Preventing and Coping with HIV/AIDS in Post Conflict Situations: Gender-Based Lessons

“The HIV epidemic rages in situations where power is exercised without regard of others, whether that power be economic, social, sexual, psychological or the power of force. It spreads where there is a disregard for life, an intolerance of difference, a devaluing of women, a lack of a will to live, a breakdown of community values, violence and conflict. (…)  What is required to respond to it is a way of perceiving and constructing social reality in its interconnectedness.”

Ever more Effective Responses to HIV/AIDS Discussion: HIV in Situations of Conflict[1]

The purpose of this note is to summarize the rationale behind the upcoming symposium and the themes on which it focuses. The note provides a background to the development of the meeting, states its main objectives, describes the planned procedures and outlines the logic behind each of the topics.

Introduction

The background of the symposium relates to the need to address the formidable threats to human  security posed by the twin crises of violent conflict and HIV/AIDS in Africa. The number, and nature of violent conflicts and related complex emergencies, coupled with the HIV/AIDS pandemic are now setting development in Africa back, and negating many of the gains achieved over the last 50 years. Half of all the conflicts going on in the world in 1999 were located in Sub-Saharan Africa (SSA), involving 2/3 of the countries in the region. Six high intensity conflicts (causing over a thousand deaths per year), were still raging in the region in late 2000. Africa is also the part of the globe that has been hardest hit by AIDS. Over 25 million people, or nearly 70% of the world’s infection by HIV/AIDS, and 90% of deaths from AIDS are to be found in a region that is home to just 10% of the world’s population[2].  The 3.8 million new HIV/AIDS cases reported from the Africa this year, is a reduction of approximately 200,000 in relation to the new cases reported in 1999. It is too early, however, to say if this is the start of a declining trend.

Although there is little cross-country epidemiological data available, there is evidence to suggest that conflicts increase the risk and impact of HIV/AIDS in several ways. Conflicts dislocate communities, create flows of refugees and internally displaced persons, and seriously disrupts family life. They also bring in soldiers and fighters into contact with civilians in situations where women and young girls and boys are highly vulnerable to sexual violence and sexual exploitation. The breakdown of basic services and psycho-social stress compound the situation.  The magnitude of these problems has prompted considerable work among national and international actors to mainstream HIV/AIDS prevention and control into humanitarian response and post-conflict reconstruction.

Over the past ten years since the end of the Cold War, many intra-state and regional wars have come to an end in Africa. Some of these countries, like Mozambique, have gone on to obtain sustained economic growth and others like Uganda have achieved success in preventing growth of HIV rates. Others have not. So what are the factors driving the pandemic in post-conflict countries? What interventions make a difference in these countries? What conditions favor action, and what hinders success in building the capacity of people affected by conflict, to prevent HIV infections and provide essential services to those who are directly affected by AIDS?

Currently there is no established set of best practices to guide policy and programming for addressing HIV/AIDS in post-conflict countries. They are however, many initiatives. All across Africa, people from all walks of life, and especially women, are engaged in formal and informal initiatives that not only strengthen the coping capacities of families, communities, and countries in the face of these crises, but also contribute to create environments that enhance human security in all its dimensions.

To tap on this experience, Tulane University’s Payson Center for International Development and Technology Transfer and the African Center for the Constructive Resolution of Disputes (ACCORD), in collaboration with USAID's Africa Bureau Conflict, Mitigation and Recovery Division are organizing the symposium “Preventing and Coping with HIV/AIDS in Post Conflict Situations: Gender-Based Lessons,” to be held late March 2001 in Pretoria, South Africa.

The main objectives of the symposium are:

1.      To provide a quick overview of gender-sensitive practices in preventing and coping with HIV/AIDS in communities in the aftermath of violent conflict. 

2.      To identify interventions and strategies that empower men and women recently affected by violent conflict to address or engage more effectively in HIV/AIDS prevention.

3.      To explore the practical implications of HIV/AIDS prevention and control for building sustainable peace. 

Why gender-based lessons?

