitor and document violence, and increase access to victim services. For more information, see http://www.usaid.gov/our_work/cross-cutting_programs/transition_initiatives/country/sudan/fact0107.html. 80 "Fighting Sexual Exploitation and Abuse by U.N. Peacekeepers," by Jonas Hagen, U.N. Chronicle, December 13, 2006, available at http://www.un.org/Pubs/chronicle/2006/webArticles/121306_unp.htm. ¢ that the U.N. Department of Peacekeeping Operations organize intensive training for peacekeepers.81 The Department of Defense provides VAW training and education through a small number of programs. Most of the VAW content in DOD programs for international students is incorporated into programs for peacekeepers and military forces participating in disaster and humanitarian relief operations. Funding for the VAW-related components of these programs is generally incorporated into the overall program budgets and not separably identifiable. The U.S. Global Peace Operations Initiative (GPOI), for example, trains foreign peacekeepers and incorporates VAW and SEA content in its training exercises.82 Three of GPOI's four regional components, Africa, Western Hemisphere, and Asia, reported VAW content in their training, and the African program is considering expanding its VAW training.83 VAW topics are incorporated into curricula at some DOD educational and training institutions. The DOD-funded Center of Excellence in Disaster Management and Humanitarian Assistance (CoE-DMHA), for example, reports a broad and apparently growing number of training and education modules on VAW and SEA.84 These programs--sometimes funded through DOD accounts, sometimes by the Department of State--are offered throughout the world to foreign government personnel, including civilians, military, and police, as well as NGOs. Similarly, DOD's Defense Institute of International Legal Studies (DIILS), which trains and educates military personnel and civilian government officials on international legal issues, offers a one- hour module related to gender-based violence in a resident course on conducting military and peacekeeping operations.85 DIILS also incorporates gender-based violence issues in mobile courses, and has addressed VAW in occasional special courses prepared, on request, for foreign militaries. For instance, in 2008, DIILS conducted 12 separate week-long seminars on Investigation and Prosecution of Sex Crimes for the Democratic Republic of Congo (DRC) armed forces.86 81 Letter dated March 24, 2005, from the Secretary-General to the President of the General Assembly. U.N. document A/59/710, March 24, 2005. For more information on U.N. peacekeeping, see CRS Report RL33700, United Nations Peacekeeping: Issues for Congress, by Marjorie Ann Browne. 82 According to the State Department, GPOI aims to train some 75,000 foreign troops in peacekeeping skills by the end of 2010. The program is funded through the State Department's Peacekeeping account (PKO) and is administered by the State Department Bureau of African Affairs (the Sub-Saharan Africa component). Some 96% of the more than 28,000 troops trained through March 2007 were from African nations, and the program is attempting to diversify by incorporating troops from other areas. For more information, see http://www.state.gov/t/pm/ppa/gpoiteam/gpoi/. 83 The Center for Excellence for Police Stability Units (CoESPU) in Italy--which receives GPOI funding and currently has a U.S. military officer as its Deputy Director--also reports an hour of SEA content in its five and six week programs for civilian police trainers. 84 CoE-DMHA offers several education and training programs designed to promote effective civil-military management in international humanitarian assistance, disaster response, and peacekeeping. More information is available at http://www.coe-dmha.org/. 85 DIILS also incorporates gender-based violence issues in mobile courses, and has addressed VAW in occasional special courses prepared on request for foreign militaries. The Western Hemisphere Institute for Security Cooperation, a DOD school which provides professional education and training for civilian, military, and law enforcement students from nations in the Western Hemisphere, also addresses issues related to VAW in its human rights course. 86 These seminars, held in Kinshasa and eight interior locations, were attended by investigators and magistrates of the DRC armed forces' military justice system. For 2009 and 2010, DIILS plans to include one to two hours of instruction related to sexual violence in seminars for operational commanders and staff officers of the DRC armed forces. CRS (continued...) ¢ In recent years, Congress has worked to incorporate VAW awareness into foreign military training. The Foreign Operations, Export Financing, and Related Programs Appropriations Act, 2006, required that training on gender-based violence be included, where appropriate, as a component of programs funded through bilateral assistance and military assistance accounts.87 These accounts include funding for the education and training of foreign military and civilian defense personnel. The Foreign Operations appropriations section of the Consolidated Appropriations Act, 2008, also includes the provision.88 Trafficking in women and girls is a high-profile form of violence against women. It gained attention in the United States and worldwide in the late 1990s, and is considered by many experts to be one of the leading criminal enterprises of the early 21st Century. Female victims of trafficking are often subjected to physical and mental abuse in order to keep them in servitude, including beating, rape, starvation, forced drug use, confinement, and seclusion. Victims may be forced to have sex, often unprotected, with large numbers of partners, and to work unsustainably long hours. Studies have found that trafficking occurs in every country and disproportionately affects women and girls. The International Labor Organization (ILO) estimates women and girls account for 56% of victims in forced economic exploitation, such as domestic service, agricultural work, and manufacturing--and 98% of victims in forced commercial sexual exploitation.89 The vulnerability of women and girls is due to a number of factors in source, transit, and destination countries.90 Many experts conclude that a country is more likely to become a source of human trafficking if it has recently experienced political upheaval, armed conflict, economic crisis, or natural disaster-- phenomena that tend to have a disproportionate impact on women and children. Even in the absence of a major crisis, chauvinistic attitudes and limited educational and job opportunities for (...continued) email correspondence with DIILS, January 27, 2009. 