| Towards a Christian Aid Policy on HIV/AIDS /24.09.01|
This Policy Paper sets out Christian Aid’s corporate response to the HIV/AIDS pandemic, the beliefs and principles that underpin this response, and the specific policy commitments we aim to fulfil. The HIV/AIDS Strategy Paper (now being developed separately) will outline how we intend to resource and fulfil these commitments over the period 2001-2004. A Background Paper on HIV/AIDS, which details Christian Aid’s analysis and understanding of HIV/AIDS and wider efforts to address its spread and impact, will also be made available (also under development).
This Policy Paper is to be shared with staff, partners, supporters and other agencies working on HIV/AIDS. It will be periodically reviewed in order to ensure that we learn from the experience of Christian Aid staff, partners and others attempting to address HIV/AIDS in their work, and incorporate lessons from this into the planning of future efforts to improve both our own and others’ policy and practice
Christian Aid Beliefs and Principles
We recognise that…
1. HIV/AIDS is not only a human tragedy but has by virtue of its magnitude become one of the most serious development challenges of our time. It is already the leading cause of death in Sub-Saharan Africa and is fast becoming a problem of epic proportions in other parts of the world, particularly Asia and Eastern Europe. In 2000, 36 million people were estimated to be living with the HIV virus with 21.8 million having already died from AIDS. There are now estimated to be 13 million orphans as a result of AIDS. The effect of this on development - and on the social and cultural fabric of communities - is devastating, with some of the hardest hit countries finding their development gains of the previous decades wiped out and life expectancies plummeting. With 15,000 new HIV infections per day globally the need for a broad, holistic and flexible response to halt its spread and control its impact is more pressing than ever. But how best to do this remains an ongoing debate as the complexities, sensitivities and evolving nature of the HIV/AIDS pandemic make the analysis of its relationship with poverty and development an ever-present challenge.
2. HIV/AIDS thrives in situations of poverty, inequality and conflict. Poor countries have neither sufficient resources nor infrastructure to reduce HIV infection nor limit the impact of the virus on society. Poor people, particularly women, youth, children and the elderly, are the most vulnerable - physiologically, economically and socially. Yet it is only through complementary efforts at national and community levels that the path of HIV/AIDS will be altered. The support of the international community is therefore vital in providing financial resources, technical expertise and sharing lessons and experiences to support these efforts.
3. HIV/AIDS flourishes especially in situations of gender inequity as women (young, old, single and married) suffer the consequences of not being in a position to protect their sexual health in ways that men can and have limited power when it comes to negotiating sexual relationships. It is also women who bear the brunt of caring for people living with HIV/AIDS and for AIDS orphans. Understanding the link between gender inequity and HIV/AIDS is therefore crucial when attempting to reduce its spread and impact.
4. Whilst the spread and impact of the virus is at different stages across regions as well as within countries and communities, HIV/AIDS is a global threat which affects every one of us either directly or indirectly. We believe that the voices and actions of ordinary people – in the UK, Ireland and in partner countries – should be at the heart of efforts to respond to the virus. In the absence of medical solutions to HIV/AIDS, communities are in the strongest position to raise awareness and understanding of prevention; to care for those affected; to challenge discrimination; to promote behaviour change; and to lobby for change at national and international levels.
5. Challenging HIV/AIDS is possible - it is a preventable disease. Christian Aid sees prevention as a fundamental element of a meaningful response to the HIV/AIDS crisis, and believes this can properly be achieved when wider development issues are also addressed. Concerted efforts, at both national and community levels, are beginning to show success in some countries. With strong political and religious leadership, increased education and care at community level, vigorous and targeted campaigning at all levels, and a willingness to fight the stigma and prejudice often associated with HIV/AIDS, countries like Uganda, Senegal and Thailand have been able to reduce the incidence rate of new infections. Lessons from success in such countries, and from failures in others, need to be shared globally.
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6. Given comprehensive care and support, people living with HIV/AIDS can lead fulfilling and productive lives. Local communities are in the best position to offer social and emotional solidarity with HIV infected individuals and their families, particularly in ways that mitigate discrimination and rights violations.
