Thursday, December 4, 2008

IFPRI: Helping Women Respond to the Global Food Price Crisis

The current food price crisis has received widespread attention, but discussions to date have largely overlooked the gender dimensions of the crisis. More than 15 years of rigorous research on gender and intrahousehold resource allocation suggest not only that men and women will be affected differently by the global food crisis, but also that, as both consumers and producers, they will have different stocks of resources with which to respond to rising prices. Although the current situation calls for an urgent national and international response, urgency is not an excuse for misguided policies that fail to address the gender implications of the crisis. Instead, decisionmakers should take this opportunity to incorporate what is known about women’s roles in agricultural production and household welfare, and the specific challenges they face, both to craft more effective policy responses and to enable women to respond better to the current challenges and opportunities.
Download the document from Reliefweb (pdf, 78kb).

ICASA: 15th International Conference on AIDS and STIs in Africa: “Africa’s Response: Face the facts”

For more than two decades, the African continent has participated in the fight against AIDS and provided potential solutions to the numerous challenges posed by this epidemic.

However, even as the fight continues, it is important to stop and evaluate these many initiatives, in order to recognize their contributions, successes and ambitions, as well as to acknowledge their weaknesses and shortfalls. It is time to take stock of political commitments, unfulfilled promises and actions and practices employed in the fight against HIV/AIDS.

At ICASA 2008, International and African experts will evaluate the current state of the HIV and STI epidemics with regard to science, communities and leadership.

In addition, the conference will broach topics concerning other, equally important infectious diseases such as tuberculosis, malaria and hepatitis.


Addressing the vulnerability of young women and girls to HIV in southern Africa
HIV Data

3 December 2008

On the opening day of ICASA 2008, a new regional report is launched by UNAIDS Executive Director Dr Peter Piot that looks at the vulnerability of women and girls in Southern Africa to HIV.

Dr Peter Piot addresses the launch of the UNAIDS RST report on vulnerability of women and girls in Southern Africa.
Credit: UNAIDS/Jacky D. Ly
Almost two-thirds of all young people with HIV live in sub-Saharan Africa where about 75% of all infections among young people aged 15 to 24 years are among young women.

Responding to the need to understand why young women and girls living in countries in this region are so vulnerable to HIV infection, UNAIDS and the Reproductive Health and HIV Research Unit of the University of Witwatersrand in South Africa convened an expert technical meeting in June 2008.

The meeting agreed four specific sets of actions at community and country levels that are grounded in national strategies and are context specific. The four key actions are:

Mobilize communities for HIV prevention, with strong male involvement, to design relevant strategies and messages about the causes, consequences of and solutions to young women and girls’ vulnerability
Expand access to high quality, well-integrated essential sexual and reproductive health and prevention services, while mobilising demand for and use of them.
Develop and ensure adequate technical and financial resources for implementation of national strategies that address the structural drivers of vulnerability.
Strengthen country capacities for epidemiological and behavioural surveillance, priority research, and monitoring coverage and impact of prevention responses to generate information to improve decision-making.


“UNAIDS Technical Meeting on Young Women in HIV Hyper-endemic countries of Southern Africa” was launched on the opening day of ICASA 2008, Dakar.

Participants at the meeting included regional researchers; representatives of national AIDS councils, government departments and the Southern African Development Community; and members of the eastern and southern Africa United Nations Regional AIDS Team. Participants were selected for representation across high-level policy, social and scientific research and programming expertise related to women, girls and HIV, from all countries of southern Africa.

Andy Seale, Senior Regional Adviser for Advocacy and Communications with UNAIDS Regional Support team for Eastern and Southern Africa, said: “A major acceleration in social mobilization, service scale-up, increased resources and better surveillance is needed to successfully address the vulnerabilities explored at the meeting. Actions are needed at all levels from the state level to actions at community, family and individual level.”

The outcomes of that meeting are reflected in a new publication launched by UNAIDS in Eastern and Southern Africa on 1 December 2008 that outlines the experts’ conclusions, recommendations and needed sets of action.

“UNAIDS Technical Meeting on Young Women in HIV Hyper-endemic countries of Southern Africa” also includes a number of the background technical papers which were commissioned for the meeting.

Southern Africa context explored

On the opening day of ICASA 2008, a new regional report is launched that looks at the vulnerability of women and girls in Southern Africa to HIV.
Credit: UNAIDS/Jacky D. Ly The papers explore some of the factors that are driving the current epidemic in southern Africa. These include the practice of age disparate and intergenerational sex; biological vulnerability of young women; economic empowerment; education and gender-based violence. A final paper examines the complex interaction between environmental factors and individual choices, behaviours and community norms.

Improved analyses of these factors will enable appropriate and evidence-informed responses to these specific challenges that increase vulnerability of young women and girls in the region.

Social transformation

Meeting participants called for a social movement to address the drivers that contribute to the risk of HIV infection in the region. Addressing human rights violations, harmful social norms, weak community and leadership capacities are seen as some of the fundamental steps to tackle the vulnerability of young women and girls to HIV in southern Africa.

JHA: Gender Mainstreaming During Disasters: The Case of the Tsunami in India

The 2004 tsunami had disastrous consequences for entire coastal regions bordering the Indian Ocean. Yet the tsunami’s impact on the affected populations varied according to their pre-disaster vulnerabilities. Specifically, gender roles contributed to the vulnerability of girls and women by limiting their social rights and access to resources. This study, which was conducted by researchers from the Anawim Trust in Tamil Nadu, India, documents ways in which 10 local Indian NGOs brought a gender dimension to their post-tsunami emergency and rehabilitation programs in the state of Tamil Nadu, and it offers recommendations to help local and international NGOs improve their gender mainstreaming efforts at both the programmatic and organizational levels.

Read more on the Journal of Humanitarian Assistance (JHA) website.

JHA: Understanding the Effect of the Tsunami and Its Aftermath on Vulnerability to HIV in Coastal India

In 2006, Oxfam commissioned the Swasti Health Resource Center in Bangalore, India, to study whether the 2004 tsunami and its aftermath increased vulnerability to HIV infection among affected residents of coastal India. Researchers found that such vulnerability did indeed increase in most of the 30 communities studied, primarily because the physical, social, and psychological conditions after the tsunami led to a significant increase in unprotected sex with non-regular sexual partners, especially among people living in temporary shelters. The research team recommends measures that government, local NGOs, and international aid groups can take to minimize the risk of HIV infection among displaced people after major disasters.
Read more on the JHA website.

Convention on Cluster Munitions signed in Oslo

More than 100 governments, with some notable exceptions, will sign an international convention today banning the production of cluster bombs whose unexploded canisters have killed and maimed thousands of innocent civilians and are dangerously scattered over more than 20 countries.

The convention is enthusiastically welcomed today by the Red Cross, and on the Guardian's website by David Miliband, the foreign secretary, and Frank-Walter Steinmeier, his German counterpart. The weapons had "rendered huge tracts of land unusable, cutting farmers off from their crops and visiting further suffering on families forced to risk their lives simply to pursue their livelihoods", said Matthias Schmale, international director of the British Red Cross.
The Guardian, 3rd December 2008

Civil society played a key role in bringing about this strong convention, as did the International Committee of the Red Cross/Red Crescent. Its president, Dr Jakob Kellenberger, captured the spirit of what we were trying to achieve when he quoted from the authors of the 1868 St Petersburg Declaration that our task was shaped by the need to "fix the technical limits at which the necessities of war ought to yield to the requirements of humanity." Civil society's involvement in the process helped to ensure that when redefining these limits humanitarian concerns were given due weight.
David Miliband in the Guardian, 2nd December 2008
Almost exactly ten years ago, the world celebrated a comprehensive ban on anti-personnel landmines, an immense achievement which has saved countless lives and spared the suffering of thousands around the globe.

Then, as now, the Red Cross and the British Government were at the forefront of the debate. The Red Cross first called for a Cluster Munitions treaty in 2000 following the conflict in Kosovo. More recently it was largely due to the United Kingdom that a conference in Dublin in May was able to reach agreement on the final wording of the treaty being signed today.
Matthias Schmale, British Red Cross press statement
We are committing ourselves to preventing further civilian deaths and injuries from cluster munitions, and to helping those whose lives have been blighted by them.... we are showing our commitment to international humanitarian law, and celebrating the tremendous positive energy which comes about through working together with civil society.

...

Our global community must continually keep challenging itself about the way it behaves. Political leaders must show they are prepared to listen and respond to the voices of victims, of civil society, and of ordinary people. The Cluster Munition Convention, the "Oslo Convention", shows both the importance and the power of advocacy to make the world a safer, better place.

It's only the beginning because we must continue working together internationally, and so must our military forces, to prevent conflicts and deal with their legacy. And when military force is required, it must be used responsibly.

David Miliband, short speech on signing the Convention.

UNAIDS:Understanding HIV transmission for an improved AIDS response in West Africa

“West Africa HIV/AIDS epidemiology and response synthesis”

On the opening day of International Conference on AIDS and STIs in Africa (ICASA), taking place in Senegal under the theme “Africa’s Response: Face the facts,” the World Bank launched a new report exploring the character of the HIV epidemics and responses in countries in West Africa.

The “West Africa HIV/AIDS epidemiology and response synthesis” is a review and analysis of surveillance and research data in 15 West African countries: Benin, Burkina Faso, Côte d’Ivoire, Ghana, Guinea, Mali, Niger, Nigeria, Senegal, Togo, Cape Verde, The Gambia, Guinea Bissau, Liberia, and Sierra Leone.

