Development and the HIV Epidemic

Development and the HIV Epidemic: A forward-looking evaluation of the approach of the UNDP HIV and Development Programme

8. CONCLUSIONS AND RECOMMENDATIONS

The UNDP HIV and Development Programme (HDP) used the Special Programme Resources (SPR) to explore and enhance understanding of the ways in which the approaches of sustainable human development can be applied towards building capacity to understand, and to effectively respond to, the HIV epidemic. The evaluation process was exploratory and forward-looking, aiming to generate further and deeper understanding of the nature and approach of this type of programming.

Key findings of the evaluation were:

- that there are many people now engaged enthusiastically in what they themselves consider to be effective and sustainable responses to the HIV epidemic within their own contexts;

- that these people themselves affirm that the approaches used within the Programme, and similar approaches used by others, have enhanced their understanding and responses to the epidemic within the context of human development; and

- that the way these approaches have been described, developed and articulated by the HDP have validated and enhanced their own capacity, and thus helped answer the central question of, "How can we, together, move forward?"

In essence, it could be said that the work of the Programme was based on an interrelated series of active and reflective processes which were used to catalyse further active and reflective processes in responding to the HIV epidemic. Using approaches which evolve from its understanding of development practice, the Programme worked with people committed to responding compassionately and effectively to the epidemic to help catalyse such reflective processes. Those processes began to challenge commonly held assumptions about what drives the epidemic and what may work to slow it down, and to shift the focus of attention onto the processes of social change which will lead to effective community and national responses.

The types of process-oriented approaches explored through the HDP are:

based on human interaction, and the facilitation of processes;
necessarily slow at first because they must grow from shared understanding and consensus building which, in turn, must evolve as real human relationships evolve within the context of lived experience; but
lead to more effective, adaptable and sustainable responses in the long term because they build on capacity which already exists and thus create strategic effects which continue beyond the participation of the Programme, without resulting in dependency relationships with donors or technical advisers.

In effect, the processes of inclusion and partnership draw out people's understanding of both what is occurring within their own contexts and of their capacity to respond. An important strategic effect of these approaches, as described by evaluation participants, is that the people who are involved as direct partners of UN or donor agencies which use these types of development practice themselves use similar approaches in their interaction with others in their own countries and in regional networks addressing specific concerns. Thus, their own practice extends the effects of the individual programme under consideration. The evaluation was, in effect, another component of this ongoing evaluative and action-focussed approach.

Understanding of sustainable human development is still evolving as the nature of effective development practice is being explored on many fronts. The HIV epidemic, varying in its evolution and its effects in different countries, and at different stages of the epidemic within countries, presents particular challenges to any fixed understanding of what may work to catalyse effective responses to it. The problems addressed with certain responses today will be different tomorrow, or in different contexts. Therefore, new processes must continually be created to enhance understanding and to develop effective responses to new problems based on processes of social learning which arise from within communities and nations.

Such processes do not end with the drawing together of lessons learnt through one programme such as the SPR. This is important because, even though many of the practices of the Programme are now being adopted by other agencies, approaches based on the need to enhance understanding of the nature of effective processes and partnerships are not. While it is important that the lessons learnt through the Programme are shared and disseminated, it is equally important that the processes which led to these lessons themselves continue, both in UNDP and elsewhere. This is very different from the nature of lessons learnt through many other types of research or programming: in this case, understanding and practice must continue to evolve simultaneously through use of inclusive processes and continual questioning.

The evaluation has highlighted that approaches consistent with the principles of sustainable human development are taking place within a world in which development practice is often characterised by the mores of traditional technical cooperation. Approaches for the achievement of sustainable human development which include shared reflection, inclusion, and the conscious use of processes to allow scope for a range of possible outcomes, are beginning to be adopted. Traditional technical cooperation is driven by donor preferences, and characterised by use of external experts and use of quantitative measures to ascertain effectiveness in meeting pre-determined objectives or outcomes. It is less concerned with capacity building or with the discourse of partnership or participation.

The differences between these two approaches lead to different types of practice. However, the differences are not often acknowledged, as highlighted by some reported experiences of evaluation participants. The result is that many people seek to promote social learning through using the project design processes, reporting, measuring procedures and language systems of traditional forms of technical cooperation. Conversely, it is possible for people to change their use of language but not practice. However, both the Programme and the evaluation process found that it is possible for people and agencies to shift their understanding and practices from traditional approaches to those described in Section 5. This occurs more easily when the reasons for, and the approaches of, sustainable human development are articulated, explained and communicated interactively, allowing people space to consider the relevance of these approaches within their own contexts.

