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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)
Supporting civil society organisations to reach key populations in the Latin American and Caribbean region. A look at HIV / AIDS projects financed by the World Bank.
[Brighton, United Kingdom], International HIV / AIDS Alliance, 2006. 52 p.The purpose of this study is to assess the extent to which World Bank financed projects are supporting civil society organisations (CSOs) to reach four key populations (men who have sex with men (MSM), sex workers (SW), intravenous drug users (IDUs) and persons living with HIV/AIDS (PLWHA) in the Latin American and Caribbean (LAC) region. The study refers to the first three key populations (KPs) as 'at-risk KPs' when discussing KPs who may or may not be HIV infected. The study has two main outputs: an initial mapping of World Bank financed AIDS prevention and control projects in LAC and the role of CSOs and KPs in those projects; identification of factors that impede or facilitate CSO access to World Bank resources that target KPs. The International HIV/AIDS Alliance has commissioned this study to improve understanding of the dynamics at the country level with World Bank financed projects concerning CSOs and KPs. (excerpt)
Sexual and reproductive health of women living with HIV / AIDS. Guidelines on care, treatment and support for women living with HIV / AIDS and their children in resource-constrained settings.
Geneva, Switzerland, WHO, 2006.  p.The sexual and reproductive health of women living with HIV/AIDS is fundamental to their well-being and that of their partners and children. This publication addresses the specific sexual and reproductive health needs of women living with HIV/AIDS and contains recommendations for counselling, antiretroviral therapy, care and other interventions. Improving women's sexual and reproductive health, treating HIV infections and preventing new ones are important factors in reducing poverty and promoting the social and economic development of communities and countries. Sexual and reproductive health services are uniquely positioned to address each of these factors. (excerpt)
International guidelines on HIV / AIDS and human rights. 2006 consolidated version. Second International Consultation on HIV / AIDS and Human Rights, Geneva, 23-25 September 1996. Third International Consultation on HIV / AIDS and Human Rights, Geneva, 25-26 July 2002. Organized jointly by the Office of the United Nations High Commissioner for Human Rights and the Joint United Nations Programme on HIV / AIDS.
Geneva, Switzerland, Office of the United Nations High Commissioner for Human Rights, 2006. 115 p. (HR/PUB/06/9)The International Guidelines on HIV/AIDS and Human Rights arose because of various calls for their development in light of the need for guidance for Governments and others on how to best promote, protect and fulfill human rights in the context of the HIV epidemic. During the first International Consultation on AIDS and Human Rights, organized by the United Nations Centre for Human Rights, in cooperation with the World Health Organization, in Geneva, from 26 to 28 July 1989, participants discussed the possible elaboration of guidelines to assist policymakers and others in complying with international human rights standards regarding law, administrative practice and policy. Several years later, in his report to the Commission at its fifty-first session (E/CN.4/1995/45, para.135), the United Nations Secretary-General stated that "the development of such guidelines or principles could provide an international framework for discussion of human rights considerations at the national, regional and international levels in order to arrive at a more comprehensive understanding of the complex relationship between the public health rationale and the human rights rationale of HIV/AIDS. In particular, Governments could benefit from guidelines that outline clearly how human rights standards apply in the area of HIV/AIDS and indicate concrete and specific measures, both in terms of legislation and practice, that should be undertaken". (excerpt)
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)
Towards universal access by 2010. How WHO is working with countries to scale-up HIV prevention, treatment, care and support.
Geneva, Switzerland, WHO, Department of HIV / AIDS, 2006. 32 p.In 2005, leaders of the G8 countries agreed to «work with WHO, UNAIDS and other international bodies to develop and implement a package for HIV prevention, treatment and care, with the aim of as close as possible to universal access to treatment for all those who need it by 2010». This goal was endorsed by United Nations Member States at the High-Level Plenary Meeting of the 60th Session of the United Nations General Assembly in September 2005. At the June 2006 General Assembly High Level Meeting on AIDS, United Nations Member States agreed to work towards the broad goal of "universal access to comprehensive prevention programmes, treatment, care and support" by 2010. Working towards universal access is a very ambitious challenge for the international community, and will require the commitment and involvement of all stakeholders, including governments, donors, international agencies, researchers and affected communities. Among the most important priorities is the strengthening of health services so that they are able to provide a comprehensive range of HIV/AIDS services to all those who need them. This document describes the contribution that the World Health Organization (WHO) will make, as the United Nations agency responsible for health, in working towards universal access to HIV prevention, treatment, care and support in the period 2006-2010. It proposes an evidence-based Model Essential Package of integrated health sector interventions for HIV/AIDS that WHO recommends be scaled up in countries, using a public health approach, and provides an overview of the strategic directions and priority intervention areas that will guide WHO's technical work and support to its Member States as they work towards universal access over the next four years. (excerpt)
Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach. 2006 revision.
