DRAFT Workshop Overview Five sessions: Context Challenges Practical Measures Introduction to the IASC Guidelines + Brief presentation Participatory activities and/or group discussion Introduction
DRAFT Workshop Purpose Workshop Purpose To discuss: the for HIV/AIDS in emergency settings.the broader context for HIV/AIDS in emergency settings. related to HIV/AIDS programming in emergency settings.the key challenges related to HIV/AIDS programming in emergency settings. for addressing HIV/AIDS in emergency settings in a multisectoral approach.different interventions for addressing HIV/AIDS in emergency settings in a multisectoral approach. To introduce: information provided in the information provided in the IASC Guidelines
DRAFT Workshop Objectives Workshop Objectives By the end of this workshop you should be able to… 1.Explain the relationship between HIV/AIDS and emergencies 2.Strategically address the challenges related to HIV/AIDS programming in emergency settings 3.Apply a multisectoral approach to HIV/AIDS interventions 4.Use the IASC guidelines for HIV/AIDS interventions in emergency settings
DRAFT Session 2 Introducing the HIV/AIDS Context
DRAFT Discussion In small groups, reflect on your individual experiences in a past or current emergency.In small groups, reflect on your individual experiences in a past or current emergency. Did/do you in this emergency?Did/do you consider HIV/AIDS to be important in this emergency? –If yes, why? –If no, why not? Which individuals or groups do/did you view as Why?Which individuals or groups do/did you view as most vulnerable to HIV/AIDS? Why? Could there be others? Could there be others?
DRAFT Context for HIV/AIDS Interventions in Emergency Settings Purpose: To discuss the for HIV/AIDS in emergency settings. To discuss the broader context for HIV/AIDS in emergency settings. To discuss. Who is vulnerable? Why? To discuss vulnerability to HIV/AIDS in emergencies. Who is vulnerable? Why? To discuss the link between To discuss the link between HIV and emergencies
DRAFT World leaders commitment – 2015.World leaders commitment – HIV/AIDS integral to the achievement of the MDGs. HIV/AIDS integral to the achievement of the MDGs. Goal 6 states:Goal 6 states: to halt and begin to reverse the spread of HIV/AIDS by HIV/AIDS in all contexts, including emergencies.HIV/AIDS in all contexts, including emergencies. The Global Context: HIV/AIDS and the Milennium Development Goals the Milennium Development Goals
DRAFT Global estimates of HIV and AIDS as of end 2004
DRAFT Countries in Conflict (2003)
DRAFT Countries in Crisis (2003)
DRAFT HIV/AIDS in emergencyHIV/AIDS in emergency HIV/AIDS as emergencyHIV/AIDS as emergency in emergency Haiti Swaziland southern Africa famine HIV/AIDS & Emergencies: 3 perspectives
DRAFT HIV/AIDS, Emergencies and Vulnerability Vulnerability is defined as the conditions determined by physical, social, economic, and environmental factors or processes, which increase the susceptibility of a community or group to the impact of hazards.
DRAFT HIV/AIDS, Emergencies and Vulnerability : Emergencies generate situations of high risk to HIV infectionVulnerability to HIV infection: Emergencies generate situations of high risk to HIV infection : HIV/AIDS undermines existing coping strategies and may reduce social stability and available resourcesVulnerability to crisis: HIV/AIDS undermines existing coping strategies and may reduce social stability and available resources
DRAFT Who is vulnerable to HIV/AIDS in emergencies? Everyone is vulnerable to HIV/AIDS Groups that are vulnerable: women, children, the poor, mobile populations, injured people (blood transfusions) Other groups at risk of HIV infection include: The armed forces, police, humanitarian workers, truck drivers. humanitarian workers, truck drivers.
DRAFT Disruption of social norms and care capacity Services cannot manage HIV/AIDS related requirements Assets and social safety nets deplete Risk of HIV infection increases How do emergencies increase HIV/AIDS related vulnerability? Reduce social stability/ supportReduce social stability/ support Overwhelm or destroy essential public servicesOverwhelm or destroy essential public services Reduce household and community resourcesReduce household and community resources Increase personal insecurity and risk of sexual assault.Increase personal insecurity and risk of sexual assault. How do emergencies increase HIV/AIDS related vulnerability?
DRAFT Conflict-affected populations: How does HIV/AIDS contribute?
DRAFT Chronic livelihood insecurity. Shocks such as drought or conflict tip situation into acute emergency. Acute crisis develops, with increased risks to lives and livelihoods. HIV/AIDS undermines livelihood security. HIV/AIDS increases vulnerability to shocks. HIV/AIDS-affected people/households have less capacity to respond and sustain more severe losses/impacts. The trajectory of a crisis: How does HIV/AIDS contribute?
