WFP World Food Programme

The humanitarian crisis in Haiti is exacerbating the vulnerability of people living with or affected by HIV, particularly women, girls, and key populations. The situation has deepened existing inequalities, and multiplied the risks faced by marginalised communities. In the face of this adversity, UNAIDS continues to work with partners to ensure that people living with or affected by HIV have access to life-saving HIV services, including treatment and prevention services.

For example, in the West Department, over 50,000 people are receiving antiretroviral treatment and are at high risk of disruption. HIV prevention and health care services also face disruption. The recent violence continues to leave thousands of families traumatized. Thousands of people now find themselves unsafe and exposed to all types of risks. Displaced people and vulnerable populations need emergency aid and safe, protected spaces.

"Communities already at risk of HIV in Haiti have been made even more vulnerable, and people living with HIV are facing greater challenges in accessing treatment and care", said UNAIDS Regional Director for Latin America and the Caribbean, Luisa Cabal. "Together with all the United Nations agencies, and with partners, UNAIDS is advocating for safe and unhindered humanitarian access, and the protection health facilities and health workers."

The situation in Haiti is dire, with over 5.5 million people in need of assistance, including more than three million children. The World Food Programme has noted that around 1.4 million Haitians are "one step away from famine." The UN Humanitarian Coordinator for Haiti has noted that the humanitarian response plan is only six percent funded. Less than half of the health facilities in Port-au-Prince are functioning at their average capacity, and there is a pressing need for safe blood products, anesthetics, and other essential medicines.

In the face of these challenges, UNAIDS and its Cosponsors, together with the United States President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the Observatory of Civil Society for HIV/TB/Malaria are supporting Haiti’s National AIDS Program.

UNAIDS has been working with the Ministry of Health and Population Unit for Management of Health Emergencies to support HIV treatment delivery. This support includes programmes to provide a broad package of support to affected communities. For example, together with the United Nations High Commissioner for Refugees (UNHCR) and in collaboration with the Organisation de Développement et de Lutte contre la Pauvreté (ODELPA), UNAIDS supports girls and women who are survivors of gender-based violence by training community leaders and granting empowerment funds for women and men's income-generating activities.

"We are working to ensure that people living with HIV have continuity of antiretroviral treatment as well as access to essential needs, especially including the most vulnerable people across the most affected areas," explains Christian Mouala, UNAIDS Country Director for Haiti. "UNAIDS remains committed to not let the humanitarian crisis disrupt the progress that has been made in the HIV response.  The United Nations stand together to support the people of Haiti."

COVID-19 has underscored the crucial need for pandemic responses to include social protection measures that reach and benefit marginalized populations.

As the pandemic swept across western and central Africa in early 2020, the region was already grappling with socioeconomic distress and humanitarian crises. Social restrictions imposed to contain the pandemic exacerbated those challenges. Impoverished and vulnerable populations, including people living with HIV and key populations, were hit hard.  

Surveys conducted between June and August 2020 in 17 countries in the region on the situation and needs of people living with HIV—with support from UNAIDS, in partnership with the Network of African People Living with HIV West Africa—revealed that up to 80% of people living with HIV were experiencing livelihood losses, and more than 50% of them needed financial and/or food assistance.  

These findings convinced UNAIDS and the World Food Programme (WFP) to launch a pilot project on unrestricted cash transfers in July 2020 to help people living with HIV and key populations cope with the socioeconomic impact of HIV and COVID-19 in four priority countries: Burkina Faso, Cameroon, Côte d’Ivoire and Niger. The initiative was designed to capitalize on WFP’s existing arrangements with service providers and on UNAIDS’ community engagement and relationships with civil society networks in the four priority countries.

Cash transfers are increasingly recognized as an effective form of social protection, with positive social and economic effects. They provide income support and help households avoid selling off assets or removing children from school, and they have multiplier effects on local economies. They constituted approximately 40% of global social safety net expenditures in 2018, but less than 20% in western and central Africa.

As the pandemic spread across western and central Africa, only a few countries (Côte d’Ivoire and Senegal among them) allocated additional support for vulnerable households in the form of cash transfers or social grants.

The immediate objective of the pilot was to reach about 5000 households with one-off, unconditional cash transfers, which ranged from US$ 88 per beneficiary (in Côte d’Ivoire) to US$ 136 (in Cameroon).

“I am so grateful for this support. I used it to pay the fees for my sewing course and to buy a sewing machine to start my own business. I also helped my mother who lost her job due to the pandemic,” said a young woman living with HIV in Cameroon.

Civil society organizations and financial service providers were engaged during the planning of the pilot. Eligibility for the transfers was decided based on a variety of vulnerability criteria, and beneficiaries were identified with the support of community-led organizations. Additional steps involved sensitizing beneficiaries, distributing the cash transfers, troubleshooting and monitoring the process. Specific attention was made to ensure confidentiality and to mitigate any potential stigma for beneficiaries.