Geneva, Switzerland, WHO, 2006. 127 p.This publication is intended to serve as a reference tool for countries with limited resources as they develop or revise national guidelines for the use of ART in adults and postpubertal adolescents (see Annex 9 for pubertal Tanner staging; prepubertal adolescents should follow the WHO paediatric guidelines). The material presented takes updated evidence into account, including new ART treatment options, and draws on the experience of established ART scale-up programmes. The simplified approach, with evidence-based standards, continues to be the basis of WHO recommendations for the initiation and monitoring of ART. The guidelines are primarily intended for use by national and regional HIV programme managers, managers of nongovernmental organizations delivering HIV care services, and other policy-makers who are involved in the scaling up of comprehensive HIV care and ART in resource-limited countries. The comprehensive, up-to-date technical and clinical information on the use of ART, however, also makes these guidelines useful for clinicians in resource-limited settings. The recommendations contained in these guidelines are made on the basis of different levels of evidence from randomized clinical trials, high-quality scientific studies, observational cohort data and, where insufficient evidence is available, expert opinion. The strengths of the recommendations in Table 1 are intended to indicate the degrees to which the recommendations should be considered by regional and country programmes. Cost-effectiveness is not explicitly considered as part of the recommendations, although the realities of human resources, health system infrastructures and socioeconomic issues should be taken into account when the recommendations are being adapted to regional and country programmes. (excerpt)
Scaling up HIV / AIDS prevention, treatment and care: a report on WHO support to countries in implementing the “3 by 5” Initiative, 2004-2005.
Geneva, Switzerland, WHO, 2006. 143 p.In September 2003, LEE Jong-wook, Director-General of WHO, and Peter Piot, Executive Director of UNAIDS, declared the lack of access to antiretroviral therapy for HIV/AIDS in low- and middle-income countries to be a global health emergency. Shortly after this declaration, WHO and its partners launched a global initiative to scale up antiretroviral therapy with the objective of having 3 million people receiving antiretroviral therapy - representing half the total number of those globally in need - by the end of 2005 ("3 by 5"). Although the actual target of putting 3 million people on antiretroviral therapy was not reached by the end of 2005, countries have made significant progress in the past two years in expanding treatment coverage, strengthening prevention and building the capacity of health systems to deliver long-term, chronic care. Overall, in the two-year period, antiretroviral therapy coverage in low- and middle-income countries increased from 7% of those in need at the end of 2003 (400 000 people) to 20% of those in need at the end of 2005 (1.3 million people). Eighteen countries managed to increase antiretroviral therapy coverage to half or more of the people who needed it, consistent with the "3 by 5" target. (excerpt)
[Baltimore, Maryland], Catholic Relief Services, 2006 Jul. 53 p. (USAID Development Experience Clearinghouse DocID / Order No. PN-ADJ-423)In Zambia, HIV&AIDS is still approached primarily as a health issue, and therefore, interventions focus mainly on prevention and treatment. The provision of affordable, accessible and reliable public services is essential in supporting health maintenance and reducing stress for people infected and affected with HIV&AIDS. Reliable delivery of good quality water and sound basic sanitation are critical in reducing exposure to pathogens to which HIV-positive people are particularly vulnerable. Where water services are inadequate or inaccessible, time and monetary costs of access to good quality water in sufficient quantities are high, particularly for HIV-infected people and their caregivers. CRS responded to an announcement by WHO to conduct an assessment on the adequacy of water, sanitation and hygiene in relation to home-based care strategies for people living with HIV&AIDS in Zambia. The assessment was commissioned by the WHO with the goal of producing evidence-based guidance on water and sanitation needs in home-based care strategies, particularly in resource-poor situations. In addition, WHO desired the assessments to lead to both practical and strategic recommendations to be made at the programme and policy levels, while also identifying the most critical measures to be taken by the health sector and the water and sanitation sector to provide short- and medium-term solutions in the area of water, sanitation and hygiene support to home-based care. (excerpt)
