UNESCO consultation on the role of schools in providing HIV treatment, care and support a

As the special agency for Education For All and for HIV prevention for young people in education institutions, UNESCO in collaboration with the Botswana National Commission for UNESCO convened a technical consultation meeting that brought together Ministries of Education, researchers, United Nations agencies (UNICEF, WFP, FAO) and civil society from 7 SADC countries: Botswana, Lesotho, Malawi, Namibia, South Africa, Zambia and Zimbabwe, to deliberate on their experiences and recommendations for further strengthening the roles of school in providing HIV treatment, care and support in southern Africa. Forty two people participated in the meeting held from 22-24 May in Gaborone Botswana.

The objectives of the consultation were to:

• identify the needs of learners, educators and communities regarding HIV and AIDS care and support and develop a conceptual framework for schools to be centres of care and support for HIV-affected communities;

• determine the requirements for supporting schools to be centres of care and support;

• identify actions and strategies needed to scale-up models of best practice;

• determine strategies to engage community leaders, networks and groups of people living with HIV, and other community-based organisations; and

• discuss how to mobilise sufficient political will, closer involvement of the education community and donor support.

Key highlights of the consultation include a field visit to 3 schools which aimed at providing participants with an opportunity to observe the impact of the Circles of Support pilot project implemented by the Botswana Ministry of Education and its partners (the Institute of Development Management and Health Development Africa). Participants expressed appreciation of the pilot project and its committee members who mainly comprised school staff and community volunteers.

Participants shared experiences on the existing programmes in the region, the benefits and challenges of each programme. Some of the presentations include:

• Media in Education Trust Model (MIET)on Schools as Centres of Care and Support;

• Circles of Support for orphans and vulnerable children pilot project implemented in 36 schools in Botswana, Namibia and Swaziland; and

• Addressing care and support needs of teachers as part of a comprehensive package for comprehensive school based responses.

The meeting discussed the management, monitoring tools and indicators that could be integrated to strengthen existing programmes. It shared with participants, the District Education Management and Monitoring Information System (DEMMIS) developed by the Mobile Task Team in South Africa to capture key indicators of HIV and AIDS impact, to guide response at the school, provincial or circuit and district levels.

Recommendations:

• Establish progress made by Southern African Development Community (SADC) countries in implementing the commitments made by SADC Ministers of Education in Swaziland in 2005.

• Programmes that promote schools to be centres of care and support should be inclusive and non discriminatory and consider gender inequalities.

• Integrate treatment literacy programmes in school and community HIV and AIDS programmes.

For more information, email: m.zulu@unesco.org.  Top

SAfAIDS launches e-forum on Accelerating HIV Prevention

The Southern Africa HIV and AIDS Information and Dissemination Service (SAfAIDS), with support from the Health and Development Networks (HDN) and the Joint United Nations Program on HIV and AIDS (UNAIDS), has launched an electronic AIDS discussion forum Accelerating HIV Prevention, which aims to foster dialogue on the prevention of AIDS in the region. It will bring together ideas from different people in southern Africa and promote advocacy, partnerships and networking at both national and sub-regional levels.

Co-hosted by SAfAIDS and UNAIDS, the forum has the following six themes:

• Key drivers of the epidemic (including condom use and concurrent partnerships).

• Role of men in HIV prevention (including male circumcision).

• HIV prevention for young people.

• Role of classical sexual transmitted infections (STI) treatment in HIV prevention.

• Prevention from the perspective of people living with HIV (including positive prevention).

• Strategic condom programming.

Current discussions on the need to design appropriate HIV prevention interventions for sub-Saharan Africa have presented a unique opportunity for launching a dialogue around prevention-related issues. Targeting stakeholders in eastern and southern Africa, the forum will discuss pertinent HIV prevention issues that will inform programme design and implementation across the region. The discussion forums implementation is divided into two phases. The first phase began on 30 April 2007 and is expected to run until the end of October 2007. Its aims include:

• stimulating lively exchange and constructive dialogue on topical HIV prevention issues in eastern and southern Africa;

• creating a space for an expert, focused discussion on key issues related to HIV prevention in the region; and

• encouraging further discussion on the conclusions of the Southern African Development Community (SADC) Think Tank Meeting of May 2006.

Following this discussion, SAfAIDS will prepare a summary that captures the highlights of all contributions to inform the next stage. During the second phase, the discussion will aim to engage a broader audience on HIV prevention, specifically to establish a space for people in eastern and southern Africa to share knowledge, skills and experiences in HIV prevention. It will also promote advocacy, partnerships and networking at all levels.

In all stages, the forum provides papers by experts on the six topics above and also offers an opportunity for participants (with the help of moderators) to critique them and contact the authors personally. Speaking at the launch, SAfAIDS executive director, Mrs Lois Chingandu, emphasised on prevention as a key strategy for the response to the HIV and AIDS pandemic. Though she acknowledged the growing political commitment in the region, Mrs Chingadu noted that the number of new infections remained unacceptably high, indicating shortcomings in prevention programmes. According to UNAIDS and the World Health Organisation, properly targeted prevention efforts can avert 28 million new infections. Prevention in sub-Saharan Africa alone could avert 55 percent of the 53 million new infections projected for 2003 to 2020.

