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Care and the 53rd Commission on the Status of Women: a transformative policy space?

Abstract: In March 2009, UN member states met at the 53rd Commission on the Status of Women (CSW) to discuss the priority theme of "the equal sharing of responsibilities between women and men, including caregiving in the context of HIV/AIDS." This meeting focused the international community's attention on care issues and generated Agreed Conclusions that aimed to lay out a roadmap for care policy. I examine how the frame of "care"--a contested concept that has long divided feminist researchers and activists--operated in this site. Research involved a review of documentation related to the meeting and interviews with 18 participants. Using this research I argue that the frame of care united a range of groups, including conservative faith-based actors who have mobilized within the UN to raft back sexual and reproductive rights. This policy alliance led to important advances in the Agreed Conclusions, including strong arguments about the global significance of care, especially in relation to HIV; the need for a strong state role; and the value of caregivers' participation in policy debates. However, the care frame also constrained debate at the CSW, particularly about disability rights and variations in family formation. Those seeking to reassert sexual and reproductive rights are grappling with such limitations in a range of ways, and attention to their efforts and concerns can help us better understand the potentials and dangers for feminist intervention within global policy spaces. [c] 2010 UNRISD. All rights reserved.

Keywords: care policy, advocacy and political process, sexual and reproductive rights, HIV/AIDS, disability, family formation, United Nations

Resume

En mars 2009, a la 53e session de la Commission de la condition de la femme (CSW), les Etats membres de l'ONU ont debattu du << partage des responsabilites a parts egales entre les femmes et les hommes, y compris devant la fourniture de soins dans le contexte du VIH/sida >>. Cette reunion a centre l'attention de la communaute internationale sur les soins et a formule des Conclusions concertees pour definir une feuille de route de la politique de soins. J'examine comment le cadre des << soins >>, un concept conteste qui a longtemps divise les chercheurs et les militantes feministes, a opere dans ce contexte. J'ai analyse la documentation de la reunion et me suis entretenu avec 18 participants. J'avance que le cadre des soins a reuni divers groupes, y compris des acteurs confessionhels conservateurs qui s'etaient mobilises au sein des Nations Unies pour faire reculer les droits genesiques. Cette alliance politique a permis des progres substantiels dans les Conclusions concertees, notamment des arguments solides sur la signification mondiale des soins, en particulier en rapport avec le VIH; la necessite

d'un role etatique fort ; et la centralite de la participation des prestataires de soins dans les debats politiques. Neanmoins, le cadre des soins a egalement limite le debat a la CSW, specialement sur les droits des handicapes et les variations dans la formation de la famille. Ceux qui veulent reaffirmer les droits genesiques luttent contre ces limitations de diverses facons et en accordant une attention a leurs activites et leurs preoccupations, nous pouvons mieux comprendre le potentiel et les dangers pour l'intervention feministe dans les espaces de politique internationale.

Resumen

En marzo de 2009, los estados miembros de la ONU se reunieron en la 53a Comision de la Condicion Juridica y Social de la Mujer (CSW) para discutir el tema principal: "compartir las responsabilidades entre mujeres y hombres, incluido el cuidado en el contexto del VIH/SIDA". Esta reunion enfoco la atencion de la comunidad internacional en asuntos de cuidado y genero Conclusiones Convenidas, cuyo objetivo fue sentar las pautas para la politica sobre los cuidados. Examino como ha funcionado el marco de "cuidados", un concepto refutado que desde hace mucho divide a los investigadores y activistas feministas. La investigacion comprendio una revision de los documentos relacionados con la reunion y entrevistas con 18 participantes. Mediante esta investigacion, arguyo que el marco de cuidados unio a una variedad de grupos, incluso actores religiosos conservadores que se han movilizado en la ONU para dar marcha atras a los derechos sexuales y reproductivos. Esta alianza de politicas publicas aseguro importantes avances en las Conclusiones Convenidas, incluidos solidos argumentos sobre la importancia mundial de los cuidados, especialmente con relacion al VIH; la necesidad de una marcada funcion del Estado; y la centralidadde la participacion de las personas que prestan cuidados en los debates de politicas. Sin embargo, el marco de cuidados tambien restringio el debate en la CSW, particularmente sobre los derechos de discapacidad y las variaciones en la estructura familiar. Las personas que buscan reafirmar los derechos sexuales y reproductivos estan luchando contra rales limitaciones en una variedad de formas. Si prestamos atencion a sus esfuerzos e inquietudes, podremos entender mejor las posibilidades y los peligros de la intervencion feminista en los espacios de politicas internacionales.