It is important to explore specific gender sensitive approaches that affect the effectiveness of responses to the AIDS pandemic because in Africa AIDS has virtually become a condition of women. Over 50% of new HIV infections in Africa occur in women. Young women seem to have a special vulnerability. For example, one in four South African women in the 20-29 age group carry the virus today.

The number one form of transmission of HIV among women in Africa is sexual intercourse. Women’s risk has been associated with prostitution, rape and incest, poor health, (particularly access to quality reproductive health services) and little ability to do any thing about these risks. Women also carry the main burden of care of family members with HIV/AIDS. In situations of conflict and post-conflict women are not only more exposed and vulnerable to HIV, there are also have less coping capacity, not least because they are not usually involved in planning the allocation of resources for reconstruction –including those for HIV/AIDS prevention and management.

At the same time, there is also a need to understand better the impact of conflict and HIV/AIDs on African men, as they too are suffering and dying.  Countries with a population with a significant bulge of young males who are out of school have higher risk of violent political conflict. There are many anecdotal accounts that suggest that during high intensity conflicts boys and men are susceptible to sexual violence as much as women. Also, overall rates of infection among the military -traditionally an almost exclusive male domain —is significantly above the average rate of the general population.

After the end of a war, when people are dying of AIDS, who takes care of rebuilding? Particularly, who takes care of the children? Thus, it is important to re-examine gender-based roles and identify norms and cultural behaviors that are fuelling violent conflict and the pandemic in Africa. New coping strategies have to be developed in order to mitigate, and ultimately reverse, the impact of HIV/AIDs. 

Procedures

Tulane and ACCORD have worked collaboratively to plan this symposium, which has financial and logistical support from USAID’s Africa Bureau. The planning process was greatly enhanced by the contributions of an advisory group made up by members from the International Center for Research on Women; the State’s Department Bureau of Population, Refugees and Migration; the George Washington University Center for International Health, the Civil-Military Alliance to Combat HIV and AIDs; as well as interested individuals. Africa-based USAID field officers and Washington-based World Bank officials also provided valuable inputs.

The symposium will bring together a selection of Africans engaged in governmental and non-governmental activities to combat HIV/AIDS in post-conflict countries, to explore commonalities in their approaches.

Twelve to twenty leaders and professionals who are currently residing in Namibia, Angola, Mozambique, South Africa, Rwanda, Uganda, Kenya, Ghana and other post-conflict countries in SSA, will be identified and invited as participants. In the selection process, priority will be given to those with actively dealing with:

1.      Gender issues in addressing HIV/AIDS in the process of demobilization and reintegration of ex-combatants

2.      Gender issues in caring for HIV/AIDS orphans in communities recently affected by conflict

3.      Gender issues in caring for PLWAs (people living with HIV/AIDS) in communities recently affected by conflict

4.      Gender issues in mainstreaming HIV/AIDS prevention and control in the process of rehabilitating or rebuilding health services

5.      Promoting HIV/AIDS prevention and control as a bridge for peace —The role of women

At the meeting, each invitee will be asked to present on one panel and also participate in small group work aimed at identifying common “lessons learned” in programs that seek to empower communities to live in peace and prevent and cope with HIV/AIDS. Following broad guidelines, participants will be required to prepare and submit, in advance of the symposium, a 5-7 page narrative of the project or activity in which they are engaged. The narrative will describe the nature of the problem being addressed, the resources required, types of interventions that are warranted, and how to measure success.

Participants will also be encouraged to propose ways in which to maximize the benefits of their participation in the symposium, including suggestions on the agenda and mechanics of the event.

The meeting is conceived as neither a formal academic conference nor a training course led by outside “experts.” Rather, it will provide a forum for networking, learning, and sharing experiences amongst all participants. Symposium sponsors, in this sense, will not be “trainers” but facilitators; participants will learn from and teach one another.

The following are expected outputs:

• Strengthening of African women’s networks in the field of peacebuilding and HIV/AIDS prevention
• Publication of best practices, including list of resources ?people, organizations, materials, which participants judge to be relevant and reliable
• Framework for guiding NGOs, government and international donors in identification of policy and programmatic linkages between conflict, the pandemic and women’s empowerment
• Agenda for action: next steps, how to disseminate experiences and ensure continuity in networking.