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HIV/AIDS
Reducing the impact of HIV/AIDS
HIV/AIDS (Human Immunodeficiency Virus/Acquired Immune Deficiency
Syndrome) will kill more people this decade that all the wars
and disasters in the past 50 years. Since the AIDS epidemic
began, 25 million people have died and more than 40 million
are now living with HIV and AIDS. In 2001 alone, five million
people became infected worldwide.
Epidemic diseases are not new but what sets HIV/AIDS apart is
its unprecedented negative impact on the social and economic
development of nations. Everyone, rich or poor, young or old,
is affected by the HIV/AIDS epidemic but people in developing
countries, particularly young women, are the most vulnerable.
The majority of the victims are adults in the prime of their
working and parenting lives. Their legacy is a decimated workforce,
fractured and impoverished communities, and millions of orphans.
While 70 per cent of HIV-infected people live in sub-Saharan
Africa, AIDS is a global problem. In countries like Zimbabwe
and Botswana, over 25 per cent of people between the ages of
15-49 are infected with the virus. HIV infection is also spreading
rapidly in south and south-east Asia, the countries of the former
Soviet Union and the Caribbean.
AIDS can be prevented. The fight against the disease must be
waged at the local level. Individuals and communities can cope
with the spread of HIV/AIDS by being properly informed, assessing
accurately the factors that put them at risk of infection and
by subsequently acting to reduce those risks. The problem, according
to the World Bank, is that there has not been sufficient amount
of coordinated activities to slow and eventually reverse the
spread of the disease. Individuals, governments, civil society,
private sector groups, international and non-governmental organizations
must fully commit and participate in scaling up response ensuring
that complementary initiatives occur at the national and regional
level. |
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Education
programmes are crucial to revert the continuing spread
of the HIV/AIDS virus. |
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Waiting
to die
"Gezia is 23, lives alone in a bare earth hut,
and is seriously ill with AIDS. The disease has decimated
her family: her husband died of AIDS in 1997 and the second
daughter was born with the virus. The children are elsewhere
today, cared for by a sister, while destitute Gezia contends
with her persistent ailments, diarrhoea and pneumonia
among them. Her body is wasting, her skin tormented by
mosquito bites that take forever to heal.
She spent short spells in hospital, but in Kenya
more than 50 per cent of hospital beds are occupied by
AIDS related patients and long-term hospital treatment
is out of the question. So, like millions of AIDS sufferers
across the African continent, she was sent home prematurely,
and there she must wait to die. She counts herself fortunate.
A Red Cross home-care programme is helping - there is
someone to nurse, counsel and encourage her. But there
are days when she goes without eating, and her strength
is sapping away."
World Disasters Report 2000 |
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Strengthening local response
The International Federation of
Red Cross and Red Crescent Societies has been involved in the
fight against the spread of the HIV/AIDS infection since the
mid-1980s. With its 100 million volunteers, the International
Federation is able to play an essential role in coordinating
and supporting local efforts to combat the disease. While these
efforts, together with national and international initiatives,
have helped many individual beneficiaries, they have lacked
the consistency and scale to make a significant impact on reducing
the epidemic worldwide.
Things are starting to change. The African Red Cross and Red
Crescent Health Initiative (ARCHI2010), for example, was launched
in 1998 to better focus Red Cross and Red Crescent public health
programmes in Africa. Together, 53 African National Societies
along with government authorities, academics and representatives
from several UN agencies, worked in a participatory planning
process to identify public health priorities and initiatives
where Red Cross and Red Crescent scaled up contributions could
have the greatest benefit. HIV/AIDS emerged as the most urgent
priority. Similarly, National Societies from Southeast Asia
are currently working together within the Asia Regional Task
Force developing a common strategy to combat AIDS. National
Societies within the former Soviet Union are also jointly identifying
scale up strategies through the European Regional AIDS Network.
The foundation for these strategies is the Red Cross and Red
Crescent's volunteer network, its extensive experience in community-based
first aid programmes, and its proven capacity in emergency situations
to alleviate suffering and mitigate the effects of disasters.
The main focus of all Federation programmes related to HIV/AIDS
will be:
a) Developing internal competence - A major
step in the process of becoming a global partner in reducing
the impact of HIV/AIDS requires that Red Cross and Red Crescent
societies address the pandemic's effects on members, volunteers
and staff. To achieve this, all members and volunteers must
be knowledgeable about the disease, commit to actions to prevent
the spread of it and the appropriate policies and procedures
must be put in place to institutionalize the fight against
HIV/AIDS.
b) Reducing vulnerability to HIV/AIDS - Community-based
action involving the different local stakeholders will be
a core component of all programme areas.