87 Foreign Operations, Export Financing, and Related Programs Appropriations Act, 2006, Section 573, "Programs funded under titles II and III of this Act that provide training for foreign police, judicial, and military officials, shall include, where appropriate, programs and activities that address gender-based violence," (P.L. 109-102; 119 Stat. 229; November 14, 2005). This provision scaled down the provision in the House-passed version of that act (H.R. 3057), which would have required that all police, judicial, and military training funded by the act to include GBV training. 88 See Division J, Section 660: "Programs funded under titles III and IV of this Act that provide training for foreign policy, judicial, and military officials, shall include, where appropriate, programs and activities that address gender- based violence," (P.L. 110-161; 121 Stat. 1844; December 26, 2007). A similar provision was included in the House- passed version of the FY2007 Foreign Operations Appropriations bill (H.R. 5522), but not in the Senate-passed version of the bill. 89 The State Department estimates that between 600,000 and 800,000 people are trafficked across borders each year. If trafficking within countries is included in the total world figures, the State Department estimates that between 2 to 4 million people are trafficked annually; see http://www.state.gov/g/tip/c16467.htm. The International Labor Organization (ILO) estimates that there are some 12.3 million victims of forced labor at any given time. For more information, see A Global Alliance Against Forced Labor, ILO, 2005. 90 While there is no single victim stereotype, many trafficked women are under the age of 25, with many in their mid- to late teens. In Latin America, for example, research indicates that children tend to be trafficked within their own countries, while women between the ages of 18 and 30 are often trafficked internationally, sometimes with the consent of their husbands or other family members. See Laura Langberg, "A Review of Recent OAS Research on Human Trafficking in the Latin American and Caribbean Region," in Data and Research on Human Trafficking: A Global Survey, International Organization for Migration (IOM), 2005. ¢ women and girls in many source countries place them at-risk for trafficking.91 Such circumstances often intersect with other racial, ethnic, and class disparities to make poor and minority women and girls especially vulnerable to trafficking. Families in some of the most impoverished countries have reportedly sold their daughters to brothels or traffickers for the immediate payoff and to avoid having to pay their dowries in the future. In transit and destination countries, female migrant workers are reported to be at particular risk of trafficking and other forms of exploitation because of their subordinate economic status.92 Women and children are also frequently trafficked to work in sweatshops and as domestic servants. The U.S. government supports several types of anti-trafficking in persons (anti-TIP) initiatives overseas, many of which focus on women and girls. However, there is no official record of how many U.S. anti-TIP programs specifically address the trafficking of women and girls. U.S. anti- trafficking policy has long emphasized prevention, protection, and prosecution. As discussed below, prevention programs combine public awareness campaigns with education and employment opportunities for those at-risk of trafficking, particularly women and girls. Protection programs directly support shelters, as well as train local service providers, public officials, and religious groups to identify and protect trafficking victims. Some programs also improve the prosecution rates of traffickers and help countries draft or amend existing anti-TIP laws and train law enforcement and judiciaries to enforce those laws. Many U.S. anti-TIP programs operate under the authority of the Victims of Trafficking and Violence Protection Act of 2000 or TVPA, as amended.93 In FY2007, the U.S. government obligated an estimated $79 million in anti-trafficking assistance to foreign governments. U.S. agencies and departments supported roughly 180 global and regional anti-trafficking programs in 90 countries.94 This is up from $74 million in FY2006. For FY2009, the Administration requested some $31.2 million for trafficking and migrant smuggling programs to be carried out by the State Department and USAID in FY2009. The Trafficking Victims Protection Reauthorization Act of 2005 (TVPRA), P.L. 109-164, authorizes appropriations for anti-TIP programs in FY2006 and FY2007.95 The TVPRA increases support to foreign trafficking victims in the United States, addresses some of the needs of child victims, and directs U.S. agencies to develop anti-trafficking programs for post-conflict situations and humanitarian emergencies abroad. Many U.S. anti-trafficking programs abroad are administered by the State Department, USAID, and the Department of Labor. Since 2001, the State Department has evaluated foreign governments' anti-TIP efforts in its annual Trafficking in Persons report, which is issued each June. In addition, the State Department PRM office funds programs focused on victim's assistance, return, and reintegration. The Office to Monitor and Combat Trafficking in Persons 91 U.N. Development Fund for Women (UNIFEM), "Trafficking in Persons, A Gender & Rights Perspective Briefing Kit," 2002. 92 U.N. document, E/CN.4/2000/76, Report of the Secretary General on Violence Against Women Migrant Workers, December 9, 1999. 93 For more information, see CRS Report RL34317, Trafficking in Persons: U.S. Policy and Issues for Congress, by Clare Ribando Seelke and Alison Siskin. 