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THE CSW is the UN's principal norm-setting and policy-making body on issues of gender equality and the advancement of women. Its most important activity is its annual March meeting in New York, where delegates of Member States gather "to evaluate progress on gender equality, identify challenges, set global standards and formulate concrete policies to promote gender equality and advancement of women worldwide." * More specifically, after the 1995 Beijing Conference the CSW adopted new working methods designed to move the international community forward on the Platform for Action, including via adoption of negotiated Agreed Conclusions on thematic areas of focus. Themes are set several years in advance, after consultation with other UN entities and NGOs. Although not binding in the way that treaties are, and lacking the threat of sanctions, the Agreed Conclusions forged at the CSW play a key role in forging international norms around the chosen themes (p.16). (1)

The CSW also provides a site for civil society engagement and ideas exchange. NGO representatives gather to hold parallel events--over 200 such meetings were held at the 53rd session in 2009. Additionally, independent experts and NGOs discuss the theme outside the annual meeting process itself, through mechanisms such as an online discussion forum, for which 1,243 participants registered, and an Expert Group Meeting prior to the March meeting that resulted in an independent report circulated to the Secretary General.

Framing the theme of care policy

"I was concerned that the issue of care become an issue of policy. The popular discourse on care is that it is some voluntary experience ... that this is an organic role for women to play ... What was central to me was to frame it differently, as an issue of policy." (Interviewee 10, original emphasis)

Attention to framing--to how policy problems are defined, how the solutions are constructed, and who has a voice in that process (p. 10) (2)--is an important part of feminist policy analysis, revealing the opportunities for and limits on gender policy within particular institutional contexts. A recent collection of work on this issue defines a political frame as "an organizing principle that transforms fragmentary or incidental information into a structured and meaningful policy problem, in which a solution is implicitly or explicitly included" (Verloo, p. 11). (2) Frames do not precede political practice, in this view; rather they are a form of political practice (Poguntke, p. 14). (2)

The political nature of flaming is very clear in relation to the 2009 CSW. The priority theme for the 53rd session was chosen in 2006 when the Commission adopted its multi-year programme of work. As is clear in the briefing notes of the Division for the Advancement of Women, (3) and as several interviewees confirmed, the 53rd session merged three themes (equal sharing of responsibility, care, and HIV/AIDS). Binding them together into a coherent frame that could produce action-oriented conclusions was a core challenge, since each sub-component had its own trajectory within UN debate, and its own dominant policy narratives and authoritative texts. For example, while the language of the equal sharing of responsibilities came from the Beijing Platform for Action, it was understood there to include political participation and equal sharing of leadership roles; it was not predominantly about care. The International Labour Organization (ILO) approached the theme via its initiatives on work and family, and protecting domestic workers (p.7). (4) In turn, gender and development conversations about care have focused on issues such as gender budgeting, measuring unpaid work, and the consequences of neoliberal policies for the care sector. The 53rd session thus had to do considerable conceptual and movement-building work, gesturing to the aims of a diverse group of constituencies that had not previously been mobilized as an effective coalition in past meetings.

Particularly crucial here was the successful construction of a linear policy narrative running across past international agreements, wherein a new, combined emphasis on care, equal sharing, and HIV/AIDS was legitimated. The narrative identified a progression from the 1994 ICPD agreements in Cairn and the 1995 Beijing agreement to the 53rd session, via numerous other international conferences, on the grounds that they reflected a global consensus on the importance of partnership between men and women, which included the equal sharing of care. This (re)entrenched a very narrow vision of the Cairo and Beijing agreements, as being about promoting harmony within couples rather than fights to sexual autonomy and bodily integrity. ** For example, it was regularly asserted that previous conventions and treaties, especially CEDAW, "provide a legal framework and a comprehensive set of measures for the promotion of equal sharing of responsibilities between women and men" (p. 1). (5,6)