In response to this…
7. Christian Aid’s approach to HIV/AIDS is rooted in the Christian Gospel and focused on the poor. We have a catalytic role to play in bringing prevention and care to the poor and vulnerable in communities, by supporting and learning from partners currently working with HIV/AIDS, developing new partnerships where appropriate and using our position as an advocate on issues of poverty and injustice to tackle structural issues which exacerbate the spread and impact of the virus.
8. We are committed to speaking out: challenging discrimination; promoting hope and empowerment; supporting information, education and communication; and continuing to work for the eradication of poverty and inequality that together both fuel, and in turn are fuelled by, the HIV/AIDS pandemic.
9. We will stand up for the dignity and human rights of all people – women, men, the young and the old – infected and affected by HIV/AIDS. This includes people living with HIV/AIDS, those vulnerable to contracting HIV, those vulnerable to the impact of HIV/AIDS and those responsible for caring. We are committed to the greater involvement of people living with HIV and AIDS in all aspects of our work.
10. We believe that the church and church-based organisations have a critical role to play in reducing the spread and impact of HIV/AIDS, based on values of care and compassion, and the trust invested in them by communities throughout the world. The church is in a unique position to provide spiritual, moral and practical leadership; challenge social stigma; extend compassion; and provide spiritual and practical support and guidance to those infected and affected.
11. We are inspired and challenged by our partner organisations and the communities they work with to give corporate commitment, priority and resources to HIV/AIDS-related activities. We recognise that the magnitude of the pandemic will require activities tailored to the characteristics of each situation, as well as coordination with other NGOs, national and international bodies. It will also require clear and serious choices to be made within Christian Aid about where best to prioritise our resources for HIV/AIDS, alongside other corporate priorities. These choices will need to be clearly communicated to all Christian Aid staff, supporters and partners.
Building on our experience of HIV/AIDS work with partners over the last decade, Christian Aid affirms HIV/AIDS as a corporate priority. To effect this, we will pursue a four-pronged approach:
Effective education and awareness-raising – equipping staff, partner organisations and supporters with the knowledge and skills necessary to address HIV/AIDS issues in their personal and professional lives and creating a climate of openness and sensitivity to enable this to happen;
Strengthening community-based prevention, care and support – through our partners, for the vulnerable, and those infected and affected by HIV/AIDS;
‘Mainstreaming’ HIV/AIDS in all our work – ensuring it is considered in our work to eradicate poverty and challenge inequality, and continues to be raised as a major public issue – both internationally and at home;
Global advocacy - lobbying, influencing and campaigning for national and international responses that are informed by, complement and strengthen community-based efforts.
In each of these distinct but inter-related areas we will seek to work with and through church-based, other faith-based and secular alliances, networks and organisations. We will play an active role in national, international and especially ecumenical fora relating to HIV/AIDS, adding value where possible, challenging where necessary, but ensuring our efforts complement rather than duplicate the work of others.
Effective education and awareness-raising
With our staff…
1. We will give the highest priority to ensuring that our staff have a thorough understanding of HIV/AIDS in order to protect themselves, to share this knowledge with others and to respond appropriately to HIV/AIDS issues in their personal and professional lives. We will promote a climate of openness that enables the realities of HIV/AIDS to be communicated and discussed in ways which encourage sensitivity and combat prejudice or stigmatisation.
With all our partners…
2. We will support and learn from partners working on HIV/AIDS through training, information on innovative activities, networking and sharing relevant lessons and experiences.
With our church partners…
3. We will facilitate the development of appropriate HIV/AIDS training, as well as training of trainers, packages specific to the needs and experience of church-based organisations and church leaders. We will give particular attention to the provision of biblical, liturgical and theological resources for use in churches.
4. We will support and draw upon southern-based theologians in developing a theology of AIDS and promote the introduction of HIV/AIDS into the curricula of theological institutions.
With our supporters…
5. We will inform churches in the UK and Ireland of the unfolding reality of HIV/AIDS as it affects poor people in poor countries. We will ensure that our UK and Ireland supporters are aware of the impact HIV is having on Christian Aid’s work as well as why and how we intend to prioritise and intensify our work in this area. We will reflect with the churches and supporters in the UK and Ireland on the theological dimensions of the AIDS pandemic.