94 The U.S. Trafficking in Persons Report 2007 is available at http://www.state.gov/g/tip/rls/tiprpt/2007/. A list of U.S. anti-TIP project obligated in FY2007 is available at http://www.state.gov/g/tip/rls/rpt/101295.htm. 95 P.L. 109-164 (January 10, 2002; 22 U.S.C. 7101 et seq.). ¢ (G-TIP) and the Bureau of Europe and Eurasian Affairs support prevention and public awareness campaigns, victim's assistance programs, and anti-TIP law enforcement programs. G-TIP and the Bureau of Education and Cultural Exchanges also sponsor TIP-related research and exchange programs. USAID has supported prevention programs that include education and income generation for potential victims, protection programs, including training and support for local victim services providers, and anti-TIP training for police, prosecutors, and judges.96 In addition, the Department of Labor's Bureau of International Labor Affairs works to provide assistance to child victims of trafficking, support public awareness campaigns, and build capacity for governments and service providers that combat TIP. Moreover, the Department of Justice's International Criminal Training Assistance Program (ICITAP) and Office of Overseas Prosecutorial Development, Assistance, and Training (OPDAT) provide some anti-TIP training for law enforcement and judicial officials overseas.97 Some experts maintain that to successfully address VAW on a global level, national governments and communities must strengthen the capacity of their political, legal, and law enforcement institutions. In some countries, for example, legal and political institutions may hinder rather than help women seeking information, assistance, and protection from violence. Many experts maintain that addressing possible weaknesses in these institutions is especially crucial in some developing countries where national government infrastructures may be weakened by poverty, corruption, or other factors. Some have increasingly advocated the value of providing women with education and training to prevent and address violence and gender discrimination in both public and private life. The U.S. government supports programs that aim to strengthen the legal and political capacity of women in developing countries. Because of the cross-cutting nature of U.S. programs that address VAW, however, the number and cost of programs addressing its political, legal, and legislative aspects are difficult to quantify. In 2005, President Bush announced the creation of the Women's Justice and Empowerment Initiative (WJEI), a three-year, $55 million program to improve legal rights for women in Benin, Kenya, South Africa, and Zambia.98 Some observers, however, were concerned that the Administration delayed or did not meet its funding obligations for WJEI. The Middle East Partnership Initiative (MEPI), which is implemented by the Department of State, also focused some of its resources on VAW and women's empowerment. It supported programs 96 Between FY2001 and FY2007, USAID provided over $100 million for anti-TIP programs; see http://www.usaid.gov/ our_work/cross-cutting_programs/trafficking. 97 ICITAP and OPDAT are part of the DOJ Criminal Division. ICITAP aims to build the capacity of foreign government law enforcement service. For more information, see http://www.usdoj.gov/criminal/icitap/. OPDAT provides technical and developmental assistance for foreign justice sector institutions and their law enforcement personnel. More information available at http://www.usdoj.gov/criminal/opdat/. In past years, both ICITAP and OPDAT have also addressed other aspects of VAW, including domestic violence and sexual violence against women. 98 More information on WJEI is available at http://www.state.gov/p/af/rt/wjei/. ¢ that provided training for judges and legal professionals on types of VAW, including honor killings and intimate partner violence.99 The State Department, USAID, and DOJ support other programs and activities that aim to strengthen the legal and political capacity of national governments. The State Department's Bureau of Democracy, Human Rights, and Labor (DRL), for example, funds initiatives in sub- Saharan Africa to support work on the rule of law, empowerment of women and youth, and democracy initiatives.100 The USAID Office of Women in Development (WID) recently supported the Women's Legal Rights Initiative (WLRI), which aimed to strengthen the capacity of women to work for greater economic and legal rights in Albania, Guatemala, Benin, South Africa, and Rwanda.101 A USAID WID program in Ethiopia also works with community leaders to advocate the enforcement of laws that address harmful traditional practices such as bride abduction.102 Other reported U.S. activities include training specialists and advocates on how to effectively influence foreign governments to address VAW, and working with governments and NGOs in developing countries to draft legislation on women's rights. Moreover, the USAID Safe Schools program works with partners at national, institutional, community, and individual levels to combat school-related gender-based violence.103 International organizations, particularly the United Nations and its specialized agencies, support myriad mechanisms and programs that address VAW in all parts of the world. ¢ A July 2006 study by the U.N. Secretariat found that 32 U.N. entities work to combat VAW on a global, national, or local level.105 Their activities range from large-scale interagency efforts to 99 MEPI works to promote democracy in the Middle East by funding NGOs, businesses, and universities working toward democratic reform. It was introduced as a presidential initiative in 2002. In five years, it has provided approximately $430 million for over 350 projects in 17 countries and territories. In FY2006, funding for the Women's "Pillar" was $15 million. More information on MEPI is available at http://mepi.state.gov/c10127.htm. 100 The grants are administered through the State Department Human Rights Democracy Fund (HRDF) National Endowment for Democracy (NED). HRDF supports programming to build democratic principles and institutions and promote human rights worldwide. In past years, DRL and HRDF funded FGC awareness and prevention projects in Africa. More information is available at http://www.state.gov/g/drl/p/. 101 The WRLI project has closed, and the final report is available at http://www.usaid.gov/our_work/cross- cutting_programs/wid/dg/wlr_report.html. 102 The USAID WID office is collaborating with CARE on a three-year project to raise awareness of bride abduction. The program intends work with local leaders to advocate the enforcement of laws that reduce early marriage and bride abduction. 