Across the four countries, almost 4000 beneficiaries were reached, and it is estimated that a further 19 000 household members also benefited from the cash transfers, most of which went towards food, health care, education and housing expenses, or for income-generating activities. Country experiences varied in terms of the depth of their collaboration with community partners and the extent to which government actors were involved.  

The experience of the pilot demonstrated that delivering rapid cash transfers to marginalized people living with HIV and key populations in very difficult circumstances is possible, and that it provides valuable emergency support.   

Critical lessons learned include the need for inclusive and flexible approaches, working in ways that are clear and transparent to community partners and systematically involving community partners throughout the process. Defining clear and unbiased eligibility criteria, applying them consistently and sensitizing beneficiaries and communities are also vital.

Capacity-building and other support (including funding) for community partners is another critical element. Community-level organizations, trusted counsellors and peer educators were essential for establishing trust, identifying and reaching the intended beneficiaries, minimizing stigma and assessing the impact of the cash transfers. Engaging with government structures from the beginning helps to create the potential for long-lasting improvements.  

One-off cash transfers of this kind can help households withstand short-term shocks, but they do not do away with the need to fully integrate vulnerable and marginalized populations into crisis responses and comprehensive social protection systems. It is imperative that countries across Africa expand inclusive, multipurpose social protection that is accessible and sustainable. Enhancing the people-centredness of cash transfers and slotting them in with other forms of social provisioning and support that are not necessarily cash-based—such as free or subsidized primary health care, education, water and energy—is part of this process.

Following this pilot experience on the use of cash transfers to support the most vulnerable people living with HIV and key populations, UNAIDS and the Civil Society Institute for Health have further strengthened their collaboration on advancing HIV-sensitive and inclusive social protection in western and central Africa. Recently they organized, with the support of LUXDEV funding and in collaboration with several UNAIDS Cosponsors, a capacity-building workshop to mobilize and build the capacity of civil society and communities and to promote dialogue and collaboration among civil society organizations, partners and governments to advance inclusive, HIV-sensitive social protection in the region.

Building on the recommendations of the workshop, a number of follow-up activities were agreed to enhance the role and positioning of communities in advancing HIV-sensitive social protection within their countries and the region. 

“The cash transfer initiative in Niger came at the right time. The cash transfers were used by the beneficiaries to stockpile food and pay rent, but most importantly to allow the children to continue their schooling. This initiative demonstrated the value and importance of working together with the communities and our Cosponsors to achieve a common goal,” said El Hadj Fah, the UNAIDS Country Director for Niger.

GENEVA, 9 October 2020—UNAIDS sends its heartfelt congratulations to the World Food Programme (WFP) for being awarded the 2020 Nobel Peace Prize. WFP’s efforts to ensure food security for all, particularly the most vulnerable women, men and children, including people living with HIV, have saved countless lives and prevented hunger and starvation in countries all around the world.

“We are so proud of WFP’s achievement and are honoured to have WFP as one of our Cosponsors, working with us to end AIDS,” said Winnie Byanyima, Executive Director of UNAIDS. “We will continue to work closely together to achieve our shared goals of zero hunger, zero new HIV infections, zero AIDS-related deaths and zero discrimination for all.”

For people living with HIV, food and nutrition are critical components of care and support. WFP’s work on HIV includes nutritional recovery for malnourished people living with HIV, support at the individual and household levels, supplying food, cash and vouchers, and linking food and health systems. As part of its HIV and tuberculosis programmes in 29 countries, WFP also links clients with social protection programmes and livelihood strengthening activities in order to ensure that health gains can be sustained in the long term, as people living with HIV need to stay on treatment for life.

WFP’s efforts have improved the lives of people living with and affected by HIV and have advanced access and adherence to HIV treatment. UNAIDS thanks WFP for its work and collaboration and congratulates WFP on its well-merited achievement of being awarded the Nobel Peace Prize.

Additional information on WFP’s work on HIV is available here.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 26 August 2020—UNAIDS is calling on countries to adopt urgent measures to reinforce social protection programmes to shield the most vulnerable people from the health impact and socio-economic fall-out of the COVID-19 pandemic.

People living with HIV and tuberculosis (TB) are being significantly impacted by COVID-19. Modelling has estimated the potential catastrophic impacts of the COVID-19 pandemic with increases of up to 10%, 20% and 36% projected deaths for HIV, TB and malaria patients, respectively, over the next five years.

Among the most vulnerable are women and girls, gay men and other men who have sex with men, sex workers, people who use drugs and transgender people. Many of them are excluded from existing social protection programmes.