Aiming to gain an improved understanding of HIV transmission dynamics in this sub-region, the paper focuses on the degree to which epidemics in each country are concentrated or generalized, and the implications that this has for effective prevention strategies. The report argues that more prevention focus is needed on the specific groups in which HIV transmission is concentrated, including female sex workers and men who have sex with men.

The new publication highlights a need for better understanding of the complex nature of transactional sex in West Africa. Many women involved in commercial sex do not self-identify as sex workers and have other occupations as well. The boundaries between commercial and non-commercial sex are blurred and it is difficult to have an idea of the proportion of men having commercial sex due to substantial under-reporting.

The importance of men who have sex with men (MSM) in the HIV epidemic in West Africa is being increasingly recognized. High proportions of MSM are also married and/or have sex with other women with very low rates of condom use, acting as a bridge for HIV between MSM and women.


For more information, see the UNAIDS website.

“Know your epidemic. Know your response”

The paper was written as part of the work programme by the World Bank’s Global AIDS Monitoring and Evaluation Team (GAMET) to support countries to “know your epidemic, know your response” so that interventions are carefully chosen and prioritized based on a careful characterization of each country’s epidemic.

Understanding the behaviors that are giving rise to most new infections is a crucial first step to being able to develop a results-focused, evidence-based response that will be effective in preventing new infections. In turn this will improve resource allocation, all the more appropriate when global economic outlook may impact AIDS response.

The work was carried out in partnership between the World Bank and UNAIDS and with the collaboration of the National AIDS Councils and AIDS programmes of the countries.

Tuesday, December 2, 2008

ICRC: The Convention on Cluster Munitions - Time to Act

British Red Cross podcast for World AIDS Day

In honour of World AIDS Day, a new podcast on the work of British Red Cross peer educators in Scotland and their link with peer educators in Nepal is up on our external website.

Other podcasts include episodes on the aftermath of Cyclone Nargis in Myanmar, and child soldiers in Sierra Leone.

Monday, December 1, 2008

A message from Bernard Gardiner, Federation HIV Unit Manager

World AIDS Day has become the traditional day throughout the world to say the right things about HIV, BUT the real test comes on every other day of the year when we need to DO the right things to keep the promises. Good intentions and hope are not a method. Promises have to be followed up with specific targets, and monitoring to ensure those targets are met.

Two years ago on World AIDS Day the previous Secretary General launched the Federation's Global Alliance on HIV, and committed the Federation to doubling the amount of HIV work by 2010.

In the late 1990s the Federation was spending only about CHF 3 million each year on HIV work. Last year we pushed past CHF 45 million, meaning we are on track to keep our promise. 80 National Societies are now members of the Global Alliance on HIV, detailed plans and costings of exactly how each will double HIV work, and how Zones will support national society capacity building, can be seen on the Federation's website.

Our resource mobilisation target for 2010 is CHF 270, which is more feasible today as global HIV funding has increased from millions to billions of dollars. To stay on track to meet our target the Secretariat has to put intensive effort into supporting National Societies to access Global Fund to Fight AIDS TB and Malaria and other funding sources at the country level. The reality of HIV funding architecture is the 'country driven approach' - most donor support is dispersed at country level. The Global Alliance on HIV means national societies have technically credible plans and budgets to take to the table in country, and donors are taking the Federation's standardised approach as a signal the Federation is serious and organised.

Some resource mobilisation opportunities still exist at Zone and Global levels, and these must also be maximised.

So in summary, we are now in a position where we have a clear platform for co-operation (the Global Alliance on HIV), specific plans and budgets, and improved resource mobilisation. We need to build on this hard work and success, to DO MORE and DO BETTER. We aim to fully deliver this promise to double the Federation's HIV work by the end of 2010.

The banners hanging in the IFRC Geneva Secretariat's foyer today are an adaptation of the current 'Stop AIDS. Keep the Promise' materials of the World AIDS Campaign, and address key elements of how we will deliver over the coming year. These designs will be made available to all national societies for use throughout 2009.

Felicita Hikuam came to the Secretariat four years ago from Namibia Red Cross to develop our colourful 'Come Closer - you cannot get HIV by being a friend, kissing, hugging, playing, talking etc' anti-stigma campaign, and then went on to work for World AIDS Campaign. She suggested IFRC develop its own version of World AIDS Campaign materials focusing on how the IFRC will keep its promises over the coming year.

The first banner highlights our Global Alliance on HIV platform to DO MORE and DO BETTER. The Global Alliance approach is all about PARTNERSHIP, and how we can achieve much more by working together.

The second banner highlights our key 'added value'. National Society volunteers mobilise the community, usually the community where they live. The 'Partner' theme captures the spirit of this mobilisation work. The main job of National Societies is to support these volunteer change agents to DO MORE and DO BETTER. The Secretariat needs to advocate more strongly and convince donors and governments of the value of this work, and of the need to fund community systems strengthening.

The 3rd banner represents the foundation of our HIV work, partnership with PLHIV.

UNAIDS and IFRC will this month sign a new three year UNAIDS Collaborating Centre Agreement, to partner with the Global Network of PLHIV (GNP+) to reduce stigma and discrimination. The agreement includes work to improve how the needs of PLHIV are met in humanitarian situations. To maximise co-ordination, the Secretariat focal point person for this Collaboration will be co-located in the Principles and Values Department with the Gender expert. This, combined with Secretariat support to the newly formed network of Red Cross and Red Crescent staff and volunteers living with HIV, and the Human Resources Department's HIV in the Workplace programme, will mean we move closer to keeping our promise to make IFRC a better home for PLHIV.

HIV is something that touches us all, personally and professionally. We can DO MORE and DO BETTER, and by our actions show real leadership in the global HIV response.

Thank you for all you do to help the Federation to deliver its promises. I hope today that you feel proud to be part of this collective effort. You make the difference - thank you!

A message from Alyson, our HIV and AIDS advisor

Dear Colleagues,

Today, 1 December 2008 marks the 20th anniversary of World AIDS Day. In a report by UNAIDS it is clear that since 1988, efforts made to respond to the epidemic have produced positive results. However, there are still huge outstanding needs and consequent efforts required by all of us to reduce HIV. Please take the time to read through this message today and consider what we can do to make a difference.

This year’s theme is “Lead – Empower – Deliver”. Designating leadership as the World AIDS Day theme for 2007 – 2008 highlights both the political leadership needed to fulfill commitments that have been made in the response to AIDS – particularly the promise of universal access to HIV prevention, treatment, care and support by 2010 – and celebrating the leadership that has been witnessed at all levels of society.

This year WAD activities are being held across the Territories, for example:
  • South East Territory are holding a conference to launch their HIV project where workshops will be held on Anti stigma, HIV awareness and Sexual health .The conference will also include personal statements from young people.
  • Northern Territory is running a number of events up to and during WAD week. This includes a Universal Children’s day conference where peer educators raised awareness of their work throughout the year, through displays and discussions. The Mayor of Liverpool and Hollyoaks stars, will join young British Red Cross volunteers and Liverpool school children to celebrate Universal Children’s Day and gain awareness of HIV and AIDS
Many of the National Societies that we are working with are holding different events with their volunteers, staff and partners across their countries. This aims to demonstrate their commitment to increase awareness of HIV and reduce discrimination.

Some key facts on the AIDS epidemic which we should consider in planning and implementing our work:
  • An estimated 33 million people were living with HIV in 2007. There were 2.7 million new HIV infections and 2 million AIDS-related deaths last year.
  • The rate of new HIV infections has fallen in several countries, but globally these favourable trends are at least partially offset by increases in new infections in other countries.
  • Globally, women account for half of all HIV infections—this percentage has remained stable for the past several years.
  • The global percentage of adults living with HIV has levelled off since 2000. In virtually all regions outside sub-Saharan Africa, HIV disproportionately affects people who inject drugs, men who have sex with men and sex workers.
  • Prevention
  • In the last two years, good progress has been made in the prevention of mother-to-child transmission of HIV, but more work is urgently required with only 33% of pregnant women living with HIV receiving antiretroviral treatment to prevent mother-to-child transmission in 2007.
  • The scaling up of HIV prevention programmes globally is paramount.
  • For people most at risk, since 2005 we have seen a tripling of HIV prevention efforts focused on sex workers, men who have sex with men and people who inject drugs.
  • The number of new HIV infections continues to outstrip the advances made in treatment numbers—for every two people put on antiretroviral drugs, another five become newly infected.
Treatment

  • Nearly 3 million people were receiving antiretroviral treatment in low- and middle-income countries at the end of 2007. This represents 31% of estimated global need and a 45% improvement over 2006.
  • Globally, treatment coverage is higher for women than men.
  • But children are not benefiting equally as adults. In sub-Saharan Africa, children living with HIV are about one third as likely to receive antiretroviral therapy as adults.
  • Increases in treatment have been extraordinary in many countries.
  • After decades of increasing mortality, the annual number of AIDS deaths globally has declined in the past two years, in part as a result of greater access to treatment.
  • The cost of providing HIV treatment will continue to increase – as some of those on treatment currently need to access second and third line treatment regimens, and as delayed access makes disease management more complex for the estimated 30 million HIV-positive people worldwide who have never been on treatment.
  • Most countries have policies providing free antiretroviral drugs—however many patients have to pay ‘out-of-pocket’ costs such as diagnostic tests, treatments for opportunistic infections and transportation, items which can be quite considerable depending on local contexts.
Tuberculosis and HIV
  • Tuberculosis remains a leading cause of death for people living with HIV in low- and middle-income countries.
  • While tuberculosis incidence has declined globally in recent years, the number of cases continues to increase in areas heavily affected by HIV or drug-resistant TB.
  • Despite the availability of affordable treatments for tuberculosis, only 32% of TB cases in people living with HIV received both antiretroviral and anti-tuberculosis drugs—the greatest need for dual treatment is in sub-Saharan Africa.
  • Efforts to prevent, diagnose and treat tuberculosis must be scaled up in HIV care settings
Source: Report on the global AIDS epidemic 2008, August 2008 (UNAIDS/WHO next plan to publish an AIDS Epidemic Update in 2009).

