International Violence Against Women: U.S. Response and Policy Issues
Released: 2011-07-26T00:00:00

Introduction

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. 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. 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.

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 completed and ongoing 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 112 th Congress, including the scope and effectiveness of current U.S. programs, further integrating VAW prevention and treatment into U.S. foreign assistance programs, coordinating among U.S. executive branch agencies and departments, and U.S. funding of international anti-VAW programs.

Defining Violence Against Women

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." 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.

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.

Scope and Context

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. 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.

Social and Health Consequences

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. 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. Moreover, some studies have found that harassment and sexual abuse contributes to low female enrollment rates and high dropout rates from secondary schools.

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. 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," 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.)

Prevalence and Circumstances

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. 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. Some research indicates that approximately one in five women experiences rape or attempted rape during her lifetime. 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.

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. 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.

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. 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. In Ecuador, for example, a World Bank study found that approximately 22% of women reported being sexually abused in school. A qualitative study in Ethiopia found that harassment and sexual abuse contributed to low female enrollment rates and high dropout rates from secondary school.

Types of Violence

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 ). Some research has 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.

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. 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. 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. 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 are at risk each year. 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. Some research indicates that these child brides may face a greater risk of violence.

Harmful Traditional Practices

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. 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. 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.

Administration Actions

Most U.S. agencies and departments 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. 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. (See the Appendix 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. Capturing the overall U.S. government response to VAW is complicated by the number of programs, the degree 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.

Obama Administration

The Obama Administration has expressed its commitment to incorporating issues important to women—including violence against women—into all aspects of U.S. foreign policy. Secretary of State Hillary Clinton has sought to bring attention to VAW, particularly sexual violence in conflict, through speeches, meetings, events, and editorials. She has also focused on violence against women in U.N. fora, playing a lead role in the adoption of U.N. Security Council Resolution 1888 and 1889 on sexual violence in conflict and obstacles to women's involvement in peace processes, peacekeeping, and peacebuilding. In April 2010, she established the Secretary's International Fund for Women and Girls, a State Department-led grants program that provides funding for NGO activities that improve the well-being of women, including those that aim to combat VAW. The State Department has also engaged in public-private partnerships that aim to end violence against women.

The Obama Administration has also sought to address violence against women in specific countries, particularly in Africa. In August 2009, for instance, Secretary of State Clinton traveled to Goma, Democratic Republic of the Congo (DRC), where she focused on activities to prevent and combat sexual violence and announced $17 million in "new funding" to be distributed to organizations across eastern parts of the country. For FY2012, the Administration requested approximately $117.2 million for programs addressing GBV worldwide, including $87.9 for Africa; $1 million for East Asia and the Pacific; $2 million for Europe and Eurasia; $2.5 million for the Near East; $5.2 million for South and Central Asia; and $8.6 million for the Western Hemisphere. On a global level, the Administration requested $1 million for GBV and economic growth, agriculture, and trade; $425 million for global health and GBV; $292 million for International Narcotics and Law Enforcement Affairs and GBV; and $8 million for population, refugees, and migration activities addressing GBV.

Bush Administration

The 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. 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. 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 Middle East Partnership Initiative. Other Bush Administration initiatives with VAW components included the Women's Justice and Empowerment Initiative and an initiative to respond to ongoing and widespread violence against women and girls in Darfur, Sudan. The Administration also strongly supported the adoption of U.N. Security Council Resolutions 1325 and 1820 on women, peace, and security.

Interagency Activities

U.S. agencies and departments participate in formal and informal intra- and interagency working groups that address aspects of international violence against women. The National Security Staff (NSS) for example, leads the International Violence Against Women Working Group, a coordinating and information-sharing mechanism for U.S. government agencies addressing VAW. Members include the State Department, USAID, the Department of Justice (DOJ), the Millennium Challenge Corporation (MCC), and others. 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. In early 2011, USAID established a policy task team to develop agency policy on gender equality and women's empowerment through its Policy, Planning, and Learning Bureau. In addition, the PEPFAR interagency Gender Technical Working Group addresses the links between HIV/AIDS and gender. 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.

In March 2009, President Obama issued an executive order (EO) establishing the White House Council on Women and Girls (the Council). The Council serves as an advisory body to the President with the purpose of (1) establishing a coordinated federal response to issues that impact the lives of women and girls and (2) ensuring that federal programs and policies "address and take into account" their specific concerns. The EO identifies violence against women as a "global epidemic." Council members are comprised of Members of the Cabinet and other high-level executive branch officials. The Council is charged with, among other things, developing and submitting a federal interagency plan to ensure that interagency activities are consistent with the goals expressed in the executive order.