Community-based prevention, care and support
With our staff…
1. We will ensure our staff are aware of the particular importance of HIV/AIDS prevention whilst the cure for AIDS remains elusive. We will encourage them to give special emphasis to this in their prioritisation of funding and support to partners. We will especially encourage support to community-based approaches to prevention, through both health-targeted interventions and broader efforts to tackle underlying poverty and injustice.
With our partners…
2. Christian Aid will support existing and potential partners in strengthening community-based approaches to prevention, care and support among those infected and affected by, or vulnerable to, HIV/AIDS. This will involve identifying and strengthening current ‘good practice’ which is rooted in and appropriate to local community contexts. It may also involve supporting the development of innovative models and pilot programmes with potential for learning, replication and scaling up. Through all this work we will seek to tackle those attitudes and beliefs that bolster the HIV/AIDS pandemic.
3. Wherever possible, we will encourage partners to develop all their HIV/AIDS programme activities in partnership with local communities and people living with HIV/AIDS, in order to ensure that they reflect the local situation and are sensitive to the particular needs and aspirations of people infected or affected by HIV/AIDS.
4. Harnessing both in-house and external expertise, we will intensify our support to partners capable of demonstrating effective work on HIV/AIDS, forge new partnerships where appropriate, and assist partners to access ‘back donor’ funds to resource this work wherever we can.
Alongside its support to specific community level activities, Christian Aid also commits itself to "mainstreaming" HIV/AIDS across all its work – a process that requires HIV/AIDS to be analysed and addressed in all aspects of the organisation – policy, planning, management and communications. It involves using multi-sectoral and inter-disciplinary approaches, building institutional links both within and outside the organisation, and reviewing employment policies and guidelines.
Within Christian Aid…
1. We will ensure personnel policies are sensitive to and protect the rights of those living with HIV/AIDS and actively promote an open and inclusive working environment that counteracts stigma among colleagues infected or affected by HIV/AIDS.
2. We will ensure that our internal systems, policies and guidelines enable staff managing our international partnerships and programmes to effectively address HIV/AIDS issues in all their work, particularly in assessing ways in which the spread and impact of HIV/AIDS is likely to influence, and be influenced by, this work.
3. We will ensure we develop sufficient in-house expertise and capacity to lead and influence our work on HIV/AIDS, enable us to network with and learn from other actors, and to tap resources from donors for HIV/AIDS work.
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With our partners…
4. We will ensure HIV/AIDS is considered in all our poverty eradication and emergency response strategies – those we promote globally and those we pursue within our own regional and country programmes. We will document our experience on the links between poverty and AIDS, share our knowledge and experience, and encourage networking and cooperation between projects and partners.
5. We will give greater prominence to HIV/AIDS in our dialogue with current partners in relation to on-going projects and programmes, and especially in relation to new initiatives involving community-based approaches to awareness raising, prevention and care, campaigning, research and advocacy.
6. We will encourage and support all partners to identify ways in which the spread and impact of HIV/AIDS is likely to influence, and be influenced by, their work. We will actively involve partners in analysing the relationship between poverty, inequality and HIV/AIDS in the context of their work – and in identifying ways of mainstreaming attention to HIV/AIDS.
7. We will place emphasis on promoting human rights – defending the rights of people infected or affected by HIV/AIDS and encouraging the greater involvement of people living with HIV/AIDS in HIV/AIDS-related work. Particular attention will be paid to issues of gender equality and the rights of women. We will support activities directed towards the needs of particularly vulnerable groups, such as older people, orphans, and people living in situations of emergency and conflict.
8. We will use our influence to promote a partnership model with national governments, donors and NGOs. We will promote partners’ advocacy work which is rooted in community-led and rights-based approaches, ensuring that the voices, rights and needs of people infected or affected by HIV/AIDS are heard.
With our Church partners…
9. We will stimulate further dialogue on the role of the church in dealing with the challenge of HIV/AIDS. This will include the church’s role in combating stigma and discrimination, its influence over national governments, and its role in preserving life and dignity through HIV/AIDS prevention, care and support.
1. We will support new initiatives in media, lobbying, policy and campaigning areas of work and ensure that, wherever possible, these are rooted in the experience of partners working on HIV/AIDS. We will, in particular, use our influence to highlight important issues relating to HIV/AIDS in the global development arena, and will develop strategic alliances – both ecumenical and secular - to this end.
