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London, United Kingdom, ACF International Network, . 80 p. (Hunger Watch Publication)This report documents the findings of Local Voices, a six month qualitative research project that provided HIV orphans, vulnerable children and their carers with the opportunity to discuss and document the difficulties they face providing food, water and healthcare for their families. Through meetings, detailed interviews and discussions the project initiated and developed an ongoing dialogue with 20 families in four areas of the Kitwe district in the Copperbelt province of Zambia: Chimwemwe, Kwacha, Chipata and Zamtan. The discourse that developed over the course of the project has given Action Against Hunger (ACF-UK) and CINDI insight in two key areas. Firstly, the research has added a household perspective to existing ideas and analysis of food security in an HIV/AIDS context. Secondly, the project highlights the knowledge and learning that can be gained when people living with a positive HIV diagnosis are seen as 'experts' and their experiences are used to help identify and address the problems they face. Through the voices of the project's participants, the testimonies and images that are the core of this document explore the social and economic impact HIV/AIDS has on families affected by the disease. ACF-UK and CINDI pioneered this work because we believe HIV/AIDS can no longer be seen as just a medical issue. Within this report we demonstrate that HIV/AIDS has a direct impact on the economic and social well-being of both households and communities; and as such it must be tackled using an integrated approach where food, livelihoods and social protection are highlighted as solutions alongside access to medical care. This report opens with statistics that outline current rates of HIV/AIDS and poverty in Zambia, focusing specifically on the Copperbelt province and the Kitwe district. The testimonies that form the centrepiece of this report are introduced by a summary of the key social and economic issues that HIV orphans, vulnerable children and their carers face, together with a synopsis of government and community based organisation (CBO) responses. These topics have been selected as they cover the core issues that were raised during the Local Voices project. The document ends with a brief conclusion and the report recommendations.
Supporting and sustaining national responses to children orphaned and made vulnerable by HIV and AIDS: Experience from the RAAAP exercise in sub-Saharan Africa.
Vulnerable Children and Youth Studies. 2006 Aug; 1(2):170-179.The growing number of children orphaned and made vulnerable by HIV and AIDS in sub-Saharan Africa presents an enormous socioeconomic and public policy challenge. Despite international commitments to increase resource allocation and scale up services and support for AIDS-affected children, families and communities, the national- and sub-national-level state responses have been inadequate. The rapid assessment, analysis and action planning (RAAAP) process for orphans and vulnerable children, conceived in late 2003, was intended as a multicountry incentive to identify and resource immediate actions that can be taken to scale in 16 heavily affected countries. This review of experiences to date with the RAAAP process highlights some key areas of learning, including: (a) fund mobilization has been slow and has reached approximately only one-third of what is required; (b) ownership and integration into development planning of the issue of orphans and vulnerable children at country level has been undermined by the perception that the response is an 'emergency' and externally (donor) driven exercise; (c) centralized planning has failed to appreciate the complexity of context and responses at the meso- and micro-levels within countries, entailing the need to support a comprehensive decentralization process of planning and implementation; (d) comprehensive multisectoral and interagency collaboration, involving civil society, is an important but overlooked element of the planning process; and (e) definitional variation between countries has led to large variations in budgets and coverage targets. While the RAAAP process has undoubtedly raised awareness at state level of the nature and extent of the 'orphan crisis' and raised vital resources, only full integration of the new planning process for orphans and vulnerable children within the range of macro and national development tools will allow the response to be sustainable in the longer term. (author's)
Setting national targets for moving towards universal access. Further guidance to complement “Scaling Up Towards Universal Access: Considerations for Countries to Set their own National Targets for AIDS Prevention, Treatment, and Care and Support”. Operational guidance. A working document.
[Geneva, Switzerland], UNAIDS, 2006 Oct. 23 p.This document provides operational guidance to country-level partners and UN staff to facilitate the next phase of the country-level consultative process on scaling up towards universal access to prevention, treatment, care and support services. It concerns the setting of ambitious targets for the national HIV response to achieve by 2008 and 2010, and builds on previous guidelines. Targets need to be ambitious in order to achieve the universal access goals. Analysis by UNAIDS of existing national targets and rates of scaling up indicates that current efforts are inadequate to achieve universal access in the near future. The process of countries setting their own targets will promote partner alignment to national priorities, strengthen accountability and facilitate efforts by countries and international partners to mobilize international support and resources. Targets should have political and social legitimacy. The consultative process should be multi-sectoral, include full civil society participation, lead to consensus on the targets, and formal approval of these targets before the end of 2006. (excerpt)
Washington, D.C., World Bank, Knowledge and Learning Center, 2005 Nov.  p. (Findings Infobriefs No. 118; Good Practice Infobrief)The Mali Multi-sectoral AIDS Project (MAP) began implementation in late 2004 and is in the preliminary phases of the project cycle. This project has been commended by the World Bank's Board for its innovation and the involvement of the private sector to address HIV/AIDS. Mali is one of the poorest countries in the world due to factors such as its limited resource base, land-locked status and poor infrastructure. According to the 2001 Demographic and Health Survey (DHS) published by the Ministry of Health, Mali's HIV/AIDS prevalence rate is estimated at 1.7% in 2001. The project objective is to support the Government of Malis efforts to control the spread of the HIV/AIDS epidemic and provide sustainable access to treatment and care to those infected with or affected by HIV/AIDS. While Mali currently has a low HIV prevalence rate by Sub-Saharan African standards, it runs a high risk of experiencing an increase in prevalence rates. (excerpt)
[Kyiv], Ukraine, UNDP, . 11 p.HIV/AIDS presents the greatest challenge to human development the world has ever seen. With nearly 42 million people living with HIV/ AIDS, 20 million already dead and 15,000 new infections daily, its devastating scale and impact constitute a global emergency that is undermining social and economic development throughout the world and affecting individuals, families, communities and nations. HIV/AIDS reverses gains in human development and denies people the basic opportunities for living long, healthy, creative and productive lives. It impoverishes people and places burdens on households and communities to care for the sick and dying, while claiming the lives of people in their most productive years. HIV/AIDS also results in social exclusion and violations of human dignity and rights affecting people's psychological well-being. While the long-term consequences may not yet be visible here, Ukraine is glimpsing the enormity of the problem in its newly independent country. The number of reported cases of HIV infection in the country has increased 20 times in the past five years yielding estimates of 300,000 to 400,000 people already infected, which is approximately 1% of the adult population. The Declaration of Commitment of the UN General Assembly Special Session on HIV/AIDS notes "the potential exists for a rapid escalation of the epidemic". The dynamics of the spread of the epidemic can be indicative of the potential magnitude of future human development impacts, deepening over time and affecting future generations. (excerpt)
New England Journal of Medicine. 2003 Feb 20; 348(8):758-759.The report by Khatri and Frieden (Oct. 31 issue) on tuberculosis control in India echoes the official line of the Indian government, health policy bureaucrats, and the World Health Organization. Sadly, data collection in India cannot be taken at face value, and the accuracy of the impressive cure rates has been questioned. The 200,000 new health workers alluded to are but a small fraction of those required to take on the additional burden imposed by direct observation. This shortage constrains the Revised National Tuberculosis Control Program (RNTCP) to recommend direct observation of only 6 of the 18 continuation-phase doses, and this incomplete supervision at a time when the illness is improving and the patient is least compliant has been dismissed as only partially observed therapy. (excerpt)