This narrative, identifying a nascent UN "policy and legal framework ... on the need to ensure more equal sharing of responsibilities between women and men" (p.1) (7) and applying it to caregiving, proved extremely successful. It was repeated, in a virtually cut-and-paste fashion, on the CSW website, (6) in the background document put out in advance of the CSW, (7) in the Secretary General's Report to the session (p.3), (8) and in the preamble to the Agreed Conclusions (p.1). (5)

The 53rd CSW is thus a prime example of how various collectivities were mobilized through construction of a frame about what previously agreed language *** on gender equality meant. In other words, the theme used in this meeting was defined as having a history of consensus such that a wide range of constituencies were held together throughout the negotiations. To give just a few examples, groups who submitted statements in support of the theme included a women's NGO that advocated "channeling national wealth from arms trade and military spending to care, health, education and welfare" (International Alliance of Women); a missionary organization fighting AIDS in Africa (Associazione Comunita Papa Giovanni XXIII); the Minister of Youth in Barbados, who highlighted the importance of participatory workshops for men in achieving gender equality; and the Cuban delegation, who attributed the problem of care in part to a drain of medical personnel from the Global South. (5) The flame of care thus proved an exceptionally expansive one.

In particular, by emphasizing care within the parameters of equal sharing of responsibility between men and women, the frame of the session appealed both to those interested in radically changing gender relations and to more conservative parties interested in defending what they understand to be the natural family. To understand how this somewhat peculiar unity was achieved, it is helpful to recall Buss and Herman's (12) analysis of the rise of Christian Right activism in the UN since 1995, involving an alliance of mostly US Catholic, Mormon, and Protestant conservative organizations to bring a "faith perspective" to UN work, encouraged under the Presidency of George W Bush. ([dagger]) This constituency invokes a global crisis in the natural family, requiring international action through the UN orbit.

Although the Obama administration did not align itself with the US Christian Right in the 2009 CSW the continued presence of conservative Christian actors was very clear. Statements on the theme were submitted to the Secretary General by, for example, the Holy See, the international NGO Mothers' Union, and the Anglican Consultative Council, all of whom found that the theme resonated well with their faith-based care-giving activities. (6) The threats facing the family, and the need to enact a global policy agenda to protect and support it, are core themes of these statements: the family is being stretched "to the breaking point" and "devastated" by ever-growing burdens of care. ****

The language of care, when linked with the language of equal sharing of responsibility between men and women, could thus successfully mobilize a wide range of constituencies. It allowed a diverse group of actors to get behind a new global gender priority, including actors who might otherwise be hostile to UN gender efforts. This expansive frame helped facilitate many of the achievements noted below, while also constraining debates on rights in specific ways.

Key achievements

The key objective of many of those involved in the 53rd session was to raise the profile of care issues and to put them on the international policy agenda. This objective was achieved with remarkably little contestation. As several participants noted, there was widespread support among Member States for key paragraphs within the Agreed Conclusions regarding measuring care, integrating care into budgeting processes, and so on.

Progress was especially significant in relation to HIV. Given the donor emphasis on treatment (heavily skewed towards antiretrovirals), it has been hard for HIV/AIDS organizations working on care issues to get their programmes funded by major donors or scaled up as part of the global AIDS strategy. The CSW represented a key step forward in this regard. Issues of care and HIV/ AIDS were made central to the meeting, and several country and regional statements mentioned the inadequate resourcing of care compared to prevention and treatment. UNIFEM and UNAIDS also collaborated in producing a paper for the Expert Group Meeting, (14) setting the stage for the head of UNAIDS to make a rousing appeal at the CSW for a new alliance of gender activists and HIV/AIDS activists on care issues (Sidibe). (5) Several interviewees noted this intervention as an important achievement.