103 The Safe Schools program is a five-year project piloted in Ghana and Malawi. It is funded by the USAID Office of Women in Development. It began in September 2003 and will close in September 2008. For more information, see http://www.usaid.gov/our_work/cross-cutting_programs/wid/ed/safeschools.html and http://www.igwg.org/articles/ safeschools.htm. 104 The U.N. efforts listed in this section represent only a selection of U.N. system agencies, activities, and agreements that address violence against women. Also see U.N. document A/61/122/Add.1, July 6, 2006, and Preventing and Eliminating Violence Against Women: An Inventory of United Nations System Activities On Violence Against Women, July 2007. 105 U.N. document, A/61/122/Add.1, July 6, 2006, p. 20. ¢ smaller grants and programs implemented by NGOs, national governments, or individual U.N. agencies. Agencies that work to combat VAW include the U.N. Development Program (UNDP), the U.N. Children's Fund (UNICEF), UNIFEM, WHO, ILO, the Joint U.N. Program on HIV/AIDS (UNAIDS), the U.N. Office of Drugs and Crime (UNODC), the U.N. Population Fund (UNFPA), and the U.N. High Commissioner for Refugees (UNHCR). The U.N. Secretariat's Department of Peacekeeping Operations (DPKO) has also made efforts to address the problem of violence against women by U.N. peacekeepers. Many U.N. member states are parties to international conventions and agreements that address VAW and women's rights, including the U.N. Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), the U.N. Convention on the Rights of the Child (CRC), and the Protocol to Prevent, Suppress, and Punish Trafficking in Persons, Especially Women and Children (Trafficking Protocol).106 U.N. member states have also demonstrated concern for VAW through World Conferences on Women and resolutions adopted by the U.N. Security Council. Between 1974 and 1995, for example, U.N. member states--including the United States--participated in four World Conferences on Women. The Fourth Conference, which was held in 1995 in Beijing, China, identified VAW as a human rights concern and an obstacle to the achievement of women's equality. In addition, U.N. Security Council Resolution 1325 on Women, Peace and Security, adopted on October 31, 2000, highlights the need to protect women and girls from human rights abuses.107 U.N. system anti-VAW activities are part of a much larger international effort composed of many international actors. NGOs, international financial institutions, and intergovernmental and regional organizations such as the International Organization for Migration (IOM), World Bank, and European Union (EU) develop, fund, and implement anti-VAW initiatives and programs at all levels of society.108 The World Bank, for example, supports pilot projects in Bolivia, Honduras, and Nicaragua to improve awareness of VAW in their health systems.109 The EU's Daphne II and Daphne III Programs, which complement existing EU member state efforts to combat VAW, support organizations that work to prevent or combat violence against children, young people, 106 The U.S. government ratified the Trafficking Protocol in December 2005, but has not ratified CEDAW or CRC because of concerns over U.S. sovereignty. For CEDAW, see Letter from Secretary of State Colin Powell to Senator Joseph Biden, Chairman of the Senate Foreign Relations Committee, July 8, 2002. For CRC, see United States Participation in the United Nations: Report by the Secretary of State to the Congress for Year 2002, Department of State Publication 11086, October 2003, p. 70. 107 On June 19, 2008, members of the U.N. Security Council unanimously adopted Resolution 1820 as a follow-up to Resolution 1325. Resolution 1820 "demands the immediate and complete cessation by all parties to armed conflict in all acts of sexual violence against civilians with immediate effect." See U.N. document, S/RES/1820 (2008). For more information on U.N. efforts to address violence against women, see CRS Report RL34518, United Nations System Efforts to Address Violence Against Women, by Luisa Blanchfield. 108 IOM has worked with international partners on a variety of VAW-related issues. It has, for example, conducted a study on GBV faced by female migrant workers. For more information on this study, see http://www.iom.int.vn/ joomla/index.php?option=com_content&task=view&id=83&Itemid=143. It has also supported activities that address HIV/AIDS and GBV in countries such as Zimbabwe. For more information, see http://iom.org.za/site/ index.php?option=com_content&task=view&id=63&Itemid=68. 109 The World Bank also provided Uruguay with a $300,000 grant to combat domestic violence through legal and legislative reform. For more information on World Bank efforts to combat VAW, see U.N. document A/61/122/Add.1, July 6, 2006, and Preventing and Eliminating Violence Against Women: An Inventory of United Nations System Activities On Violence Against Women, July 2007, p. 78. ¢ and women.110 In addition, regional organizations such as the Organization of American States (OAS) have adopted agreements that address violence against women. The OAS Inter-American Convention on the Prevention, Punishment and Eradication of Violence Against Women, for example, entered into force on March 5, 1994, and declares that "every woman has the right to be free from violence in both the public and private spheres."111 Parties to the Convention agree to condemn all forms of VAW and to pursue policies to prevent, punish and eradicate violence. The United States has not signed or ratified the Convention. ¢ For more than a decade, Congress has demonstrated an ongoing interest in addressing international violence against women. It has passed legislation addressing specific types of VAW, such as human trafficking and FGC,112 and has adopted legislation addressing VAW in different regions and countries, particularly in Africa and Asia.113 In some cases, Congress has incorporated VAW components into legislation and programs addressing international HIV/AIDS prevention and foreign military and law enforcement training.114 Congress has also committed resources to the UNIFEM Trust Fund in Support of Actions to Eliminate Violence Against Women, an international mechanism that addresses violence against women. In addition, Congress has adopted resolutions expressing concern about