For more information, visit: www.safaids.org or join the forum by sending an email to: join-accelerating-revention@eforums.healthdev.org.  Top

Japan approves capacity building of pre-service colleges of education on HIV & AIDS and Education in Zambia

The Japanese Government, through the Japanese Funds-in-Trust (JFIT) for the Capacity Building of Human Resources Sector, has approved a project to build capacity on HIV & AIDS and Education in pre-service teacher training institutions in Zambia. Implemented under the auspices of the Global Initiative on Education and HIV & AIDS (EDUCAIDS), the project aims to contribute to the reduction of HIV prevalence rates among young men and women aged between 10 and 24.

The project will contribute to this objective by completing the following activities:

• Conducting a Strategic Stakeholders Consultation to develop a Joint Strategy for EDUCAIDS in Zambia.

• Producing learning materials for professional development programmes for college principals and teacher trainers.

• Developing a programme for teacher education college principals.

• Designing a programme for teacher educators.

Primary beneficiaries comprise teacher trainers and college principals participating directly in the capacity-building programme  88 teacher trainers and 22 principals are expected to benefit. Other beneficiaries include teachers and learners (at both primary and secondary levels) whose access to HIV prevention education will be improved as a result of the capacity-building taking place in Zambias colleges of education.

Expected outcomes include the:

• development of a Joint strategy for EDUCAIDS in Zambia;

• production of learning materials for ongoing professional development of college principals and teacher trainers; and

• enhanced capacity of pre-service teacher education colleges in Zambia to train teachers in EDUCAIDS.

Limited numbers of activities focusing on HIV and AIDS in the 22 pre-service colleges of education make capacity building of teacher educators on HIV and AIDS and integration of HIV and AIDS into pre-service training programmes a crucial and urgent matter. Training exercises should encompass all stakeholders, including college principals, ensuring commitment to HIV prevention education and the importance of sustaining the project, among other things. The project encourages integration of HIV prevention measures into performance management of teacher trainers.

Zambia is one of the 13 pilot countries in the African region implementing the EDUCAIDS initiative launched in March 2004 in Livingstone, Zambia. The country is strongly committed to Education for All (EFA) and has scaled up its response to the pandemic. The Ministry of Education has developed a comprehensive national policy, Educating Our Future, which focuses on increasing access to education, life skills training and building capacity for the provision of quality education. The country has also established a comprehensive strategic framework for implementation of EFA and an HIV and AIDS Policy Implementation Strategy for colleges of education with the assistance of the UNESCO Harare Cluster Office. Launched in 2004, EDUCAIDS is a UNAIDS initiative led by UNESCO and aimed at addressing the global impact of HIV and AIDS by supporting comprehensive educational responses. The initiative is based on the premise that education has a vital role to play in national responses to the pandemic.

For more information, email: j.shabani@unesco.org.  Top

First international summit on HIV and AIDS and Zimbabwe 

The Zimbabwe AIDS Relief, a project of the Allen Temple Baptist Church AIDS-Ministry, in Oakland California and the HIV and AIDS Zimbabwe Charity, Inc., in Lexington Kentucky, is organising the first International Summit on HIV and AIDS and Zimbabwe (ISoHAZ) on 30 November 2007 in Oakland, California, USA. The theme of the summit is Unifying diverse organisations and projects working on HIV and AIDS in Zimbabwe. This summit aims to bring together interested parties involved in HIV and AIDS related work with a specific focus on Zimbabwe. Participants will range from interested individuals, people living with HIV and AIDS (PLWHA), governmental and non-governmental agencies, grant-makers, businesses, corporations, faith-based communities, activists, drug manufacturers, and health care providers, researchers, nurses, health educators and social workers.

Topics to be covered include:

• Existing national and international commitments which includes exploration of current services provided by existing organisations, non-governmental organisations, among others.

• Statistical database and research efforts (exploration of current research efforts, needs, availability and accessibility of resources and utilisation of databases).

• Available resources comprising human, financial and other resources for implementation of services, training, continuing education and research.

• Health promotion to review treatment challenges and successes in Zimbabwe, including model programmes, home-based care issues, nutrition, extended family support, traditional and cultural influences and support and care for orphans.

• Stigma reduction.

In addition to the above, the summit will address issues in providing care and treatment. A key expected outcome is the provision of an arena for establishing networks and stronger frameworks for addressing the challenge posed by HIV and AIDS. Zimbabwe has been commended for managing to cut down HIV prevalence rates in the 15-49 age group. This is attributed to effective successful behavioural change strategies that have seen people having less casual sex partners. Behaviour change has resulted, to some extent, from a sustained programme of prevention activities based on consistent messages, and increased availability of condoms, among others.