DRAFT Summary Points Reduction of HIV/AIDS is in all integral to MDGs in all contexts, including emergency situations The is very articulated The relationship between HIV/AIDS and emergencies is very articulated In emergencies, is potentially everyone is potentially at-risk from HIV/AIDS. High HIV infection rates increase vulnerability to external shocks such as drought or conflict
DRAFT Session 3 Key Challenges to HIV/AIDS Programming in Emergencies
DRAFT Session 3 The Challenges in Implementing HIV/AIDS Interventions in Emergency Settings Purpose: To identify specific that apply in different emergency scenarios.To identify specific HIV/AIDS- related problems that apply in different emergency scenarios. To discuss HIV/AIDS as a key issue for responding personnelTo discuss HIV/AIDS as a key issue in the workplace for responding personnel To discuss the related to HIV/AIDS programming in emergency situations.To discuss the key challenges related to HIV/AIDS programming in emergency situations.
DRAFT Group Activity (45-60 min What are the challenges in implementing HIV/AIDS interventions in different emergency situations? Group Activity (45-60 min) What are the challenges in implementing HIV/AIDS interventions in different emergency situations? 1.Read your groups specific emergency scenario. 2.Drawing on your experiences, identify the likely HIV/AIDS-related challenges in this situation. 3.Write each challenge on a separate card. 4.Cluster together cards with similar problems, and stick the card-clusters on flip chart(s). 5.Stick chart(s) on wall for a gallery walk
DRAFT Addressing HIV/AIDS in emergency settings: challenges and problems Collapsed/inadequate health and public services.Collapsed/inadequate health and public services. Limited financial, social & economic resources.Limited financial, social & economic resources. Lack of information (on infection levels, trends, target populations,...).Lack of information (on infection levels, trends, target populations,...). Special situations of emergency-affected populations (access, security, language, culture, stigma..)Special situations of emergency-affected populations (access, security, language, culture, stigma..) Institutional and human resource constraints.Institutional and human resource constraints.
DRAFT Health and public services collapse or are inadequate HIV/AIDS in emergencyHIV/AIDS in emergency HIV/AIDS as emergencyHIV/AIDS as emergency in emergency In conflicts, infrastructure is destroyed/services collapse High HIV infection rates and related infections overwhelm existing services Public services are doubly overwhelmed by HIV/AIDS and additional demands
DRAFT Financial, social & economic resources are stretched, depleted and constrained Household/community resources deplete, especially in recurrent or protracted emergencies Limited public service constrains capacity constrains rapid up-scaling of response Break-down in disrupts authority disrupts established social order – especially in complex emergencies International aid is geared to to alleviate immediate and often does not crisis and often does not bridge the emergency phase with long term development
DRAFT Lack of information (infection levels, trends, target populations,...) among displaced population/ host population HIV infection rates are often unknown among displaced population/ host population Quality information about may not be available. Quality information about affected population(s) at risk may not be available. Limited use of (health centre level, Health Management Systems, NGO programs, etc) Limited use of available secondary data (health centre level, Health Management Systems, NGO programs, etc) HIV/AIDS may not be included in HIV/AIDS may not be included in rapid assessments
DRAFT Special situations of emergency-affected populations Remote/inaccessible locationsRemote/inaccessible locations Ongoing hostilities/unsafe conditionsOngoing hostilities/unsafe conditions Lack of safe road/air accessLack of safe road/air access Constrain access, limits coverage of target population and range of services Increased risk of abuse and exploitation, particularly of women and children Increase exposure of women and children to HIV/AIDS Language barriers, cultural perception of certain issues, gender roles, stigma, etc Limit translation of existing interventions and reutilization of tools/ methods
DRAFT Lack, attrition and death of skilled and support personnel constrain and.Lack, attrition and death of skilled and support personnel constrain program implementation and human resource capacity building. Response to humanitarian assistance appeals biased in favour of interventionsResponse to humanitarian assistance appeals biased in favour of life saving interventions Humanitarian assistance funding parameters often HIV/AIDS reduction programmes.Humanitarian assistance funding parameters often do not link to long-term HIV/AIDS reduction programmes. Institutional and Human Resource Constraints
DRAFT Summary – Key Points HIV/AIDS programming in emergencies is affected by (human, infrastructural, financial) HIV/AIDS programming in emergencies is affected by resource constraints (human, infrastructural, financial) to base implementation may be very limited, if at all available. Quality information to base implementation may be very limited, if at all available. The may require specific tools/ strategies/ human resources The characteristics of the target populations may require specific tools/ strategies/ human resources HIV/AIDS may be seen as in priorities and be given low priority/ funding. HIV/AIDS may be seen as in competition with other life saving priorities and be given low priority/ funding.
