A
Development Approach to HIV/AIDS
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Communities,
organizations and governments have more resources and
knowledge available to fight HIV/AIDS than ever before.
HIV/AIDS impacts many aspects of people’s lives,
not just their health. Illness and death due to HIV/AIDS
have meant less food and less food security. Workers in
all sectors – social services, education, entrepreneurs,
businessmen, and transport workers – are impacted
by illness and death in families and throughout communities.
HIV/AIDS clearly influences the social, economic and political
dimensions of people’s lives: any effective response
to the HIV/AIDS pandemic must take this into account.
Currently, the global community is moving toward the
adoption of a set of principles and practices
for preventative programs, clinical care, social
support and ensuring universal access to HIV/AIDS
medicines by 2010.
Along
with caring for the increasing number of people infected
and affected, addressing HIV/AIDS as it affects people’s
lives remains a critical challenge. HIV/AIDS should
be confronted with a multi-sectoral, interdisciplinary
containment strategy that resists the impulse to respond
with only a medical focus and short-term quantitative measures
of progress. We must address the myriad of factors and
circumstances that impact this pandemic, especially those
outside of the traditional treatment of a disease.
In January
2003, President Bush announced the President’s
Emergency Plan for AIDS Relief (PEPFAR) to quickly
provide treatment options in resource-poor communities,
and to scale up prevention, care and support efforts. To
realize this vision, he laid out three broad goals to be
reached by 2008, known as the 2-7-10 Goals:
- Two million people on treatment;
- Seven million new HIV infections averted; and
- Ten million people infected and affected by HIV/AIDS,
including orphans and vulnerable children (OVC), receiving
care and support in focus countries.
To
achieve these goals, the Bush Administration created
the Office of the Global AIDS Coordinator (OGAC) within
the U.S. State Department. OGAC has primary responsibility
for the oversight and coordination of all resources
and activities of the U.S. Government (USG) to combat
the HIV/AIDS crisis overseas.
With
55 percent of PEPFAR funding required to be spent on
treatment, the USG has focused on developing a facility-based
model to put two million people into treatment by 2008.
While a heavy emphasis on treatment is understandable
and necessary, with five million new infections
annually, alternative approaches are clearly necessary to break
the cycle of transmission, chronic illness,
death, orphans and deeper poverty. These approaches must
build on a broader based response that includes interventions
that proactively work to turn around this
pandemic rather than simply react to the health problems
caused by the disease. InterAction urges OGAC to
develop a more comprehensive, holistic approach and
to allow PEPFAR money to be used more flexibly and
to support interventions that could assure a truly
comprehensive “wrap-around” response
to the pandemic. For ease of understanding, we call this
a “development approach” to
HIV/AIDS.
A
development approach builds on many successful efforts
already initiated through PEPFAR. The
Assistance to Orphans and Other
Vulnerable Children in Developing
Countries Act, signed in late 2005, authorizes OGAC
to implement a development approach in its OVC programming,
broadening the response to HIV/AIDS beyond health
care measures. The legislation focuses on children
and families infected and affected by HIV/AIDS, and
proposes a multi-sectoral response, including support
for nutrition, education, economic livelihoods and
psychosocial well-being. InterAction looks forward
to working with the newly-appointed OVC Coordinator
to ensure that OVC issues are funded to the full
extent of their allocation and are expanded to ensure
access to treatment, care and support.
A
development approach to HIV/AIDS addresses human health
within the broader context of
other essentials of human life, including nutrition,
psychological well-being, child development, education
and economic livelihoods. It also strengthens local
technical and managerial capacity to shape sustainable,
community and national structures to ensure that the
views of the affected and inflected are integral to
the response and that the response is locally managed,
supported and sustained. This approach has two key,
inter-related elements:
- Involve a wider range of actors to promote local ownership
and build sustainable local capacity to provide
HIV/AIDS services and programs over
the long term.
- Address a wider range of needs to affect the realities
of people’s lives, including but not
limited to the need for health care.
One of the challenges for HIV/AIDS
response is the need to strengthen
capacity of people, organizations and
government bodies fighting HIV/AIDS
on the ground. InterAction welcomes
OGAC’s recognition of the need to build local capacity
that is represented
in the New Partners Initiative (NPI). InterAction believes, however, there
is still a need for strong intermediary organizations with long-standing experience
working in
partnership with local organizations. We support reaching small local organizations
but believe that for these organizations to be successful,
they need experience with USG funding mechanisms
and the capacity to design, implement, monitor and report on funded programs.
The extensive experience of U.S. NGOs working at the grassroots
with local organizations to implement
programs can assure both effective programs and capacity-building,
while meeting all USG accountability requirements.
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the full report
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