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Areas of action: building on comparative
advantages
National Societies, in cooperation
with the Federation, will scale up their HIV/AIDS-related initiatives
over the next five years. The proposed action requires a dramatic
increase in the level of external aid and commitment to Red
Cross and Red Crescent HIV/AIDS programmes.
Areas of programme activity to be scaled up include:
Advocacy: The Declaration of the Pan African Red Cross
and Red Crescent Conference in September 2000 proclaims National
Societies' commitment to advocacy initiatives related to HIV/AIDS.
National Societies will follow up on the Declaration and undertake
efforts to convince authorities and political leaders to declare
HIV/AIDS a national public health emergency. Efforts will be
made to raise awareness of the risks of unsafe sexual behaviors,
discrimination and stigmatization of people living with HIV/AIDS,
gender differentials in vulnerability to HIV/AIDS and the availability
of voluntary counseling and testing.
Additionally, while continuing to provide essential care to
the maximum number of people living with HIV/AIDS through the
Red Cross and Red Crescent home care approach, the Federation
will advocate at every possible level for the availability of
all needed drugs including antiretrovirals.
Building and applying knowledge: Efforts will be made
to ensure that all members, volunteers and staff are knowledgeable
on HIV/AIDS prevention and that they apply this to their own
lives.
National Societies will also strengthen youth peer education
initiatives both in schools and outside, using local adaptations
of the Federation's "Action with Youth - HIV/AIDS and STD"
peer education training manual. The aim is to make a significant
impact on young people's attitudes and behaviour by providing
them with the necessary information to lead healthy lifestyles.
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| "Of
course, until there is a viable vaccine, education and
risk reduction remain key elements in the fight against
AIDS." |
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Distribution of condoms and promotion
of proper use: This activity, currently undertaken on a
small scale by National Societies, will be expanded. Its goal
will be to increase availability and accessibility, particularly
in rural areas where community volunteers serve as valued outreach
condom distributors and promoters of usage.
Support home care for people living with HIV/AIDS: Focus
will be on training family members in basic medical care, first
aid and support techniques for home care of the illness. While
this approach has been implemented in small scale projects,
the Red Cross and Red Crescent will be expanding coverage throughout
all the countries where it is working.
Strengthen local support mechanisms for AIDS orphans:
In collaboration with other partners, the Federation and National
Societies will assist communities in strengthening their traditional
coping methods to address the problem of children orphaned by
the AIDS pandemic.
Promote voluntary non-remunerated blood donation: Existing
national programmes and activities will be extended, in particular
the joint Federation and WHO World Health Day campaign "Safe
Blood Starts with Me" to raise awareness regionally and
globally about safe blood donations.
Prevention of HIV/AIDS infection in complex emergencies:
Reproductive health in complex emergencies is of primary concern
to Red Cross and Red Crescent Societies. Disruption of societal
structures, family units and sexual networks; sexual interaction
with military; sexual violence, coercive sex; and psychological
trauma all add to the vulnerability of refugees and displaced
people, with whom the Red Cross and Red Crescent is in daily
contact. To tackle these issues, the Federation and UNFPA have
signed an agreement to combine and broaden efforts
Reduction of mother-to-child transmission and increase access
to HIV/AIDS-related therapy: The French Red Cross is contributing
to developing affordable solutions through a series of day care
centres in African countries which are providing counseling,
screening and medical care for the prevention of vertical transmission
of HIV. |
Delivery Mechanisms
Red Cross and Red Crescent volunteer
efforts have been highly effective both in emergency situations
and non-crisis community-based first aid programmes. However,
sustaining ongoing volunteer involvement in HIV/AIDS work requires
strengthened and additional support capacities. A central element
of the Federation's HIV/AIDS strategy is to build these capacities
at intermediate levels between headquarters and local branches,
using a network of "coaches" responsible for training and managing
community workers and volunteers.
The Federation will encourage the collection of lessons learned
and promote best practices in the implementation of community-based
initiatives in an ongoing effort to improve programme outputs.
Partners
Many
HIV/AIDS prevention activities currently being implemented are
based largely on the local resources of National Societies.
Limited bilateral assistance has been provided to National Societies
for HIV/AIDS efforts, but it remains insufficient in the face
of the epidemic. A call for support to scale-up activities is
underway and more partnerships, especially at the community
level, are needed to achieve the desired impact.
To enhance Red Cross and Red Crescent HIV/AIDS interventions,
the Federation will continue to work with partners whose complementary
activities provide the synergy needed for success. Currently,
the Federation is a member of the "International Partnership
against AIDS in Africa", a partnership that links the Federation
to African and donor governments, as well as UN agencies and
private sector organizations committed to fighting AIDS.
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