Washington, D.C., World Bank, Global HIV / AIDS Program, 2006 Aug. 11 p.AIDS has wide consequences for development, and presents enormous challenges to businesses in the worst hit countries. The epidemic affects workers, managers and markets by increasing costs and reducing productivity. The International Finance Corporation (IFC), the private sector arm of the World Bank Group, works with client companies to mitigate the effects of the epidemic on their operations through its IFC Against AIDS program. The program works with companies in Africa and India, and efforts are underway to raise awareness among clients in China and assess program conditions in Russia. (author's)
Washington, D.C., World Bank, Global HIV / AIDS Program, 2006 Jul. 7 p.A Grant from the World Bank provided a strong impetus to Djibouti's national HIV response in 2003. Clear objectives and priorities, effective government action and commitment, and close cooperation among the key donors and government organizations have contributed to strong results in the national response to HIV. The Global Fund cites Djibouti as a "best practice" example of donor coordination and harmonization and UNICEF recognizes the outreach to young people and community interventions as best practices. (author's)
Ottawa, Canada, Youth Coalition, 2006. 30 p.The current global generation of young people is the first in history to have lived their entire lives in the prevalence of HIV/AIDS, and are disproportionately affected. Millions of children and youth have been orphaned by HIV/AIDS; thousands of others are HIV positive themselves; and many others are affected by it in a variety of ways. None of us are immune to it. In response to the pandemic, governments and international organizations have adopted a variety of responses, but the numbers show that what has been done thus far clearly is not adequate. The reality is that none of these responses, initiatives or programs will be truly successful and effective until they integrate a sexual and reproductive rights and a gender perspective. Furthermore, every initiative must include youth from the beginning to ensure that we young people, have the youth-friendly information, education, services and products that we are entitled to as our human right, in order to make informed and healthy decisions about our sexual and reproductive lives. This guide is intended to: Provide an overview of the linkages between sexual and reproductive rights and HIV/AIDS; Explain the importance of HIV/AIDS initiatives having a sexual and reproductive rights perspective, as well as a youth perspective; and Discuss ways that young people can advocate for their sexual and reproductive rights within HIV/AIDS frameworks, in their countries, regions, and globally. (excerpt)
Integration between sexual and reproductive health and HIV and AIDS and malaria: opportunities and strategic options for the Global Fund to Fight AIDS, Tuberculosis and Malaria. Discussion piece.
[London, England], HLSP, 2006 Nov.  p.There is a growing body of knowledge which emphasises integration of sexual and reproductive health (SRH) as critical to the effectiveness of responses to HIV and AIDS, and the success of HIV and AIDS programmes. Further, accelerated headway in malaria prevention and/or treatment can be achieved through integration with SRH efforts. This paper briefly explores the evidence base for integration, identifies the enabling environment at global and national levels and discusses the opportunities and challenges for supporting integration by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund). The paper concludes with strategic options for the Global Fund. (excerpt)
London, England, International Community of Women Living with HIV / AIDS, 2006.  p.WHO supported ICW to map positive women's experiences of access to care and treatment in three countries - Namibia, Kenya and Tanzania. The findings will contribute to advocacy for increased political support and resources to address gendered barriers to care, treatment and support. The project complements a mapping and database of civil society organizations (CSOs) providing treatment by the French consortium - SIDACTION. This mapping presents results from three focus group discussions with HIV positive women conducted in two districts of Tanzania - Arusha and Moshi (2006). Women who participated in these focus group discussions were aged between 30 to 45. Most of them came from villages Munduli (Arusha) and Seliani (Moshi). Three focus groups were also conducted with men only in Arusha. A mixed-sex focus group was conducted in Chalinze in the Bagamoyo district (Dar es Salaam coastal area) with men and women aged between 35 and 42. There were between 12 - 15 participants in each group in Arusha and Mosh. However, in Chalinze there were only 8 people. Results from the mixed sex and men only focus groups are presented here but the main emphasis is on the results from the women only focus groups. Medical personnel were also interviewed and their experiences are included. (excerpt)