“Countries must ensure that everyone is able to receive essential services including health care and they must invest adequately in social protection programmes to keep people safe and to shield them from the consequences of losing their livelihoods,” said Winnie Byanyima, Executive Director of UNAIDS.

The socio-economic fall-out of the COVID-19 pandemic will have the greatest impact on some of the most disadvantaged people in societies around the world. For example, COVID-19 threatens to double the number of people facing acute food insecurity to more than 265 million by the end of the year. Most of these people will be in countries already badly afflicted by conflict, economic or climate crises. Refugees are among the groups facing the greatest dangers.

Hundreds of millions of people around the world are also in line to lose their jobs in the formal and informal sectors of the economy. Around 150 million full time jobs were lost in the first quarter of the year and millions more people are set to lose their livelihoods in the months ahead.

“Today, only 29% of the world’s population has access to adequate social protection coverage,” said Guy Ryder, Director General of the International Labour Organization.” Governments must act to ensure the sustainability of livelihoods, businesses and jobs and the protection of workers’ health, rights and incomes during and after COVID-19.”

Women are particularly vulnerable to the economic crisis being disproportionately employed in the informal sectors of the economy and therefore most likely to lose their incomes. They are also often employed on the frontline of the response to COVID-19, making up 70% of the workforce in the health and social care sectors, as well as carrying out the bulk of unpaid domestic duties in the home, childcare and other caring functions.

An increase in gender-based violence during lockdown also makes it imperative for governments to invest in social protection programmes designed specifically for the protection of women and girls.

A generation of young people are also at risk from the socio-economic crash caused by the pandemic. The vulnerability of children and young people is being further amplified by school closures which have affected more than 90% of the world’s student population, interrupting their education and their access to crucial social services, such as school meals.

“Children and young people are suffering disproportionately from the socio-economic impact of the COVID-19 crisis,” said Henrietta H. Fore, Executive Director of UNICEF. “Before the outbreak, two out of three children had no or inadequate social protection fund. Countries need to live up to their commitment for social protection for everyone who needs it.”

The call for action for governments to invest adequately in social protection programmes is endorsed by UNAIDS, the United Nations Children’s Fund (UNICEF) and the International Labour Organization (ILO) and supported by the World Food Programme (WFP), the Office of the  United Nations High Commissioner for Refugees (UNHCR), the United Nations Entity for Gender Equality and the Empowerment of Women (UN Women), the United Nations Office on Drugs and Crime (UNODC), the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the World Bank.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Thousands of households have been helped in Abidjan, Côte d’Ivoire, through a joint initiative to reach vulnerable households with money for nutrition and food security and basic health kits during the COVID-19 pandemic. 

Restrictions on movement imposed to stop the spread of the new coronavirus in Côte d’Ivoire have had a significant impact on the ability of people to earn a living, resulting in an increasing danger of hunger. For people living with HIV, malnutrition and food insecurity reduce HIV treatment adherence, impacting their health and increasing HIV transmission, since stopping treatment can increase a person’s viral load, which increases the chance of passing the virus on. Food insecurity can also increase HIV risk behaviours, potentially putting people at increased risk of acquiring HIV.

The partnership between the World Food Programme, UNAIDS and the Magic System Foundation—a nongovernmental organization that works in the fields of education, health, the environment and culture—allows for a cash transfer of 51 000 central African CFA francs (around US$ 89) per household to cover food needs for two months, distributes hygiene kits and protective equipment to limit the transmission of COVID-19 and gives advice on nutrition.

“The cash transfer allowed me to buy my medicine for three months and to stock up on rice for my family. It gave me the strength to live and smile again,” said one of the recipients.

The priority focus of the campaign are female-headed households and households with pregnant and breastfeeding women, young children, the elderly, people with disabilities and people living with HIV.

“UNAIDS and the Ivorian Network of People Living with HIV are working with various partners—mayors, nongovernmental organizations, the Red Cross, mosques, churches, community leaders, neighbourhood leaders and traditional chiefs—to facilitate access to especially vulnerable people living with HIV,” said Brigitte Quenum, the UNAIDS Country Director for Côte d’Ivoire.

“The health crisis has forced some households to adopt irreversible food strategies, such as selling assets or borrowing money to meet their food needs. Cash-based food aid helps build the resilience of vulnerable households and preserve their livelihoods. The cash transfer provides the opportunity to have a diversified and balanced diet for good health, while leaving recipients with a choice,” said Adeyinka Badejo, the World Food Programme Representative in Côte d’Ivoire.

A further round of assistance for vulnerable households, especially households containing members of key populations or people living with HIV, will take place soon. The second round will draw on a rapid assessment of the needs of people living with HIV during the COVID-19 pandemic, which was carried out by the network of people living with HIV with the support of UNAIDS, and on the lessons learned from the first round of assistance.