The Importance of a Multisectoral approach in addressing HIV/AIDS

1. The Importance of a Multisectoral approach in addressing HIV/AIDS Africa Region HIV/AIDS Consultation on Multisectoral Response Rwanda June 2007 Elizabeth Lule ACTafrica

2. What is a multisectoral Approach? • Involving all sectors of society, governments, business, civil society organizations, communities, PLWHA at all levels in addressing the causes and impact of HIV/AIDS. • It requires action to engender political will, leadership and coordination, develop and sustain new partnerships, strengthen capacity of all sectors to make an effective contribution • It has to be dynamic, flexible, strategic and coordinated Commonwealth Think Tank (2001)

3. HIV/AIDS is a broad development challengeEconomic and Social Impact • Affects workers in their most productive years, may reduce/depletes saving rates and disposable income • Decrease in productivity and increased absenteeism • Increases turn-over, hiring and training of new workers, death/disability benefits • Reduces expected returns to investment in human capital and disruption of transfer of human capital between parents and children • Contributes to persistence of poverty and inequality, affecting both the stock as well as the accumulation of human capital

4. HIV/AIDS is development challenge Economic and Social Impact(2) • Tax base shrinks • Social cohesion and social capital decline • Long-run impact on socioeconomic development can be substantial • Studies surveyed typically predict 1% to 1.5% declines in GDP growth rates for the worst affected countries (prevalence rates >20%)

5. Demographic Impact: Life expectancy at birth in selected most affected countries 1980-1985 to 2005-2010

6. HEALTH • AIDS has caused between 19-53% of all deaths of government health care employees in Africa. • Limited resources allocated to AIDS resulting in neglect of other health issues. • AGRICULTURE AND FOOD INSECURITY • In the ten worst affected African countries the agricultural labor force will decline between 11-26% by 2020 resulting in lower food production. • PRIVATE SECTOR • Increased costs and absenteeism leading to decreased productivity and profits. • ILO projects labor force in 38 countries will be between 5-35% smaller because of HIV/AIDS. HIV/AIDS Affects All Sectors • EDUCATION • AIDS decreases the quality of education, the availability of teachers and the number of children enrolled in schools. • INFRASTURCTURE, TRANSPORT & MINING • Potential high-risk behavior for workers due to mobility and time away from family. • In Cameroon, a study found HIV prevalence of 7.6% in men away from home for more than 31 days, 3.4% in those away less than 31 days and 1.4% in stationary. • ECONOMIC IMPACT • HIV/AIDS adversely affects GDP, exacerbates income inequality and increases poverty. • AIDS destroys existing human capital and mechanisms for human capital formation.

7. Drivers of the Epidemic require a multisectoral response • Poverty and social exclusion • Gender Inequalities • Conflict • Violence • Culture and Social norms/practices • Labor mobility and transport/trade corridors

8. Benefits of a Multisectoral Approach • Coordinated political, economic and social efforts at different levels • Efforts at national level targeting specific sectors and groups complement the interventions at the individual level • Inclusion of all stakeholders to play a role within their comparative advantages e.g faith based groups, media, business coalitions, PLWHA • Information Sharing and learning • Generate demand for accountability and results

9. Multi-Country HIV/AIDS Program (MAP)in Africa Basic principles/activities of the MAP in 2000: • Emergency program in response to the epidemic • Defined AIDS as a development issue • Establish national AIDS councils to coordinate a multisectoral response • National strategies with social mobilization for “multi-sectoral” demand driven response to the full range of prevention, care, support, mitigation and treatment • Civil society would receive most of the funds for a broad population based response required for behavior change

10. Challenges for a multisectoral approach • Tailoring the response to multiple and diverse epidemics • The need for leadership and sustained political commitment in both public, private sectors and civil society • Moving beyond work place responses to addressing vulnerabilities within specific sectors and groups • Coordination across sectors • Weak regulatory and legal frameworks • Sustainability of the response • Constructive engagement between government and civil society and private sector • Generating grassroots demand for accountability, results and improved governance

11. THANK YOU