Key Issues and Related U.S. Activities

This section describes key VAW issues and discusses examples of related U.S. activities across agencies and departments. Some of the activities have been completed, while others are ongoing. 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 program's success in achieving its goal. (For more information, see the " Policy Issues for Congress " section.)

Global Health

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 abortions (sometimes outside of health setting and in unsafe environments), attempt suicide, or be beaten or killed by their partner. Women may also be killed by their spouses or other family members—though there is limited data on the frequency of this phenomenon. In some cultures, an unmarried woman's unintended pregnancy may trigger social isolation from family and friends. 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.

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. 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. 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. According to the U.N. Population Fund (UNFPA), rape victims were nine times more likely to attempt suicide than non-victims.

Related U.S. Activities

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, also support and provide health services. 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 gender-based violence component in FY2006. The report did not explain what constituted a GBV component. The U.S. President's Emergency Plan for AIDS Relief 2009 Annual Report to Congress (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. The 2011 version of the Annual Report to Congress states that in 2010 PEPFAR "intensified" its focus on GBV with a $30 million commitment that built on PEPFAR activities in all focus countries, particularly the DRC, Mozambique, and Tanzania. PEPFAR is also part of a public-private partnership, Together for Girls , which works to combat GBV by informing and implementing a coordinated approach to the issue at the country level.

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. 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 female genital cutting (FGC) prevention, awareness, and treatment at a variety of levels. USAID missions in Ethiopia, Egypt, Kenya, and Guinea, for example, support FGC prevention activities. In 2004, GH adopted a strategy to deter FGC that targets countries for continued and future support. USAID also focuses on strengthening prevention and treatment services for obstetric fistula.

HHS has supported 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 and Prevention's (CDC's) Monitoring and Evaluation to Assess and Use Results (MEASURE) program, for example, worked 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 women. CDC's National Center for Injury Prevention and Control (NCIPC) worked with partners, including the U.N. Children's Fund (UNICEF), to provide technical assistance on data collection, assess patterns of violence against women and children, and examine possible prevention strategies and policies to address violence. HHS also worked with WHO to build regional frameworks in three countries for VAW prevention. Furthermore, as a PEPFAR implementing partner, CDC's Global AIDS Program has supported prevention and response programs to address the relationship between VAW and HIV. The programs included HIV post-exposure prophylaxis (PEP) in clinical settings for survivors of sexual violence; strengthening linkages among health, community, and legal services that provide protection and care for victims; and HIV prevention programs that focused on VAW prevention.

Humanitarian Crises and Protection of Displaced Populations

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. Rape and other forms of sexual abuse reported during periods of armed conflict are common and in some cases may be systematic. Those who are displaced—including refugees, Internally Displaced Persons (IDPs), and those attempting to return home (returnees)—often lack protection and remain vulnerable, sometimes for years. 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.

During crises, 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 and community. In some cases, humanitarian and peacekeeping workers themselves are perpetrators of violence against women. VAW is a documented problem in conflict settings worldwide and particularly where there are large displaced populations, including the Darfur region of Sudan, DRC, Pakistan, and Colombia.

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. These projects are undertaken with an eye toward strengthening the protection of displaced women and promoting gender equality. Many experts view increasing the capacity of states and host communities as a priority for implementing sustained, effective measures.

Related U.S. Activities

U.S. activities addressing GBV in humanitarian and refugee/IDP settings are often incorporated into other 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 GBV in crisis settings. As the issue has gained attention, GBV has in some instances become the main focus of specific projects. In the humanitarian sector, the U.S. government's response to GBV comes from the State Department's Bureau for Population, Refugees and Migration (PRM), and USAID's Bureau for Democracy, Conflict, and Humanitarian Assistance (DCHA) through its Office of Foreign Disaster Assistance (OFDA) and Office of Transition Initiatives (OTI). USAID missions may also be involved at the regional and country level. Implementing partners include U.N. agencies, such as UNHCR, 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 GBV through its refugee assistance programs in FY2000. Since then, it has provided over $60 million toward targeted GBV programming for refugee and IDP populations. PRM funds projects that specifically respond to GBV, support GBV activities integrated into larger multi-sectoral programs, and work with its international and NGO partners to develop policies that address the protection needs of women and children in any humanitarian response. PRM projects funded specifically to address GBV in recent years have covered a range of activities, such as building local capacity among Afghan refugee populations in Pakistan and returnees in Afghanistan; working to reduce the vulnerability of women and children from the Rohingya community currently living in unofficial camps in Bangladesh; and improving capacity and supporting prevention of GBV in Colombia and the surrounding region. Global programs have focused on increasing the accountability of humanitarian workers for protecting children and vulnerable people from exploitation and abuse by agency staff, as well as ensuring protection, support, and assistance for GBV survivors through local efforts. Other programs have provided technical assistance to practitioners in developing effective livelihood alternatives for women.

USAID/DCHA supports response and prevention projects in humanitarian operations through its implementing partners. Since FY2007, USAID has 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 DRC, 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. In FY2010, DCHA funded approximately $7.5 million in stand-alone protection programs that helped to address GBV, including 14 programs in eight countries that focused on preventing and responding to GBV in humanitarian situations. Programming included a three-year project to examine the relationship between natural disasters and incidences of GBV and support for post-conflict and political transition projects. Most projects were funded through small grants to local organizations and national entities, and through larger humanitarian assistance programs implemented by international NGOs.

Foreign Military Training

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. After a special review of the situation, then-U.N. Secretary General Kofi Annan recommended that the U.N. Department of Peacekeeping Operations organize intensive training for peacekeepers.

Related U.S. Activities

The Department of Defense (DOD) has provided VAW training and education through a small number of programs. Most of the VAW content in DOD programs 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 separately identifiable.

VAW topics have been 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. 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.

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 number of training modules related to GBV in resident courses at its home facility in Rhode Island and in mobile courses conducted abroad. DIILS peacekeeping program curriculum, taught in resident and mobile programs, incorporates instruction on violence against women, as does a DIILS mobile program on "Legal Aspects of Developing a Professional Military." DIILS seminars on the Law of Armed Conflict identify non-combatant women as protected persons who are not to be targeted during hostilities. It conducts programs to build military justice capacity in post-conflict countries that include basic human rights and the duties of a professional military toward protected persons as a fundamental part of the instruction. These programs are often employed in areas affected by VAW, such as the Democratic Republic of the Congo, Burundi, and south Sudan. DIILS has also addressed VAW in occasional special courses prepared, on request, for foreign militaries.

Another military training program, the Global Peace Operations Initiative (GPOI), funded by the State Department and conducted under the oversight of the State Department Bureau of Political-Military Affairs and in cooperation with DOD, trains foreign peacekeepers and incorporates VAW content in its training exercises. According to a recent State Department report to Congress, GPOI requires that VAW/SE content "be included in its training programs, events, and activities, and provided to individual soldiers, trainers, and leaders, as appropriate." The report states that GPOI's largest component, the African Contingency Operations Training and Assistance (ACOTA) program, administered by the Africa Bureau, is successful in promoting "exemplary conduct among the African peacekeepers it trains." Noting that "no amount of training will guarantee good conduct" the report states that since ACOTA's inception in 1997, "the State Department does not know of any ACOTA-trained peacekeepers to have been implicated in any such [VAW/SEA] misconduct."

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 ( P.L. 109-102 ), required that training on gender-based violence be included, where appropriate, as a component of programs funded through bilateral assistance and military assistance accounts. These accounts include funding for the education and training of foreign military and civilian defense personnel. Similar language was included in FY2008, FY2009, and FY2010 foreign operations appropriations. Moreover, in FY2009 the Committees on Appropriations requested that USAID and the Department of State report to the Committees "on programs addressing sexual violence and gender-based violence and how these issues are being integrated into foreign police, judicial, and military training programs."

Trafficking in Women and Girls

Trafficking in women and girls is a high-profile form of violence against women. Severe forms of trafficking in persons is defined by the Trafficking Victims Protection Act of 2000 (TVPA, P.L. 106-386 , as amended) as "(A) sex trafficking in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such an act has not attained 18 years of age; or (B) the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery." Examples of human trafficking that affect women and girls include forced labor, including forced child labor, child soldiering, and involuntary domestic servitude, and sex trafficking, including child sex trafficking. Force, fraud, or coercion can take many forms, including physical and psychological violence. Another form is debt bondage, which involves the exploitation of an initial debt to coerce trafficking victims to continue to work.

Domestic violence is considered a risk factor particularly for sex trafficking and exploitation, and gender-based violence is believed to be a common experience of victims of human trafficking. Trafficking in women and girls 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 21 st Century. Studies have found that human trafficking occurs in every country and disproportionately affects women and girls. In 2009, a U.N. Office on Drugs and Crime (UNODC) study found that, on average, 65%-75% of human trafficking victims are women and 15%-25% are minors. The International Labor Organization (ILO) estimates that women and girls account for 56% of victims of forced economic exploitation, such as domestic service, agricultural work, and manufacturing—and 98% of victims of forced commercial sexual exploitation. The vulnerability of women and girls is due to a number of factors in source, transit, and destination countries. Among women victims, while there is no single victim stereotype, the majority of trafficked women are under the age of 25, with many in their mid- to late teens. Women trafficking victims also suffer higher rates of HIV/AIDS infection. In some cases, the fear of HIV infection among customers has driven traffickers to recruit younger women and girls, erroneously perceived by customers to be too young to have been infected.

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, inadequate legal recognition and protection, discriminatory attitudes toward women, and a lack of educational and job opportunities for women and girls in many source countries place them at-risk for trafficking. 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 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 often at risk of becoming trafficked because of their precarious economic and political status. The combined victimization of women due to GBV and human trafficking poses a particular challenge to policymakers as the response may require a different course of treatment, addressing the crimes both separately and in relation to each other.

Related U.S. Activities

The U.S. government supports several types of anti-trafficking in persons (anti-TIP) initiatives overseas, some of which may address violence against women and girls. U.S. anti-TIP efforts are intended to combat a broad range of human trafficking forms and consequences—and there is no specific program or budget committed to combating trafficking of women and girls. While the U.S. government does not maintain a public strategy to combat trafficking in persons, U.S. anti-trafficking policy generally emphasizes prevention, protection, and prosecution, pursuant to the TVPA, as amended. 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.

In addition, the U.S. Department of State releases an annual Trafficking in Persons (TIP) report that ranks foreign countries in "tiers" based on their level of commitment to combating human trafficking. For countries listed on the lowest tier ranking, Tier 3, the President has the option of withholding certain types of U.S. bilateral foreign assistance from such states. The 2011 TIP report identified 23 countries in Tier 3, up from 13 in 2010. All of these countries are described in the report as either a source or destination for the exploitation of women and girls.

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. In FY2010, the U.S. government obligated an estimated $85.3 million in international anti-trafficking assistance to foreign governments. U.S. agencies and departments supported global and regional anti-trafficking programs in more than 80 countries. This is up from $84 million in FY2009. The Trafficking Victims Protection Reauthorization Act of 2005 (TVPRA), P.L. 109-164 , authorized appropriations for anti-TIP programs in FY2006 and FY2007. The William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008, P.L. 110-457 , authorizes appropriations for FY2008 through FY2011. This most recent act, among other provisions, increased the technical assistance and other support to help foreign governments inspect locations where forced labor occurs, register vulnerable populations, and provide more protection to foreign migrant workers.

Many U.S. anti-trafficking programs abroad are administered by the State Department, USAID, and the Department of Labor (DOL). In addition, the State Department PRM office funds programs focused on victim's assistance, return, and reintegration. The State Department's Office to Monitor and Combat Trafficking in Persons (G-TIP) and 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. In addition, DOL'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.

Legal and Political Rights

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.

Related U.S. Activities

The U.S. government has supported 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. 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 and has been continued by the Obama Administration, has also focused some of its resources on VAW and women's empowerment. Specifically, it supported programs that provided training for judges and legal professionals on types of VAW, including honor killings and intimate partner violence. In April 2011, USAID announced the establishment of a new $14 million global grant program to increase women's involvement in peace processes as part of U.S. implementation on U.N. Security Council Resolution 1325 on women, peace and security.

The State Department, USAID, and DOJ have supported 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, funded initiatives in sub-Saharan Africa to support work on the rule of law, empowerment of women and youth, and democracy initiatives. The USAID Office of Women in Development (WID) 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. A USAID WID program in Ethiopia also worked with community leaders to advocate the enforcement of laws that address harmful traditional practices such as bride abduction. 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 worked with partners at national, institutional, community, and individual levels to combat school-related gender-based violence.

Selected International Activities

International organizations, particularly the United Nations and its specialized agencies, support myriad mechanisms and programs that address VAW in all parts of the world.

U.N. System Efforts103

In February 2011, an updated inventory of U.N. system anti-VAW activities identified 36 U.N. entities working to combat VAW on a global, national, or local level. Their activities range from large-scale interagency efforts to 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), the newly established U.N. Entity for Gender Equality and the Empowerment of Women (UN Women), 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.