For more information, email: jmziba@hivaidszimbabwe.com.  Top

UNICEF Regional Network Meeting for Project Officers on Adolescent Development and Participation in Eastern and Southern Africa

UNICEF Eastern and Southern Africa Regional Office organised a Regional Network Meeting for Project Officers on Adolescent Development and Participation in Eastern and Southern Africa in Johannesburg, South Africa from 25-30 March 2007. Participants included representatives from UNESCO Harare Cluster Office and UNFPA, and young people.

The consultation sought to:

• discuss findings from the mapping exercise of participation activities and youth polls conducted in the region to develop a practical framework for effective and meaningful participation of children and adolescents at the programme and policy levels;

• develop innovative strategies to enhance children and adolescent participation in accelerating young child survival and development initiatives within the context of health-related Millennium Development Goals (MDGs);

• review current approaches in HIV prevention programming with and for adolescents and develop new consensus on prevention interventions with and for young people in line with national priorities; and

• develop a common ground on aligning adolescent development and participation interventions with those of UN Agencies and other development partners.

The meeting adopted a participatory workshop approach, with a series of presentations and discussions on various topics. A key discussion point was the global perspective on adolescent development and participation provided by the World Development Report 2007 which places young people on the global agenda. The report identified three essential components for young people including the need for adequate support for young people through the improvement of access to primary, secondary and tertiary education particularly for the marginalised.

Another highlight is the information sharing on country experiences and existing frameworks that focus on adolescents development and participation in Eastern and Southern Africa. The meeting advocated for the need for development partners to wear an adolescent lens in their programming, implementation, monitoring and evaluation of projects. Adolescents should become the key group in programming efforts as they are the most affected category in conflict or high HIV prevalence areas. Other areas covered include:

• Regional programming approaches and initiatives for adolescents, by UNFPA and UNESCO Harare.

• Regional Perspectives on Adolescents in Emergency and Transition Settings. The findings from the Graca Machel Review Approaches to Adolescent Programming in Emergencies.

• Regional life-skills approaches.

• HIV and AIDS Programming for adolescents.

The Harare Cluster Office shared with participants a paper on UNESCOs action with and for young people. The paper outlined the Organizations youth strategy which is in line with one of its mandate: to empower youth, through education, to participate and become equal and valuable partners in society. At the close of the workshop, UNICEF called on all stakeholders to focus on the most at risk Adolescents (MARA) and especially vulnerable adolescents (EVA). Participants called on partners to develop specific programmes that focus on out of school adolescents. Other recommendations include developing meaningful involvement and partnerships with young people, utilising existing evidence based research data on adults for effective programming and improving monitoring and evaluation of young peoples programmes.

For more information, email: afayoyin@unicef.org or m.zulu@unesco.org.   Top

Assessment of primary school sexual health programmes in Tanzania

Adolescents in Tanzania are at risk of contracting HIV and other sexually-transmitted infections. Though schools provide an opportunity to reach large numbers of young people at relatively low cost, large-scale adolescent and reproductive health (ASRH) programmes are rare in sub-Saharan Africa. Dealing with private and sensitive topics, ASRH programmes are easily weakened by poor teacher training, lack of awareness of the programmes importance and limited time for delivery. Research looks at supporting factors and barriers for ASRH in rural primary schools in Mwanza Region, Tanzania, through three years of participant observation in nine villages. It reveals great challenges to ASRH programmes, such as:

• low school enrolment, inconsistent attendance and high drop-out rates;

• severe resource constraints;

• problematic teacher to pupil relationships, including authoritarian teaching methods and corporal punishment;

• practices, such as mandatory pregnancy examinations, which lead to pupils secrecy about sexual activity;

• sexual abuse of schoolgirls by teachers;

• tensions between teachers and villagers; and

• low teacher wages leading to pupil exploitation or demanding of bribes.

A related study evaluated an ASRH intervention, MEMA kwa Vijana (MkV), comparing 62 primary schools in ten intervention communities with 63 schools in ten control communities where the ASRH intervention was not taking place. The trial involved 9,645 primary school children aged at least 14 years at the start. It included a teacher-led, peer-assisted course, training of youth-friendly health workers and youth condom promotion and distribution.

In the MkV trials final survey, higher percentages of participants in intervention communities reported better attitudes and behaviours than control groups, but there was no consistent biological impact. Were these outcomes due to poor implementation, limitations of the programme or external factors? Participant observation researchers found that high quality teacher and community peer educator training courses were run across all districts, and that programme implementation, completeness of delivery and participant engagement and satisfaction were also good.

The programme was strong in addressing some key issues, but more limited in addressing others. For example, programme participants had far better ASRH knowledge than students in comparison schools. However, the programme only seemed to marginally affect some widespread and problematic attitudes and practices in youth sexual relationships, such as negative perceptions of condoms, the exchange of sex for money, and having secretive, concurrent relationships. Programme success was further blocked by the other contextual factors identified above.