VAW events in specific countries.115 The 110th Congress considered legislation addressing VAW on both a global and regional level. Enacted legislation ranged from resolutions denouncing types of VAW such as FGC, honor killings, and other forms of violence, to calling on the President and the international community 110 The EU's Daphne II and Daphne III programs run from 2002 to 2008, and 2007 to 2013, respectively. The Daphne II program receives approximately 50 million euros in overall funding (about $74 million U.S. dollars). For more information on these activities, see http://ec.europa.eu/employment_social/gender_equality/gender_mainstreaming/ violence/domestic_violence_en.html. 111 Thirty-two OAS member states have adopted or ratified the Convention. The United States, which is an OAS member, has not signed or ratified the treaty. For more information, see http://www.oas.org/cim/English/ Convention%20Violence%20Against%20Women.htm. 112 In 2000, for example, Congress passed the Trafficking Victims Protection Act of 2000, or TVPA, as amended, which addressed human trafficking (P.L. 106-386). In addition, Congress criminalized the practice of FGM in §645 of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (P.L. 104-208; 18 U.S.C. §116; September 30, 1996). The conference report accompanying the Foreign Operations, Export Financing, and Related Programs Appropriations Act, 2001 (P.L. 106-429; November 11, 2000), contained language requiring the Department of State to compile statistics on FGM. See 106th Congress, Report 106-997, 2d session, October 24, 2000. 113 For example, the Foreign Operations, Export Financing, and Related Programs Appropriations Act, 2006, requires that funds "should be made available for programs in sub-Saharan Africa to address sexual and gender-based violence" (P.L. 109-102; 119 Stat. 2177; September 30, 2006). Section 576(b) of the same Act requires that "not less than $1,500,000 should be made available for ... crimes of violence specifically targeting women ... in Guatemala" (119 Stat. 2231). 114 See United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003, (P.L. 108-25; 22 U.S.C. 7601 et seq.; May 27, 2003). Also see Foreign Operations, Export Financing, and Related Programs Appropriations Act, 2006,which states that the U.S. military, where appropriate, shall incorporate GBV training into its programs and activities (P.L. 109-102; Section 573, 119 Stat. 2229; November 14, 2005). 115 H.Res. 100 (110th), for example, expresses sympathy to the families of women and girls murdered in Guatemala and encourages the government of Guatemala to bring an end to crimes against women. The House passed the resolution on October 9, 2007. S.Res. 178 also expresses the sympathy of the Senate to the families of women and girls murdered in Guatemala. The resolution was agreed to by unanimous consent on March 10, 2008. ¢ to take immediate action on acts of sexual VAW and girls as a result of conflict in Sudan.116 Other proposed legislation included the reauthorization of anti-trafficking laws and bills addressing international violence against women.117 When considering United States and international efforts to address violence against women, Members of the 111th Congress may wish to take a number of issues into account. Some experts argue that U.S. government programs and initiatives do not sufficiently address international violence against women. They maintain that current anti-VAW funding levels do not reflect the scope of the problem, and, further, that many of the programs in place are not adequately funded. Some cite the fact that in FY2006, for example, the State Department Office of Population, Refugees, and Migration reported $4.4 million in VAW-related activities-- representing .5% of actual FY2006 Migration and Refugee Assistance Account funding of $858.79 million. Others argue that many U.S. anti-VAW programs are short in duration and often not renewed--making it a challenge for programs to have a substantive long-term impact. Some experts also suggest that when highlighting U.S. efforts to combat VAW, the U.S. government places too much emphasis on programs with VAW components, as opposed to programs solely addressing the issue. This may create the appearance that the U.S. government commits significant resources to addressing international VAW--when, according to some, the United States does not do enough. A 2006 USAID report on gender-based violence and HIV/AIDS, for example, identified 243 PEPFAR programs that incorporate gender-based violence components in FY2006.118 Some are concerned that these components do not constitute a substantial anti-VAW effort. Some also contend that U.S. anti-VAW initiatives that have been promised, such as the Bush Administration's proposed Women's Justice Empowerment Initiative (WJEI), were not adequately funded or implemented.119 Some experts and policymakers question whether U.S. programs addressing VAW should be further integrated into U.S. foreign assistance programs. Supporters of increased integration maintain that, in addition to receiving attention as a stand-alone global health and human rights issue, VAW should be a component of broader U.S. foreign assistance efforts--including health 116 H.Res. 32 (110th) expresses the sense of the House of Representatives that the President and fellow donor countries promote the rights, health, and empowerment of women. It was passed on May 1, 2007. H.Res. 726, (110th) calls on the President and the International Community to "respond to and Prevent Acts of Rape and Sexual Violence against women and girls in Darfur, Sudan, eastern Chad, and the Central African Republic." The House passed the resolution on October 10, 2007. 117 See H.R. 3887, the William Wilberforce Trafficking Victims Protection Reauthorization Act of 2007, passed by the House on December 4, 2007, by a vote of 405-2; S. 2279, the International Violence Against Women Act of 2007; and H.R. 5927, the International Violence Against Women Act of 2008. 118 The President's Emergency Plan for AIDS Relief Report on Gender-Based Violence and HIV/AIDS, November 2006. 