Utilize its comparative advantages
UNFPA recognises that the fight against HIV/AIDS is
a complex process and that the Fund’s added value to
the global effort is to concentrate its energy and resources
into areas where it has a comparative advantage. UNFPA’s
comparative advantages lie in its experience addressing
sensitive issues, negotiating with governments to guarantee
access to quality sexual and reproductive health services
and commodities, its strong network of partners, strong
country presence, use of reproductive health as an entry
point for HIV prevention, and its experience in dealing
with another multi-sectoral issue, population.
Focus
While UNFPA should use all opportunities to support
HIV prevention in its programmes, the Fund’s strategic
niche is to concentrate support in three core areas:
- sexual and reproductive health aimed at safer sexual
behaviours among young people;
- comprehensive condom programming in the context
of STI prevention to improve access to and use of condoms
(male and female); and
- prevention of infection among pregnant women and
work with other partners to prevent its transmission
to their children and HIV negative partners.
These areas are what all UNFPA country
offices should concentrate on as a matter of priority
in dealing with HIV/AIDS. At the same time, other crosscutting
factors must be considered to create an enabling environment:
gender equality and equity issues including the empowerment
of women and promotion of male responsibility; HIV prevention
within emergency and conflict situations; availability
of country specific population-based survey data on
sexual behaviour patterns that influence the STI/HIV
transmission; and policy development and implementation
especially in support of HIV prevention.
Safer sexual behaviour is the
overall aim of our actions
How do we achieve this? Through utilizing an interconnected
approach that links awareness and acknowledgement of
the epidemic (especially for leaders), training and
comprehensive prevention packages immersed in various
strategies including advocacy, IEC for behaviour change,
community mobilization, knowledge sharing, life skills
education and outreach programmes, and national capacity
building over a broad range of sectors. Key elements
of programming for HIV prevention include:
Leadership acknowledgment
Coming to terms with the reality of HIV/AIDS means being
aware that it is a serious threat, that it is multisectoral
in nature, that it has a reciprocal relationship with
4 poverty, and that girls and women have a greater vulnerability
for HIV infection. UNFPA must work to help national
leaders and other stakeholders understand the social
and demographic impact of the epidemic and its sexual
behaviour dynamics to lead to more appropriate programme
and policy development. Avenues include support for
multi-sectoral policy dialogues and for integration
of HIV/AIDS issues into population policy development.
Comprehensive prevention package
Programming should cover a wide range taking into account
issues related to demand, supply, access, providers
and recipients needs, capacities and the like. The prevention
package must include elements of information, psychosocial
support, and other products and services delivered through
education and outreach programmes, counseling (including
confidential voluntary counseling and testing) and other
sexual and reproductive health services, referral to
treatment services when possible, and provision of commodities
including male and female condoms and HIV test kits.
Prevention interventions should be in context of the
need for individuals to adopt safer sexual behavior
and should cover a broad range from abstinence, delaying
the age of sexual activity, and protection through condom
use (male and female). This may often require innovative
and nontraditional approaches for difficult-to-reach
populations.
Women generally, and young women
in particular, are more vulnerable to HIV infection
due to social and biological reasons. Special attention
is needed to protect them and address their special
needs through appropriate policies, legislation and
programming. Maternal health programmes must also be
re-aligned to incorporate HIV prevention and care concerns
of pregnant women with the realization that most pregnant
women in all countries are HIV negative and must remain
so.
Youth friendly programmes and services
must be made available to young people who currently
constitute more that 50% of all new infections. Evidence
shows that young people are empowered to make responsible
sexual and reproductive health choices when provided
with information and life skills, and have access to
counselling and services and are more likely to delay
their sexual activity, and are less likely to fall victim
to HIV infection or unwanted pregnancy.
Trained programme managers and
service providers
Building national capacities includes training programmers
and service providers from a broad spectrum of sectors
including health and education. The key is to strengthen
capacities to plan, implement, manage and evaluate programmes
related to halting the epidemic. Building national capacities
in collection and analysis of populationbased data for
use in policy and programming development and decision-making
is also important. To this end, UNFPA will also strive
to strengthen the knowledge and capacities of its own
staff to support country HIV/AIDS programme and policy
development.
Strategic partnerships
As with ICPD and ICPD+5, the UNGASS Declaration of Commitment
on HIV/AIDS goals and targets must be translated into
time-bound, measurable national goals and targets with
specific indicators to monitor progress.
To reach these collective goals
it is essential to work together with others both inside
and outside the UN system and at all levels. Strategic
partnerships have the potential to strengthen and magnify
any given response, provide a mechanism for gathering
and sharing information and knowledge, provide technical
guidance, and instill a feeling of ‘ownership’ that
is essential for sustainability of any given intervention
or programme.
Where political commitment exists,
UNFPA must capitalize on partnerships that compliment
the role of government and civil societies. Utilizing
the Theme Group mechanism is one way in which appropriate
partnerships can be identified and developed.
Involvement of people living with
HIV/AIDS as full partners at all stages of planning,
development, and implementation is also important to
ensure needs are being met and sensitivities addressed.