That this is necessary was highlighted through one of the findings of the evaluation process: those people approaching the HIV epidemic using approaches consistent with the framework of sustainable human development demonstrated more hope, confidence and forward movement than those working within alternative approaches.

It is important now to ensure that the lessons learnt through the HDP are shared amongst the people whose lives are affected, and disseminated within UNDP, other UN agencies and the international development assistance community. What is required is a more widespread understanding and adoption of the approaches of sustainable human development within the context of the HIV epidemic.

Thus, there is a need to share the lessons learnt within the HDP using approaches consistent with the Programme itself. That is, in ways which enable a wider variety of people affected by HIV and development to be involved, and which facilitate reflection about the relevance of these approaches in various contexts and the sharing of ideas about possibilities for changes in development practice.

For the people directly affected, this requires use of approaches to sharing what has been learnt in ways which are inclusive, and which create space for such sharing and further network development. The very nature of what has been learnt leads not to a set of ideas to be disseminated so much as a series of processes to be invoked.

For UN and donor agencies, this requires that approaches to sharing what has been learnt incorporate processes which enable critical reflection on the possibilities for changes within current development practice. Changes are required, for example, in the processes used for research, training, policy and strategy development, programme design, reporting procedures, and evaluation methods. These changes, in turn, require changes in skills required, and therefore in methods used for staff development and for future selection and training of staff and consultants. Ultimately, changes will be required in the management practices of UN and donor agencies, particularly changes which will enable the inclusion of the people whose lives are affected in determining priorities and aproaches to be used in programming.

UNDP has a particular role within the new joint cooperative programme, UNAIDS, and the current evaluation process indicates two key challenges:

1. There is a need to ensure ongoing association between the evolving understanding of effective approaches in sustainable human development and the evolving understanding of effective responses to the HIV epidemic. This will be most likely if there is an ongoing direct association of UNDP with development of responses to the HIV epidemic.

2. In order that UN Resident Coordinators can effectively undertake their function of coordinating the support of UN agencies to national responses to the HIV epidemic, there is a need to ensure that UNDP in-country staff, the Resident Representatives and staff of other agencies understand the ways in which the approaches of sustainable human development can enhance understanding and lead to more effective action in response to the HIV epidemic.

Recommendations are based on the lessons learnt through the HDP and the deeper understanding of the approach which has arisen through the evaluation. They are based on the need to ensure that the processes of social learning generated through the SPR continue amongst individuals, communities and nations affected, and also within the UN system. The adoption of these recommendations will enable ongoing sharing of what has been learnt amongst other people and agencies who are, or who are interested in, developing similar approaches. Such sharing will ensure more widespread adoption of approaches which promote responses to the HIV epidemic which are grounded in people's lived experiences and evolve in ways which build upon existing capacities.

RECOMMENDATION 1: That UNDP share what has been learnt through the HDP with the people whose lives are directly affected by the challenges of HIV and development. This sharing must take place using processes which enable and encourage the involvement of people who are not normally part of development networks, and using processes such as workshops and network development which enable inclusion, reflection, sharing and the development of ongoing partnerships within nations and within regions.

RECOMMENDATION 2: That UNDP share what has been learnt through the HDP with UNAIDS, other UN agencies and with bilateral and NGO donor agencies. This sharing must take place using processes, such as workshops, which enable interactive discussion and reflection on current development practice within the HIV epidemic, and which lead to the development of new approaches in project design, management and evaluation practices. This sharing must not be limited to those staff or agencies already engaged in responding to the HIV epidemic.

RECOMMENDATION 3: That UNDP take active steps to ensure an ongoing association between evolving understanding of approaches in sustainable human development and evolving understanding of effective responses to the HIV epidemic. This could commence with a series of related planning workshops at country, regional and global levels, in which UNDP staff and others develop means to ensure such an ongoing association. These methods may include new approaches to staff development and new methods for interaction between UNDP staff and others engaged in responding to the challenges of HIV and development.

RECOMMENDATION 4: That UNDP, in association with UNAIDS, support UN Resident Coordinators in coordinating UN agency support for national responses to the HIV epidemic, by ensuring that Resident Representatives are educated about both the association between HIV and development and the nature of approaches to sustainable human development which facilitate enhanced understanding of, and effective responses to, the HIV epidemic.