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HIV/AIDS: a challenge to security sector reform . Dr. Johanna Mendelson Forman Senior Fellow, Role of American Military Power Global Health in Times of Crisis 31 May 2002, Washington, D.C. Objectives . Encourage discussion on HIV/AIDs and the security sector in post-conflict settings
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HIV/AIDS: a challenge to security sector reform Dr. Johanna Mendelson Forman Senior Fellow, Role of American Military Power Global Health in Times of Crisis 31 May 2002, Washington, D.C.
Objectives • Encourage discussion on HIV/AIDs and the security sector in post-conflict settings • Promote dialogue between health and development practitioners on strategic approaches to HIV/AIDS prevention among present and former security forces
HIV/AIDS undermines development • Security is a precondition to development • Macroeconomic impact undermines growth • Destabilizes social capital • Impacts on national security
HIV/AIDS is a governance issue • To combat HIV/AIDS you need a capable state • Weak governance in states emerging from conflict have high HIV/AIDS prevalence • Good governance requires control of the security sector
What is the Security Sector? “All those organizations which have the authority to use or order the use of force, or the threat of force, or protect the state and its citizens, as well as all those civil structures that are responsible for their management and oversight.”
All military and paramilitary forces, as well as civilian structures responsible for their control Intelligence services Police forces, national and local, customs and border guards Judicial and penal systems Legislative bodies with oversight capacity The security sector includes:
HIV/AIDS in post-conflict societies • HIV/AIDS does not discriminate • Security forces affected as are irregular forces • High levels of mobility during and after conflict guarantee rapid spread of virus • Need to create a rapid response capacity after fighting stops
HIV/AIDS and the military • Militaries in both developed and developing world recognize HIV/AIDS pandemic as a threat • UN Security Council (Res.1380) mandated HIV/AIDS prevention awareness skills for soldiers participating in peacekeeping • Armies of sub-Saharan Africa, Southeast Asia, and Caribbean will suffer major losses in the officer corps and rank and file
HIV/AIDS in demobilization programs • Requires a cross-sector approach • Poses a dual policy challenge to post-conflict states • Security sector stability at stake • Reintegration poses a threat to civilian communities
HIV/AIDS AND DEMOBILIZATION • Demobilization is a priority in post-conflict societies (DDRR) • Downsizing armies • Demobilizing combatants and reintegrating to society • Key priority in the transition from war to peace • Demobilization programs often lack HIV/AIDS prevention and counseling programs, resulting in proliferation of the virus
Opportunities for Prevention • Development agencies, charged with demobilization, often avoid health issues of former fighters • Until recently, USAID did not work with militaries (this is changing, however) in HIV/AIDS prevention • Soldiers and combatants are mirrors of their societies • Data from this group could serve a larger purpose about the prevalence of infection
Challenges Ahead • Some militaries make data about HIV/AIDS a state secret • Need to integrate HIV/AIDS into wider assistance for STDS • Resources for HIV/AIDS prevention and counseling must also be available to wider civilian community • Programs must provide a full package of training and prevention measures
Reintegration of Combatants • Receiving communities must be prepared and educated • Economic impact of infected soldiers on a community must be considered • Stigma of positive status can negatively impact reintegration efforts • Donors must consider training and health care as part of the reintegration package
The Way Forward • Weak governance, lack of social services, make armed forces of many post-conflict countries and regional actors the only vehicle for education and training about HIV/AIDS • Demobilization must be weighed against such issues as maintenance of health care, HIV/AIDS prevention
Policy Recommendations • HIV/AIDS prevention integrated into demobilization activities • Donors must include this as part of HIV/AIDS strategy in post-conflict states • Given costs of HIV/AIDS on human resources, initiatives must include incentives for local partners • All militaries should have voluntary testing and counseling programs • Prevention should extend to families and wider community of fighters and soldiers
More resources dedicated to infected e.g. medical benefits in lieu of pensions • Peer counseling and outreach should be used as a means of employment to former combatants already infected • HIV/AIDS prevention must be viewed in post-conflict settings as part of social reconstruction