Many regards,
Alyson

World Aids Day: 1st December 2008



  • UNAIDS launches AIDS Outlook: a new report that provides perspectives on some of the most pressing issues that will confront policymakers and leaders as they respond to the challenges presented by AIDS in 2009.
  • The World AIDS Day calendar;
  • A press release from this morning;
    National HIV prevention programmes can become more successful using combination prevention approaches—this will help make the money work effectively during tough economic times
  • From the Federation website: HIV still with us, not defeated yet...
  • As in previous years, the World AIDS Campaign has produced a wide variety of campaign materials to be used by individuals and organizations that want to campaign on World AIDS Day and host commemorative events.
See after the jump for a list of related events.
  • The Cara Trust: World AIDS Concert with Choir from London Gay Men’s Chorus
    Date: Saturday 29th November
    Time: 12.45pm-1.30pm
    Place: St Pancras Church, Upper Woburn Place, Euston
    RSVP: 02072436147 E: mail@caralife.com
  • Steering the response to HIV through the changing global financial environment - leadership and collaboration
    Date: 1st December 2008
    Time: 2.45pm to 5pm
    Place: Overseas Development Institute, 111 Westminster Bridge Road, London SE1 7JD
    RSVP on ODI website.
    Chair: Simon Maxwell, Director, ODI
  • The Food Chain - Feeding the Fight against HIV: 20th Anniversary and World AIDS Day reception
    Date: 1st December
    Time: 5pm
    Place: The South African High Commission, Trafalgar Square, London WC2N 5DP
    RSVP: (limited places) info@foodchain.org.uk 020 7354 0333
  • The Cara Trust: World AIDS Day Evensong
    Date: 1st December
    Time: 5pm
    Place: Westminster Abbey
    RSVP: 02072436147 E: mail@caralife.com
  • Where next for New HIV Prevention Technologies? Briefing and Drinks reception
    Date: 2nd December 2008
    Time: 3-5pm
    Place: Royal Society, 6-9 Carlton House Terrace, London, SW1Y 5AG
    RSVP: whalleya@interactworldwideorg
  • HIV & Health Systems Strengthening: Opportunities for Achieving Universal Access by 2010.
    Date: 4th December
    Time: 12-2pm Place: Attlee Suite, Portcullis House, House of Commons
    Chair: Rt Hon Francis Maude MP, Vice-Chair of The All Party Parliamentary Group on AIDS
    RSVP: katy@aidsconsortium.org.uk

Friday, November 28, 2008

ODI/BBC: Left in the dark: The unmet need for information in humanitarian response

When crisis or disaster strikes, people need help. They need, shelter, food, water and safety. They need these things rapidly and effectively. Modern humanitarian responses have become more efficient and effective at providing these things.

This policy briefing argues that people need information too. It does so not to create an added burden on humanitarian responses that are always stretched thinly. It does so because such responses are too often undermined, often insufficiently effective – and sometimes outright counterproductive – if people’s information needs are considered a low priority during humanitarian crises.

Effective information and communication exchange with affected populations are among the least understood and most complex challenges facing the humanitarian sector in the 21st century.
Download the policy briefing from the BBC website, or attend the event.

ODI Blog: Realising Urban Potential: Are donors keeping pace with rapid urbanisation?

Urbanisation is characterised by the massive expansion of informal settlements and strains on existing urban work, land, services and infrastructure. For example, the number of people living in slums has doubled in India in the past 20 years and is now greater than the entire population of Britain. Are donor strategies, policies and programmes keeping up with the pace of change occurring in the least developed countries?

From a quick review of ten major international donors we saw little or no evidence that urban insecurities are moving up the aid agenda. What we tend to find is that development itself retains a very rural focus, with the urban focus limited to a series of statements about the challenges of infrastructure, environment and sustainability, and urban governance.
Read more on the ODI blog.

ODI Blog: What does 'early recovery' mean?

The international community has long been concerned with the need to strengthen the synergies between humanitarian and development assistance and improve the transition from relief to recovery and, ultimately, to longer-term development. Over the past decade, efforts to address the ‘gap’ between humanitarian and development, such as the ‘relief-development continuum’ and ‘linking relief, rehabilitation and development’, have resulted in significant discussion but little substantive impact.

The early recovery approach represents the latest expression of the ‘linking’ debates, but to move from decades-long debates to concrete solutions and actions in the field it is important that earlier mistakes are not repeated. This would mean that more significant efforts should be made to clarify this relatively new concept both at conceptual and programmatic levels.
Read more on the ODI blog.

Friday, November 21, 2008

IRIN: Juggling emergency aid and long-term development

As the global recession bites, analysts are asking if emergencies such as natural disasters will continue to receive funding (on 19 November, a record appeal for US$7 billion was launched for crises) while development aid, which could save many more lives long-term, such as agricultural investment in Africa, is left to languish.
Read more on the IRIN website.

Thursday, November 20, 2008

Alertnet: The 'sting' of climate change will be malaria and dengue

Southeast Asia and South Pacific island nations face a growing threat from malaria and dengue fever as climate change spreads mosquitoes that carry the diseases and climate-change refugees start to migrate. A new report titled "The Sting of Climate Change", said recent data suggested that since the 1970s climate change had contributed to 150,000 more deaths every year from disease, with over half of the deaths in Asia.

"Projections of the impact of climate change on malaria and dengue are truly eye-opening," said the Lowy Institute report released in Sydney on Thursday. According to the World Health Organisation, rising temperatures and higher rainfall caused by climate change will see the number of mosquitoes increasing in cooler areas where there is little resistance or knowledge of the diseases they carry.

The Lowy report said early modeling predicted malaria prevalence could be 1.8 to 4.8 times greater in 2050 than 1990. The share of the world's population living in malaria-endemic zones could also grow from 45 percent to 60 percent by the end of the century.

By 2085, an estimated 52 percent of the world's population, or about 5.2 billion people, will be living in areas at risk of dengue.

It also said diseases will spread once climate change forces people to flee their homes, such as low-lying islands or coastal land swamped by rising sea levels.

Read more on Alertnet.

UN-OCHA: Humanitarian Coordinators Pool Mapping Exercise Report

This report outlines the evolution of United Nations humanitarian leadership; reports key outcomes against the plan; reviews current leadership development across the humanitarian system (UN, NGOs, IOM, and the Red Cross/Red Crescent Movement); and highlights issues of concern and ways forward for consideration of the IASC HC Issues Group and the IASC. It goes on to outline recommendations regarding the continuation of the HC Pool and the creation of an IASC Humanitarian Coordinators Assessment Panel.

More than 200 stakeholders were contacted, from operational humanitarian United Nations agencies on the IASC, International Organizations (ICRC, IFRC, IOM), NGO Consortia, key NGO humanitarian agencies and large Red Cross National Societies, key donors on UNOCHA support network, and humanitarian standard and quality projects dealing with personnel.

Read more on Reliefweb.

Wednesday, November 19, 2008

ALNAP on Alertnet: Don't chase headlines, chase quality news

Written by: Ben Ramalingam
A leading UK newspaper recently reported a warning by Britain that lives are being lost because of a lack of U.N. leadership in responding to humanitarian crises. It sounds like a strong story, doesn't it? While not exactly inaccurate, it's a striking example of the problems humanitarians face in dealing with a story-hungry media.

The report was based on a speech given by Gareth Thomas MP, the UK Secretary of State for International Development, to the U.N. refugee agency (UNHCR) in Geneva in October. In it he set out five key changes necessary to deal with humanitarian crises in a world being buffeted by climate change, rising food prices and financial meltdown. His points covered stronger in-country leadership from the U.N.; better coordination across all agencies with more support to the U.N.; more and better humanitarian funding, especially from the USA; greater accountability to aid recipients and sustained political commitment from all quarters. He highlighted how these issues were ever more important in a world facing rising numbers of disasters.

These are good suggestions and - if backed with political will - have the potential to make a real difference for disaster affected people around the world. But the article didn't mention any of this. Its report instead focused on one particular element: that the key problem with the humanitarian system was a lack of properly trained or appropriate U.N. humanitarian coordinators to oversee disaster relief in operational settings. By positioning the story as a "warning" from Britain, the sense of drama and tension in the story was heightened.

While not incorrect or false, it was hard not to see this is as yet another example of the media absorbing a nuanced, complex narrative and broadcasting a partial and over-simplified message.
Read more on the Alertnet website.

Thursday, November 13, 2008

ALNAP: The Global Food Price Crisis: Lessons and Ideas for Relief Planners and Managers

The first half of 2008 was marked by significant rises in commodity prices, with food price increases averaging 52 percent between 2007 and 2008. While the response to the wider situation is largely outside the scope of humanitarian programmes, those managing relief and recovery efforts have faced a number of challenges. This paper lays out the background to the food price rises, outlines a number of key challenges for those planning and managing relief efforts, and suggests ideas, tools and approaches that could prove of value.

Download the paper from the ALNAP website.