These findings suggest that, despite great resource limitations, it is feasible to implement ASRH interventions through existing government structures when they are incorporated into the school curriculum. But sexual behaviour change can be an unwelcome, complex and long-term process, requiring great self-motivation and social reinforcement. Together, these studies suggest that school-based ASRH programmes must be adapted to the realities of the local setting by:

• simplification of the subject matter;

• intensive focus on problematic practices in youth sexual relationships;

• training on active teaching methods;

• improvement of teacher to pupil and teacher to community relationships; and

• close supervision and appropriate responses to abuse or exploitation.

Source: http://www.id21.org/education/e5mp1g1.html.   Top

The Role of Open, Distance and Flexible Learning (ODFL) in HIV and AIDS Prevention and Mitigation for Affected Youth in South Africa and Mozambique

Open, Distance and Flexible Learning (ODFL) should play a more proactive role in facilitating educational reform, sharing the challenges faced by schools and helping the integration of responses, including the response to HIV, to meet learners needs effectively.

This is a key recommendation from a study assessing the role of open, distance and flexible learning (ODFL) in HIV prevention and mitigation for affected youth in South Africa and Mozambique. Commissioned by the United Kingdoms Department for International Development (DFID), the study provides an examination of the potential of ODFL to mitigate the effects of HIV and AIDS on young people.

The study:

• analyses national AIDS policies and identifies major ODFL initiatives to translate this policy into practice;

• considers how ODFL can be developed to meet learning needs of affected youth in Mozambique and South Africa;

• explores the learning needs and favourite ways of learning of young people affected by HIV and AIDS; and

• suggests ways for ODFL to support and extend the work of existing infrastructures.

This report is organised into six sections focusing on the study, educational response to HIV and AIDS reviews, the potential achievements of ODFL, literature on the effects of HIV and AIDS, national AIDS policies in South Africa and Mozambique and ODFL initiatives among other others. It concludes with findings and suggestions to further develop the ODFL provision. A key highlight of the study is that it focuses on the growing number of youth who are orphans, living in child-headed households and carers who are out of school due to the effects of HIV and AIDS. The study hopes to increase awareness of this vulnerable group to ensure initiation of a broader momentum to address needs not met by the formal education system.

Results show that Ministries of Education in both countries are concerned with delivering quality basic education to children in school. The focus is on the development of HIV and AIDS curriculum and materials to provide relevant information, life skills, and training teachers to deliver this curriculum. Both countries have limited provisions for out of school youth despite the increasing number of drop-outs particularly among girls. The study also notes that affected young people need more opportunities outside the formal system to develop literacy skills and undertake vocational training. Other findings include the utilisation of different mediums such as the mass media (television campaigns) to deliver, face-to-face and peer educators to reach out of school youth. The report argues that ODFL has the potential to play a role in HIV and AIDS responses, especially in the areas of prevention, psychosocial support and vocational skills. It recommends the adoption of a flexible approach to the delivery of the national curriculum to cater for drop outs and other disadvantaged youths.

Other recommendations:

• ODFL programming to support educational transformation should develop with a broad based educational approach, focused on increasing knowledge and development for the young.

• Teachers must deliver and collect ODFL curriculum materials from young carers on home visits, by classmates participating in buddy system or by home-based care workers.

For the report, visit: www.dfid.gov.uk/pubs/files/odfl-safrica-mozambique-61.pdf. Top

South Africa launches HIV/AIDS/STI Strategic Plan for 2007-2011

The Republic of South Africa has launched its HIV and AIDS and Sexually Transmitted Infections (STIs) Strategic Plan for 2007-2011. The plan is based on the National Strategic Plan of 2000-2005 and Operational Plan for Comprehensive HIV and AIDS Care, Management, and Treatment. It represents the countrys multi-sectoral response to the challenge posed by HIV infection and the wide ranging impacts of AIDS in the country. South Africa joins other countries such as Zambia and Zimbabwe that have launched strategic plans for the same time frame. Guided by key principles of supportive leadership, effective communication and partnerships, promotion of social change and cohesion, and sustainable programmes and funding, the plan aims to reduce the:

• number of new HIV infections by 50%; and

• impact of HIV and AIDS on individuals, families, communities and society by expanding access to appropriate treatment, care and support to all people diagnosed with HIV.

The plan sets out a clear framework for monitoring and evaluation exercises including a preliminary costing of its main elements and a commitment to raising substantial funds that will be needed for its effective implementation. It outlines four key priority areas to be used in meeting the goals of the plan and these are:

• Prevention;

• Treatment, care and support;

• Human and legal rights; and

• Monitoring, research and surveillance.