U.N. funds and programs are also engaged in interagency activities that address specific types and circumstances of VAW directly. U.N. Action, for example, draws 13 U.N. entities together to improve and better coordinate the U.N. system response to sexual violence before and after conflict. It operates through existing coordination mechanisms, including the Inter-Agency Standing Committee, and focuses on building capacity and training advisers in anti-VAW programming at the country level. It aims to strengthen medical and legal services to survivors and, in the long term, address gender imbalances. It also works to raise public awareness of sexual violence and urges governments to address the issues.

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). 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 Resolutions 1325, 1820, 1888, and 1889 on Women, Peace and Security highlight the need to protect women and girls from human rights abuses and improve their participation in peace processes.

Other International Efforts

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. The World Bank, for example, supports pilot projects in Bolivia, Honduras, and Nicaragua to improve awareness of VAW in their health systems. 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, and women. 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." 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.

Policy Issues for Congress

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, and has adopted legislation addressing VAW in different regions and countries, particularly in Africa and Asia. In some cases, Congress has incorporated VAW components into legislation and programs addressing international HIV/AIDS prevention and foreign military and law enforcement training. Congress has also committed resources to the U.N. Trust Fund in Support of Actions to Eliminate Violence Against Women, an international mechanism that addresses violence against women. In both the 110 th and 111 th Congresses, Members introduced, but did not pass, House and Senate versions of the International Violence Against Women Act, which sought to coordinate and provide additional funding for U.S. efforts to address violence against women overseas.

When considering U.S. and international efforts to address violence against women, the 112 th Congress may wish to take a number of issues into account.

Scope, Effectiveness, and Funding of U.S. Programs

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. 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 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. Many are concerned that these components did not constitute a substantial anti-VAW effort. Some also contend that U.S. anti-VAW initiatives that were promised, such as the Bush Administration's proposed Women's Justice Empowerment Initiative (WJEI), were not fully funded or implemented.

Integration into Foreign Assistance Programs and Additional Funding

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 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.

Coordination Among U.S. Agencies and Departments

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 the issue, 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.

Collaboration with International Organizations

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. UN Women, 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. 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 [author name scrubbed].

Possible Program Implementation Challenges

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 112 th Congress.

Infrastructure and Priorities

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. A 2006 U.N. study on VAW found that 102 of the 192 U.N. member states lack domestic legal provisions addressing intimate partner violence. In recent years, efforts to address domestic violence have appeared to increase. A 2011 UN Women report, for example, found that 125 countries have adopted legislation on domestic violence, including almost all countries in Latin America and the Caribbean.

Despite such improvements, significant obstacles remain. Many countries lacking domestic violence laws often face 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.

Most Effective Approaches?

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. 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.

Program Evaluation

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 observers fear may leave little time and financial resources for evaluations. 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.

Lack of Comparable Data

Existing VAW research offers little in the way of comparative data. 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.

Current and Emerging Issues

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.

Links to Security

In recent years, a number of governments, international organizations, and NGOs have increasingly argued that the problem of international violence against women—particularly sexual violence in conflict situations—may be linked to national and international security. For example, U.N. Security Council Resolution 1820, unanimously adopted in 2008, affirmed that "effective steps to prevent and respond to ... sexual violence can significantly contribute to the maintenance of international peace and security." In August 2009, Secretary of State Hillary Clinton stated, "no nation can succeed in ... increasing security if it leaves out or leaves behind more than half of the population." Supporters of this position argue that the deliberate use of sexual abuse during armed conflict, which is designed to split families and communities apart, threatens public order. They further contend that sexual violence prolongs armed conflict and may undermine possibilities for long-term peace and security. Many emphasize that women may not fully participate in civil society because they are intimated by violence or the threat of violence. Some also argue that because sexual violence often destabilizes communities, it could create conditions that breed terrorism.

The Role of Men and Boys

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.

Violence and HIV/AIDS

During the last decade, researchers and policymakers have increasingly explored the relationship between HIV/AIDS and violence against women. 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. 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. 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.

Discrimination and Violence

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. 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.

Possible Economic Impacts

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. Canadian researchers, for example, estimated that the cost of damage incurred by VAW in Canada is over $4 billion Canadian dollars. 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. 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.

Appendix. Selected U.S. Agencies and Offices/Bureaus that Address Global Violence Against Women