2007 Annual Report

HIV and AIDS: Curbing an epidemic

Poverty broadens the spread of HIV. Poorer people generally have less access to information about preventing exposure to the virus and fewer treatment options once infected. HIV in turn impoverishes families and communities through illness and loss of family breadwinners and caregivers. Poorer countries struggle with overburdened health care systems, and limited resources for prevention and treatment. These problems are exacerbated by economic fallout from HIV and AIDS, including reduced productivity and labour shortages.

Through its HIV and AIDS practice, UNDP helps countries integrate responses to the epidemic across the different sectors of national development plans, supports strong public service capacities, and mobilizes governments and civil society groups behind responses to the epidemic. It is a founding member of UNAIDS, the joint UN programme that coordinates the efforts and resources of 10 agencies making distinct contributions to stopping the epidemic.

With the World Bank, for example, UNDP and UNAIDS have joined forces behind a programme to help countries prioritize AIDS in national poverty reduction strategies, including by accounting for the epidemic in macroeconomic and sectoral policies. Throughout 2006, the programme helped several countries make strategic changes. Zambia expanded activities to address HIV beyond the health sector, allocating new resources to the transport, tourism, mining and agriculture budgets. In Rwanda and Senegal, representatives from the national AIDS commissions participated in drafting poverty reduction strategy papers, offering insights drawn from extensive experience in managing the epidemic. Ghana issued District Development Planning Guidelines requiring all sectors to integrate actions on AIDS in their medium-term development plans. Tanzania has invited civil society groups to participate in public expenditure reviews on AIDS resources,
and created a forum for civil society and the Government to work together on monitoring the implementation of poverty plans.

In Ecuador, UNDP has partnered with UNAIDS and the Spanish Agency for International Cooperation to help the central Government develop a new, more far-reaching National Strategic HIV/AIDS Plan, launched in 2007. Preparing the plan brought together representatives from many quarters, including the prison system, the National Children’s Council, universities and businesses. Grounded in analysis that recognizes the epidemic is more than a health concern, the plan elaborates new actions on multiple fronts, from general prevention to specific interventions targeted to high-risk groups. Parallel work with the UN Development Fund for Women (UNIFEM) has used the training of government officials and members of civil society to raise the profile of gender-related vulnerability to AIDS, given the sharp increase in prevalence rates among low-risk heterosexual women. UNDP has also helped Ecuador’s major municipalities—Quito and Guayaquil—create the first municipal AIDS policies, which led to the establishment of testing and counselling services. In 2006, work began to extend similar strategies to 39 local and three provincial governments covering half of Ecuador’s population.

UNDP plays a major role in helping national partners develop their ability to make full use of grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria, an international funding mechanism that assists countries in significantly scaling up their resources to fight these diseases. UNDP has successfully developed the capacities of national entities to take on the principal recipient role of the grants in Argentina, Benin, Burkina Faso, El Salvador and Haiti. By the end of 2006, UNDP was managing 58 Global Fund grants in 24 countries, disbursing $155 million for the year. In the Democratic Republic of the Congo, for example, UNDP has administered three grants resulting in new prevention strategies, education and counselling for one million people, and better monitoring of blood transfusion processes.

In collaboration with the UN Children’s Fund (UNICEF), UNAIDS and WHO in Angola, UNDP has overseen a Global Fund grant that has helped the Ministry of Health improve its technical skills, financial and management capacities, and systems for monitoring and evaluation. The grant has resulted in the development of a sentinel surveillance system, and the opening of 17 voluntary counselling and testing centres around the country. Nine hospitals now help mothers prevent transmission of HIV to their children, and more than 3,000 medical and paramedical personnel have been trained on AIDS care. By early 2007, over 7,000 Angolans were receiving antiretroviral drugs.

In Burkina Faso, UNDP works through its own HIV and AIDS programme to support PAMAC, the French acronym for a national network linking community groups of people living with HIV and AIDS. PAMAC, which works under the guidance of the national AIDS council, channels UNDP technical and financial resources into helping local groups manage programmes in their communities. By 2006, PAMAC was backing 142 community organizations and had trained 403 of their representatives in techniques related to voluntary counselling and testing, access to communal care, prevention and organizational management. The project as a whole benefits 350,000 people through increased access to information and testing services. It offers regular support to over 20,000 people who have developed AIDS, including home and hospital care, workshops on treatment options, and legal services.

Beyond national AIDS strategies and services, a priority for UNDP is assisting governments in negotiating the complexities of international trade agreements and intellectual property rights covering antiretroviral medications. Late in 2006, UNDP led a consortium of regional and international organizations—including UNAIDS, the Caribbean Community, the Pan American Health Organization and the Commonwealth Secretariat—to convene a workshop on these issues for 12 Caribbean countries that face some of the world’s highest HIV prevalence rates. Government and civil society representatives reviewed national patent laws, and discussed trade rules and the balance between patent protections and access to medicine. They agreed on a series of recommendations, including for improved communications between trade and public health officials, and for increased investments in local research and development. UNDP is now assisting Barbados on its compulsory license, which broadens access to patented products for the greater public good, and is helping Haiti and St. Lucia review national patent laws. These are crucial steps towards ensuring that medicine reaches people who need it most.