Development of the plan followed an intensive and inclusive process of drafting, collection and collation of inputs from a wide range of stakeholders through workshops and meetings. It builds on work done in the past decade and provides continued guidance to all government departments and sectors of civil society in the response to the pandemic. It is informed by the nature, dynamics, character of the epidemic and developments in medical and scientific knowledge. HIV and AIDS is one of the main challenges facing South Africa. It is estimated that of the 39.5 million people living with HIV worldwide in 2006, more than 63% are from sub-Saharan Africa. In 2005, approximately 5.54 million people were estimated to be living with HIV in South Africa with 18.8% of the adult population (15-49) affected. Women are disproportionately affected; accounting for approximately 55% of HIV positive people.

In response to the pandemic, South Africa has established a multi-sectoral response managed by different structures at all levels. Provinces, local authorities, the private sector and a range of community based organisations are the main implementing agencies. Each government department has a focal person and team responsible for planning, budgeting, implementation and monitoring HIV and AIDS interventions. In this plan, communities are targeted to take more responsibility and to play a more meaningful role in the response.   Top

Profile of the Children in Distress Organisation in Kitwe, Zambia

The Children in Distress (CINDI)-Kitwe is a community based organisation that encourages and empowers the communities of Kitwe, the hub of Zambia's Copperbelt Province, to look after the orphans in their midst. The goal of the project is to mitigate the impact of the HIV and AIDS pandemic on orphans and other vulnerable children in Zambia through mobilising, scaling up and strengthening community-led responses and programmes. Its objectives include providing care and support for children orphaned by the AIDS pandemic and positive prevention, care and support to households living with people with AIDS (PLWA).

It is based on three premises which are:

• Recognition of the role of households in the care and support of orphans and other Vulnerable children (OVCs);

• Realisation of the importance of community based support for OVCs to ensure sustainability and relevance to local situations; and

• Building upon and expanding the effectiveness and efficiency of local and community-led responses to the pandemic.

Established in 1994, CINDI-Kitwe register orphans and identifies and prioritises their needs. It has a network of 720 community volunteers and care-givers in 11 townships, who register orphans, find foster homes for orphans and identify individual needs. Once registered, children have access to help with food, shelter, counselling, healthcare and education. The volunteers act as the orphans advocates, encouraging communities to look after these children to ensure that they grow up in relatively normal environment. Volunteers comprise community caregivers who have themselves lost their husbands or wives to HIV and AIDS.

CINDI-Kitwe mobilises communities to participate in the response through providing maintenance and support of orphans and other vulnerable children. The organisation works with communities to identify and define what constitutes vulnerability in their local situation. Through mapping, communities identify how they can respond to this vulnerability. Mobilisation of communities integrates PLWAs and orphans by providing education, care and support. The ultimate goal is to reduce HIV/STD transmission, mainly focusing on children, youths, women and situations which are at risk for HIV transmission. Communities contribute in a variety of ways which include labour and other services to support the most vulnerable.

Other activities comprise:

• Capacity building of communities in record keeping, financial accountability, report and project proposal writing and simple business management skills.

• Building up communities' ability to strengthen advocacy with local authorities for OVCs in issues of access to education.

• Protecting children from harmful cultural practices and beliefs that violate the Rights of Children, especially the girl-child.

Following its inception in 1994, CINDI-Kitwe in partnership with other organisation such as the Cecily Foundation, has sent over 6000 orphans to schools and universities. The organisation has trained volunteers in home health care and psychosocial skills needed to care for adults and children affected by HIV and AIDS. CINDI runs similar organisations in Kalomo and Kateke. National prevalence in Zambia is placed at 17%. It is estimated that by the 2009, Zambia will have close to 895 000 AIDS orphans excluding those above the age of 15.

For more information, visit: www.cindi.org.zm.  Top

SHORTCUT LINKS

UNESCO consultation on the role of schools in providing HIV treatment, care and support

Eastern and Southern Africa regional consultation on safe male circumcision and HIV prevention in Harare, Zimbabwe

Japan approves capacity building of pre-service colleges of education on HIV & AIDS and Education in Zambia

SAfAIDS launches e-forum on Accelerating HIV Prevention

First international summit on HIV and AIDS and Zimbabwe

Elizabeth Mataka appointed as Special Envoy for AIDS in Africa 

Off the Map: How HIV & AIDS Programming is Failing Same-Sex Practising People in Africa: A review

UNICEF Regional Network Meeting for Project Officers on Adolescent Development and Participation in Eastern and Southern Africa

85% of countries in eastern and southern Africa make progress towards ambitious access target setting

Assessment of primary school sexual health programmes in Tanzania

The Role of Open, Distance and Flexible Learning (ODFL) in HIV and AIDS Prevention and Mitigation for Affected Youth in South Africa and Mozambique

Different perspectives on male circumcision for HIV prevention

South Africa launches HIV/AIDS/STI Strategic Plan for 2007-2011

Using the Internet as a Management Tool  The HIV and AIDS Management Unit of the Namibian Ministry of Education

Profile of the Children in Distress Organisation in Kitwe, Zambia

Online resources

Forthcoming Activities

END OF LINKS

Eastern and Southern Africa regional consultation on safe male circumcision and HIV prevention held in Harare, Zimbabwe

Following the global consultation held in Montreux, Switzerland in March 2007, to review available evidence including the three randomised controlled trials undertaken in Kenya, Uganda and South Africa, the World Health Organisation African Regional Office, in partnership with other United Nations Regional AIDS Team members, the Southern African Development Community (SADC) and the East Africa Economic Community Secretariat, convened a regional consultative meeting from 7-9 May 2007 in Harare, Zimbabwe.