IRIN via Alertnet: SPHERE endorses INEE education in emergencies standards

Humanitarian policy-makers have endorsed internationally-agreed standards on rebuilding education sectors shattered by crises, in a move experts say shows that education is increasingly being regarded as life-saving. The Sphere Project has endorsed emergency education standards created by the Inter-Agency Network for Education in Emergencies (INEE), a network of 3,000 members representing UN agencies, NGOs, donors, teachers and students who promote education in emergencies.

"We believe education having been embraced within the Sphere family is a demonstration of the consensus in the humanitarian community that education must be considered as a sector within immediate emergency response," said Alyson Joyner, project manager of Sphere.

The Sphere Project which sets minimum standards food aid, shelter and other core humanitarian sectors, endorsed the INEE standards in October 2008, marking a change of approach. Prior to this Sphere had remained quiet about education because not all of its members saw it as life-saving and thus part of the classic humanitarian repertoire, according to Joyner.

Do standards work?

"Minimum standards are about boosting quality," said Allison Anderson, INEE director. "The most powerful thing they can do is give people a goal to work towards, to help them build their [emergency] response strategy." The INEE standards outline how to recruit teachers, undertake an education assessment, write up codes of conduct for educators and work with communities to develop an education programme. "The more practical they are, the more useful they are," Anderson said.

Measuring the standards' impact is difficult with so many other variables, such as security and funding, Sphere's Joyner told IRIN. But despite this, she said, "There is mounting anecdotal evidence that minimum standards have had a positive impact."

Read more on Alertnet.

Wednesday, November 12, 2008

John Holmes: New “business model” for humanitarian aid

IRIN: You are on the WEF Council on Humanitarian Assistance. What specific ideas have you brought to the council in terms of climate change and food insecurity?

JH: What we were discussing was the need to do two things which aren’t exactly new ideas but we were trying to formulate them in a reasonably coherent way. One is to spend a lot more time and effort on what you might call the upstream side - the prevention, the disaster risk reduction, the preparedness side so that there is more effort and more resources and more thought going into that, rather than concentrating too much on the response side after the event - which is necessary because you need to help people when they’re in their moment of need but it is not a very good investment because you can’t solve any problems that way. And the second related thought is to try to empower national governments, local communities, maybe regional organisations - to make them have more capacity, be more empowered, so that the international community doesn’t need to intervene so much and can reserve itself for cases of really major need. So those two things go together if we can get that combination right. It is what we try to describe as a new business model for humanitarian assistance. These thoughts have been had before but we are trying to encapsulate them in a new way.

IRIN: But what has hindered this development? Kofi Annan when he was UN secretary-general talked about the need for humanitarians to move from a culture of response to a culture of prevention. This has not happened yet.

JH: I think it is something to do with human nature. In our personal lives we know that prevention is better than cure, prevention health is better than response afterwards, but we don’t actually behave in ways which correspond to that. I think similarly governments and international institutions know in theory that it’s much better to invest more and do more on the prevention side but they don’t actually do it. You have to convince finance ministers, you have to convince presidents and prime ministers that they need to invest in something the results of which will only be seen in 10 or 15 years when they may no longer be in power. That is quite a tricky thing to do. So you’ve got to have your arguments marshalled. You have got to be able to prove to them - as we hope to be able to do in the new study which is under way - that this is actually a really good investment because there are going to be more and more disasters from climate change and hence the importance of the disaster risk reduction agenda because of the link to climate change.
Read more on the IRIN website.

Monday, November 10, 2008

Guardian: Paradise almost lost: Maldives seek to buy a new homeland

The Maldives will begin to divert a portion of the country's billion-dollar annual tourist revenue into buying a new homeland - as an insurance policy against climate change that threatens to turn the 300,000 islanders into environmental refugees, the country's first democratically elected president has told the Guardian.

Mohamed Nasheed, who takes power officially tomorrow in the island's capital, Male, said the chain of 1,200 island and coral atolls dotted 500 miles from the tip of India is likely to disappear under the waves if the current pace of climate change continues to raise sea levels.

The UN forecasts that the seas are likely to rise by up to 59cm by 2100, due to global warming. Most parts of the Maldives are just 1.5m above water. The president said even a "small rise" in sea levels would inundate large parts of the archipelago.

"We can do nothing to stop climate change on our own and so we have to buy land elsewhere. It's an insurance policy for the worst possible outcome. After all, the Israelis [began by buying] land in Palestine," said Nasheed, also known as Anni.

The president, a human rights activist who swept to power in elections last month after ousting Maumoon Abdul Gayoom, the man who once imprisoned him, said he had already broached the idea with a number of countries and found them to be "receptive".

He said Sri Lanka and India were targets because they had similar cultures, cuisines and climates. Australia was also being considered because of the amount of unoccupied land available.

"We do not want to leave the Maldives, but we also do not want to be climate refugees living in tents for decades," he said.

Read more on the Guardian website.

IASC: Humanitarian Action and Older Persons: An Essential Brief for Humanitarian Actors

Between 2006 and 2050, the number of persons aged 60 and over will triple from 650 million, or 11% of the world’s population, to 2 billion people, or 22%. By then, older persons will begin to outnumber children aged 14 and under. Just over 80% of the world’s older persons will be living in developing countries, compared to 60% today. In developed countries, the proportion of older persons will rise to about one person in three by mid-century. Globally, the “oldest-old” (80 and above) constitute the fastest growing age segment of the older population.

Recent events have brought to light the disproportionate impact of natural disasters and crises on older persons:
  • 80% of the “extremely vulnerable individuals” remaining in camps in northern Uganda’s Lira District in 2007 were over 60 years.
  • 71% of those who died in the wake of Hurricane Katrina in 2005 were 60 years and older.
Older persons play key roles in their families and communities. These roles continue, and may even become more important, in emergency situations:
  • UNICEF data show that 40 to 60% of orphaned children in countries severely affected by HIV/AIDS are cared for by their grandparents.
  • During and after the 2007 Cyclone Sidr in Bangladesh, older persons’ committees took an active role, disseminating early warning messages to vulnerable older persons and their families, identifying those who were worst hit, compiling beneficiary lists and notifying people when and where to receive relief goods.
Older persons are entitled to equal protection under international human rights and humanitarian law. Building awareness about the rights and needs of older persons is the first step to reducing their marginalization during and after crises and enabling them to continue supporting themselves and others.

Download the briefing paper from Reliefweb.

Emergencies in Urban Settings: A Technical Review of Food-Based Program Options

No. 6 in FFP's Occasional Paper Series
The objective of this paper is to provide technical information and lessons learned to support the United States Agency for International Development (USAID) and its partners to effectively design and implement emergency food assistance programs in urban and peri-urban settings.

Although food assistance needs in urban and peri-urban areas are expected to require increased resources in the coming years, most experience with food-based programs is in rural areas. Against this backdrop, USAID's Office of Food for Peace Occasional Paper No. 6, Emergencies in Urban Settings: A Technical Review of Food-Based Program Options, examines 11 common food-based programs to highlight advantages, disadvantages, targeting and implementation modalities in the urban context. The paper also presents tools to help determine the most appropriate interventions and approaches for given settings.
Download the paper from Reliefweb.

RC/RC Climate Change Centre Newsletter

Issue 12, November 2008

1. IFRC Secretary General Bekele Geleta will join the RC delegation at the UNFCCC Climate Conference COP 14 in Poznan, Poland 1-15 December 2008
The Red Cross/ Red Crescent Climate Centre and the IFRC are currently preparing for the COP 14. This year we are very pleased with a substantive cooperation amongst a large number of other humanitarian organizations in this preparatory process. Within the Inter Agency Standing Commission (IASC), that established an informal climate change taskforce, we are investing in a coordinated approach with the main humanitarian actors in the field to bring one joint message at the COP.
This has led to the production of a joint paper by ISDR and IASC in disaster risk reduction and risk management. Furthermore the Red Cross Red Crescent will organize a side event on Early warning Early Action (see news item number 4.) during the first week of the conference. At this side event, which the IFRC will host and organize together with OCHA and the Institute for Climate and Society (IRI), we shall demonstrate the first IFRC experiences of using seasonal forecasts for disaster risk management. Read more about Red Cross/ Red Crescent advocacy at the UNFCCC Climate Conference. All National RC Societies interested to be engaged in the preparatory work for the Climate Change Conference in Poznan (and in Copenhagen next year) are invited to contact the Red Cross/ Red Crescent Climate Centre. We call upon National Societies to join the IFRC delegation in Poznan, but can't provide financial support.

2. Progress of the Preparedness for Climate Change programme
The Preparedness for Climate Change Program, in which 37 National Red Cross Red Crescent Societies participate, will soon end. Many National Societies will be able to finalize the last phase of the programme successfully and we are happy to see the results. In brief, this programme consists of four consecutive steps, in which the National Societies are supported to assess the climate risks within their countries, align with all possible partners in their country, explore which climate risks are effecting the existing programmes and in the last phase: come up with a concrete action plan to integrate addressing climate risks in the operations of the National Society. In addition to that, most National Societies were able to share their experiences in a regional workshop and exchange ideas and knowledge with other National Societies. This whole process will lead to concrete ideas on how to reduce vulnerability due to climate change. In September and October four regional meetings were held in Mombasa (East Africa), Jakarta (South East Asia), Dakar (West Africa) and San Salvador (Central America plus Colombia). Read more about the regional climate risk meetings. Please find more information about the programme on our website.

