Quarterly meeting: HIV in humanitarian settings
On Wednesday 30th April, 20 STOPAIDS members gathered for our quarterly meeting on HIV in humanitarian settings.
Alice Fay presented Save the Children‘s work on re-initiating HIV services in the Central African Republic. She highlighted the challenges in a country where there’s a severe lack of basic services (health, water, eduction), more than 600,000 internally displaced people, and more than half of its population (2.5 million) in need of humanitarian aid.
In CAR, between 16-18,000 people were on ART before the conflict (around 27% of those eligible); now, treatment failure is estimated at 30% in adults and 50% in children. No second line treatment is available.
One clear recommendation was the near for communication between service providers. It is not uncommon to find one clinic with empty shelves while another is full of expired drugs.
Bev Stringer from MSF then presented on the HIV care response in fragile or neglected contexts, including lessons learned from the 2013 flood in Mozambique. Many of the challenges found during conflicts or after disasters are the same challenges faced daily in poorer countries, the lessons learned can apply to both. She highlighted the importance of contingency planning to minimise the risk of interruption to treatment. This should include investments in education, human resources capacity, communication networks, emergency drug stocks, decentralisation of care, cooperation between neighbouring regions, and integration into other services.
Lastly, Stuart Kean from World Vision presented research on improving collaboration between faith-based communities and humanitarian actors when responding to HIV in emergencies. As 40-50% of health care in developing countries is provided by faith-based communities (FBCs), and 1 in 5 organisations working on HIV programmes are faith-based, the faith community is a vital link between health care delivery and people who need it. This can be especially true in emergency settings, as they often stay open during emergencies when international organisations are unable to, and are often the first port of call for people in emergency situations. However, some partners are reluctant to work with faith groups on HIV, and they can be reluctant to challenge stigma, discrimination, and often have inconsistent attitudes to adolescent sexual and reproductive health information. He concluded with a series of recommendations, both for humanitarian organisations and for FBCs, in order to work collaboratively in future emergency settings. These included:
-Developing long-term partnerships with FBCs, including organisational capacity building;
-Supporting in-depth HIV-training, counselling and trauma within FBCs;
-Doing more to address stigma and discrimination, harmful social norms, and theological misunderstandings around HIV;
-Strengthening the role of inter-denominational bodies, through, for example, combining resources