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Programme Priorities |
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| HIV/AIDS Prevention | |
| Reproductive Health, including Family Planning and Sexual Health
Population and Development
Strategies
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In collaboration with the Joint United Nations Programme on HIV/AIDS (UNAIDS), UNFPA helped develop specific goals for HIV/AIDS prevention for the years 2005 and 2010. These goals call for assured access to HIV/AIDS information, education and services for at least 90 per cent of males and females aged 15-24 in 2005 and at least 95 per cent in 2010. They also call for a 25 per cent reduction of HIV infection among 15- to 24-year-olds in the most affected countries by 2005, and a 25 per cent reduction globally among the age group by 2010. The goals are currently being considered by the Preparatory Committee for the Special Session of the General Assembly for the Review and Appraisal of the Implementation of the ICPD Programme of Action. At the global level, UNFPA supported a number of HIV/AIDS-prevention activities. UNFPA joined the UNICEF/WHO/ UNAIDS initiative on prevention of mother-to-child transmission of HIV/AIDS and is now participating in the preparations to operationalize the programme on a pilot basis in seven countries: Cambodia, Côte d'Ivoire, Rwanda, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. In March, the Fund participated in the UNAIDS Co-sponsors Retreat held in Venice, Italy. Along with WHO and UNAIDS, UNFPA was asked to lead follow-up efforts regarding the establishment of a cosensus- building mechanism for policy and technical guidance, which has since been completed. UNFPA assisted efforts to promote the use of condoms and to conduct social research on their use. It also supported research on the effect of steroid hormonal contraceptives on the progression of HIV. This research, also supported by the United Nations Development Programme (UNDP), WHO and the World Bank, was co-sponsored by the WHO Special Pro-gramme of Research, Development and Research Training in Human Reproduction (HRP). UNFPA is also assisting a number of projects executed by the United Nations Educational, Scientific and Cultural Organization (UNESCO). The projects are designed to promote AIDS awareness and prevention in various in-school and out-of-school education activities. UNFPA continued to prepare and disseminate AIDS Update. The annual publication reports on UNFPA-supported activities at the country, regional and global levels. At the regional level, UNFPA provided assistance to conferences aimed at raising awareness and building political support for different aspects of reproductive health, including HIV/AIDS prevention, women and HIV/AIDS, and men's participation in reproductive health. Assistance was also provided for meetings that targeted special groups such as female parliamentarians. Training that addresses issues related to HIV/AIDS was another key area supported by the Fund at the regional level. In addition, regional reproductive health programmes, in particular those aimed at adolescents and youth, included HIV/AIDS-prevention activities. To assess the specific impact of UNFPA-supported HIV/AIDS-related interventions - which were usually an integrated part of reproductive health activities - the Fund carried out a thematic evaluation in seven countries. Conducted by the Fund's Office of Oversight and Evaluation in 1997 and 1998, the evaluation highlighted the comparative advantage of UNFPA's reproductive health approach to HIV/AIDS prevention. It also stressed the need to strengthen the technical capacity of field offices to promote a focused, appropriate and efficient response to the epidemic. The evaluation recommended more rigorous planning to improve the sustainability and replicability of programmes and underscored the need to make condoms central to HIV/AIDS-prevention strategies. The evaluation also recommended strengthening interventions aimed at youth; improving the quality of IEC materials and designing IEC materials and strategies suited to specific target audiences; and enhancing advocacy efforts to generate political will and community support. The evaluation's findings are being disseminated within UNFPA with the aim of translating key findings into improved programming in the area of HIV/AIDS prevention. Country-level initiatives. In 1998, UNFPA supported HIV/AIDS-prevention activities in more than 130 countries. All were developed in cooperation with national governments and coordinated through the theme group mechanism of UNAIDS, in which the Fund plays an active role. These activities were conducted as part of an integrated reproductive health approach, in line with the Fund's reproductive health guidelines issued in November 1997. The approach calls for adding HIV/AIDS-prevention services to existing family planning and maternal health services and broadening the scope of those services. The use of condoms is promoted, both for double protection (pregnancy and STD/HIV/AIDS prevention) and for the