3. Your National Society can now request a Disaster Relief Emergency Fund (DREF) BEFORE a disaster strikes.
If scientific evidence clearly shows a substantial risk of an emerging disaster, which might hit specific regions in your country, a preliminary DREF request can be granted by the IFRC so that your operations and contingency can lift off ahead of time. This early warning can improve disaster preparedness and response and hence safe lives. The supporting evidence needed for a preliminary DREF request can be based on short-term predictions, as well as seasonal precipitation forecasts (from sources like your country's meteorological service, the IRI-IFRC map room, or regional centres with climate expertise, like CATHA/SERVIR, CILSS or ACMAD, and it can be obtained with assistance from the IFRC. Until very recently it was common to only provide evidence during and after the disaster. We believe this to be revolutionary within the Red Cross Red Crescent and it can further stimulate National Society to focus also on early warnings and the climate risk management discourse. Please visit DMIS (internal IFRC information site) for more information. The RC/RC Climate Centre has recently facilitated workshop on new tools for climate risk management in two zones (Americas and West & Central Africa), and if there is interested this kind of initiative could be scaled up.

4. Early Warning Early Action
With the IFRC-secretariat in Geneva, the RC/RC Climate centre is working on a paper explaining and promoting 'Early Warning Early Action' -- routinely taking humanitarian action based on scientific information on all timescales. This concept bridges disaster risk reduction, preparedness and response, and integrates information about long-term trends in risk, seasonal forecasts and immediate early warnings for disasters, which should lead to action at international, regional, national and local levels. It is one of the most promising ways to better deal with rising risks in all aspects of our work. Shortly the Climate Centre will launch a special case study on 'early warning early action' which shall explain the concept and the Red Cross/ Red Crescent approach to the subject. This case study will be published on the Climate Centre website at the end of November. Early Warning Early Action will also be the main theme in the production of the World Disaster Report (WDR) 2009.

5. The continuation of fruitful partnerships on climate risk reduction
The IFRC and the Climate Centre cooperate closely with the:
- International Research Institute for Climate and Society (IRI)
- African Centre of Meteorological Application for Development (ACMAD)
- Centre Regional de Formation et d'Application en Agrométéorologie et Hydrologie Opérationnelle (AGRHYMET)
- Centro del Agua del Trópico Humedo para America Latina y el Caribe (Water Center for the Humid Tropics of Latin America and the Caribbean) (CATHALAC)

Cooperation with these specialized scientific agencies help the Red Cross/ Red Crescent to 'translate' important weather forecast for operational use. The RC/RC Climate Centre and the IFRC have been embarking on a number of initiatives, especially with the IRI and Cathalac. A number of interns located in Central America and West Africa have occupied themselves to bridge between the available science and the operational disaster management of the IFRC and National Societies. Specific attention was given to the development of climate forecasting tools aimed at strengthening early warning for the Movement, like the development of a flood forecasting tool in conjunction with CATHALAC. The IRI also positioned an intern at the IFRC office in Dakar, Senegal to help shape the collaboration with the IFRC, AGRHYMET and ACMAD to improve the capacity to comprehend the weather forecasts and to make the right interpretations based on the predictions.

Please find below two important achievements:
  • The IFRC and the IRI set up a specific 'help desk' for National Societies that want to understand the more technical information about forecasts in their region. Every RC-related question on observed and projected conditions are given in the most timely and reliable way possible. This partnership proves to be a solid longer lasting collaboration and we can identify the fruits of this partnership in West Africa, where a seasonal forecast indicated an enhanced chance of above average rainfall. This was communicated as a warning from the IRI to the IFRC and an early action could start in the region and a preliminary appeal based on a seasonal forecast was launched by the IFRC: Read more. Early action can lead to improved response capacity, hence to saving lives.
  • CATHALAC and the IRI organized a specific workshop on new tools for disaster management, specifically aimed at improving tools for Red Cross staff. Discussions during this workshop dealt with the use of satellite data for disaster damage assessment, prediction of hydro-meteorological events and information in real time to monitor phenomena like storms of short duration, as well as climatological information of the seasonal trends of climate long period available for the region to aid in the monitoring of extreme weather events.
6. The PAN AFRICAN Conference
At 19 October 2008 the 7th Pan African Conference took place in Johannesburg, South Africa. 53 African National Red Cross/ Red Crescent Societies reflected on today's humanitarian priorities in Africa and aimed to set the agenda of the four years to come. The Climate Centre was present at the Pan African Conference and gave a general presentation on climate change and climate risk management within the Red Cross/ Red Crescent. In preparation to this Conference the Climate Centre Journalist, Alex Wynter prepared a very interesting case study about climate risks in Africa.

7. The Pacific Round Table, Samoa October 2008
Held amongst the backdrop of coconut palms and frangipani was the 2008 Pacific Climate Change Roundtable in Apia, Samoa 14-17 October. Governments and civil society met to map out organisations working on climate change in the region, achievements to date, share information and approaches as well as look to the future. 2009 will be the Pacific 'Year of Climate Change' which will call for involvement at all levels to bring messages home not just about the causes of climate change but also practical measures that can be taken to adapt to it. There will be many opportunities for Pacific National Societies to get involved in national efforts. Further collaborations with meteorological agencies and climate science providers in the region are also being fostered as a result of the meeting. During one of the lunch breaks at the meeting the Samoa Red Cross youth volunteers conducted a funny drama routine on climate change to bring the message home that creativity and youth can bring a new vibrancy to talking climate.

8. Guatemala: growing awareness for climate change (an article by Marie Louise Belanger, Regional Communications Officer IFRC)
Protecting the livelihoods of vulnerable communities against the future effects of climate change can take many different forms. The Guatemalan Red Cross, with support from the Netherland Red Cross (funded through the HERE Campaign in the Netherlands), is working towards this goal by strengthening local capacities to respond to disasters and raising awareness about the effects of climate change. One of the activities involves the planting of saplings near the community school of Sabana Grande in the Chiquimula-region in the southeast of the country. This is done together with teachers, students and parents. Once the trees have grown, they will help keep the local stream in place, a vital water source for the whole community. Read more.

A similar project has kicked ofF in India and an article on the IFRC website, written by Amit Kumar explains very well how changes in India's annual monsoon cycle are expected to result in a combination of severe droughts and intense flooding in some parts of India. Such extremes in the availability of water resources are likely to have a serious affect on human health, agriculture, forests and wildlife. On World Red Cross Red Crescent Day, the Indian Red Cross Society launched a nationwide tree-planting initiative through its network of 700 branches. Leading the campaign is Professor S.P. Agarwal, Secretary General of the Indian Red Cross Society. He highlighted the need to work together to combat climate change. "There are no easy solutions to global warming and tree planting drives in a growing country like India have the potential to be beneficial to poor and vulnerable populations." Read more.

9. Engaging young people in the Solomon Islands for Red Cross Action on Climate Change
Julie Webb recently wrote a case study capturing the hard work of the Solomon Islands Red Cross on engaging youth on the issue of climate change. Poster competitions, school visits, village assessments, radio programmes and World Environment Day activities have all involved young volunteers. A National Youth Forum on Climate Change will be held in the first week of November and will heavily involve Solomon Islands Red Cross staff and volunteers in creating action plans for risk reduction with the young participants. Read more.

10. Climate Centre films
The Climate Centre is currently working with a number of filmmakers to explore on future possibilities of the production of videos in the coming months. A project to promote climate adaptation in Malawi has been in the works since 2007, and several short films were recently released. Here, villagers in Mphunga village produced a participatory video to share, through video screenings workshops, community-based adaptation practices with four other neighboring communities that face similar problems.
- Film nr. One: 'Adaptation to climate Change by Mphunga Villagers' was 100% made by the villagers on a participatory video approach. It consists of the villagers' perspectives on climate change and how they are adapting by capturing and sharing six of these community-based practices.
- Film number two is called: 'Farmers become Filmakers' and it includes, interviews with the neighboring villagers and viewers about what they have learned on climate risks and final interviews with the filmmakers about their impressions of making such a film. This film has been selected for the shortlist of the 'Social Dimensions of Climate Change award' and is now proceeding to an independent judges panel. . We also enrolled part of this footage at the video festival at development and climate days during UNFCCC COP 14 in Poland.
- The video 'More than Survival' was made in Tabasco, Mexico. It gives a very good overview on the harsh impacts of climate change on the living conditions. It is a spanish film with English subtitles.
To see more films on climate change and the Red Cross, please visit the Climate Centre film's section at htpp://www.climatecentre.org.

11. Publications by the Climate Centre Staff
- An interview with Madeleen Helmer: Not just a band-aid in 'Onearth', Published by the natural resources defense council, fall 2008.
- Communicating Climate Risks, by Maarten van Aalst. Published in the Forced Migration Review on climate change and displacement, October 2008
- Video-Mediated Approaches for Community-Level Climate Adaptation, by Suarez, P., Ching, F., Ziervogel, G., Lemaire, I., Turnquest, D., Mendler de Suarez, J. and Wisner, B.. IDS Bulletin 39 (4) 96-104, September 2008.
- International Youth Day: mobilizing Red Cross and Red Crescent volunteers on the impact of climate change, article produced in conjunction with the IFRC Youth Department in Geneva, August 2008.
- Climate-Related Disasters: Humanitarian Challenges and Reconstruction Opportunities, by Pablo Suarez, Graham Saunders, Sandra Mendler, Isabelle Lemaire, Jorge Karol, and Laura Curtis in the Journal called: "Places: a Forum of Environmental Design", October 2008
Please contact the Climate Centre if you would like to obtain any of the articles.


For more information and the Red Cross/ Red Crescent Climate Centre Climate Guide (5MB) or the Climate Centre's Annual report 2007 please visit the website at www.climatecentre.org.