2. We will make an explicit link between HIV/AIDS, poverty and gender inequity. We will use our position as an advocate on poverty, inequality and vulnerability to help tackle the structural issues which exacerbate the spread and impact of HIV/AIDS, whilst also giving prominence to HIV/AIDS as an issue of morality and social justice.
3. We will build on our considerable experience of analysing the impact of trade, debt, and structural adjustment on poor people and poverty. We will work with others to analyse the impact on HIV/AIDS of structural adjustment, health sector reform, cutbacks and cost sharing in health and education, and poverty reduction strategy processes. We will ensure the interrelationships between trade and HIV/AIDS are effectively considered in our corporate campaign on trade.
4. We will promote the dignity of people with HIV/AIDS, providing images that communicate the realities of HIV/AIDS without encouraging or deepening prejudice. We will strive to challenge those who portray people with HIV/AIDS as victims whose images and stories create or confirm a sense of fear or reinforce stereotypes. Wherever possible, we will endeavour to facilitate events and processes that enable the voice of those who are HIV-positive to be heard.
5. We will seek the support of churches and supporters in the UK and Ireland to lobby the British and Irish governments, the EU and the international community to provide far more resources to help those affected by HIV/AIDS, to promote the accelerated eradication of poverty, and to direct aid programmes towards initiatives rooted in the community and which help build up national health and education systems.
In all our work we will endeavour to learn from the research, lessons and experiences of others – our partners, other agencies, and particularly those living with HIV/AIDS. We will ensure that these inform our understanding and analysis of the HIV/AIDS pandemic and its relationship with poverty and development, and help to shape and improve this Policy and the strategies we adopt to fulfil it.
Work with overseas partners
The following is a checklist of the areas from which Christian Aid will prioritise its allocation of funds and support within and across regional and country programmes, and within the constraints of available resources and other corporate priorities. It will be considerably refined as Christian Aid’s HIV/AIDS Strategy is further developed:
1. Prevention and Care
Awareness raising, information and communication
Voluntary testing and counselling
Community care of PLHA
Increasing households’ access to resources through poverty alleviation strategies
Reducing vulnerable people’s exposure to the virus
Care of orphans
Ensuring that all HIV infected people have full access to vital medicines and commodities needed to prevent, treat and alleviate HIV and AIDS-related opportunistic infections, prevent maternal and child transmission. In time, these should include access to combination and anti-retro viral therapy.
Addressing the consequences of the epidemic, especially for women and children
Home-based and community care of PLHA
advocacy for the rights and needs of persons infected or affected by the epidemic
empowerment of affected groups to reduce vulnerability and strengthen coping strategies
strengthening the voice and actions of local civil society, particularly church based organisations
advocacy to ensure a multi-sectoral response from government to ensure that there are adequate resources and infrastructure for this to be done
3. Supporting activities
Maternal and child transmission
TB treatment and prevention
Strengthen basic PHC facilities so proper anti-natal care and nutrition education and treatment of opportunistic infections can be given
Support community coping strategies, increase access of household to limited resources e.g. land etc..
4. Capacity building
Direct or indirect capacity building for partners in any of the above activity areas - to ensure effective and sustainable use of Christian Aid’s funds for HIV/AIDS work.
Global advocacy work
In its global advocacy work, Christian Aid will, within the constraints of resources and other corporate priorities:
Work with our partners to ensure a multi-sectoral response from government and lobby for adequate resources and infrastructure for this to be provided.
Demand that donors follow Ireland’s example and commit sufficient and timely resources to development, meet the UN determined aid target of 0.7% GNP, and ensure that funding is demand-led rather than resource driven.
Encourage donors to prioritise HIV/AIDS work in all development work.
Promote the search for ways of transferring resources through grants rather than loans to poor countries to ensure they are not further crippled in their efforts to combat HIV/AIDS.
Demand that a greater proportion of the $3 billion spent on health research be more evenly targeted at the poor.
Call upon donors to commit funding to successful community based approaches.
Support campaigns for medicines to be made available at sustainable prices.
Look at debt cancellation with a proportion of savings being channelled into AIDS-related interventions.
These advocacy messages will be considerably refined as Christian Aid’s HIV/AIDS Strategy is further developed.