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Transport and HIV/AIDS: A survey of the issues at stake. Transport and Social Responsibility Thematic Group Julie Babinard (TUDTR) and Nina Schuler (TUDUR) May 5, 2004. Outline & Objectives. Summary review of issues and activities relating to HIV/AIDS in Transport
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Transport and HIV/AIDS:A survey of the issues at stake Transport and Social Responsibility Thematic Group Julie Babinard (TUDTR) and Nina Schuler (TUDUR)May 5, 2004
Outline & Objectives • Summary review of issues and activities relating to HIV/AIDS in Transport • Jocelyne do Sacramento (AFTTR): Africa region experience on HIV/AIDS in Transport • Suggest areas where further work and exploration may be needed Transport and Social Responsibility
AIDS/HIV at a glance • Unique disease (scale; incubation) • A threat to public health & economic development • Effects of infection felt at various levels (household; community; sector; country) • Occurrence Treatment • Sexual transmission use of condoms • Bloodstream donor screening; needles sterilization • Mother to child • About 42 million people living with HIV/AIDS Transport and Social Responsibility
Adults & Children Estimated to be living with HIV/AIDS, end 2003 EasternEurope & CentralAsia WesternEurope North America 1.2 – 1.8 million 790 000 – 1.2 million EastAsia& Pacific 520 000 – 680 000 700 000 – 1.3 million Caribbean 350 000 – 590 000 North Africa & Middle East South & South-East Asia 470 000 – 730 000 4.6 – 8.2 million LatinAmerica 1.3 – 1.9 million Australia & NewZealand Sub-SaharanAfrica 25 – 28.2 million 12 000 – 18 000 Total: 34 – 46million Source: AIDS epidemic update, Dec. 2003. UNAIDS. Transport and Social Responsibility
Impact of HIV/AIDS on transport • Role of transport for economic development • Compromises effectiveness & reliability of transport – decline in productivity • People at high risk and their families include • Construction workers • Employees who maintain infrastructure • Workers in railways, roads, airlines… • Professionals engaged in maintenance • Population living along roads & highways • Commercial sex workers • Locally based government employees • Mobile populations, refugees Transport and Social Responsibility
Transport and spread of HIV/AIDS • Transport is major vector: • Movement of people • Behaviors associated with transport sector workers and transportation hubs 42% of truck drivers report indulging in commercial sex while traveling; 33% of those who have casual sex don’t use condoms Survey results, Poland and Lithuania border areas (World Bank, 2003) Transport and Social Responsibility
HIV Prevalence prior to and post construction/improvement transport corridors Highway routes HIV prevalence prior to activity post activity Myanmar:1997 Injecting drug users Injecting drug users Mandalay-Muse HighwayHIV+, 1996 HIV+, 1998 Mandalay 51% 88% Lashio 34% 74% Muse 86% 92% China: 1996 construction Number of HIV+ Number of HIV+ Yunnan-Nanning, Guangxicases 1995 cases 1998 Guangxi 10 525 Viet Nam: Number of HIV+ Number of HIV+ Highway one: Ho Chi Minh City cumulative cases cumulative cases (HCMC)-Hanoi highway improvement1997 1998 Hanoi 51-100 101-1,000 Hai Phong 11-50 101-1,000 HCMC >1,000 >1,000 Source: Lee-Nah Hsu (UNDP 2001)
The Bank’s response in a snapshot • Support HIV/AIDS prevention, care, mitigation from mandate to reduce poverty • Policy dialogue, lending, analytical work, and global programs • US$2.21 billion committed (Jan. 2004) • Multi-Country AIDS program for Africa • $1 billion to scale up existing activities and strengthen implementation • Flexible and rapid funding • Roughly half of MAP are allocated directly for use by communities and civil society • Sub-regional and cross HIV/AIDS initiatives through MAP 2 Ex: Abidjan-Lagos Corridor • Other region: Caribbean MAP; health projects focus on HIV/AIDS Transport and Social Responsibility
The Transport HIV/AIDS response Within World Bank • SSA • HIV/AIDS Abidjan-Lagos Transport Corridor project • SA • Indian Highway to HIV/AIDS prevention External • UNDP: Multisectoral responses to Mobile Populations’ HIV vulnerability Transport and Social Responsibility
Mainstreaming HIV/AIDS within transport Within World Bank • SSA • Ethiopian Road Sector Development Project • Mali Transport Corridors Improvement Project • Chad national Transport Program Support Project • MENA • The Djibouti International Road Corridor Rehabilitation Project • EAP • Cambodia Provincial and Rural Infrastructure Project (PRIP) • Papua New Guinea Highlands Highway Rehabilitation Project External • UNDP: Preventing HIV/AIDS on road projects in Yunnan Province, China Transport and Social Responsibility
Implementing HIV/AIDS measures within transport -- Recommendations • A transport response should include components that consider • How to change behavior/ conditions that affect behavior • Which groups to target • The sector entry points • Food for thought: • How to link transport with existing HIV/AIDS projects? • How to integrate HIV/AIDS into transport projects? • External partners/ resources: UNDP; USAID Transport and Social Responsibility