Education Development Centre, Inc

October 2005 [email protected]

Education Development Centre, Inc.

Response to Change -Changing the Response:

Increasing Donor Involvement in

the Spectrum from

Prevention to Care for HIV and AIDS

Cheryl Vince WhitmanGEG Tenth Annual

MeetingKiev, Ukraine


Overview of Presentation

I. Interdependence of health with all aspects of life

II. Need for comprehensive approach to HIV and AIDS

III. Major barrier of stigma and discrimination

IV. Schools, community agencies, PLWA must do more

V. Countless opportunities for donors


EFC Goals for HIV and Health

HIV and AIDS Donor Group

European Partnership for Global Health (EPGH)

European commitment to the Millennium Development Goals

MDG #6. “Halt and begin to reverse the spread of HIV and AIDS”.


Slow Pace Donor Participation

Perceive a fit with mission?

Stigma through association with HIV

Label HIV and AIDS as health problem

Are prevalence rates perceived as threat for Europe: Eastern Europe?


Do Donors Perceive HIV/AIDS a Problem?

Approximately 1.4 million people living with HIV/AIDS (Eastern Europe & Central Asia)

Fastest growing rate in world

Young people <30 at high risk (80% Eastern Europe compared to 30% Western Europe)

Fewer than 5% young people have access to services


Tipping Point 5 %:Not Hypothetical Construct

Eastern Europe 1% and less

Botswana 37%

South Africa .5 -1% (5 years)

1 - 20% (7 years)


I. Health Interdependent with –

Academic Performance

Family & Community Stability

Workforce Productivity

Economic Development


International Definitions and Movements

WHO: health is not absence of disease but physical, mental and social well-being.

WHO Ottawa Charter 1986: Health is created and lived by people where they learn, work, play and love.

WHO Bangkok Charter 2005: a globalized world health requires strong political action, broad participation and sustained advocacy.


II. Need for Comprehensive Response

Causes HIV and AIDS rooted in all facets of society and institutions: families, schools, employers, government.

All sectors must be involved in a comprehensive response from prevention to voluntary counselling and testing to care and bereavement and children affected and infected.

Response needs more donors involved -education, public health, mental health and social services, law enforcement, (ICT) information and communications technologies and media and all civil society.


Figure I: Societal Factors Contributingto Rising Rates of HIV and AIDS

Comprehensive Approach:

ARV

Intervention Services

Voluntary Counselling &, Testing for HIV

Counselling

Prevention

HIV & AIDS

DestructiveBehaviours:

sex work,alcohol/ drug abuse

Mental health, mental illness,physical, psychological,

sexual abuse

Unemployment, poverty, school failure, dropout, gender inequality,

homophobia, family dysfunction

General Population


Risk Factors: Substance Abuse

Individual Family School Community

Friends who use

Early problem

behaviours

Hopelessness

Genetic pre-

disposition

Poor social

adjustment &

coping skills

Chaotic home

Poor family relations

Parents/family

members who

Use alcohol and drugs

Abuse/neglect

Academic failure

Peer rejection

Low degree of

commitment to

school

Highly

authoritarian;

harsh punishments

Availability

substances

Exposure to

violence

Lenient laws,

no enforcement

Neighborhood

Deterioration

Few recreational activities and jobs


Spectrum of Response

Universal: Awareness and skill building

Norms of Tolerance

Selected:Early screening &

intervention

Indicated:Clean needles,

CondomsVCT

Treatment

ARV

Primary Prevention

Secondary Intervention

Treatment and Care


III. Stigma and Discrimination

First and foremost barrier

Stands in way of prevention

Negatively affects preventive behaviours, such as condom use, diagnosis, and treatment

Disenfranchising people fuels the epidemic


Most Effective Strategies to Combat Stigma and Discrimination

Review of 22 studies: Contact with PLWA along with information about transmission

Significant effects of educational sessions given by someone who has disclosed status compared to someone who has not

Greater involvement of PLWA has positive impact on policies and programmes


IV. Schools, community agencies, together with PWLA must do more.

The education sector must play more of a leadership role

Population in Eastern Europe very young; school plays key role

Schools workplaces for thousands of staff

School success and completion are preventive

Schools can identify and refer youngsters at risk early on


… continued

Education leaders influential in setting tone

Schools transmit culture formally and informally: set norms for tolerance in classrooms, hallways

Provide accurate information and skill development

Serve as coordinating mechanisms with community and civil society

By policies, change dynamics of acceptance


Schools working with civil society


Policy Elements

Information about epidemic in countryMechanisms for cooperation health sectorEmphasis on prevention, staff trainingConfidentiality of PLWAUniversal precautionsAccess to servicesCode of ethics, tolerant, non-discriminatory


UN AIDS IATT –Education SectorGlobal Readiness Survey 2004

Survey Question YES NO

Does the MoE have a

HIV/AIDS workplace policy? 43%(in process)

57%

Guidelines for universal

precautions for all staff? 0% 100%

Confidentiality of Ministry employees affected by HIV/AIDS?

100% 0%

HIV/AIDS Education Policies in 7 Eastern European Countries


UN AIDS IATT –Education SectorGlobal Readiness Survey 2004

Survey Question Yes No

Has research been commissioned?

57% 43%

Does the Edu. sector have a shared strategy: fight against AIDS?

0% 100%

Does the MoE have a specific HIV/AIDS policy?

28.5% 71.5%

HIV/AIDS Education Policies in 7 Eastern European Countries


Summary Health and HIV affect all society

Intervention with high risk groups essential but not enough

Barrier: stigma and discrimination

Changing social norms essential to halt or stem rising rates

Comprehensive approach: prevention -intervention - care

Schools with communities and PWLA key role to play

Need for multi sectoral involvement and support from donors


Many Opportunities for Donors

Across sectors: education, public health, mental health, youth development and employment.

Research, tracking and monitoring.

Leadership development and capacity building.

Prevention – early intervention – testing – treatment – bereavement

Young people’s involvement action research, use of technology.


Impact of Connecting Young People to PLWA

I wish to share this poem with all countries.AIDS is not a disease, although the virus has killed millions.AIDS is not a set of statistics, although the numbers are horrific.AIDS is not a conference in Durban.AIDS is not a presidential PR problem.AIDS is not advertisements and education programmes, although

these help.AIDS is a feeling of hopelessness and despair.AIDS is young people who believe they’re immortal.AIDS is a secret known by everyone. AIDS is not knowing what’ll

happen to your children when you’re gone.AIDS is people who are part of families.AIDS is everyday life carrying on against the odds.

---a student from iEARN--Ukraine


Contact Information

Cheryl Vince WhitmanSenior Vice President

Education Development Centre, Inc.Director, Health and Human Development Programmes

Affiliated EDC-Europe55 Chapel Street, Newton, MA, U.S.A.

02458-1060

[email protected]

http://www.hhd.orghttp://www.edc.org

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