HIV and AIDS: meeting the challenges

To mark World AIDS Day on 1 December, here are some articles on HIV and AIDS from Development in Practice, a peer-reviewed journal published by Oxfam.

Summaries of every published article on a range of development issues are also available in French, Portuguese, and Spanish on the Development in Practice website.

These articles first appeared in Development in Practice, and do not necessarily reflect the opinions or policy positions of Oxfam GB

Clarke, Matthew: Achieving behaviour change: three generations of HIV and AIDS programming and jargon in Thailand
NGOs have played an important role worldwide in trying to prevent the spread of HIV and AIDS through achieving behaviour change. NGOs have often been at the fore of innovative changes, influencing government and international programming activities. This paper identifies and analyses the evolution of the HIV and AIDS programmes of one NGO in Thailand over a period of ten years. Three generations of programming are identified both through distinct approaches to this area of work, and also by the changing jargon describing the people the programmes are aimed at.
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Jacob, W. James, Stacey S. Mosman, Steven J. Hite, Donald E. Morisky, and Yusuf K. Nsubuga: Evaluating HIV and AIDS education programmes in Ugandan secondary schools
Although not part of the national curriculum until 2004, HIV and AIDS education has been taught for some time in Ugandan secondary schools through a variety of extracurricular means, including the media, youth groups, drama, music, and Parent Teacher Associations. This article identifies and evaluates the integration of HIV and AIDS information into the national curriculum in Ugandan secondary schools between 2002 and 2004, based on the viewpoints of administrators, teachers, and students from 76 schools. While most schools did not include HIV and AIDS as part of the formal national curriculum at this time, the information was disseminated through a range of alternative means. The authors identify the most effective of these, discuss the perceived reactions of various stakeholders regarding HIV and AIDS being taught in secondary schools, and make recommendations for curricular reform.
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Lethbridge, Jane: Combining worker and user interests in the health sector: trade unions and NGOs
This paper examines the relationship between workers in the health sector and users of health services as seen through two case studies of trade unions and NGOs working together, one in Malaysia and the other in South Africa. In spite of a history of tensions between these two types of organisations, when they work together effectively, the results can be influential. The Malaysia Citizens' Health Initiative has set up a separate organisation and now has the power to mediate differences between trade unions, NGOs, and the government. The partnership between the Treatment Action Campaign and the Congress of South African Trade Unions (COSATU) in South Africa is providing a unified voice demanding government action on HIV and AIDS.
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Poku, Nana K. and Bjorg Sandkjaer: Meeting the challenges to scaling up HIV and AIDS treatment in Africa
AIDS-related morbidity and mortality affects not only individuals and their families, but is rapidly undermining the struggling capacity to develop of African states. Stemming the impacts of the pandemic has therefore become a major concern. This calls for addressing the issues of care and support for those affected, and increasing the access of persons living with HIV and AIDS to effective treatment. Provision of such complex medication in resource-limited settings is a fairly recent phenomenon. In this context, the paper builds on emerging experiences from the field in identifying issues and challenges that need to be addressed in order to facilitate the scaling-up of HIV and AIDS treatment in Africa.
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Nsarhaza Bishikwabo, Kizito and Alessandro Lanteri : The role of Ministries of Finance in implementing the “Three Ones”
Ministries of Finance (MoF) cannot ignore the major challenge to development posed by HIV and AIDS. To tackle the epidemic a new comprehensive and consistent approach is required: HIV and AIDS must be mainstreamed. This paper investigates the instruments MoF do, can, and should employ in order to be proactive and effective in mainstreaming HIV and AIDS through supporting the implementation of the ‘three ones’, promoted by UNAIDS and other partners – One strategic framework, One Authority, and One Monitoring and Evaluation (M&E) System. It suggests strategic paths as well as specific initiatives to exploit the comparative advantages of MoF in ensuring the implementation of national strategic plans, repositioning national authorities, and providing the basis for a strong M&E system.
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White, Joanna and John Morton: Mitigating impacts of HIV and AIDS on rural livelihoods: NGO experiences in sub-Saharan Africa
HIV and AIDS is having profound impacts on livelihoods in sub-Saharan Africa. These include the deaths of working-age adults, the diversion of resources to caring, and the rupture of traditional chains of knowledge transmission. NGOs are responding by providing assistance to communities affected by the epidemic in the fields of agriculture, skills training, and microfinance, as well as by offering home care and support. A key feature of such initiatives is the focus on previously neglected groups such as women, school dropouts, and orphans. Factors of success include the use of participatory processes to identify target groups, and the involvement of local political leaders and adults trusted by young people in project activities. Challenges include improving monitoring systems, effectively disseminating lessons learned, and persuading donors, whose responses to the epidemic are currently focused on preventive and curative health services, to support livelihoods interventions as a matter of urgency.
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Date of original publication: December 2006