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.
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:
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:
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
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.
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.