These pages are designed to provide easy access to some of the key initiatives and ideas in the assessment and response to HIV/ AIDS.
Other recommended websites
A great deal of data and information is now available on websites, and these ought to be the first places to look for up-to-date material. The HIV and Development website of UNDP is http://www.undp.org/hiv and all Issues Papers, Study Papers, etc. are easily accessible on this website.
Note that the HDP/UNDP website at the top of this page contains links to other important sites (e.g. HIV/AIDS Surveillance Data Base of the U.S. Census Bureau, UNAIDS, Global Network for and of People Living with HIV/AIDS, and so on).
The UNAIDS website: http://www.unaids.org (also above) provides links to most UN agencies and other organisations with HIV and AIDS activities, and a good deal of other data and information (including the UNAIDS Best Practice Collection).
website, which publishes a regular newsletter, is that of the International
AIDS Economics Network (IAEN) at http://www.iaen.org.
The HIV/AIDS Impact on Education Clearinghouse is an ongoing sharing of information coordinated by the International Institute for Educational Planning (IIEP), with the assistance of ministries, NGOs, researchers and co-operation agencies.
News from the University of California HIV site watch. "Comprehensive, up-to-date information on HIV/AIDS treatment, prevention and policy".
ASSESSMENT OF THE SOCIO-ECONOMIC CAUSES AND CONSEQUENCES OF HIV/ AIDS
Increasing numbers of countries have undertaken or are proposing to undertake studies of the socioeconomic issues relating to the HIV epidemic. In some cases these studies are planned as part of the preparations relating to Strategic Planning for HIV and AIDS, and in other cases are seen as one of the important outputs of the Plan. The main objectives of such Studies are as follows: -
Advocacy: to increase understanding of the multiple ways in which the HIV epidemic affects human development as an essential input in the mobilisation of government and civil society in the national response to HIV and AIDS.Given these as the two main objectives of such Studies the key outputs that can be expected are: -
· an increased understanding of the threat that the epidemic has for the sustained development of the country, both as a mechanism for raising awareness and as a means of increasing commitment to broad-based action, and,The precise focus of such Studies needs to reflect the policy and programme needs of the country taking into consideration both the objectives and outputs identified above. Thus if the important issue that requires analysis is the impact of the epidemic on households then this should become the focus of the Study, and resources will not be misused in more general analysis and in less useful ways.
The processes followed in undertaking a Study must ensure that potential users of the data and information are involved throughout so as to ensure that it reflects policy and programme priorities. Furthermore, processes need to ensure national ownership, involve all important stakeholders in the design and implementation of the Study, and strengthen national research and other policy, programme and institutional capacity.
set out precisely what this entails.
Stage 1. Situation Analysis
Studies must involve an analysis and description of the socioeconomic conditions in the country as an essential step in identifying those factors which affect the susceptibility of the population to the HIV epidemic. Consideration will need to be given to the following: -
· identification of those behavioural and other factors which affect HIV transmission and the capacity to cope with a range of socioeconomic impacts of the epidemicThus poverty is often seen as a factor which leads to behaviours which expose socially and economically excluded groups to risk of HIV infection, and which then reduces the capacity of such households to cope with the effects of HIV/AIDS [which are social, economic and psycho-social in their nature]. Exploring these relationships is crucial for ensuring that HIV and AIDS are integrated in poverty programmes.
An important output of will be a better founded understanding of the socioeconomic vulnerability of the population and of the country1s institutions, through a deeper understanding of the structure of the society and the economy. Thus the situation analysis will, for example:
· identify and explore the ways in which conditions of poverty and social exclusion, gender relationships, employment [especially of young persons], labour migration etc. affect the transmission of HIV, and thus have direct relevance for policies for HIV prevention, care and the mitigation of the socioeconomic impact of the epidemic,in order to:
· strengthen understanding of the socio-economic factors which underlie the epidemic and which determine household, sectoral and national capacity to respond to the epidemic, as a foundation for a broader-based and more effective inter-sectoral national response.It is also important to undertake an analysis of the existing epidemiological data on HIV and AIDS, so as to establish: -
· from the data/information what are the trends in HIV in the population, its spatial distribution, and its distribution by gender and age,This review of HIV surveillance and other data should generate a better understanding of trends in the epidemic in the country; a clearer perception of the factors that seem to be important in HIV transmission [including those which are social, cultural and economic in nature]; analysis of those factors which affect coping capacity in affected populations at household and sectoral level; provide a firm base for recommendations in the Study for improvements of the HIV surveillance data and system, and identify behavioural and other socio-economic data important for policy and programme development.
Stage 2. Assessing Socioeconomic Conditions
Causes and Estimating Impacts
This section of the Study needs to build on the Situation Analysis and other data/information drawn from regional and global sources. It should NOT simply address issues of actual and expected socioeconomic impact but also analyse those conditions which determine vulnerability and susceptability in the different sectors under discussion.
It is also important that each of the following sub-sections lead to practical recommendations of value to those developing the national response to the epidemic.
The Study may
focus its analysis and description in respect of each or all of the 3 levels
depending on policy and programme priorities as noted above.
These are the primary socioeconomic unit in all societies with critical functions of an economic, social and cultural nature. They are important as productive units, especially in respect of farming and food production but also in the formal and informal productive sectors. They have crucial social and reproductive functions in terms of children and their socialisation [economic support, transference of productive skills and social patterning]. At the early stages of the HIV epidemic the effects are usually first felt and are observable at household level ? although many factors may intervene to hide these effects due to the shame, stigma and discrimination often associated with HIV and AIDS.