Thursday, November 6, 2008

What will Obama mean for Africa?

In 2006, reporting on an Obama visit to Kenya, Time magazine asked not only what Africa could do for Obama, but as the saying goes, what he could do for Africa.

As the news of his historic victory in the US presidential elections sinks in, the media and the blogosphere are reflecting today on the implications of an Obama administration for Africa.

The South African Times concludes that policy will not be markedly different under the Democrat; Vanguard in Nigeria collects the comments of government ministers and a human rights activist; the Kigali New Times reports on the hopes of President Paul Kagame of Rwanda that Obama's victory will inspire Africa to do better and more for themselves; and a bewildering array of reactions and reportage on the news on AllAfrica.com.

Meanwhile, as the eyes of the world focussed on the polling booths of America, many Western news outlets could spare an occasional cutaway spot to coverage of the reaction in Africa, including the Chicago Tribune.

John Liebhart collates comments from bloggers back in July, on Voices without Votes, including an interesting reflection from South Africa on whether that nation is ready for a white President. Meanwhile, theleoafricanus says 'We’re celebrating this week. Next week we start asking questions.'

For background a useful summary of policy indications from the Guardian, although of course, the President-elect is notoriously difficult to predict.

Alertnet want to know what you think:
As Africans celebrate the election of Barack Obama, hopes are high that America's first black president will tackle poverty, hunger, conflict and disease across the continent.

But what reason is there to suppose Obama's commitment to Africa will be any greater than that of U.S. President George W. Bush, whose efforts to draw attention and aid for combating diseases in Africa has been one of the few widely hailed successes of his foreign policy agenda?
Read and add your comments on the Alertnet website, or below.

Monday, October 27, 2008

Global price crisis update from Mary Atkinson, BRC Food Security Advisor

Agency activities
Of the US$20 billion pledged to help tackle the "world food crisis" triggered by rising food price in Rome in June, only US$1 billion has been paid out from the fund (compared to US$700 billion bail out in US in one day). Concern that global financial crisis may be used as an excuse for inaction. UN estimate that US$25- 40 billion is needed to lessen impact of price rises in developing countries.

FAO World Food Security Committee meeting in Rome in October

Global food crisis - highlighted by many agencies on World Food Day (Oct 16):
  • Oxfam GB launched a £15 million appeal to help tackle the "world food crisis" and released a report, "Double-Edged Prices, Lessons from the food price crisis: 10 actions developing countries should take". They report a lack of a co-ordinated international response to the crisis
  • ODI event - Soaring Prices, rising hunger: what next in the global food crisis - notes and recording available online.
  • WFP expect to feed 1/3 more people in 2009 (90 million people in 2008) including urban area, as global financial crisis adds to pressure in food prices
  • Wahenga debate about how price crisis impacted on perspective on use of cash as alternative to food in emergency & social protection. Underlying issue that cash not being sufficiently indexed to rising prices, particularly in Ethiopia, where large beneficiaries switch to food aid in national safety net programme.
Price/situation updates
  • Price crisis has pushed 75 million more people into hunger and poverty (FAO) with 967 million malnourished people in the world (World Bank)
  • FAO warn that the new global financial crisis could deepen the situation of the poor even more
  • With industrialised countries in crisis, less vital remittances sent to developing countries , e.g. Bangladesh usually receives $4billion US annually
  • African banks thought not directly impacted by credit crunch as virtually no exposure to sub-prime market, aside from South Africa where Rand severely hit. However, with global economic crisis, demand for African commodities and hence export earnings will fall. Recent growth rates of 5% per annum over last 10 years in Africa likely to fall to 3% (IMF)
  • WFP report on Summary of Price Impact Assessment findings to date available includes Uganda, Nepal, Tajikistan, Pakistan, Liberia.
  • World cereal forecast for 2008 better than expected (i.e. 4.9% increase to record 1,232 million tonnes, possibly giving 8% increase in world stocks). International prices of most cereals continued to fall in last 2 months due to such improved supply and falling price of oil, food prices still 51% higher than 2 years ago and FAO state 36 countries still in need external assistance, particularly Somalia.
Update on food security situation in most chronically food insecure regions (from FAO report):
  • East Africa: Unfavourable outlook for cereal harvest in parts of Ethiopia, Somalia, parts of Kenya and Uganda.
  • West Africa: Overall early crops prospects favourable with improved FS situation from October
  • Southern Africa: Recent main season cereal harvest OK but far below last year
  • Asia: Regional cereal harvest to increase slightly from last year with bumper crops in China and India offsetting reductions in Pakistan and Iran, but serious food insecurity still affects 12 countries in region

HPG: Beneficiary perceptions of corruption in humanitarian assistance: a Sri Lanka case study

Corruption in emergency relief is a huge challenge for humanitarian agencies. It can potentially undermine the effectiveness of their interventions and ultimately lead to the loss of lives. Corruption risks are often determined by the environment in which aid agencies operate, and are likely to increase in conflict-affected countries where governments are usually weak, the rule of law is not effectively enforced, the media and civil society are constrained and aid flows can become a lucrative resource.

Such an environment is present in Sri Lanka. The state is highly centralised and clientalistic, and political power is derived from patronage rather than performance. This is mirrored in the nature of civil society and the media is deeply partisan. Sri Lanka is ranked 3.2 out of a possible score of 10 on Transparency International’s Corruption Perception Index. Furthermore, non-state actors in the north and east of the country have formed predatory networks of taxation and extortion and are often the de facto authority in the areas they control. In this environment, humanitarian assistance is often manipulated for personal or political gain at the expense of affected populations. The sudden and substantial aid received in the aftermath of the tsunami in December 2004 further compounded these corruption risks.

This case study explores perceptions of corruption amongst beneficiary populations, with the aim of informing strategies that seek to reduce corruption in humanitarian assistance.
Download the report from the HPG website (pdf link).

International Crisis Group: Sri Lanka’s Eastern Province: Land, Development, Conflict

Sri Lanka’s government must address the security needs and land-related grievances of all ethnic communities in its Eastern Province or risk losing a unique opportunity for development and peace. Muslims, Tamils and Sinhalese all feel weak and under threat, and recent ethnic violence could easily worsen. The government must devolve real power to the newly elected provincial council, end impunity for ongoing human rights violations and work to develop a consensus on issues of land, security and power sharing with independent representatives of all communities, including those from opposition parties.
Download the report from the ICG website.

UNISDR: Climate Change and Disaster Risk Reduction: Weather, Climate and Climate Change

Climate change and disaster risk reduction are closely linked. More extreme weather events in future are likely to increase the number and scale of disasters, while at the same time, the existing methods and tools of disaster risk reduction provide powerful capacities for adaptation to climate change.

This Briefing Note, prepared by the secretariat of the United Nations International Strategy for Disaster Reduction Secretariat (UNISDR), outlines the nature and significance of climate change for disaster risk, as well as the main perspectives and approaches of disaster risk reduction and how they can support adaptation strategies.
Download from Reliefweb.

Tuesday, October 21, 2008

World Food Day: British Red Cross film on the Afghanistan food crisis

IFRC: 'War, poverty, HIV' and hope

Juan Manuel Suez del Toro, President of the International Federation of Red Cross and Red Crescent Societies.
Humanitarian organizations seeking funds for relief operations in Africa face an acute dilemma. If we stress the suffering of Africans who lack food or health care, who struggle against floods, drought and possibly famine, who flee war and communal violence, we risk reinforcing the image of Africa as a "basket case", beyond help. If we take the purely positive approach, the donors - whose resources are scarce and with the global financial crisis becoming more so - are unlikely to respond.

Hunger again stalks parts of Ethiopia while the food-security situation in Zimbabwe is widely regarded as the worst ever. Both countries are the focus of major - but so far poorly covered - appeals for funding by the Red Cross Red Crescent¹. In 2008 conflict simmered in eastern Democratic Republic of the Congo, Somalia and Darfur and flared anew in Burundi, Chad and Mali; there was serious communal violence in Ghana and South Africa - all reported in the western media, which also picked up on other "negative" stories like piracy in Somali and Nigerian waters, the persecution of albinos, and xenophopic violence.

But has this depressing portrayal of Africa as a "chamber of horrors" becomes a self-fulfilling prophecy, smothering the good news that also exists in increasing quantities? Is it now, in itself, an obstacle to progress, making the world turn away from Africa in despair? It's far too early to say HIV in Africa is beaten, but could it have peaked?
Read more on Alertnet.

HPN Network paper: Measuring the effectiveness of Supplementary Feeding Programmes in emergencies

Carlos Navarro-Colorado, Frances Mason and Jeremy Shoham
Emergency Supplementary Feeding Programmes have been widely implemented for a number of decades as part of the standard toolkit of emergency response. Programmes are normally implemented in conjunction with general food distributions in order to address moderate malnutrition in emergencies.

While individual implementing agencies routinely monitor and evaluate programme performance, findings are rarely published in peer-reviewed literature. There have been no large-scale studies of the effectiveness of these programmes in emergencies, despite frequent claims of poor performance.

This Network Paper reports on a study to determine the efficacy and effectiveness of emergency SFPs, conducted in 2005–2006 by Save the Children UK and the Emergency Nutrition Network.
Read more on the HPN website.

On the HPN blog: Linking protection and livelihoods in conflict: is it worth the effort?

