Acknowledgements
Foreword
Preface
List of Acronyms
Background
Setting the stage for UNDP’s contribution
The First Caribbean Workshop on HIV & Development
Results delivered to date
Follow-up
Appendices:

1. Opening Speeches


2. Workshop goal, objectives and programme


3. List of workshop participants


4. Participant evaluations


5. List of persons consulted during preparatory stages

CARICOM	Caribbean Community
CTO	Caribbean Tourism Organization
HDP	HIV and Development Programme (of UNDP)
HIV/AIDS	Human Immunodeficiency Virus / Acquired Immune Deficiency Syndrome
OECS	Organization of Eastern Caribbean States
PAHO	Pan American Health Organization
STD	Sexually Transmitted Diseases
UNAIDS	Joint United Nations Programme on HIV/AIDS
UNDP	United National Development Programme

Purpose

In collaboration with the UNDP Regional Bureau for Latin America and the Caribbean and Country Offices, the UNDP Bureau for Development Policy, UNAIDS and CARICOM, and in response to the regional work of the Caribbean Task Force on HIV/AIDS, UNDP has been implementing an initiative to reinforce national capacity to address specific developmental dimensions of the HIV/AIDS epidemic.

HIV/AIDS and Development

It is now generally recognized that the HIV epidemic has its foundations in the structural characteristics of economies and societies. The extent and distribution of poverty, the concentration of wealth, the position of women and the nature of gender relations more generally, together with the processes and determinants of socio-economic development, all play important roles in the generation of the conditions in which the epidemic thrives.

By far the majority of HIV infections globally have been transmitted through unprotected sex. Thus, those who become infected tend also to be those who are in their most economically and socially productive years and those with most responsibility for financial and other kinds of support and care of others. In many countries these also include the better educated and skilled: incapacitation among this group has particular implications far beyond immediate families and communities.

While the spread of infection can occur with alarming speed, the broader impact of the epidemic may remain obscured for several years. Ample evidence exists to demonstrate longer-term impact of the epidemic across numerous sectors including tourism, agriculture, enterprise and industry, public services such as health, social welfare and education, public administration and security.

The coping mechanisms and capacities of affected communities can be stretched to the limit as people shoulder responsibilities for care and support of those who are infected and their survivors, including orphans.

Collectively these impacts result in a cumulative loss of human resources, erosion of capacity for development, and ever-deepening personal and social distress.

Clearly, the epidemic represents a significant and unprecedented challenge to development and as such, it requires broad, creative and innovative responses. And yet typically, when first recognized in a given country, the epidemic tends to be perceived narrowly (and often exclusively) as a health problem, with responses designed and implemented accordingly. In some countries such perceptions have broadened over time to include recognition of the inter-sectoral nature of the problem, while, in others, perceptions and responses have remained narrowly focused upon health.

UNDP and the UNAIDS Framework

Growing recognition of the need for an expanded response to the epidemic has resulted in the establishment of UNAIDS, comprising the work of an international secretariat together with the HIV/AIDS-related work of its six co-sponsoring UN agencies - UNDP, WHO, UNFPA, UNICEF, UNESCO and the World Bank. UNAIDS is the main advocate for global action on HIV/AIDS and is charged with responsibility for leading, strengthening and supporting an expanded response to the epidemic. Within this context and with its own specific mandate of promoting sustainable human development, UNDP’s HIV/AIDS-related work focuses upon strengthening capacity to identify and respond to the social and economic causes and consequences of the epidemic.

HIV/AIDS in the Caribbean

A Caribbean consultation on HIV/AIDS, supported by UNAIDS and the European Commission, was held in June 1998 with the purposes of enhancing regional planning and identifying the strategies and resources necessary for an expanded response to the epidemic. This led to the establishment of a Regional Task Force chaired by CARICOM and charged with responsibility, among its tasks, for the development of a regional strategy.

Following discussions with CARICOM, UNAIDS Secretariat and the UNDP Regional Bureau for Latin America and the Caribbean and the UNDP Bureau for Development Policy, it has become clear that with its focus upon capacity development in addressing the social and economic determinants of the epidemic, UNDP can make a potentially significant and complimentary contribution towards expanded regional and national responses. To this end, UNDP has undertaken a number of preparatory activities which culminated in the First Caribbean HIV and Development Workshop held in March 1999 in Barbados.

The HIV & Development workshop was selected as a means through which increased understanding of the socio-economic causes and consequences of the epidemic could be generated among participants. It was agreed that intial work would focus on three countries in the region: Guyana, Trinidad and Tobago, and Barbados,

In appreciation of the critical importance of strengthening capacity in relation to local problem identification, analysis and action, and in recognition of the wealth of existing experience within the region, a highly participatory approach was adopted by UNDP. This approach consisted of two stages.

