A/68/293 stereotypical view of gender roles in the household has not changed significantly. 68 Disastrously, many States have failed to respond to these challenges in a rightsbased and inclusive manner, instead cutting back on social investment and in particular failing to provide accessible and quality public services. 63. In this section, the impacts of the HIV/AIDS pandemic, global migration and austerity measures will be examined, because of their profound ongoing effects on the unpaid care of women living in poverty. 64. The HIV/AIDS pandemic has severely disrupted and/or increased unpaid care work in many countries. Women are affected by the virus in greater numbers than men 69 and also, in conjunction with girls, provide 70 to 90 per cent of HIV/AIDS care. 70 Caring for an AIDS patient can increase the workload of a family caretaker by one third, 71 so that scarce family financial resources, as well as women’s time, are stretched even further. The Special Rapporteur has seen herself during country visits how in communities ravaged by HIV/AIDS the desperate care needs of the sick as well as orphans and other vulnerable children all too often go unmet by the State. Instead, grandmothers, aunts or older girls struggle to fill the care deficit. Moreover, the burden of caring is disproportionately borne by people living in poverty, especially in rural areas, even in those contexts where HIV is more common among urban, wealthier people. 72 65. Many States with high rates of HIV/AIDS rely on home-based care undertaken by family or community members, essentially shifting the responsibility for care from public institutions to women living in poverty. 73 The long-term social and economic costs of this strategy have been greatly underestimated. Women may have to give up or lose their jobs involuntarily and are likely to find it difficult to return to work, while women who are self-employed may lose earning opportunities. Eighty per cent of family caregivers in South Africa have reported reduced income levels. 74 States’ failure to provide meaningful support or alternatives to home-based care impedes greater gender equality, intensifies the poverty and insecurity of whole households, and also threatens the rights, health and well-being of those requiring care. 66. In many countries in the global South, growing numbers of women are compelled to migrate in order to provide for the future of their family, often as a result of shortages of well-remunerated jobs at home. Often migrant women take on jobs abroad as domestic workers, in what has been called the “global care chain”. Migrant workers therefore fill the unmet need for care services in the richer destinations, while family members that remain at home must devise new strategies __________________ 68 69 70 71 72 73 74 16/24 World Bank, On Norms and Agency: Conversations about Gender Equality with Women and Men in 20 Countries (Washington, D.C., 2012). Women account for nearly 60 per cent of people living with HIV in sub-Saharan Africa (Joint United Nations Programme on HIV/AIDS (UNAIDS), Report on the Global AIDS Epidemic 2012). UNDP, Unpaid Care Work. UNAIDS, United Nations Population Fund and United Nations Development Fund for Women, Women and HIV/AIDS: Confronting the Crisis (New York and Geneva, 2004). Debbie Budlender and Ruth Meena, “Unpaid and overstretched: coping with HIV & AIDS in Tanzania”, in Shahra Razavi and Silke Staab (eds.), Global Variations in the Political and Social Economy of Care: Worlds Apart (United Kingdom, Routledge, 2012). Akintola, “Towards equal sharing of care responsibilities”. Anesu Makina, “Caring for people with HIV: state policies and their dependence on women’s unpaid work”, Gender and Development, vol. 17, No. 2 (2009). 13-42271