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Moreover, in part because HIV/AIDS was a core component of the care conversation at the CSW, the meeting also forged a consensus that the equal sharing of responsibility between men and women within the private family is not enough to resolve the care problem. As the UNRISD Director noted in his statement:

"The HIV/AIDS pandemic has been a tragic wake-up call to those who assume that families and communities--and more concretely women and girls--will continue to provide an unlimited supply of unpaid care to meet rising needs and to compensate for the shortfalls in policy." (Mkandawire) (6)

This lesson was extended outwards from HIV/ AIDS. Several of the Expert Group Meeting papers argued that redistribution of care responsibilities to men was an insufficient solution, and they criticized neoliberal policies that had overburdened the family. (14-16) In turn the Secretary General's report, which provided recommendations for consideration by the CSW and which was in many ways the most important document prepared in advance of the meeting, ***** advocated a comprehensive approach from the start involving improvements in labour market policies, health, education and infrastructure (p.2-3). (8) It also noted explicitly that the equal sharing of responsibilities between men and women was insufficient (p. 17-18).

Most importantly, the Agreed Conclusions laid out an extensive social policy roadmap on care that locates responsibility firmly with States. For example, they recommended that States should, among other measures:

* design, implement and promote family-friendly policies and services, including affordable, accessible and quality care services for children and other dependants

* measure unremunerated work and incorporate the value and cost of unpaid work in policies across all relevant sectors

* develop and improve social protection and/or insurance schemes, including pension and savings schemes, and recognize leave periods for caregiving in the calculation of benefits

* strengthen efforts to protect domestic workers

* increase the availability, access to, and use of critical infrastructure to reduce the burden of care on households

* scale up efforts towards the goal of universal access to comprehensive HIV/AIDS prevention programmes, treatment, care and support by 2010. (5)

This roadmap attempted to protect, and extend, care services during the global recession, something that a number of actors agreed was significant. ([dagger])([dagger])

Importantly, faith-based organizations mobilizing to protect the family were fully signed up to this agenda. (6) The Holy See urged governments to better protect immigrant caregivers and to give professional training to home-based carers, and Caritas (a key international Catholic charity) fore-grounded the importance of States resourcing home-based care. Similar recommendations were made by the Anglican Communion, After detailing its experiences with a Worldwide Parenting Programme that aims to improve parenting skills and increase equal sharing of responsibilities within families, the Mothers' Union advocated government support for flexible working practices, parental and carer's leave, and improved childcare provision. These recommendations are similar to those promoted by organizations with very different approaches to gender equality, such as the International Planned Parenthood Federation, the ILO, and Sonke Gender Justice, a South African NGO that used its statement to the CSW to criticize unfair trade and debt policy. (6)

That such diverse actors are advocating for the enhanced role of States in care policy is noteworthy, indicative (among other things) of shifting alignments between free market neoliberals, religiously motivated neoconservatives, and gender equality advocates. As Gita Sen (19) has noted, in the 1990s much debate at UN conferences reflected a disconnect between issues of gender justice (defined primarily as about sexual and reproductive rights), and economic justice (on fairer regimes of trade, debt, development financing, etc). The US, under Clinton, advanced a strong neoliberal agenda on world trade and debt repayment while nominally supporting women's reproductive and sexual rights (p.1). (19)Meanwhile some conservative faith-based actors aligned themselves with countries in the global South on economic issues, while opposing sexual and reproductive rights (p.9). (19) Writing in 2005, Sen argued that George W Bush had inaugurated a neoconservative era that opposed both gender and economic justice, creating new dynamics in global negotiations (p. 11). (19) The 2009 CSW, in contrast, can be read as a moment where economic justice concerns were placed centre stage in a gender justice forum. The understanding of care forged there, involving a fundamental challenge to free market models of the economy, had the support of many religious conservatives as well as many gender equality advocates who see economic concerns as central to their work.

Finally, the CSW had a positive impact on civil society organizations working around caregiving, and it increased the voices of caregivers in UN policy debates. Several UN entities involved grassroots caregivers in their preparations for the sessions, and some caregiver organizations attended the Expert Group Meeting and the CSW. One group of participants formed a new advocacy group, the Caregivers Action Alliance, with other international NGOs working on home-based care from a community perspective. Moreover, successful lobbying work was undertaken by carers to influence the Agreed Conclusions, leading to the insertion of language on making caregivers' voices central to policy debates. (5) As a result, the Agreed Conclusions were regarded by many interviewees as an important new resource in their activism.

