1. EMPOWERING & SUSTAINING LIVELIHOODS OF PEOPLE LIVING WITH HIV (PLWH) IN ARAB COUNTRIES THE ‘karama’ INITIATIVE (DigNITY) By Dr. Nathalie Milbach Bouché Poverty Practice Leader, UNDP Regional Center Cairo Solution Forum – Building Resilience in an Age of Uncertainty

2. The ‘KARAMA’ Initiative: Regional Context UNAIDS 2013 Regional Report for the Middle East and North Africa :http://www.unaidsmena.org/index_htm_files/UNAIDS_MENA_layout_30_nov.pdf Low Prevalence BUT INCREASED VULNERABILITY TO HIV-AIDs  134% increase in the number of PLWH from 2011 - region is second highest in terms of new cases  Vulnerable populations (mobile people, women, youth) face increased economic, social and structural vulnerability to HIV  Gender inequality and increased feminization of the epidemic - 44% of the PLWH are women Persisting challenges facing PLWH  Poor access to treatment and high-quality services (Persistent low treatment coverage: 18%)  High levels of HIV-related stigma, discrimination contributing to economic and social marginalization

3. The ‘KARAMA’ initiative: Main Thrusts PARTNERING with national community-based CSOs to:  Provide PLWH and affected families an opportunity to lead a life with hope, economic security and dignity through income generating and other economic empowerment support;  Reduce stigma and discrimination through socio-economic interactions and changes in self-perceptions and public perception about the contribution of PLWH to the society;  Increase public awareness – Foster acceptance

4. The ‘KARAMA’ initiative: Dynamics and Outreach 2010: Challenging attitudes and perceptions … Leadership Development for Women Living with HIV (350 WLWH trained in Egypt, Tunisia, Yemen, Libya, Saudi Arabia, Djibouti) 2011 Onwards: Empowering PLWH economically and socially through Micro- loans (200USD to 4000USD), vocational training, marketing campaigns and life-skills training PILOT PHASE (2011): 6 CSOs supporting 100 IGA projects (Egypt, Yemen, Djibouti, and Tunisia) NOW Over 1300 beneficiaries in 7 countries 17 CSOs supporting close to 300 IGA projects for 184 WLWH and 113 MLWH

5. THE ‘KARAMA’ initiative: Dynamics and Outreach Solution Development and Scaling - Up November 2013 – Regional consultation on Economic Empowerment for PLWH – 60 participants from 9 countries, including CSOs, PLWH, & Management Skill Training for partner CSOs July 2012 - Multi-country Training Workshop for partner CSOs (organized by UNDP, UNWOMEN, ILO) Through Regional Knowledge Sharing, Networking and Skill Development for Solution Practitioners..

6. THE ‘KARAMA’ initiative: Key Pathways to Success  No one ‘fits all model’ - Solution ‘profile and maturity’ depend on country context (e.g in Algeria, initiative aligned with National Strategic Plan of Fight Against HIV/Aids, which underscores microcredit for PLWH)  National-Local Ownership: Importance of strong local actors/CSOs with deep knowledge of community, people needs, challenges and opportunities : In Egypt, WHIA (Women Health Improvement Association) was able to explore the integration of PLWH into its services nation-wide.  PLWH Participation and Leadership – Trust-building (CSOs/PLWH) – Some partner CSOs in Yemen and Djibouti are run by PLWH  Integrated approaches: combining micro-lending/IGAs with vocational /business/project management training, psycho-sociological support, access to treatment-health and other services ( e.g in Algeria and Lebanon )  Networking and broad based Partnerships (CSOs, Government (national/local), Private Sector, and other Development Partners): in Algeria, El Hayet partners with the Ministries of Health, of Solidarity, of Vocational Training and the national Agency of Microcredit)

7. Resilience Self-Confidence

8. How is ‘Karama’ changing people’s lives?

9. Get to know more… Djibouti, Online at: http://www.youtube.com/watch?v=8aI7ehvbCtE&list=PL6CBC9A4FA1E49EC4 http://www.youtube.com/watch?v=8aI7ehvbCtE&list=PL6CBC9A4FA1E49EC4 Tunisia, Online at: http://www.youtube.com/watch?v=A5pPeHOSxGo&list=PL6CBC9A4FA1E49E C4&index=31 http://www.youtube.com/watch?v=A5pPeHOSxGo&list=PL6CBC9A4FA1E49E C4&index=31 Egypt, Online at: http://www.youtube.com/watch?v=74c3hO4Wuog&list=PL6CBC9A4FA1E49E C4 http://www.youtube.com/watch?v=74c3hO4Wuog&list=PL6CBC9A4FA1E49E C4 Algeria, online at: http://m.youtube.com/watch?feature=plpp&v=GxDAtm_- Luk&p=PL6CBC9A4FA1E49EC4http://m.youtube.com/watch?feature=plpp&v=GxDAtm_- Luk&p=PL6CBC9A4FA1E49EC4 Thank You

10. MERCI