detection and management of STDs (as some STDs increase the risk of HIV transmission). During 1998, the Fund participated in the UNAIDS theme groups in 124 countries, serving as chair of the groups in 13 of them. The theme groups helped coordinate activities among the co-sponsoring agencies and facilitated the planning and implementing of joint activities. NGOs were implementing partners of UNFPA-supported activities in 108 developing countries and countries with economies in transition. The HIV/AIDS-prevention activities supported by UNFPA focused on providing reproductive health services; training service providers and counsellors on HIV/AIDS issues; supplying and/or distributing condoms (including female condoms in a few countries); providing counselling services; creating awareness and conducting advocacy campaigns; integrating HIV/AIDS components into in-school and out-of-school education; and providing information and services to young people. Preliminary estimates indicate that expenditures for UNFPA-supported HIV/AIDS activities in 1998 totalled $23 million - $22 million at the country level and $1 million at the regional/global level. UNFPA supported targeted awareness-raising and advocacy activities in over 120 countries. Some innovative examples included orientations on HIV/AIDS for religious leaders and government officials in Bangladesh and for community leaders and Catholic priests in Ecuador, as well as activities conducted during such sporting events as the African Cup soccer matches in Burkina Faso. Sensitization activities aimed at men in general or at groups made up primarily of males, such as the police or military forces, were supported in Bangladesh, Nepal, Nicaragua, Nigeria and the Philippines. In Paraguay, UNFPA-supported projects for the armed forces and the police focused on educating military and police personnel on HIV/AIDS transmission and prevention and on providing condoms for distribution in military and police units around the country. In the Philippines, support was provided to an empowerment-education project benefiting female sex industry workers. To encourage participation in the project and promote the use of services, the project makes use of the casual setting of a café, which also serves as a clinic. UNFPA supported educational activities for in-school and out-of-school youth in 96 countries and counselling and other services for youth in 30 countries. These services were provided by health workers, peer counsellors, teachers and parents. Telephone hotlines proved a popular source of information in India, the Philippines and Poland. In Lithuania, preparations were made to establish five youth centres, which will provide peer counselling, a hotline for adolescents, and reproductive health counselling and services from a trained midwife and a part-time doctor. In Uganda, as a result of the success of youth-friendly services in attracting adolescents, services will be expanded to four new districts each year. It is hoped that this will contribute to the current positive trend towards falling HIV-prevalence rates among adolescents in the country. Information and awareness-raising activities for young people have been provided outside of schools through such channels as the theatre in Jordan, Malawi, Republic of Moldova and Rwanda; youth camps in Jordan, Latvia, Romania and the Syrian Arab Republic; parent education in Estonia, Poland and Uganda; discussions with and among young people in Bhutan and South Africa; anti-AIDS clubs in Guinea and "Cool Clubs" in Haiti; magazines in Honduras; pre-marriage counselling in the Islamic Republic of Iran; youth competitions in Mali and Myanmar; festivals in Mauritania; sports activities in Niger; parent/ church activities in Papua New Guinea; and film screenings in South Africa and Togo. Recognizing the wide reach and impact of the media, UNFPA supported radio and television serials focusing on reproductive health issues, including HIV/AIDS, in several countries, including Ethiopia, Nepal, Papua New Guinea, Rwanda, Sao Tome and Principe, and the United Republic of Tanzania. In Eritrea, UNFPA assisted the Ministry of Education in conducting a radio audience listenership survey that showed that HIV/AIDS messages had been fairly well understood. Promoting condom use is an essential part of HIV/AIDS-prevention strategies. During 1998, UNFPA provided 177.5 million condoms worth $5.1 million to 52 countries and procured an additional 39.1 million condoms on behalf of other donors. Female condoms were provided to five countries. Community-based services supported by the Fund included the distribution of condoms in Azerbaijan, Benin, the Central African Republic, India, Madagascar, Mali and South Africa. In Azerbaijan, female volunteers from the NGO Women and Development Centre were trained to disseminate information about reproductive health, including materials promoting behaviour that would minimize the risk of STDs and HIV/AIDS. The approach appears to be working, as there has already been a significant increase in condom use in some of the areas covered by the Centre. |