Key constraints

These advances notwithstanding, there were two issues that received less attention: disability, and variations in kinship and intimate arrangements. These issues reveal current gaps in UN care debates, which in turn allow consideration of the constraints within which feminist policymakers are operating when they try to use care policy to take forward gender equality. This process of reflexivity about policy is crucial since, as Carol Bacchi and others note, we need critical reflection on hegemonic feminist approaches to ascertain how they may create borders or silence voices (p.9). (2) The process is already a well-established part of the CSW's work, given that it will return to the care theme in 2-3 years to review implementation of policy recommendations and identify remaining challenges.

Disability and care: "The trend is upwards"

"Disability issues are starting to have their moment within the UN system. The Convention is great, it's an extraordinary thing ... The trend is upwards." (Interviewee 14)

There were many reasons to expect that a UN-based conversation about care policy in 2009 would have disability firmly on the agenda, namely because in 2008 the Convention on the Rights of Persons with Disabilities came into effect. The Convention includes binding agreements by states and other entities (e.g. the European Union) on care provision, and on the importance of including the voices of persons with disabilities in debates about care. It includes several relevant commitments on care, development, and poverty, including Article 26 (which guarantees all persons with disabilities access to voluntary rehabilitation in their community), Article 27 (on access to work), and Article 28 (on an adequate standard of living, including via coverage of disability-related expenses and the access of persons with disabilities, especially women and older people, to social protection and poverty reduction programmes). (20)

However, there were only sporadic references to disability concerns in the 2009 CSW, and they stayed within the paradigm of framing disabled people as a care burden, alongside children, the sick and the elderly, e.g.p.38 and para.9.5. The Agreed Conclusions mention persons with disabilities briefly, pledging to "strengthen, expand, improve and promote the accessibility of quality comprehensive public health care and services, including community-based health services specifically related to the prevention and treatment of HIV/AIDS, including for people with disabilities ..." (p.7), (5) but the theme is not mainstreamed throughout the text. There are no references to centring the voices or needs of persons with disabilities in debates about care. Disability was also sidelined within the preparatory processes leading up to the CSW, such as the Expert Group Meeting and the NGO parallel events:

Q: "Was there discussion of disability and care [in the NGO events]?"

A: "Hardly at all. I mean no more than just occasionally recognizing, you know, "Oh, and disability and older people' as if, kind of, throw it in there, but not ever saying 'OK, can we just talk about this issue for a moment'?" (Interviewee 11)

To clarify the significance of this sidelining, it may be helpful to sketch how some of the core assumptions behind the CSW's work on care would have been unsettled by work on disability. For a start, the deployment of care as a normatively "good" concept that can bind diverse actors together in pursuit of a universally valued goal has been challenged by some disability researchers and activists, who regard care as part of the problem against which they are mobilizing. As Teppo Kroger notes in a recent review of the tensions between care research and disability research:

"Care as a concept has symbolized a century-long confinement of disabled people to institutions and of lives controlled and colonized by others, by professional social workers and by care providers as well as by other family members" (p.403). (21)

As a result, resisting the terms "care" and "carer" has become a political act for some disability rights activists. (22) Terms such as help, assistance, and support, have been preferred by many, since these lack the "historical disrepute" (p.407) (21) associated with care.

In particular, the principle of self-advocacy--central to disability rights activism and scholarship--adds new perspectives to the CSW's debates about care. In self-advocacy, emphasis is placed on the fact that disabled people need human rights and control over their own lives, including choice and control over how any help or assistance necessary to facilitate their independence is provided. This results in a strong push for user-led or needs-led services, and it reinforces the importance of centring disabled people (and others classified as "care receivers") in the planning and evaluation of care policies. (21)

In this regard, the Agreed Conclusions presume a dichotomy between caregivers and care receivers, and policy prescriptions privilege the former. While the dichotomy itself has been troubled by some care research and by disability scholarship and activism, ****** the latter community has engaged in extensive debate about the decentring of care receivers in care policy. There has been "deep and bitter controversy" over how family members and other informal carers are positioned in relation to the struggle for disabled people's rights, (24) in part because the principle of empowerment for disabled people requires going so far beyond investment in caters' projects (p.356). (22) Moreover disability activism has consisted, in many cases, of wrestling control away from care professionals (p.801), (25) a reality which sits uncomfortably alongside the fact that several Agreed Conclusions embrace the provision of more--unaltered--professional care services, e.g. paragraphs aa, bb, and mm. (5)