In the first stage, visits to the three countries were initiated to consult with key players in the national response, and to identify potential participants, resource persons and facilitators for the workshop (see Appendix 5). The objective of these consultations was to assess the level and nature of demand for the workshop, to determine design criteria, and to collect relevant information. A second objective of the consultations was to initiate feedback from key partners in the region regarding how UNDP could best contribute to an expanded, multisectoral response to the epidemic in the Caribbean. The findings of stage one largely determined specific workshop objectives, format, and a first draft of workshop materials. Furthermore, through this collaborative process, a team of 12 individuals from the region were identified as resource persons and facilitators.

In the second stage the team of 12 resource persons and facilitators were invited to a workshop in Barbados held late February 1999. This workshop provided them with orientation to the scope and specific content of the workshop materials, and provided HDP with the opportunity to solicit detailed substantive feedback on the materials with a view to increasing their relevance within the Caribbean context. As a result of this part of the process, a set of adjusted materials were produced and the workshop goal, objectives and programme were revised and refined (see Appendix 2).

Furthermore, these preparatory activities assisted in the building of consensus among all concerned that UNDP support would be most useful if:

• The HIV & Development workshop is considered as an instrument designed to set the stage for a further in-country strategic planning process designed to support a multi-sectoral response.


• All the countries in the region are considered as potential participants in the initiative.

Therefore the initiative was perceived as requiring a longer-term commitment by UNDP.

The workshop lasted 3 days and was preceded by an opening ceremony and reception. The political and public visibility of the workshop was increased by the presence of local press and representatives from the Government of Barbados, CARICOM, UNAIDS and UNDP (opening speeches can be found in Appendix 1). Among the guests at the opening ceremony were representatives of all the UN agencies based in Barbados.

In addition to participants from Barbados and Guyana, a number of delegates attended from regional institutions. Participants consisted mostly of senior level policymakers and representatives from the ministries of health, education, social development and services, finance and economics, social security, statistics, justice, foreign affairs, national AIDS coordinators, and key NGOs (see Appendix 3).

The participant evaluations (see Appendix 4) clearly indicate that the workshop achieved its objectives. In particular, for most of the participants, expectations were fully met, most if not all topics were covered, the workshop process was effective, the performance of the facilitation team was highly satisfactory, the general content of the workshop was adequate, the approach used was very useful (and different), the workshop was well organized and resulted in a greater degree of engagement among participants.

Among the most frequently mentioned recommendations for improvement were:

• more focus on strategic policy planning


• more on how to engage the political level


• the incorporation of a glossary of technical terms used


• more time for certain exercises.

Informal comments made by participants highlighted the informal and highly interactive basis of the workshop, together with the experiential nature of the learning. These features were felt to be both pleasant and stimulating.

As a result of the preparatory missions and a substantial amount of managerial work, a number of critical outputs have been delivered. These include:

• A team of capable and committed individuals have been identified and resourced as facilitators of the HIV and Development Workshop. Group members have already successfully run the first Caribbean workshop and have expressed great enthusiasm to be involved in subsequent national level activity.
• Delegates from most key regional institutions have been exposed to the workshop and its potential. Most of these delegates have expressed an interest in collaborating with UNDP in follow-up activities.
• Selection criteria were developed for workshop participants including those from participating countries and those from key regional institutions.
• The workshop objectives and programme were substantially revised in response to the findings of the preparatory fieldwork (the final versions of these can be found in Appendix 2).
• Workshop materials have been thoroughly reviewed, tested and further refined. These materials, which include a manual for facilitators and a workbook for participants, will be produced and distributed to participants and facilitators subsequent to this report.

In terms of follow-up activities a number of possibilities present themselves. These include the following:

Local Facilitators and Resource Persons
The preparation of the group of facilitators and resource persons to take over the facilitation of the HIV and Development workshop, is rapidly approaching completion. Finalisation of this process requires that group members be provided with structured opportunities to strengthen specific facilitation skills.

National Level HIV and Development Workshops
The HIV and Development workshop has proved to be a valuable instrument in setting the stage for or reinforcing pre-existing or subsequent strategic planning processes. The product (i.e. the HIV and Development workshop) is now sufficiently regionally relevant to be implemented on a country by country basis throughout the region. In the immediate to short term, a series of workshops is suggested for Trinidad & Tobago, Jamaica and the Eastern Caribbean countries.

Multi-Sectoral Policy and Programming
The HIV & Dveelopment workshop provides a tool for promoting understanding of the interaction between the epidemic and contextual, socio-economic factors. Furthermore, several countries in the region are already (or will be soon) facing a more advanced stage of the epidemic. In this context, UNDP’s contribution could be demonstrated through facilitating the development of local multi-sectoral policy responses. Similarly, while concern is expressed within the region in relation to the potential of the epidemic to affect specific sectors, there is both a paucity of data and a scarcity of tools with which to explore sectoral specific impact together means of mitigation. Again this is an area in which UNDP could make a significant contribution.

Documentation and Evaluation
To communicate the lessons learned through this capacity-building initiative, there is a clear need for UNDP to collaborate with other stakeholders in the development of mechanisms through which the lessons learned can be articulated , documented and shared with a maximum of clarity and with a minimum of delay.