The consultation had the following objectives:

• Provide the latest evidence on male circumcision and HIV prevention, including the three Randomized Controlled Trials (RCTs) and other data on the efficacy, safety and acceptability of the male circumcision for HIV prevention.

• Brief participants on outcomes of country, regional and international male circumcision consultations, including reviewing the recommendations from the international consultation.

• Update participants on country plans of action on male circumcision, initiate the development/update of the country plans of action for male circumcision as part of comprehensive HIV prevention programming.

• Agree on mechanisms for United Nations (UN) and other partners support to these countries in implementing their plans.

65 participants comprising UN Country Teams, international agencies, Ministry of Health officials from 12 high HIV/low male circumcision prevalence countries from eastern and southern Africa and key support partners (the United Kingdoms Department for International Development-DFID and the United States Presidents Emergency Plan for AIDS Relief-PEPFAR). Representatives from Botswana, Kenya, Lesotho, Malawi, Mozambique, Namibia, Swaziland, South Africa, Tanzania, Zambia, and Zimbabwe also attended.

Proceeding by way of plenary sessions, countries shared information on their experiences, including challenges in scaling up male circumcision. The available doctors in Swaziland providing the procedure are fully booked up to August as a result of findings of the studies.

Participants acknowledged the important role played by traditional practitioners in male circumcision. They also recognised the need for further consultations to ensure proper integration of traditional practitioners in scaling up male circumcision.

Delegates endorsed policy and programmatic recommendations from the global consultation in Switzerland.

Country teams from Botswana, Kenya, Lesotho, Malawi, Mozambique, Namibia, Zambia, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe developed detailed plans on key actions to be undertaken over the coming year to develop guidance and costed strategies and action plans.

Other recommendations:

• UN organisations should continually support member countries, providing guidance on male circumcision scale up, including development of a communications frame to be used by countries to guide communications programming, among other things.

• Integration of male circumcision in HIV prevention campaigns and approaches to rapidly increase practice in countries.

• Develop policy guidance that defines who is to be circumcised, how and by whom.

• Mobilise resources to fund male circumcision activities.

This meeting was in response to the call made by African Union Health Ministers to establish male circumcision strategies and action plans with emphasis on scaling the practice through integration into HIV prevention strategies to achieve maximum public health benefit.

UN agencies, SADC and other relevant stakeholders will convene to review progress made and challenges faced in scaling up male circumcision by February 2008.

For more information, visit: http://www.afro.who.int/note_press/2007
/pr20071705.html.  Top

Elizabeth Mataka appointed as Special Envoy for AIDS in Africa 

United Nations Secretary General, Ban Ki-moon, has appointed Elizabeth Mataka, a national of Botswana and a resident of Zambia, as a Special Envoy for AIDS in Africa. Ms. Mataka, a social worker by training, has worked in the field of HIV and AIDS for the past 16 years.

She has been involved in different aspects of the pandemics response, including programmes on HIV prevention, clinical treatment for opportunistic infections, care and support at community and national levels.

Presently, Ms Mataka serves as the Executive Director of the Zambia National AIDS Network (ZNAN) and represents civil society on national policy-making bodies such as the National AIDS Council.

Other credentials include representing non-governmental organisations from developing countries on the Board of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, which she serves as Vice-Chair.

Her appointment is a triumph for women who bear the heaviest burden posed by the AIDS pandemic. According to UNAIDS, women and girls make up almost 60 percent of adults living with the HIV virus in sub-Saharan Africa. Various challenges such as financial dependence and gender inequalities cause women to be vulnerable to HIV infection.

The Secretary General also renewed, until the end of 2008, the appointments of Dr. Nafis Sadik, Special Envoy for AIDS in Asia and the Pacific; Professor Lars Kallings, Special Envoy for AIDS in Eastern Europe and Central Asia; and Sir George Alleyne, Special Envoy for AIDS in Latin America and the Caribbean.

Special Envoys make valuable contributions in advancing the AIDS agenda in the regions they cover. Working with a wide range of partners, including governments and civil society, they have helped mobilise and strengthened responses in many countries.

Most notably, envoys have played a key role in advocacy on issues related to women and AIDS, championing the greater involvement of people living with AIDS in national responses and promoting support from the private sector.  Top

Off the Map: How HIV & AIDS Programming is Failing Same-Sex Practising People in Africa: A review

Throughout Africa, HIV is having a decidedly grave effect on same-sex practicing people. Lesbian, Gay, Bisexual and Transgender (LGBT) communities are being decimated with a speed and breadth reminiscent of the impact of the epidemic on gay men in New York, San Francisco, and other North American and European cities in the 1980s.