DRAFT Session 4 Practical measures: The planning and response matrix
DRAFT Practical Measures for Implementing HIV/AIDS Interventions in Emergency Settings Purpose: To of the multisectoral nature of HIV/AIDS interventions in emergencies.To strengthen awareness of the multisectoral nature of HIV/AIDS interventions in emergencies. To in inter-disciplinary collaboration in reducing HIV/AIDS in emergenciesTo build skills in inter-disciplinary collaboration in reducing HIV/AIDS in emergencies To introduce the in emergencies.To introduce the HIV/AIDS matrix for minimum response in emergencies.
DRAFT Previously, HIV/AIDS was viewed primarily as a health-sector concern We now know that HIV/AIDS is a multisectoral responsibility HIV/AIDS priorities must be integrated into emergency planning/response Reducing HIV/AIDS in emergency settings Why a multisectoral approach?
DRAFT Introducing the Matrix for HIV/AIDS actions in emergencies Ten complementary clusters of sectoral responses. Three phases of response –Emergency preparedness –Minimum response –Comprehensive response
DRAFT Matrix for HIV/AIDS actions in emergencies: focus on minimum response EmergencypreparednessMinimumresponseComprehensive response response Sector Coordination Assessment/monitoring Protection Water/sanitation Food security Site planning Health Education Behaviour Change Com HIV/AIDS at work Focus on: MinimumResponse
DRAFT Group Activity - Role Play (60-90 min) Planning multisectoral HIV/AIDS responses Group Activity - Role Play (60-90 min) Planning multisectoral HIV/AIDS responses : from the previous exercise. Take your groups flipchart with you. 1.Return to your group from the previous exercise. Take your groups flipchart with you. to group members – ensure there 2.Distribute roles to group members – ensure there is at least one observer / rapporteur. in which representatives of the different sectors address identified challenges. 3.Conduct a meeting in which representatives of the different sectors address identified challenges. 4.Observers / rapporteurs group process. 4.Observers / rapporteurs document group process.
DRAFT Coordination action priorities: Minimum response requirements The goal of coordination efforts is to meet humanitarian needs effectively and coherently. Coordination works best when all stakeholders work together to establish a shared set of ethical and operational standards Establish coordination mechanisms
DRAFT Assessment and Monitoring: Minimum response requirements In emergencies, accurate information is often lacking, especially in conflicts. This allows a shared/uniform understanding of health trends and patterns. It strengthens coordination across agencies This allows progress to be tracked and improves the management of HIV/AIDS Assess baseline data Set up and manage a shared database Monitor activities
DRAFT Protection: Minimum response requirements Prevent and respond to sexual violence and exploitation Protect orphaned & separated children Gender-based violence intensifies in conflict. It increases the risk of Transmission of HIV and STIs. Orphaned and separated children face higher risks of abuse, exploitation and recruitment into fighting forces. Ensure access to condoms for military, peacekeepers and humanitarian staff Peacekeepers, humanitarian staff and armed forces are vulnerable to STIs
DRAFT Water, Sanitation and Hygiene Protection: Minimum response requirements Consider HIV in water and sanitation planning People with weakened immune systems are less able to manage diarrhoeal diseases and other opportunistic infections. Access to safe and culturally acceptable toilets and water points helps protect women and girls from sexual harassment and abuse.
DRAFT Food Security and Nutrition: Minimum response requirements Target food aid to affected and at-risk households/communities. Plan nutrition and food responses for populations with high HIV infection. Promote appropriate care and feeding practices for PLWHA. Protect food security of HIV/AIDS affected and at-risk households and communities. Distribute food aid to affected households and communities.
DRAFT Shelter and Site Planning: Minimum response requirements Establish safely designed sites Sites for displaced people should reduce the vulnerability of female-headed households and separated children, especially girls. It may be necessary to set up a specific safe place within the site to protect separated children and female-headed households.
DRAFT Health: Minimum response requirements Ensure access to basic health care for the most vulnerable Ensure a safe blood supply Provide condoms and establish condom supplies Establish syndromic STI treatment Ensure IDU appropriate care Manage the consequences of sexual violence Ensure safe deliveries Practise Universal Precautions
DRAFT Education: Minimum response requirements Ensure childrens access to education Schools are effective sites for HIV/AIDS awareness, promoting human rights, tolerance and non-violent conflict resolution In HIV/AIDS-affected populations, parents may be less able to impart essential life skills. Children and young people who attend school are more likely to delay the age of first sex.