London, England, International Community of Women Living with HIV / AIDS, 2006.  p.Namibia, Kenya and Tanzania. The findings will contribute to advocacy for increased political support and resources to address gendered barriers to care, treatment and support. The project complements a mapping and database of civil society organizations (CSOs) providing treatment by the French consortium - SIDACTION. The research was carried out in Homabay (rural) and Kibera community (urban) involving women and men living with HIV and AIDS (13th December 2005 - 31st January 2006). Data was gathered through questionnaires and focus group discussions (FGDs). Women who participated in the focus group discussions were aged between 22 - 45 years old and in total 100 people took part in the project, including questionnaire respondents. The service providers in both sites were of varied age group (28-45 years) and both female and male service providers participated in the focus group discussions. Results from the mixed sex and service provider focus groups are presented here but the main emphasis is onthe results from the women only focus groups. (excerpt)
Geneva, Switzerland, WHO, 2006.  p.Even though children living with HIV/AIDS respond very well to treatment with antiretroviral therapy (ART), to date few children living with HIV/AIDS have access to ART mostly due to a lack of cheap feasible diagnostic tests for infants, lack of affordable child-friendly ARV drugs and lack of trained health personnel. This course aims to address the issue of lack of trained personnel. With an ever increasing burden of HIV and a high percentage of children infected, health workers urgently require accurate, up to date training and information on assessment and management of HIV in children. The IMCI complementary course on HIV is designed to assist health workers to assess, classify, treat and follow up HIV exposed infants and children, to identify the role of family and community in caring for the child with HIV/AIDS and also to enhance health workers' skills in counseling of caretakers around HIV/AIDS. (excerpt)
Joint ILO / UNESCO Southern African Subregional Workshop, 30 November - 2 December 2005, Maputo, Mozambique. Improving responses to HIV / AIDS in education sector workplaces. Report.
Geneva, Switzerland, ILO, 2006. 63 p.The workshop was organized under the auspices of an ILO programme initiated in 2004, developing a sectoral approach to HIV/AIDS education sector workplaces, as a complement to the ILO's code of practice HIV/AIDS and the world of work, adopted in 2001. A number of research papers and assessments prepared by international organizations in recent years have highlighted the impact of HIV and AIDS on the education sector workforce in developing countries, especially in sub-Saharan Africa. High prevalence results in morbidity and mortality rates which deprive affected countries of some of their most educated and skilled human resources. In addition, teachers are often not trained or supported to deal with HIV in schools, and the disease has also affected the management capacity of education systems. In 2005, UNESCO joined the ILO in a collaborative project, aimed at the development of an HIV and AIDS workplace policy and related resource materials for use by education staff and stakeholders at national and institutional levels in southern African countries. The workshop in Maputo brought together representatives of government (ministries of labour and education), employer organizations and teacher/educator unions from seven countries to participate in this process, along with representatives of regional and international organizations (see Appendix 1 for list of participants). (excerpt)
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:80-87.The paper critically analyzes, from the gender standpoint, official results presented in the Brazilian government report to the Joint United Nations Programme on HIV/ AIDS (UNAIDS). Specifically, the fulfillment of 2003 targets set forth in the United Nations Declaration of Commitment on HIV/AIDS, under the category of Human Rights and Reduction of the Economic and Social Impact of AIDS, are evaluated. Key concepts are highlighted, including indicators and strategies that may help civilian society better monitor these targets until 2010. (author's)
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:94-100.The objective of this study was to analyze, on the national level, the process of monitoring the proposed UNGASS indicators through the use of the Brazilian National Program for STD/AIDS's indicators. Two groups of proposed indicators were analyzed in 2002 and 2005 respectively, as part of the monitoring of the progress of the UNGASS Declaration of Commitment. The availability of information and limitations in calculating the proposed indicators in Brazil were analyzed and the appropriateness of the indicators for monitoring the epidemic in Brazil was discussed. Of the 13 quantitative indicators originally proposed by UNGASS, five were not included in the National Program. One was not included due to its qualitative nature. Two of the indicators were considered to be of little use and two were not included due to the lack of available data needed for their calculation. As the epidemic in Brazil is characterized as being concentrated, within the second group of proposed UNGASS indicators those that refer to the accompaniment of epidemic among high-risk population groups were prioritized. The study highlights that the National Program concentrates its efforts in the development, adaptation, and sharing of sampling methodologies for hard to reach populations. Such activities are geared towards estimating the size of vulnerable population groups, as well as obtaining more information regarding their knowledge, attitudes, and practices. The study concludes that by creating the possibility of international comparisons between advances achieved, the proposal of supranational indicators stimulates countries to discuss and make their construction viable. In a complementary way, the national monitoring systems should focus on program improvement by covering areas that permit the evaluation of specific control and intervention actions. (author's)