This is one of the key highlights of the publication released by the International Gay and Lesbian Human Rights Commission (IGLHRC). The publication Off the Map: How HIV/AIDS Programming is Failing Same-Sex Practising People in Africa, aims to motivate dialogue and end silence about African homosexuality, HIV and AIDS.

The report exposes and analyses the unacceptable climate of silence surrounding same-sex practising people in the region. It focuses on the effects of such discrimination, demonstrating the importance of equal prevention, care and treatment for all those affected. 60% of people living with HIV are found in Africa. The pandemic has claimed more 15 million people, changing the social, economic, and political landscapes of the entire continent.

Though HIV and AIDS interventions have increased, only a few formal HIV prevention, testing, treatment and care programmes target men who have sex with men in Africa and same-sex practicing women.

It is estimated that Africa needs US$353 million, from 2006-2008, for HIV prevention activities for men who have sex with men. According to the report, the needs of African same-sex practicing people are off the map that government and civil society have drawn to guide national and regional HIV strategies, due to:

• homophobic stigma, denial, political and cultural resistance to African homosexuality;

• restrictive international reproductive health policies of donors and conservative social agendas of African governments; and

• limited capacity, skills and resources among non-governmental organisations to effectively advocate for access to HIV-related services and other health-related human rights at the domestic, regional, and international levels.

The challenges above have led organisations, governments and the general population to disregard the issue of same-sex HIV transmission in Africa, contributing to widespread human rights abuses and increasing vulnerability to HIV and AIDS.

Off the Map explores the ways in which governments, donors, and non-governmental organisations address same-sex practicing Africans. The report highlights the potential impact of denying this practice in programmes designed to respond to the pandemic.

Some areas covered in this report include denial and homophobia; knowledge on same-sex practicing people in Africa and the role of foreign and local governments, non-governmental organisations and donors in addressing the plight of same-sex practicing people and the HIV and AIDS pandemic.

The report makes recommendations for all stakeholders involved, including governments, donors and non-governmental organisations. Some of the recommendations comprise:

• Increasing financial resources to African government agencies, international, and local organisations to implement programs for same-sex practicing people in Africa.

• Developing policies that promote equality and respect for same-sex practicing people who access programs and services.

• Repealing all laws that criminalise same-sex consensual conduct, in keeping with international human rights law.

For more information, email: b.mapanda@unesco.org.  Top

85% of countries in eastern and southern Africa make progress towards ambitious access target setting

The Joint United Nations Programme on HIV and AIDS (UNAIDS) Regional AIDS Team for Eastern and Southern Africa conducted a second rapid review to establish progress made by countries in the region in setting universal access targets in April 2007. This is a follow up to a review conducted in September 2006.

Findings show that a total of 17out of 20 countries (85%) have set draft or final targets through a consultative process including civil society. This marked a significant progress compared to the first review, where only eight countries had finalised their targets and another six were in the process.

Though all countries have set targets, none of the countries have all the seven core indicators relating to antiretroviral access, orphans and vulnerable children support, prevention of mother to child transmission (PMTCT), HIV testing, condom distribution, age of sexual debut and national resource commitment.

Countries are generally stronger on treatment targets, and weaker on prevention and national resource commitment. 16 countries have treatment targets compared to 14 with prevention and only 8 have resource commitment targets.

Seven out of 20 countries have incorporated universal access targets into their National Strategic Framework and six of these have costed the frameworks.

Three countries have costed their frameworks but are still to incorporate the targets.

Common challenges faced by countries include a weak evidence base from which to set targets, delayed member state follow up on international commitments and insecure funding to realise ambitious targets.

Following the 2006 Brazzaville Declaration on Universal Access adopted by African Member States and the Political Declaration on HIV and AIDS adopted by the United Nations General Assembly, countries committed themselves to setting, in 2006 and in accordance with the core indicators recommended by UNAIDS, ambitious national targets to ensure universal access to HIV prevention, treatment, care and support by 2010.

In line with the proposed four-year Strategic Framework for UNAIDS Support to Countries Efforts to Move towards Universal Access, UNAIDS is supporting countries to complete their target setting process, including building consensus for joint action in the following areas:

• develop and cost robust national action plans to strengthen harmonisation and alignment of partners efforts in support of a scaled up national response;

• continue support to the development of one national monitoring and evaluation system to allow monitoring of progress towards universal access;

• strengthen civil society engagement in the entire scaling up process; and

• address the obstacles to scaling up towards universal access.

UNAIDS continues to support the countries to ensure completeness and consistency of the core indicators.

A key priority is to address weaknesses in prevention and national commitment targets.

Other required supports include brokering technical and financial support for action planning, costing and monitoring an evaluation.