Issues that need to be addressed include the following: -
· an assessment of the factors affecting the capacity of households to survive in the face of the HIV epidemic,
The Study should identify the ways in which the epidemic affects the capacity to maintain efficient forms of production and service provision in key economic and social sectors in the country. It is essential that the Study understand the structural foundations of the economy and the fact that its efficient operation depends on the functioning of its separate parts. In other words that the economy consists on an inter-dependent set of activities and has to be analysed and described in ways that recognise that the epidemic has systemic effects due to the losses of human and institutional capacity. An example is the impact of losses of transport capacity and higher costs in the transport sector for the marketability of rural products both in local and external markets.
· it is not the case that all productive sectors are equally affected by the losses of human and institutional capacity brought about by HIV and AIDS,Amongst the key sectors that will need to be analysed are the following:-
Transport and CommunicationsThe Study should therefore -
· establish what are the reasons for selecting sectors to be identified in terms of their essentiality for the continued functioning of the economy, and in the light of the predicted effects due to HIV and AIDS,Important in this analysis is the identification of the impact of HIV and AIDS on public budgets and on public polices and programmes [including the establishment of effective HIV in the Workplace Programmes and review of training and other policies for public servants ? including review of the Government1s personnel policy framework so as to make this more relevant].
In all cases
the Study should make recommendations as to what actions are needed to
reduce future HIV infection amongst workers and managers; what needs to
be done to mitigate current and expected socio-economic impact, and where
responsibility lies for the development and implementation of appropriate
policies and programmes.
Within the limitations of the HIV surveillance and other data available in the country the Study should attempt to set out the main channels through which the economy in the aggregate may be affected by the HIV epidemic. In addition it:
· should review data from other countries in the region who have attempted to estimate the macro impacts, and review other information on global estimates of the macro-economic impact on developing countriesWhere data and other resources permit estimates of the macro-economic impact then these estimates can be made. Bearing in mind -
· the fact that projections of HIV are extremely unreliable in most countries, such that estimates more than 2 years into the future may have very high errors,It is important before setting out to make these predictions to realise their limitations, and to understand their role in the development of practical responses to the epidemic in the country.
Summary of Recommendations and Follow-up Processes
There are 2 basic conditions that need to be established and met by any studies that are undertaken. The study outputs must include the following:-
· the identification of, and policy and programnme recommendations relating to, all important socioeconomic aspects of the epidemic; concentrating on those recommendations that are most relevant for the operationalisation of the National Strategic Plan by the National AIDS Programme and other stakeholders.The operationalisation of the recommendations and any consequent decisions at national and other levels will be the litmus test of the value-added by the Study, given that the purpose of such studies is to strengthen the national response to HIV and AIDS within policy and programme frameworks which are multisectoral.
There is now an enormous general literature on HIV and AIDS, although research and other information on development and the epidemic remains limited. The following are suggested starting points for those interested in discovering more about development and HIV/AIDS. Most of the publications listed are available on the UNDP website noted above http://www.undp.org/hiv, or from the HIV and Development Programme, United Nations Development Programme, 304 East 45th Street (Room FF-616), New York, New York 10017; Telephone (212) 906-6978; Facsimile (212) 906-6336.
UNDP Issues Papers
I.P. #1 The HIV Epidemic and Development: The Unfolding of the Epidemic, 1992 (Also available in French, Spanish)
I.P. #2 The Economic Impact of the HIV Epidemic, 1992 (Also available in French, Spanish)
I.P. #13 Children in Families Affected by the HIV Epidemic: A Strategic Approach, 1993 (Also available in French)
I.P. #16 Development Practice and the HIV Epidemic, 1995
I.P. #22 The Impact of HIV on Families and Children, 1996
I.P. #26 Strengthening National Capacity for HIV/AIDS Strategic Planning, 1998
I.P. #27 Poverty and HIV/AIDS in sub-Saharan Africa, 1998
I.P. #28 The Vulnerability of Women: Is This Useful Construct for Policy and Programming, 1996
I.P. #29 The HIV Epidemic and Sustainable Human Development, 1998
I.P. #30 The Impact of HIV/AIDS on Children, Families and Communities: Risks and Realities of Childhood During the HIV Epidemic, 1998
I.P. #31 Socio-Economic Causes and Consequences of the HIV Epidemic in Southern Africa: A Case Study of Namibia, 1998
I.P. #32 The HIV Epidemic and the Education Sector in Sub-Saharan Africa, 1999
UNDP Gender and HIV
Adolescent Sexuality and the HIV Epidemic, 1999
Men and the HIV Epidemic, 1999
UNDP Study Papers
S.P. #1 The HIV Epidemic in Uganda: A Programme Approach, 1993
S.P. #2 The Socio-Economic Impact of HIV and AIDS on Rural Families in Uganda, 1994
S.P. #3 Wheeling and Dealing: AIDS and Development on the Shan State Borders of Myanmar, 1994
S.P. #6 The Implications of HIV/AIDS for Rural Development Policy and Programming, 1998
S.P. #7 From Single Parents to Child-Headed Households: The Case of Children Orphaned by AIDS in Kisumu and Siaya Districts in Kenya, 1998
UNDP Human Development Report (annually)
UNDP National Human Development Report (various dates and countries, see especially UNDP/UNAIDS ? HIV/AIDS and Human Development in South Africa, December 1998)
UNDP Economic Implications of AIDS in Asia (ed. D. Bloom and J.V. Lyons, 1993)
UNDP The Economics of HIV and AIDS : The Case of South and South East Asia (ed. By D. Bloom and P. Godwin, 1997)
USAID/ AIDS in Kenya : Socio-Economic Impact and Policy, AIDSCAP/ Implications (1996) FHI
Process Consulting and Capacity Development
The following publications all contain important insights into the How of undertaking activities on development in ways that ensure relevance, ownership and capacity development:
on Process Consultation
UNDP Capacity Development: Lessons of Experience and Guiding Principles (mimeo,1994)
Assessment and Development