Almost 16 million people with HIV/AIDS are receiving treatment today, and the number dying from the disease has been decreasing for the past decade. Fifteen years ago, however, public health experts and policymakers cautioned against spending scarce resources on treatment for people with AIDS, and advocated for investment exclusively in disease prevention. This grim logic was informed by the prohibitively high cost of anti-retroviral AIDS drugs and the fact that relatively inexpensive interventions might protect tens of millions of uninfected people from transmission. It wasn’t until 2003—18 million AIDS deaths into the pandemic—that the United States changed its approach and embraced both prevention and treatment.

Today there is remarkably similar tension between “prevention” and “treatment” in the anti-slavery movement. An estimated 35.8 million people live in slavery, and the bulk of investment by national governments, foreign donors, and international organizations is for prevention. Prevention programs aim to decrease the vulnerability of people who might be trafficked or enslaved, and include community development, raising awareness, education, and economic empowerment. Notwithstanding the value of these initiatives to non-slaves, such prevention efforts are largely irrelevant to children, men, and women who are already victims. They need “treatment”—which in this context means rescue and restoration.

Trafficking and slavery—I use the terms interchangeably here—have been at the top of the human rights agenda for decades, but very few governments of slavery-burdened countries have identified and freed significant numbers of slaves. The US State Department’s most recent “Trafficking in Persons Report” estimates that less than one percent of modern-day victims of slavery were identified for rescue last year.

How is it possible that slavery, which is legal nowhere, is common in many countries? Why have governments, development institutions, donors, and NGOs not made the actual freeing of tens of millions of slaves a priority? The answer lies in the fact that well-meaning investors have neglected the essential characteristic of slavery that makes it quite different than poverty, vulnerability, joblessness, social exclusion, or migration: the perpetrators. For every trafficked and enslaved child and adult, there is at least one person who inflicts abuse, restricts movement, confiscates earnings, and benefits financially from the victim’s coerced labor or exploited body. Securing and sustaining freedom from slavery requires that we restrain those responsible for it.

The profits to be made from coerced labor or sexual exploitation are astounding: The International Labor Organization estimates that they exceed $150 billion annually. Those involved in such profits through the violent exploitation of others do not give up the source of their wealth willingly. But they are seldom required to do so. Slavery flourishes in countries with poor criminal justice systems because it is profitable, and perpetrators perceive low or no risk of apprehension and punishment.

Donors and development agencies for their part, haven’t invested in law enforcement capacity to actually bring enslaved people out of brick kilns, garment factories, fishing boats, and brothels. Of the approximately $100 million of US annual foreign aid investments in counter-trafficking, the bulk is for anti-poverty strategies or awareness campaigns. Since most anti-trafficking NGOs in the developing world are involved in prevention; only a handful are working alongside local authorities to rescue slaves and apprehend, prosecute, and punish the criminals who trafficked them.

The global response to the HIV/AIDS pandemic in the global South was strikingly similar in the 1990s and early 2000s. Such resources as were available to combat the pandemic were limited to preventing HIV infections. The number of NGOs providing AIDS treatment to poor patients in poor countries could be counted on one hand.

Major donor governments and philanthropies took the same approach. The head of the US Agency for International Development, Andrew Natsios, said in 2001 that Africa’s lack of health infrastructure ruled out providing anti-retroviral treatment for people with AIDS and recommended that agencies use money to combat the pandemic entirely for prevention. The Clinton Administration that preceded him provided virtually no foreign aid for AIDS treatment. The Gates Foundation, similarly, channeled its resources exclusively towards prevention in the early 2000s.

Two factors transformed the prevention-only policy to a full-fledged effort that broke the back of the AIDS pandemic. First were successful AIDS treatment programs launched by Medicins Sans Frontiers and Partners in Health in South Africa and Haiti. These programs proved the effectiveness of anti-retroviral therapy among the poor, and demonstrated to donors, policymakers, and governments that mass treatment was actually possible. And that led to the second transformative factor: the creation in 2002 and 2003 of robust aid programs (including both the Global Fund to Fight Aids, Malaria and Tuberculosis, and the United States’ bilateral program, PEPFAR), which took both prevention and treatment to scale in dozens of countries.

We are at a similar inflection point today in the global struggle against slavery. Training and deploying specialized anti-trafficking police units in Southeast Asia have resulted in the rescue of thousands of victims from labor slavery and sexual servitude. There are also promising models of rescue and restoration for tens of thousands of children and adults in bonded labor in South Asia, which is home to the majority of the world’s slaves. Criminal justice officials in some of the poorest countries in the world are apprehending suspected perpetrators, collecting court-worthy evidence against them, and bringing them to justice.

Significantly, we’re finding that anti-slavery “treatment”—which includes police intervention to rescue victims and apprehend predators—is a prevention initiative in its own right. Our organization, International Justice Mission, conducted before-and-after studies of child sex trafficking prevalence in the Philippines and Cambodia. When trained police units began arresting suspected traffickers and courts prosecuted them, the child sex trafficking diminished dramatically. Slavery—a discretionary crime fueled by greed—turns out to be disproportionately vulnerable to law enforcement.

There are disagreements among anti-slavery activists over whether to prioritize rescue, prosecution, or prevention, just as there was in the public health field 15 years ago, when resources to combat HIV/AIDS were grossly inadequate. But when President George W. Bush, in collaboration with a Democrat-controlled House and a Republican-controlled Senate created PEPFAR and the Global Fund, money became available to do both

Funding for an integrated and complimentary approach to combatting slavery is something anti-slavery activists have dreamed of for many years. It may well be a reality in the coming year: Public and private donors are in the stretch to create a $1.5 billion foundation to end modern-day slavery. US Senate Foreign Relations Committee Chairman Bob Corker (R-TN) has made the issue his own and crafted legislation to create the End Modern Slavery Initiative (EMSI). The bill has strong bipartisan support in the Senate and is expected to be enacted in the current Congressional session. It will create an independent foundation that will disburse grants to slavery-burdened countries, providing $250 million over the next seven years.

The new fund offers not only the prospect of a huge increase in money, but also the possibility of a highly disciplined approach that takes the fight directly to those who profit from labor and sexual exploitation and who, to date, have operated with near complete impunity. A central provision of the legislation creating the fund is the requirement that programs show a 50 percent reduction in slavery prevalence within seven years—a high bar, but one that will help channel resources to strategies that actually release slaves and deter perpetrators. This innovative feature of EMSI would accelerate the development of prevalence data collection.

EMSI’s holistic approach would strengthen prevention and “treatment” for victims of slavery, and thereby enhance the effectiveness of both efforts. Preventative economic and community development in high-risk regions, for example, would be much more effective if well-trained police and courts (that remove victims from exploitation and bring traffickers and slave owners to account) were serving them. By the same token, public awareness prevention efforts in high-risk areas would push police accountability and improve law enforcement on behalf of victims. And wrap-around, “treatment” services for rescued victims, including reintegration into the community, would help prevent re-trafficking.

Decreasing the vulnerability of people who might be trafficked or enslaved through economic and community development, and public awareness, while increasing criminal justice capacity and strength is an anti-slavery strategy that is long overdue. If EMSI becomes a reality, it may well do for slavery what PEPFAR and the Global Fund did for HIV/AIDS: deal it a mortal blow. 

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