Sorcha O'Callaghan and Susanne Jaspars
While aid actors often differentiate between people’s protection and people’s livelihoods, this distinction tends not to be as obvious to those affected. The threats that people face are frequently interrelated. In fact, the direct targeting of civilian populations (and their assets) is often a deliberate tactic in war. And even if not intended, violence has major implications for people’s livelihoods because it can disrupt basic services, limit access to employment, markets and farms, and even undermine social networks. Likewise, protection and livelihoods are also connected in the way people respond to destabilising situations. We only have to think of women searching for firewood as a source of income in Darfur – where the risk of rape is preferable to the death of their men – to grasp how closely people calibrate costs to their safety and dignity against their economic status.
Read more on Online Exchange.

Monday, October 20, 2008

BBI: Moving Beyond Rhetoric: Consultation and Participation with Populations Displaced by Conflict or Natural Disasters

UPDATE: Download an additional report, Listening to the Voices of the Displaced: Lessons Learned; author Roberta Cohen reviewed over 800 interviews with IDPs from different regions, stages of displacement and circumstances to analyze the concerns voiced by IDPs. The report is available from Reliefweb.

This desk study seeks to encourage reflection and debate on the benefits, limitations and risks of consultative and participatory approaches in working with communities displaced by both conflict and natural disasters.

It reviews previous experiences of consultation with internally displaced persons and others and explains why consultation is critical for both displaced communities and the agencies which work with them. Advantages of consultation and participation include both instrumental benefits, for example, better needs assessments, improved efficiency, implementation, and sustainability of projects; and value-based benefits, including empowerment and capacity building of affected communities.

Download the study from Reliefweb.

ODI: Humanitarian Exchange Magazine - focus on Somalia

Reading about Somalia can be a depressing experience: because of the awfulness of the situation; the dim prospects for things getting any better; and the long-running nature of the crisis there. Throughout the last two decades, humanitarian actors have sought to ameliorate the worst consequences of the conflict in the country, hampered by constant insecurity and the lack of funding that goes with low-profile crises like Somalia’s. While the events of 9/11 raised brief hopes of a renewed focus on failed states, attention to the potential threat of terrorism has not translated into positive action to resolve Somalia’s political crisis.

As the articles collected here demonstrate, the current situation is truly dreadful. The remarkable resilience of Somalis in the face of decades of crisis and the generosity of the huge Somali diaspora may finally be stretched to breaking point. Any society, let alone one without a functional central government and reeling from decades of war, would struggle to cope with the combined consequences of massive displacement, intensified conflict, rapidly rising prices for food, fuel and water, hyper-inflation and drought. The articles here make clear that Somalis are no longer coping, and urgently need large-scale humanitarian assistance.
Read more on the HPN website, or keep an eye on the magasine rack for a hard copy.

Friday, October 17, 2008

IFPRI: on the food crisis

The International Food Policy Research Institute continue to release policy papers and discussion pieces on the impact of the global price crisis on food.

All of their writing on this and other topics is available from their website.

XVII International AIDS Conference 2008 Mexico City

Update - conference information now available online!

Archived, online coverage of the XVII International AIDS Conference (AIDS 2008) is now available from kaisernetwork.org, the official webcaster of AIDS 2008.

In partnership with the International AIDS Society, kaisernetwork.org has prepared the following online coverage:
  • Webcasts, transcripts and slide presentations of the opening and closing sessions, all plenary sessions, and over 75 other sessions and press conferences;
  • English- and Spanish-language audio podcasts of more than 80 sessions;
  • Narrated video highlights of conference developments;
  • News summaries of conference developments and newly-released studies in the Kaiser Daily HIV/AIDS Report; and
  • Interviews with newsmakers and journalists summarizing conference developments.
Updates from British Red Cross Advisors!
  • Some Good News from Zimbabwe!
Feedback from the International Aids Conference 2008 Mexico City
4 August 2008
Today at the IAC08 researchers from the Imperial College London and Harvard University confirmed the recently documented decline of HIV Prevalence in Zimbabwe.Using robust epidemiology data it was shown that HIV Prevalence in adults aged 15- 49 peaked around 1997/8 at 29.3% then levelled off and declined most significantly in the period 2001 to a current level of 15.6%. This represents a 50% reduction in 6 years and the aversion of an estimated 660,000 new infections.

Zimbabwe is the first country in the region to experience such a significant decline. Not only is this good news for Zimbabwe but also significant for the surrounding countries in the region that are experiencing similar generalised epidemics but as yet have not experienced such trends.

The question is how has this been achieved in Zimbabwe? Is it a demonstration of the natural course of the disease or as a result of major prevention successes in behaviour change in the country?

The mathematical modelling does indeed suggest that this trend of sharp incline, plateau and decline is thought to be the expected norm for the course of the disease and goes some way to explaining the decline; but cannot explain the extent of the decline and therefore must also look to possible behaviour change to explain further the trends.

With use of population based and cohort studies this was the question understudy. Key findings show that whilst mortality certainly has contributed to some decline, migration even in the levels recently seen in Zimbabwe has not significantly contributed.

What is more important is to consider which factors have contributed to a decline in HIV incidence. The studies clearly show that whilst condom use is relevantly high this has remained relatively consistent over the time period 1999-2005 and would have little impact on the decline. Significantly however, is the reported decline in the number of sexual partners of men in this period of 6 years, which also seems to mirror the maturation of the disease when high levels of mortality are experienced in the communities and families. As people see the reality of the disease this appears to impact their behaviour.

This of course can only result in change of behaviour such as reduced number of sexual patterns if there is understanding of HIV transmission routes, which suggests that the general HIV and Aids information available in Zimbabwe has been to some level been understood and used. This was mapped against the National HIV prevention programme interventions in Zimbabwe, which in fact show to be the general HIV response approach seen across the region.

Of course the special context of Zimbabwe in the last decade has been the rapid economic decline and the affect on both rural and urban communities. Certainly this has seemed to play some part in the reduction of sexual partners simply as men report they are unable to afford to socialise as they did, take additional girlfriends or pay for sex. Ironically of course in times of hardship more women are turning to transactional sex for source of additional incomes, but report that ‘business is slow’. HIV is of course a dynamic disease and some men reported certainly they would have more ‘girlfriends’ again once they have overcome the current economic problems!

The clear conclusion of the research suggests the decline can be attributed to a combination of factors; - certainly a reflection of the natural course of the disease plus some change in sexual norms including significant reduction of sexual partners, and additionally influenced by the economic downturn and possibly significantly influenced by the community response as the disease reaches a critical point in the community.

But why Zimbabwe and not the surrounding neighbouring Southern African countries? Is it good news for the region? Well possibly - it is possible that Zimbabwe is simply the earliest in the epidemic and that other countries may follow similar decline in years to come. The research is not there to make these country comparisons as yet. (No examination made of any studies made of the effect of role out of ARV on the prevalence decline).
  • HIV, Nutrition, Food Security and Livelihoods (including microfinance)
Feedback from the International Aids Conference 08 Mexico City
8 August 2008
1) Supporting quality and delivery of integrated home based care
A satellite session held on HIV food security and livelihoods presented by RENEWAL/FAO/WFP discussed what progress has been made in furthering our understanding on the interactions between HIV, food security and livelihoods and how to respond to this at scale.

The session highlighted how we may be underestimating the impact of the increase in food prices on people’s behaviour and on nutrition and the need to respond to the 3 concurrent epidemics:
· HIV
· TB
· Malnutrition

Studies from Swaziland and Malawi July 2008 demonstrated an increase in risky sexual behaviour as food prices increase.

Also transport costs to collect vital antiretroviral treatment (ART) were placing greater demands on families who at times had to choose between continuing their ART and buying food.

Labour challenges in food security and livelihoods programmes were discussed and the need to ensure more collective actions at community level.

Nutrition counselling within care and support programmes for people living with HIV was highlighted as an area that requires further implementation.

In a further session on the HIV, Nutrition and Food Security, researchers of the University of KZN , AMPATH/USAID , and UNAIDS re-emphasised the importance of nutrition as part of management of HIV. Outlined the increased nutritional requirements of the PLWHIV; and understanding of HIV in weakening household food security.

Conclusions were reached that there is a need for balance of nutrition interventions as therapeutic care for PLWHIV with a strategy for maintaining long term food security of household in long term HIV programming as part of care and support package which is relevant and responsive to PLWHIV, households and communities; and which also contributes to psychosocial well-being as well as nutrition needs. There is Need to develop further partnerships of FS in public health and HIV response with a balance of interventions including micro finance, cash transfers, skills building, community projects leading to increase in income/savings or access to loans and strengthened FS.

If we grasp the issue FS can be part of the combination prevention strategy in increasing access to food, income, health services, treatment, care and well being; and reduce vulnerability that may contribution to increase risk behaviours (such as transactional sex) or weakened immunity.

Responses should be therefore:
· Target those who are food insecure and those nutritionally at risk, which includes people living with HIV
· Integrated to include care and support, water and sanitation, livelihoods
· Gender sensitive- evidence from Ethiopia food for work programmes highlights significant increase in school enrolment for boys but not girls – need to consider in design of programmes
· Long term and built on community response
· Include range of activities including access to nutritional food, nutritional knowledge, agricultural and livelihood skills

Challenges may be:
· Including appropriate exit strategies
· Cash transfers appropriate in stable economies

2) Micro-finance

Presentations at a Poster Session discussed that a large body of research, experience and understanding of micro-finance exits in the development field and in most countries. It is generally accepted that micro-finance programmes can mitigate against the affects of destitution though it is less evident that micro-finance schemes can mitigate GBV or have preventive effects against HIV.

Important not to expect too much – micro credit is about credit!