Finally, incorporation of a disability rights perspective into care conversations would bring new insights to ongoing conversations over the role of the market in care. There has been, for example, extensive debate in several countries (including Canada, the UK, and the US) over the issue of direct payments for personal assistance. Direct payments aim to transform care provision into a less personal, more formal relationship, where people needing assistance can be better protected from the pejorative aspects of caring relationships (p.405). (21) However, debate continues to rage over the problems of marketized delivery; (26,27) the emancipatory and oppressive experiences of employee-employer relations; the limits of consumer choice in terms of genuine empowerment; (28) the need to defend robust collective service provision; and the tensions caused by the low level of payments, resulting in reliance on low-paid workers vulnerable to exploitation. While there were disputes at the CSW over paying wages for informal care, and whether this undermined affective attachments, none of the aforementioned disability debates about marketizing care were foregrounded.

That said, however, the failure of the Agreed Conclusions to link up to the vibrant UN work on disability was noted by several interviewees as an obvious gap, and it was registered at the time as well. In a 17 March press release from the Economic and Social Council, delegates lamented that the Agreed Conclusions made no reference to the new disability Convention (p. 1). (29) Moreover, as one participant noted, there is a clear common cause between disability rights advocates and HIV/AIDS activists to increase the voices of care recipients in the UN system and to resist binarized understandings of who gets and gives care (Interviewee 15). These possibilities for cross-movement organizing, along with the high levels of state and NGO mobilization around disability in the global policy arena, suggest that a revisited CSW on care would forge better links between care and disability. It also raises the possibility that the UN's ongoing disability conversations can draw on the 53rd session's Agreed Conclusions to push forward their own struggles around user-led assistance provision.

Diversity of family formations in care conversations

"In some parts of the negotiations, delegations proposed language on various forms of the family ... but after more negotiations these ... disappeared. Instead they were replaced by family kinship and community responsibilities. That is because some of the delegations understand that [acknowledging] various forms of the family is contrary to the view that there is one [kind of] family, meaning, one man and one woman and that's it...." (Interviewee 7)

A second important gap in the Agreed Conclusions relates to the diversity of family forms and kinship arrangements through which care is provided. The Agreed Conclusions strengthened the notion that the privatized nuclear family consisting of a long-term male-female partnership, sharing care and paid work in an egalitarian way, is the ideal for better care and better development, albeit supported with stronger state services. For example, member states pledged to "take appropriate measures to achieve equal sharing of work and parental responsibilities between women and men, including measures to reconcile care and professional life and emphasize men's equal responsibilities with respect to household work" (p.4), (5) and their conversations about family were largely limited to this model. Attempts to create space to discuss other kinship arrangements were, overall, unsuccessful.

This is most obvious in relation to sexual minorities, such as gay and lesbian communities. Although sexuality-based organizations attended the CSW, and there were NGO sessions held on sexual rights, in general the groups attending these meetings did not engage with the care agenda. Some of the experts consulted for the CSW mentioned same-sex families, and the final report of the Expert Group Meeting raised this issue (p.10), (18) but it was not taken up as a major theme of the meeting. Likewise the groups and individuals working to challenge dominant masculinities as part of gender and development initiatives repeatedly put the issue of homophobia on the agenda, both in presentations at the CSW and in statements submitted to the Secretary General, but these references were absent in the Agreed Conclusions. Similarly, one participant recalled an NGO panel at the CSW that included a man relaying his experience of caring for his HIV-positive male partner: "It was brilliant and powerful and he spoke brilliantly, but I didn't see that kind of thing reflected more broadly in the discussions." [Interviewee 11)

This is unsurprising. The CSW, like other UN gender fora, has experienced conflict over sexuality since the mid-1990s, and the issue still threatens to divide Member States and provoke confrontation. (10,30) As one participant put it:

"Ideally I'd be talking about lesbians and sex workers. That is really difficult in these environments, and we--meaning a small group of allies who are sexual rights advocates--we use every entry point we can. But it is also sometimes difficult because we know that to put in certain language in a particular area will elicit not only scrutiny but a fight, and a right that could cost us elsewhere. So if we are trying to have an particular outcome without, sorry, I'm going to be crass, but without a dogfight around certain language, you know--I mean we pick and choose what our battles are going to be," (Interviewee 14)

Moreover, as suggested above, the progress being made in carrying forward the global gender equality project via a unifying focus on care, and by moving beyond the fights of the last decade, is in part based on a consensus about a universal model of a male-female couple, and a silence about the fights around sexuality at Cairo and Beijing. A battle to get the language of sexual rights or sexual diversity into care debates was thus one that sexual rights activists were bound to lose.

What is perhaps more surprising is the fact that other references to the diversity of family formation also dropped out at the 53rd CSW. Gay and lesbian communities are not the only groups excluded from consideration when "family" is defined as being about privatized nuclear units, after all. In fact there was quite considerable discussion of the role of grandparents in care, of female-headed households, of children caring for parents, and of extended family support in the NGO online discussion forum, the Expert Group Meeting, the NGO sessions, and formal statements to the Secretary General. The CSW's background document included key recognition of diverse family forms; a section on "innovative approaches to leave provisions and benefits" highlighted the value of leave for grandparents, and the importance of giving child support grants to a child's primary caregiver, "regardless of whether that person is the child's biological parent" (p.3). (7) Crucially, the Secretary General's report also made the issue of "changes ... in household composition" explicit (para.20, p.8). (17)

In response, while a few references to extended families did make it into the Agreed Conclusions, they did not fundamentally disrupt the ideal of the sharing couple on which the care conversations hinged. As one participant noted in recalling the conversations about extended family units, older relatives, neighbours and so on in HIV/AIDS care: "What I don't see people doing is saying 'OK, if that is the case why are we still talking about this as if it's a nuclear family setup?' I'm not sure people were necessarily framing responses differently because of that recognition." (Interviewee 11)

The failure to mainstream debates about diverse family formation may in part be due to the marking of those forms of care provision as problems. For example, the high proportion of female-headed households in some Latin American countries was identified as part of the problem to be solved by many CSW participants, (6) rather than as an indication of the need to fundamentally reassess how we are talking about family, care, and intimate attachments. Family diversity is recognized here, but only as a problem to be overcome.

However, some more positive discussion of diverse family formation also occurred. The ILO emphasized the crucial role in care played by sisters, mothers, aunts, co-wives and daughters, and advocated widening entitlement to parental leave to grandparents (p.15). (4) Several of the groups working on HIV/AIDS were at the cutting edge of these debates, noting how their experiences of care had challenged stereotypes about what family meant. These HIV/AIDS activists were joined by civil society groups focused on the needs of ageing populations. For example, in its statement to the Secretary General, the American Association of Retired Persons discussed grandparents who are caring for children, (6) not as a problem per se, but as receiving inadequate resources stemming from a narrow definition of who counts as family.

On these grounds, it is clear that the issue of diverse family formation is already on the table in relation to care, sometimes as a problem but sometimes in a more positive way. Honest conversation about diverse family formation thus seems long overdue. As one participant commented:

"The issue of single female-headed households is a huge policy issue in Latin American countries. I think that sometimes the language in UN documents gets filtered or laundered a little bit ... back to this stereotype [of a nuclear family]. People are very aware from their own national context, [but] UN documents don't always acknowledge those issues ... But as soon as you start talking about migration, the disruption of extended households, you know, single-parent families, orphaned families, it resonates immediately. There wasn't so much discussion about it, because I think people are just already thinking about it from their national perspective. But there should be." (Interviewee 3)

Such conversations will be immensely difficult, raising key questions for feminists and others about what UN agreed language on "partnership" between men and women in the family means; about the role that conjugality should play in determining care arrangements; and about how to reconcile the enthusiasm for increasing men's involvement in families as fathers with recognition of diverse intimate lives. ******* Those conversations are unlikely to happen through the inter-state negotiations process: there is justified fear that the limited commitments to sexual rights and autonomy forged at Cairo and Beijing might be rolled back rather than advanced if diverse family forms were to be put centre stage in debates, However, the NGOs who mobilized so successfully around care in 2009 may be able to continue these conversations horizontally, should they consider them relevant.