For more information, email: nzimam@unaids.org.   Top

Different perspectives on male circumcision for HIV prevention

Following the findings from the Kenya, Uganda and South African trials and the recommendations from the World Health Organisation, researchers, scholars and other interested stakeholders have held discussions on the benefits and challenges of male circumcision among other things. Two such discussions include papers: Male Circumcision and HIV Prevention: Is there really enough of the right kind of evidence? and Just a Snip?: A Social History of Male Circumcision .

Professor Thomas Coram discusses the political and cultural aspects of male circumcision in Just a Snip?: A Social History of Male Circumcision.

This paper seeks to add balance and context to current debates on male circumcision.

It also views male circumcision from various contexts which include religious and public health contexts. Lastly, it highlights the similarities between male circumcision and female genital mutilation.

The article focuses on the historical background of the practice, tracing it through Egyptian and Greek dynasties, the Ottoman and Moorish Empires and Nazi Germany.

In these communities, male circumcision remained an indicator of hierarchy and social difference.

Professor Coram notes that male circumcision  like its counterpart female genital mutilation  is nearly always a strongly political act, enacted upon others by those with power, in the broader interests of a public good but with profound individual and social consequences.

In some nations, a mans circumcision status determines how he is treated. Violence, torture and death are the consequences for those that are uncircumcised.

Other issues highlighted in the article include the idea that male circumcision is a panacea to medical and social problems.

Male Circumcision and HIV Prevention: Is there really enough of the right kind of evidence? examines evidenced used to argue for the adoption of male circumcision as an HIV prevention technology. It discusses the various categories of evidence used and identifies the gaps which are missing from the debate.

A key highlight of the paper is the fact that each of prevention technology (putting on a condom, taking pills and inserting microbicides among others technologies) relies on human behaviour.

It highlights the need to consider social, cultural values, moral issues and other factors prior to adoption of male circumcision for HIV prevention.

According to Dowsett and Couch, observational studies and systematic reviews proffer limited discussion of low HIV prevalence areas in non- or low circumcising cultures (North Western Europe, South America, Australia and New Zealand) and the escalating epidemics in high circumcising cultures.

They recommend the introduction of comparisons to establish the causes of these variances.

Another aspect underscored in this article is difference between real world and trial contexts which may play a role in scaling up male circumcision.

It calls for further investigation and explanation of background information from the trials such as how subjects were motivated to be circumcised. Effectiveness of male circumcision covers a wide range of factors that include efficacy, social and cultural phenomena.

Some of the issues covered comprise:

• medical literature on male circumcision;

• traditional circumcision including religious and ritualistic practices;

• absence of the aspect of men having sex with men in the trials; and

• the minimum age for circumcision.

For full articles, visit: http://www.sciencedirect.com/science/

journal/09688080. 

Top

Using the Internet as a Management Tool  The HIV and AIDS Management Unit of the Namibian Ministry of Education

In an effort to develop effective and quick communication channels between national and regional levels, the Ministry of Education in Namibia has set up an HIV and AIDS Management Unit (HAMU) with the support of the European Union through the Institutional Strengthening and Capacity Building Facility of the Ministry of Education, Namibia. HAMU oversees and manages all HIV and AIDS related activities in the sector.

In the 13 regions in the country, Regional AIDS Committees on Education (RACE) coordinate HIV and AIDS related activities on this level.

To open further opportunities for information exchange between different stakeholders, presentation of work on national and regional levels and capacity building (by making relevant documents available), HAMU utilises the internet and email.

The Unit has established a website which provides information, education and communication. The website is a public-private venture in that it is hosted by a private service provider. This partnership ensures access to the Internet and e-mail addresses in all parts of the country.

Some of the sections of the website include the following:

• News, documents and links;

• Regions - the work on HIV and AIDS at grassroots level;

• Games and riddles on HIV and AIDS;

• Monitoring forms; and

• HAMU staff contact details.

The content of the website is provided by various target groups, ensuring a high degree of ownership. It is designed in such a way that it can be extended according to the different needs of stakeholders. A key expected outcome is to use the website as a platform for e-learning projects.

Challenges faced include:

• slow internet access;

• limited equipment; and

• low levels of training and skills in the use of information and communication technologies.

Despite the challenges, the project provided key lessons learnt comprising the design of a website with shorter download times, conducting survey to assess status of software, hardware and skills of the relevant stakeholders.

The website could serve as a prototype to other developing countries with slow Internet connections and a developing interest in the Internet.

Namibia belongs to the countries most affected by HIV and AIDS. The HIV prevalence and infection vary significantly between the 13 regions of Namibia.

With My Future is my Choice and Window of Hope, the country has two powerful school based programmes educating the youth about life skills and HIV and AIDS.

For more information, visit: www.hamu-nam.net or
http://hivaidsclearinghouse.unesco.org/ev_en.php?ID=7807_201&ID2=DO_TOPIC.  Top