Key points are:
§ General accept that Microfinance can uplift households and reduce financial pressure. May be particular important to PLWH households to support increase access to services
§ Microfinance not necessarily prove to reduce transmission of HIV but contribute to welfare of households and individuals well being and health, and links to community gains and involvement
§ Work in partnership with those that know Microfinance – knoweldge and experience exits in almost all countries.
§ Consider involvement of volunteers and community based health workers in the microfinance scheme as part of community engagement and also their well being and support.
  • Comprehensive Combinations: Key findings from the Mexico IAC 2008
Feedback from the International Aids Conference 2008 Mexico City
4 August 2008
To more effectively prevent and respond to HIV “Combination HIV prevention at scale with combination care, support and treatment for life within universal primary health care, education and support for all is the minimal action required”.

Currently each year an estimated 1 million people are started on antiretroviral treatment (ART) but 2.7 million people are newly infected, we are not keeping pace with the HIV pandemic.

There is a window of opportunity and vulnerability to HIV – increasing evidence highlights need for rapid point of care, diagnosis and treatment of HIV and Tuberculosis, (TB) including multiple drug resistance (MDR) TB, plus ongoing care and support.

ART has been a major success but only as a disease suppressant- like insulin for diabetes and anti inflammatory for rheumatoid arthritis- a cure still required.

Further details below highlight what combination HIV prevention and care, support and treatment include such as prevention of mother to child transmission (PMTCT), male circumcision, palliative care, care for OVC, TB, HIV in emergencies and in conflict and post conflict, responding to HIV and violence and service delivery. These are all areas for BRC to further consider in future support to HIV programming, which require discussion and action. Immediate points to follow are included within.

Further details are provided on separate papers on HIV and food security and livelihoods, male circumcision and the success of the HIV response in Zimbabwe.

Combination HIV prevention improves life
Proven prevention methods which need to be used include primary prevention through behaviour change communication, life skills linked to education and support, positive prevention, prevention of mother to child transmission (PMTCT), male circumcision, condom use, harm reduction. Not ABC approach !
· Need a combination of biomedical, behavioural and structural interventions using non-judgemental harm reduction approaches
· Countries need to develop evidence driven context-specific national HIV prevention strategies which are better coordinated
· Need to embrace the political, economic and social determinants of risk and not focus on individual behaviours
· Need further research on effectiveness of antiretroviral therapy (ART) in prevention- pre exposure prophylaxis (PreExpP), microbicides, treatment of common infections and vaccines (Ref SCIENCE 28.07.08)
· Need to know where infections will happen
· Need to diversify HIV testing approaches- include opt out, remove barriers, stigma and increase access across communities
· Need to become more effective against stigma as stigma and discrimination increase risky behaviour, decreases uptake of HIV testing and willingness to disclose.
(For further info see special issue www.thelancet.com HIV prevention August 2008)
Prevention of mother to child transmission (PMTCT)
· Some increase in prevention of mother to child transmission to 23 % globally (only 1:10 infants receiving ART within PMTCT) and access to ART for children but coverage and quality remains unacceptably low – Nigeria and Ethiopia below 10% (UNAIDS 2007).
· In 2007 estimated 2.1 million children younger than 15 years were living with HIV. More than 90% of these children had been infected through mother to child transmission.
· Although an increasing number of countries have PMTCT programmes only 18% of pregnant women in low and middle income countries received a HIV test in 2007 and coverage remains low, 11% in West and Central Africa and inadequate in many countries with only 33% of women accessing the most effective regimen of a combination of two or three antiretroviral drugs.
· Globally 80% women have at least 1 antenatal contact but only 50% have skilled care at delivery – need to offer support for PMTCT at first contact and during delivery at minimum.
· Barriers to uptake include negative attitudes from HCWs, poor access to services and poor services, stigma and discrimination and fear of HIV testing and disclosure. Limited male involvement – study S Mamman Uni KZN, SA.

Care, treatment and support
· ART - Challenges to retention 1 in 3 people who start ART are not in care – receiving ART – after 3 years – Nathan Ford MSF SA advised only 60% of clients are continuing to be part of ART programme after 24 months. Reasons include client’s fear of disclosure, costs, negative attitudes by care provider and access to programme – need to consider model of delivery of programme and support such as RCRC community based volunteers.
· Still reaching only 30 % of those in need of treatment – Q do we have the capacity to reach and treat for life everyone who requires ART
· Management of ART related side effects is part of the model of comprehensive care
· According to WHO research gaps March 2008 decision when to start ART still based on personal opinion, general view from conference need improved diagnostic facilities and treatment for HIV globally, start treatment earlier with improved treatment regimes for most people in developing countries.
· What is the optimal non ART care and support package and need for guidelines regarding this (i.e. CHBC minimum standards).
· Palliative care regarded as a key component of care – discussed principles and relevance of palliative care in HIV response. Clear pain and symptoms experienced by people living with HIV and also suffering from TB and other related conditions. Palliative care includes supporting adherence to treatment and also psycho social and spiritual support- improves overall patient care
· Task shifting – resource poor countries don’t or will not simply have the human resources of healthcare workers to implementation to scale. Need to consider alternative health systems management
· More than 50 countries in the world still do not have access to opioids.
· Opioids are not available in rural areas and in home care in most countries.
· Support for palliative care should be in national health plans- guidelines for CHWs available (includes RCRC module).
· Recommended adapting WHO definition to define palliative care services nationally
· Joint declaration and statement of commitment on palliative care and pain treatment in human rights- see www.hospicecare.com/resources/pain_pallcare_hr/
· Also further info from pain and policy studies group Uni Wisconsin in USA
Orphans and vulnerable children (OVC)
· SAfAIDS has produced children’s ART and TB treatment literacy pack targeted at 6-12 years olds in recognition that children are being marginalised from their own treatment literacy. The pack includes booklets for children and activities plus manual for carers and parents/ caregivers- AL requested pack suggested adaptation and use within support groups for OVC
· CRS produced paediatric counselling course –AL follow up
· Recommended policies programmes and funding must be redirected to provide support for children to and though their families. IN generalise epidemics HIV clusters in families, strengthening the capacity of families through systematic public sector initiatives has been identified globally as one of the most important strategies of building an effective response for preventing and mitigating the impact of the epidemic on children.
· Need to reconsider policies to develop comprehensive and integrated family-centred services. Need to address not just children but also family’s health basic material needs, psychosocial support and development.
· More attention is required for social protection for poor families, Households afforested by HIV and AIDS experience a worsening of their socio economic status, suggested loss of at least 25% average household income.
· Critical additional resources including income transfers should go direct to those most affected by HIV and AIDS- includes advocacy and support for universal social security support grants plus programmatic interventions targeted to vulnerable households. The interventions should be regarded as an entry point to large scale integrated national responses characterised by access to essential services, such as health and education, social welfare an social justice, enabled by basic income security.
Tuberculosis TB
· 2 million cases of TB have been missed due to the missed opportunity to offer testing to people who undertake HIV testing
· The number of TB cases has tripled in the high HIV prevalence countries in the last two decades
· TB is the leading cause of death among people living with HIV in Africa and a major cause of death elsewhere.
· WHO recommendation - the three I’s for TB/HIV –Isoniazid preventive therapy, intensified case finding for TB and infection control must be urgently implemented to reduce the burden of TB among people living with HIV.
Caring for Carers
· Highlighted globally we are not caring for health care workers, who are not accessing HIV and TB testing and diagnosis
· Health care workers (and RCRC volunteers) involved in care should know the symptoms of TB and be given counselling and health screening annually for TB and HIV. All should be encouraged to know their status.

HIV in conflict and post conflict
· Research paper UNHCR March 2007 highlighted concerns regarding protection and increasing HIV among internally displaced persons (IDPs) in DRC with particular risks to women. Access to HIV prevention services including behaviour change communication, information education and communication, condoms and HIV testing were limited resulting in low levels of knowledge and high risk behaviours. Recommendations from the study included:
o Supporting community based structures and gender sensitive approach
o Prevention activities should address points above
o Increased support to improve basic health facilities and services, including HIV testing and support
o Implementation of the IASC guidelines
· Kenya – following the civil conflict a study undertaken from Jan – June 2008 found 7.500% increase in sexual violence in Nairobi. Highlighted need for increased support and counselling in gender based violence, rape, trauma and HIV. Lessons from the conflict highlighted need for HIV emergency preparedness plan to be developed by all stakeholders and include people living with HIV and community organisations, consider community support and ongoing access to essential antiretroviral treatment.
HIV violence and women
· WHO multi country study 2005 domestic violence and women’s health- Ethiopia 16% of young women forced to have first sex/60% women interviewed suffering from intimate partner violence
· IMAGE – CBO supporting microfinance for women – recently invited to SA regional HIV meeting SARAWO/Sister ACT and Girl Child network Zimbabwe all promoted as effective supporting organisations in this area.
· Although limited biological evidence re violence and HIV Charlotte Watts – LSHTM - study microfinance and women in SA found in SA women with violent partners 50% more likely to have HIV and UNAIDS in Tanzania x 10 more likely
Harm reduction
· Despite UNGASS recommendation in 2005 for access to prevention to include harm reduction programmes only 78 countries known to have programmes.
· Continued moral and religious beliefs negating services offered and increasing stigma and discrimination
HIV and criminalisation
o Recent Acts in Sierra Leone and Zimbabwe increase risks to women living with HIV. Similar laws are being passed in other African countries – handout available.
Service delivery
· Need for improved leadership and management
· Serious implementation bottlenecks – even if we had effective vaccines and microbicides how would we be able to deliver?
Countries and even districts are working in isolation – unable to effectively respond through this “ cottage industry” approach.