Conclusion

This article is both backward- and forward-looking, seeking a better understanding of the processes through which care emerged as such a powerful theme at the CSW, aiming to unpack what was achieved there, and trying to identify the constraints that stemmed from the care frame. I have suggested that the agreement forged at the 53rd CSW session offers to harmonize global care policy around key principles of the equal sharing of responsibilities within male/female partnerships, state responsibility for care, and the importance of including care-givers' voices in care debates. Consensus on these issues allowed the discussions of care at the CSW to link up with the existing objectives of a wide range of actors, including conservative religious actors who might otherwise be hostile to gender equality measures. One can see a new coalition emerging here which may prove significant in defending care services from state cutbacks in a recession, and in helping civil society actors mobilize around care, especially in HIV circles.

Notwithstanding the advances secured, however, the framing of care at the 53rd session, and the policy alliance that it facilitated, also had costs. It severely limited the potential for fruitful interaction on disability fights and gender issues, and it shut down space to talk about diverse family formation and the tight to sexual autonomy. The challenges of including these themes should not be underplayed. Taking disability and diverse family formation into account reveals some key limitations of current care framings, such as that care is a universally endorsed concept, that caregivers are the key policy constituency, and that certain intimate attachments--but not others--should be promoted by social policy. Unsettling such core assumptions risks destabilizing the current policy alliance, but it also enables us to imagine new frameworks bringing new actors into the conversation about how human (inter) dependency is to he secured in feminist ways.

Acknowledgements

This is a shortened version of an analysis I developed in a paper commissioned by the UN Research Institute for Social Development (UNRISD), entitled "Harmonizing Global Care Policy? Care and the Commission on the Status of Women", Gender and Development Programme Paper No.7, February 2010, At: <www.unrisd.org/ 80256B3 C005BCCF9/sea rch/F4E650DDSBEB 3175C12576DBOO3CDFA3?OpenDocument>. It is published here with the kind permission of UNRISD, who retain the copyright, I would like to thank Shahra Razavi for commissioning that project, and Barbara Klugman for her on-going support, including in this re-publication.

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Kate Bedford

Senior Lecturer and Research Councils UK Research Fellow, Kent Law School, University of Kent, Canterbury, UK. E-mail: k.bedford@kent.ac.uk

* The Commission consists of 45 member state representatives. A Bureau with representatives from five regional groups organizes the annual meetings. Support and servicing for the CSW is provided by the Division for the Advancement of Women, part of the Department of Economic and Social Affairs (see <www.un.org/womenwatch/ daw/csw/index.html#about>].

** See Petchesky (9) and Correa and Jolly (10) on the diverse readings of Beijing and Cairo, regarding on one hand endorsement of sharing couplehood between men and women, and on the other the advancement of an agenda focused on women's sexual autonomy.

*** For more on agreed language and gender policy at the UN, see Riles, (11)

([dagger]) Representatives of the Christian Right from Latin America have increased recently, but the movement as represented at the CSW is still overwhelmingly US-based.

**** For more on the slippage between feminist concern about a crisis in care engendered by neoliberalism, and religiously-inflected concern about a crisis in the family, see Bedford. (13)

***** Most member states will read the Secretary General's reports, (8,17) and the Bureau prepares the first draft of the Agreed Conclusions based on the recommendations in those reports.

([dagger])([dagger]) E.g. the Secretary General's report emphasized the importance of the state's role in infrastructure and social protection in a crisis context (p. 18), (8) as did DAW's report from the Expert Group Meeting. (18)

****** E.g. many feminist care researchers have emphasized the universal nature of human dependence. (23) In turn, disability research has long challenged the idea of independence as self-sufficiency while also highlighting the care done by people regarded as "dependant", especially disabled women. (22)

******* Several UN actors spoke about the importance of men's involvement in families as fathers, e.g. Zukang, (6) and the Secretary General's report mentioned numerous examples of countries taking measures to support and strengthen men's involvement in caregiving (p. 12-14). (8)

DOI: 10.1016/S0968-8080(11)38576-X
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