UNAIDS Executive Director Michel Sidibé joined the former First Lady of the United States of America, Laura Bush, the First Lady of Namibia, Monica Geingos, and the First Lady of Panama, Lorena Castillo de Varela, on 18 September to discuss how they have used their political platforms and voices to bring attention to some of the most pressing issues affecting the world.

The event, A Role Without a Rulebook: the Influence and Leadership of Global First Ladies, was held at the Concordia Annual Summit in New York, United States, and explored the challenges of being a woman of influence without a job description. Unelected but official, the spouses of government leaders have a unique opportunity to build bridges between civil society and government institutions. The three first ladies each shared how they have navigated the role, crafting their own platforms and agendas for progress.

“I know the power of first ladies,” said Mr Sidibé, who moderated the discussion. “They have become our special champions for ending the transmission of HIV from mother to child. It is when I enlisted their support that we started to see real progress. Now we have some countries that have managed to almost eliminate new infections of HIV among infants.”

Ms Bush discussed her efforts to advance the human rights agenda for women in Afghanistan and her efforts in global health. She recalled her experiences in championing the health of women and girls, including ending the transmission of HIV from mothers to children. Ms Bush focused on her commitment to end AIDS through the United States President’s Emergency Plan for AIDS Relief and her desire to build on the positive progress of the AIDS response and eliminate cervical cancer.

“We found out that women were living with HIV, but they were dying from cervical cancer, which is also sexually transmitted through the human papillomavirus (HPV). We launched Pink Ribbon Red Ribbon to add testing and treatment for HPV and the vaccine to the AIDS platform that was already set up with the President’s Emergency Plan for AIDS Relief. So far, we have been very successful,” Ms Bush said.

Ms Geingos focused on her work with young people and empowerment, emphasizing the importance of young people with regard to issues of gender-based violence, education, health and cultivating entrepreneurship. Ms Geingos said that there is a great need to encourage confidence in young people and to include them in conversations about their health. She spoke candidly about the youth bulge in Africa, where 60% of the population is under the age of 25 years, with the population set to double by 2050.

“We let young people lead the conversation in the language they understand. We use the opportunity to give them important health information. Namibia has done great work with the help of global partners like UNAIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria in reducing new HIV infections. We have halved them in less than a decade, and we are about to eliminate mother-to-child transmission of HIV,” said Ms Geingos.

Ms Castillo highlighted her efforts to ensure inclusion and respect for all people. Mr Sidibé noted that Ms Castillo, the UNAIDS Special Ambassador for AIDS in Latin America, has been a powerful advocate for communities and people who are excluded. He highlighted her efforts to counter stigma and discrimination in all its forms in order to build an inclusive society.

“We should all work on leaving no one behind. By leaving no one behind, I mean truly no one,” said Ms Castillo.

From their platforms as global leaders, first ladies are able to take risks, challenge expectations and push against deeply ingrained biases to offer a more inclusive and equitable vision of society.

In closing, Anita McBride, former assistant to former President of the United States George W. Bush and former Chief of Staff to Ms Bush said, “Concordia is an action tank, not a think tank, and this session clearly shows how a first lady’s podium, when used effectively, is a catalyst for action, and for change, and that there is even greater value when they come together and work together.”