119 For more information, see statements by Human Rights Watch and the Global Aids Alliance, at http://hrw.org/ reports/2007/zambia1207/9.htm and http://aidsalliance.3cdn.net/f80a03c5b9ee9c3bcb_fhm6b5zvf.doc, respectively. ¢ services, development, human rights, foreign military training and law enforcement training, humanitarian assistance, and legal and political reform. They argue that additional funding is needed to adequately coordinate government-wide efforts and fund current and future U.S. programs and activities. Some have expressed concern that the U.S. government does not adequately coordinate its anti- VAW efforts. Many argue that in order to effectively combat VAW, the U.S. government should actively track its anti-VAW programs and establish mechanisms that will identify potential gaps and weaknesses in U.S. approaches. Some observers have reportedly found it difficult to assess the adequacy of U.S. efforts in this area because of the lack of anti-VAW program data collection, coordination, and analysis. Some have proposed that the government establish a discrete office or coordinating body to address U.S. efforts to address violence against women. Such actions, they argue, may be a valuable tool for policymakers who wish to prevent the possible duplication of U.S. anti-VAW activities and more effectively disseminate best practices among and within U.S. government agencies. £ Some experts contend that providing financial and technical support to international organizations that address VAW is a particularly effective use of U.S. resources. They maintain that such cooperation benefits the United States because it allows the U.S. government to share anti-VAW- related costs and resources with other governments and organizations. Opponents argue that the U.S. government should focus on its own anti-VAW initiatives, and emphasize that U.N. activities addressing VAW, for example, may not always align with U.S. priorities. Were Congress to opt to use U.N. mechanisms to combat VAW, there are a number of programs and options that might be considered. The United Nations and its specialized agencies support a range of programs to eliminate violence against women. UNIFEM, for example, administers the U.N. Trust Fund in Support of Actions to Eliminate Discrimination Against Women, an interagency mechanism to fund and promote U.N. actions on violence against women. In recent years, some policymakers have recognized the Trust Fund as a possible tool for combating international violence against women.120 For a discussion of U.N. system programs and mechanisms that address VAW, see CRS Report RL34518, United Nations System Efforts to Address Violence Against Women, by Luisa Blanchfield. Finding ways to address VAW is a significant and ongoing challenge for the U.S. government and the international community. There may be a number of oversight issues of interest to the 111th Congress. 120 In FY2006, Congress appropriated $1.485 million to the Trust Fund. In FY2007, Congress appropriated $1.485 million, and in FY2008 it appropriated $1.785 million. ¢ Some governments, particularly those of developing countries, lack the political, legislative, and financial infrastructures to establish and maintain policies and programs to eliminate violence against women.121 A U.N. study on VAW, for example, found that 102 of the 192 U.N. member states lack domestic legal provisions addressing intimate partner violence. Such countries, which may face other challenges such as poverty, health epidemics, and political unrest, may not view combating VAW as a policy priority--either because they do not view it as a significant problem or lack the resources to address it. Moreover, in some cases, national governments may pass laws that support anti-VAW policies, but ineffective legal, political, or law enforcement infrastructures may hinder their ability to implement and enforce laws and provide the necessary support services to be effective. Some experts disagree on the most effective methods to address violence against women. This lack of consensus may pose a challenge for policymakers who determine funding levels for and implementation of anti-VAW programs. There is debate, for example, over where to draw the line between the need to protect women's rights and to preserve their freedom of choice.122 Moreover, in the past, some experts have disagreed on how to most effectively allocate scarce resources for anti-VAW programs. Some maintained that anti-VAW programs should focus on providing treatment services for VAW victims, while others contended that programs should focus on prevention and the root causes of violence. Many experts have concluded, however, that the most effective anti-VAW approaches address both prevention and treatment. Local, national, and international governments and NGOs implement thousands of anti-VAW programs annually, but few of these programs are evaluated for their effectiveness. Many anti- VAW programs tend to be short in duration (one to two years) and have small budgets, which some fear may leave little time and financial resources for evaluations.123 Consequently, some argue, experts and policymakers may have difficulty gauging a program's effectiveness. Some believe that this may lead to scarce resources being allocated to programs with limited impact. In recent years, some analysts have increasingly recognized the importance of program evaluation, and are taking steps to improve data collection instruments, share existing best practices, and improve coordination among funding and implementing organizations. Some experts have advocated for program donors and members of the policy community to provide additional funding for program evaluations when funding anti-VAW projects and programs or providing technical assistance.124 121 U.N. document, A/61/122/Add.1, July 6, 2007, p. 23. 122 Drawn from U.N. document, A/61/122/Add.1, July 6, 2007, p. 24, paragraph 59. 123 Small program budgets may also not allow for collection of baseline data that is needed for comparative purposes. Furthermore, there is no generic evaluation method for VAW programs. Some experts maintain that programs addressing specific types of violence should have their own context, and therefore be evaluated using different criteria. 124 Presentation by Mary Ellsberg, PATH, "Overview of Evaluation and GBV," Promising Practices in Monitoring and Evaluation of Gender-Based Violence Event, National Press Club, Washington DC, November 8, 2007. ¢ Existing VAW research offers little in the way of comparative data.125 Many researchers use different sampling techniques, methodologies, and criteria for defining VAW and conducting surveys--which may lead to inconsistent and varied findings. The lack of comparable data may present a challenge to policymakers attempting to identify the scope of the problem and implement programs to address the issue. Some researchers and policymakers have recognized this and are actively working to streamline survey processes and reporting procedures. Some have also called for the creation of comprehensive international indicators for violence against women.126 In the past three decades, the level and quality of research addressing VAW have increased as awareness of the problem has grown. This section highlights some current and emerging areas in VAW research, prevention, and treatment. ¢ Research on VAW has evolved to include not only treatment and prevalence but also root causes. As a result, many experts and policymakers have increasingly focused on the role of men and boys in preventing violence against women. Some NGOs and governments have developed school curricula, services, and public awareness campaigns to educate boys and men on the negative consequences of violence against women. These efforts range from rehabilitating perpetrators through counseling to establishing curricula for young boys that challenge traditional notions of masculinity.127 During the last decade, researchers and policymakers have increasingly explored the relationship between HIV/AIDS and violence against women.128 Studies have found that women in developing countries are disproportionately affected by HIV, with the United Nations estimating that two-thirds of new infections among people from 15 to 24 years old are among women.129 125 Andrew Morrison, Mary Ellsberg, Sarah Bott, "Addressing Gender-Based Violence: A Critical Review of Interventions," The World Bank Research Observer, Oxford University Press, May 7, 2007 p. 25. 126 See "Violence against Women: A Statistical Overview, Challenges and Gaps in Data Collection and Methodology and Approaches for Overcoming Them," a publication of the Economic Commission for Europe, WHO, and the U.N. Division for the Advancement of Women, April 2005, available at http://www.un.org/womenwatch/daw/egm/vaw-stat- 2005/index.html. 127 For more information on the role of men and boys in preventing and eliminating VAW, see "Men's Role in Gender- Based Violence Fact Sheet," distributed by the Pan American Health Organization. Also see (1) an article by Michael Flood, "Involving Men in Gender Policy and Practice," Critical Half, Winter 2007, vol. 5, no. 1, and (2) "The Role of Men and Boys in Achieving Gender Equality," expert group meeting, list of documents, October 21-24, 2003, available at http://www.un.org/womenwatch/daw/egm/men-boys2003/documents.html. 128 The President's Emergency Plan for AIDS Relief, Report on Gender-Based Violence and HIV/AIDS, November 2006, available at http://www.state.gov/documents/organization/76447.pdf. 129 In FY2005, for example, 60% of the people receiving antiretroviral treatment through the U.S. PEPFAR initiative were women. For further information on the relationship between VAW and HIV/AIDS, see UNAIDS Backgrounder at (continued...) ¢ Global statistics indicate that women who are victims of violence are more likely to contract HIV than those who are not, leading some experts to conclude that there may be a correlation between rates of HIV in women and violence.130 Reportedly, women who experience or fear violence appear to be less likely to request or insist on using condoms during sexual encounters, increasing their risk of HIV and other sexually transmitted diseases. Women who are raped are also more susceptible to contracting HIV due to vaginal and anal tearing. Some experts have linked VAW to discrimination. Many in the international community view violence as a form of discrimination against women and maintain that discrimination also causes violence.131 To successfully combat VAW, they contend, equal attention should be paid to the causes and impacts of female discrimination. Women who are discriminated against because of their sex may not receive a formal education or have access to healthcare. In many societies, women may not own property or have inheritance rights. Some analysts argue that these factors may contribute to an unequal power relationship between men and women--which in turn may lead to a cycle of violence. Some developed countries have undertaken studies to determine the economic costs of violence against women. Though the results vary because of differing methodologies, the studies generally found that the cost to society may be significant.132 Canadian researchers, for example, estimated that the cost of damage incurred by VAW in Canada is over $4 billion Canadian dollars.133 Most studies analyze both long-term and short-term cost variables such as treatment and services for women victims of violence (including healthcare and legal costs), and reduced employment and productivity levels because of violence against female employees. Some studies also address the economic impact of pain and suffering inflicted on women by violence, though estimating the costs of such intangibles can present a challenge to researchers.134 Moreover, many experts generally agree that because of VAW's complex and wide-ranging impact on society, it is likely that existing research underestimates the economic consequences of violence. (...continued) http://data.unaids.org/GCWA/GCWA_BG_Violence_en.pdf. 130 Addressing Violence Against Women and Achieving the Millennium Development Goals, WHO, 2005, p. 20. 131 See U.N. document, A/61/122/Add.1, July 6, 2007, p. 14. 132 For further information on the possible socio-economic costs of VAW, see "Preventing and Responding to Gender- Based Violence in Middle and Low-Income Countries: A Global Review and Analysis," by Sarah Bott, Andrew Morrison, and Mary Ellsburg, World Bank Policy Research Working Paper 2318, June 2005, p. 12. 133 Lorraine Greaves et al., "Selected Estimates of the Costs of Violence Against Women," Center for Research on Violence Against Women and Children, London, Ontario, 1995, available at http://www.crvawc.ca/docs/ pub_greaves1995.pdf. A March 2003 HHS study estimated that the cost of intimate partner violence in the United States exceeds $5.8 billion per year, including $4.1 billion for direct medical and mental health services; $.9 billion in lost work productivity; and $.9 billion lost in lifetime earnings by victims of intimate partner violence homicide. The U.S. study was completed by the Centers for Disease Control and Prevention and funded by Congress. The study is available at http://www.cdc.gov/ncipc/pub-res/ipv_cost/IPVBook-Final-Feb18.pdf. 134 For a list of studies on the economic and social costs of VAW, see the Annex (pp. 133-138) of U.N. document, A/61/122/Add.1, July 6, 2007. ¢ ¡ Selected Websites (U.S. Government, United Nations, NGOs) U.S. State Department--Recognizing Violence Against Women http://www.state.gov/g/wi/92987.htm USAID Interagency Gender Working Group, Gender-Based Violence Priority Area http://www.igwg.org/priorityareas/violence.htm World Health Organization, Gender-Based Violence http://www.who.int/gender/violence/en/ U.N. Division for the Advancement of Women, Violence Against Women http://www.un.org/womenwatch/daw/vaw/ U.N. Population Fund, Ending Violence Against Women http://www.unfpa.org/gender/violence.htm UNICEF, Gender-Based Violence http://www.unicef.org/emerg/index_33202.html Violence Against Women, Facts and Figures (UNIFEM) http://www.unifem.org/campaigns/vaw/facts_figures.php. End Violence Against Women (Johns Hopkins University Bloomberg School forPublic Health, Information and Knowledge for Optimal Health (INFO), andUSAID) http://www.endvaw.org/ Human Rights Watch, Women's Rights http://www.hrw.org/women/ Amnesty International, Stop Violence Against Women http://www.amnesty.org/en/campaigns/stop-violence-against-women Gender-Based Violence Prevention Network (Africa) http://www.preventgbvafrica.org/ ¢ Selected Journal Articles and Studies Addressing Gender-Based Violence in the Latin American and Caribbean Region: A Critical Review of Interventions, World Bank Poverty Sector Unit Policy Research Working Paper # 3438, October 2004. "Engaging Men in `Women's Issues:' Inclusive Approaches to Gender and Development," Critical Half , Winter 2007, vol. 5, no. 1. Guedes, Alessandra, Addressing Gender-Based Violence From the Reproductive Health/HIV Sector--A Literature Review and Analysis, USAID Interagency Gender Working Group, May 2004, available at http://www.prb.org/pdf04/AddressGendrBasedViolence.pdf. Heise, Lori, Ellsberg, Mary, and Gottemoeller, Megan, "Ending Violence Against Women,"Population Reports, series L, no. 11, Johns Hopkins University School of Public Health, Population Information Program, December 1999, available at http://www.infoforhealth.org/pr/ l11/violence.pdf. "Gender-Based Violence and Reproductive Health," International Family Planning Perspectives, December 2004, vol. 30, no. 4. Programming to Address Violence Against Women: 10 Case Studies, UNFPA, 2007, available at http://www.unfpa.org/upload/lib_pub_file/678_filename_vaw.pdf. Responding to Gender-Based Violence: A Focus on Policy Change, A Companion Guide, USAID, May 2006, available at http://www.policyproject.com/gbv/. Strategic Framework for the Prevention of and Response to Gender-Based Violence in Eastern, Southern and Central Africa, USAID and UNICEF publication, 2006, available at http://www.unicef.org/southafrica/resources_3553.html. The Safe Schools Program: A Qualitative Study to Examine School-Related Gender-Based Violence in Malawi, USAID publication, Center for Educational Research and Training and DevTech Systems Inc., available at http://devtechsys.com/services/activities/documents/ SafeSchoolsMalawi_PLAReport_January82008.pdf. Understanding the Issue: An Annotated Bibliography on GBV, USAID (prepared by the POLICY Project, May 2006, available at http://www.policyproject.com/gbv/Documents/ AnnotatedBibliography.pdf. Violence against Women and HIV/AIDS: Setting the Research Agenda, World Health Organization, Geneva, 2001, available at http://www.who.int/gender/violence/VAWhiv.pdf. dna tnemeganaM retsasiD ni ecnellecxE fo retneC noitarepooC ytiruceS rof etutitsnI erehpsimeH nretseW esnefeD fo tnemtrapeD noitneverP ecneloiV fo noisiviD ,lortnoC dna noitneverP yrujnI rof retneC lanoitaN-- margorP SDIA labolG-- htlaeH evitcudorpeR fo noisiviD-- noitneverP dna lortnoC esaesiD rof sretneC secivreS namuH dna htlaeH fo tnemtrapeD snoitaleR lanoitanretnI fo eciffO-- gnikciffarT namuH dna ,robaL decroF ,robaL dlihC fo eciffO-- sriaffA robaL lanoitanretnI fo uaeruB robaL fo tnemtrapeD gniniarT dna ,ecnatsissA ,tnempoleveD lairotucesorP saesrevO fo eciffO-- margorP ecnatsissA gniniarT evitagitsevnI lanimirC lanoitanretnI-- ecitsuJ fo etutitsnI lanoitaN noisiviD lanimirC ecitsuJ fo tnemtrapeD snoissiM/uaeruB naebbiraC eht dna aciremA nitaL snoissiM/uaeruB aisaruE dna eporuE snoissiM/uaeruB tsaE raeN dna aisA sevitaitinI noitisnarT fo eciffO-- ecnatsissA retsasiD ngieroF .S.U fo eciffO-- ecnatsissA snoissiM/uaeruB acirfA nairatinamuH dna tcilfnoC ,ycarcomeD rof uaeruB htlaeH evitcudorpeR dna noitalupoP fo eciffO-- tnempoleveD ni nemoW fo eciffO-- SDIA/VIH fo eciffO-- edarT dna erutlucirgA ,htworG cimonocE rof uaeruB htlaeH labolG rof uaeruB tnempoleveD lanoitanretnI rof ycnegA .S.U snosreP seussI s'nemoW lanoitanretnI fo eciffO ni gnikciffarT tabmoC dna rotinoM ot eciffO labolG stinU eciloP ytilibatS rof ecnellecxE fo retneC sriaffA yratiliM-lacitiloP fo uaeruB sriaffA larutluC dna noitacudE fo uaeruB sriaffA naisaruE dna naeporuE fo uaeruB sriaffA sriaffA cificaP dna naisA tsaE fo uaeruB tnemecrofnE waL dna scitocraN lanoitanretnI rof uaeruB robaL dna sthgiR namuH ,ycarcomeD fo uaeruB noitargiM dna seegufeR ,noitalupoP fo uaeruB etatS fo tnemtrapeD ¡ ¢ ¢ etatS fo tnemtrapeD seidutS lageL lanoitanretnI fo etutitsnI esnefeD ecnatsissA nairatinamuH ytiruceS dnalemoH fo tnemtrapeD tnemecrofnE smotsuC dna noitargimmI sproC ecaeP seitivitca reetnulov sproC ecaeP emoS Luisa Blanchfield, Coordinator Rhoda Margesson Analyst in International Relations Specialist in International Humanitarian Policy lblanchfield@crs.loc.gov, 7-0856 rmargesson@crs.loc.gov, 7-0425 Clare Ribando Seelke Tiaji Salaam-Blyther Specialist in Latin American Affairs Specialist in Global Health cseelke@crs.loc.gov, 7-5229 tsalaam@crs.loc.gov, 7-7677 Nina M. Serafino Specialist in International Security Affairs nserafino@crs.loc.gov, 7-7667 ------------------------------------------------------------------------------ For other versions of this document, see http://wikileaks.org/wiki/CRS-RL34438