DRAFT Behaviour Change Communication: Minimum response requirements Provide information on HIV/AIDS prevention and care. Communication in emergencies helps people to maintain/adopt behaviours that reduce the risk of contracting HIV/AIDS. It also helps those affected by or living with HIV/AIDS to access services and support.
DRAFT HIV/AIDS in the Workplace: Minimum response requirements Prevent discrimination by HIV status in staff management Provide post-exposure prophylaxis (PEP) for humanitarian staff Workplace information and education help increase respect, tolerance and understanding of workers with HIV/AIDS PEP is a short-term antiretroviral treatment that reduces the risk of HIV infection after potential exposure.
DRAFT Summary – Key Points HIV/AIDS activities should seek to should seek to build on or and not duplicate or replace existing work. Key stakeholders and affected populations in must participate inplanning/implementation HIV/AIDS interventions in humanitarian crises must be multisectoral. HIV/AIDS activities for displaced populations should should also service host populations
DRAFT Introducing the IASC Guidelines Purpose: To provide for the development of the guidelinesTo provide background and context for the development of the guidelines To and their contentTo introduce the guidelines and their content To introduce developed by IASCTo introduce complementary HIV/AIDS resources developed by IASC
DRAFT WHO/What is the IASC? (IASC) was established in 1992 by GA Resolution 46/182.Inter-Agency Standing Committee (IASC) was established in 1992 by GA Resolution 46/182. Primary mechanism for in complex emergencies and natural disasters.Primary mechanism for interagency decision- making in complex emergencies and natural disasters. IASC developed these guidelines.IASC Task Force on HIV/AIDS in Emergency Settings developed these guidelines.
DRAFT Why these Guidelines? HIV/AIDS as a priority in humanitarian crises.HIV/AIDS previously disregarded as a priority in humanitarian crises. But, since 2000, increasing awareness of interplay between.But, since 2000, increasing awareness of interplay between emergency conditions and HIV/AIDS. Also, awareness that HIV/AIDS emergency responses multisectoral.Also, awareness that HIV/AIDS emergency responses must be multisectoral. Guidelines for HIV/AIDS interventions in emergency settings
DRAFT Guidelines for HIV/AIDS interventions in emergency settings HIV/AIDS now viewed as an – and an emergency priority – and a responsibility. a multisectoral responsibility. To ensure uniformity across agencies and sectors - the agencies and sectors - the Matrix
DRAFT Focus for the Guidelines Purpose Target audience To ensure delivery of the required minimum multisectoral response to HIV/AIDS in an emergencys early phases. National authorities, personnel and organisations operating in emergencies at international, national and local levels.
DRAFT How/when to use the guidelines? The Guidelines apply to The Guidelines apply to any emergency setting In emergency settings with infection with high HIV/AIDS infectionrates In emergency settings with infection with low HIV/AIDS infectionrates Integrated HIV/AIDS action is an urgent priority to avert even greater HIV/AIDS impacts Collapse of health services/ infrastructure can increase HIV/AIDS transmission, if guidelines not applied.
DRAFT Reducing HIV/AIDS in emergency settings Introducing the IASC tools 1.Hard-copy and electronic guidelines 2. Learning Package: A.B.C. HIV/AIDS Self-Study CD ROM: HIV/AIDS interventions in emergency settings interventions in emergency settings : HIV/AIDS Briefing Session: HIV/AIDS interventions in emergency settings HIV/AIDS interventions Workshop: HIV/AIDS interventions in emergency settings and IASC Guidelines
DRAFT Discussion How would these guidelines?How would you use these guidelines? –for programming, fund-raising, proposal-writing? –for practical implementation? What do you anticipate as ?What do you anticipate as constraints? Are there... lessons learned?Are there success stories... lessons learned? What are theWhat are the next steps?
DRAFT For follow-up resources For more information on... : HIV/AIDS Briefing Session: HIV/AIDS interventions in emergency settings interventions in emergency settings HIV/AIDS interventions in Workshop: HIV/AIDS interventions in emergency settings and IASC Guidelines emergency settings and IASC Guidelines HIV/AIDS Self-Study CD ROM: HIV/AIDS interventions in emergency settings interventions in emergency settings interventions Guidelines for HIV/AIDS interventions in emergency settings in emergency settings Please contact UNAIDS…
DRAFT Please also visit the UNAIDS HIV/AIDS in Emergency Settings web site: