Mabel Bianco: blazing a trail for women's reproductive rights.

On the wall of Mabel Bianco’s offi ce in the centre of Buenos Aires hangs a US propaganda poster from World War II, with a woman in overalls and a headscarf fl exing her muscles and proclaiming “We can do it.” It could be the motto for Bianco herself: the tenacious 64-year-old doctor is the founder and director of Argentina’s Foundation for Studies and Research on Women (La Fundación para Estudio e Investigación de la Mujer, FEIM). For the past four decades, she has been a pioneer in the drive to put women’s health, reproductive rights, abortion, sex education, and HIV/AIDS on the public policy agenda in socially conservative Argentina. Bianco trained as an epidemiologist, where her research into breast and cervical cancer fi rst began to focus her mind on women’s health issues and her country’s “lamentable” rates of maternal mortality. When she fi nished her studies in Colombia, in the late 1960s, and returned home, Argentina was in the grip of a military dictatorship and family-planning services simply did not exist. Indeed, a decree from that time “prohibited family planning, invoking the need to lift our birth rate”, Bianco notes, wryly. Thus Bianco sees her most important achievement as having pierced the taboo surrounding sex in a country where the Roman Catholic Church is highly infl uential, by “getting a law on sexual and reproductive health passed and getting more than 90% of people to agree with sex education and to recognise that this is a right”. But that achievement took “15 years of fi ghting”. Bianco had administered family-planning programmes in Colombia, and on her return home she began networking with women’s groups in Latin America to campaign for such programmes. When democracy was restored in Argentina, in 1983, she joined the health ministry as an adviser, a role that gave her the opportunity to shape public policy. There, she promoted the fi rst study in Argentina into maternal mortality; it revealed how a lack of familyplanning information was pushing poor women into risky back-street abortions. After a change of government, in 1989, however, Bianco was ditched from her health ministry job and decided to set up FEIM to promote sexual and reproductive rights and access to safe abortions. Just a generation earlier, while still illegal, abortion had been more socially tolerated and safer—Bianco’s own mother had had one. But family planning was forbidden in public hospitals in 1974 and it was not until 1986 that the ban was lifted. Abortion was—and still is—illegal in most cases and at fi rst only private health-care systems off ered family planning. “I managed to set up a [family-planning] programme in the public health system, and that’s saying a lot”, Bianco explains. Her vision was to shift the issue to the standpoint of human, and specifi cally reproductive, rights. Illegal abortion, however, is still a cause for concern and each year at least half a million Argentine women are estimated to have illegal, often unsafe, abortions, since terminations are only sanctioned after the rape of a mentally disabled woman or if the mother’s life is at risk. The government recently invited public comment on a proposal to allow fi rst-trimester abortions, and although the reform agenda was swiftly put on ice, the fact that Argentina could consider such a debate at all is testimony to the perseverance of Bianco and other campaigners. “She has provided very strong leadership, particularly in policy advocacy...She’s also very strategic about how to get involved”, said Marianne Mollmann, advocacy director of the women’s rights division at Human Rights Watch. Bianco’s stance on HIV/AIDS in Argentina exemplifi es such strong leadership. When the fi rst cases of women infected with HIV were reported in 1987, Bianco seized the opportunity to put the issue on the public agenda: “For us, working in HIV and AIDS was a strategy to be able to talk about sexual and reproductive rights.” With women—especially teenagers—increasingly infected with HIV, a law making sex education compulsory in state schools was fi nally passed in October, 2002. “It wasn’t and it isn’t the best”, Bianco admits, not least because it is not enforced and private schools, which represent about 50% of the education system, are not required to off er it. “But it’s a fundamental step forward”, she insists. FEIM and other non-governmental organisations brought the fi rst lawsuit against the health ministry for its failure to supply medicines to people infected with HIV, and won—giving Bianco ammunition in her job as head of the National AIDS Programme from 2000 to 2001. But she quit because of a lack of political will, which she says is still a major problem. “The government has a double message—it’s very big on human rights but it hasn’t managed to consolidate women’s rights. There’s still just rhetoric”, she asserts. Bianco has not confi ned her work to Argentina. “Mabel has been at the forefront of bringing gender and reproductive health to the agenda of international policymakers”, said Carmen Barroso, regional director of the International Planned Parenthood Federation/Western Hemisphere Region. Bianco’s passion is evident, but she believes it is her doctor’s training that has helped her get results. “I’ve always based myself on scientifi c studies that showed the ‘evidence’ of the impact, in terms of illness and death, of not implementing or not adopting a policy, rather than on isolated observations”, she says.