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:42-51.Items from the UNGASS Draft Declaration of Commitment on HIV/AIDS (2001) are analyzed. The Brazilian experience of new methods for testing and counseling among vulnerable populations, preventive methods controlled by women, prevention, psychosocial support for people living with HIV/AIDS, and mother-child transmission, is discussed. These items were put into operation in the form of keywords, in systematic searches within the standard biomedicine databases, also including the subdivisions of the Web of Science relating to natural and social sciences. The Brazilian experience relating to testing and counseling strategies has been consolidated through the utilization of algorithms aimed at estimating incidence rates and identifying recently infected individuals, testing and counseling for pregnant women, and application of quick tests. The introduction of alternative methods and new technologies for collecting data from vulnerable populations has been allowing speedy monitoring of the epidemic. Psychosocial support assessments for people living with HIV/AIDS have gained impetus in Brazil, probably as a result of increased survival and quality of life among these individuals. Substantial advances in controlling mother-child transmission have been observed. This is one of the most important victories within the field of HIV/ AIDS in Brazil, but deficiencies in prenatal care still constitute a challenge. With regard to prevention methods for women, Brazil has only shown a shy response. Widespread implementation of new technologies for data gathering and management depends on investments in infrastructure and professional skills acquisition. (author's)
Orphans and vulnerable children affected by HIV / AIDS in Brazil: where do we stand and where are we heading?
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:23-30.This study aimed at identifying human rights' status and situation, as expressed in the United Nations General Assembly Special Session on HIV/AIDS, of children and adolescents living with HIV/AIDS, non-orphans and orphans affected by AIDS, based on local and international literature review. The main study findings did not allow to accurately estimating those children and adolescents living with HIV and non-orphans affected by HIV/AIDS but data was available on those living with AIDS and orphans. The limitations and possibilities of these estimates obtained from surveillance systems, mathematical models and surveys are discussed. Though studies in literature are still quite scarce, there is indication of compromise of several rights such as health, education, housing, nutrition, nondiscrimination, and physical and mental integrity. Brazil still needs to advance to meet further needs of those orphaned and vulnerable children. Its response so far has been limited to providing health care to those children and adolescents living with HIV/AIDS, preventing mother-to-child HIV transmission and financing the implementation and maintenance of support homes (shelters according to Child and Adolescent Bill of Rights) for those infected and affected by HIV/AIDS, either orphans or not. These actions are not enough to ensure a supportive environment for children and adolescents orphaned, infected or affected by HIV/AIDS. It is proposed ways for Brazil to develop and improve databases to respond to these challenges. (author's)
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:31-41.The focus of the present study is the Brazilian response within science, technology and innovation to the targets formulated in the UNGASS document. An analysis was made of items 70-73 of the UNGASS Draft Declaration of Commitment on HIV/ AIDS (2001), which defined science, technology and innovation targets relating to HIV/AIDS. The main topics listed in these items were put into operation in the form of keywords, in order to guide systematic searches within the standard biomedicine databases, also including the subdivisions of the Web of Science relating to natural and social sciences. The success of Brazilian research within the field of characterization and isolation of HIV-1 is undeniable. Phase II/III vaccine studies have been developed in Rio de Janeiro, Belo Horizonte and São Paulo. Empirical studies on the monitoring of primary resistance have been developed in specific populations, through the Brazilian HIV Resistance Monitoring Network. Within the field of monitoring secondary resistance, initiatives such as the National Genotyping Network have been highlighted. Two national systems - the Mortality Information System and the Notifiable Diseases Information System-AIDS - and some studies with wider coverage have given rise to work on trends within the epidemic. The production of high-quality generic medications and their free distribution to patients have been highlighted. Brazil has implemented a consistent and diversified response within the field of HIV/AIDS, with studies relating to the development of vaccines, new medications and monitoring of the epidemic. (author's)
Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:5-8.Recognizing the HIV/AIDS pandemic as an unprecedented worldwide emergency and one of the greatest challenges to life and the enjoyment of human rights, the United nations called on member states to reflect on this matter. In June 2001, around 20 years after the first AIDS cases were recorded, the United Nations General Assembly Special Session on HIV and AIDS (UNGASS HIV/AIDS) was held in New York. The Session culminated in the drafting of the Declaration of Commitment on HIV and AIDS: a document that reflected the consensus between 189 countries, including Brazil, and stated some essential principles for an effective response to the epidemic. The Declaration recognized that economic, racial, ethnic, generational and gender inequalities, among others, were factors that boosted vulnerability and, whether acting separately or in synergy, favored HIV infection and the onset and evolution of AIDS. The Declaration of Commitment on HIV and AIDS has become transformed into a tool for reaffirming the urgency and necessity of promoting the solidarity that the epidemic demands. It aims towards better management of the actions and resources destined for controlling HIV and AIDS and towards social control over public HIV/AIDS policies. (excerpt)
Breaking barriers. Effective communication for universal access to HIV prevention, treatment, care and support by 2010.
Lusaka, Zambia, Panos Southern Africa, Panos Global AIDS Programme, 2006. 25 p.Effective HIV and AIDS communication is central to the achievement of universal access. This paper reviews lessons learned from the response so far and suggests that there is an urgent need to strengthen communication approaches that look beyond narrow, short-term interventions focused on individual behaviours. Development actors must realistically and effectively engage the social, political and economic drivers of the epidemic, in a way that is informed by the experiences and priorities of those most affected. There is also a need to better understand and engage with the distinct communication dynamics of social movements and the neglected area of interpersonal communication - both of which are key to an effective response. The intransigent problems of stigma and discrimination must also be addressed. The challenge is at once social, political and technical, but without this paradigm shift in development and communication practice, universal access will remain elusive. As country-level plans for universal access are being developed in late 2006, it is vital that they explicitly include fully resourced communication strategies, activities and targets that are integrated into programming at all levels. Communication challenges include: the effective coordination of the response; sustained advocacy to tackle the underlying drivers of the epidemic; and the specific communication needs of prevention, treatment and care initiatives that require grassroots ownership and social mobilisation. (excerpt)
Geneva, Switzerland, World Health Organization [WHO], 2006 Mar 30.  p.This independent formative evaluation was conducted by a team of six international consultants between August 2005 and January 2006 to appraise WHO's contributions and roles in implementing the "3 by 5" Initiative. Funded by the Canadian Government, and as a requirement for its grant to WHO, the evaluation investigated all three levels at which WHO operates (headquarters, regional offices and country offices), placing particular emphasis on Africa. This included seven country assessments and an extensive consultation of international and country-level partners and stakeholders. A number of focused technical studies were also commissioned. The evaluation reviewed how effectively WHO provided technical, managerial and administrative guidance and support pursuant to the "3 by 5" goals and target. An assessment was also made of the extent to which WHO has mobilized, sustained and contributed to this major global partnership through improving harmonization between United Nations agencies and working with other stakeholders and partners. Key lessons from "3 by 5" have been documented, including those on how the initiative contributed to health systems strengthening and HIV prevention, as well as the ways with which equity and gender concerns were dealt. Potential opportunities for future collaboration between WHO, main donors and partners were identified and recommendations have been provided for future plans and the way forward for WHO and its partners. (excerpt)