Credit: UNAIDS

The fertile northern region of Uganda was known for many years as one of the granaries of the country, consistently producing surpluses for local and international food markets. But two decades of civil conflict between the Uganda People’s Defense Forces (UPDF) and the Lord’s Resistance Army (LRA) have left the Acholi and Lango sub-regions destitute.

Between 1986 and 2006 an estimated 1.8 million people fled from their villages to the shelter of temporary camps. In Kitgum, Gulu, Pader and Amuru districts an estimated 95% of the population lived in such camps.

The war caused significant setbacks in education, healthcare, food production and infrastructure. It also increased vulnerability, particularly amongst girls and women, as well as gaps in HIV service provision to the internally displaced persons (IDPs).

"They have lost almost everything, their assets, their livelihoods. They have lost their skills. You know, they were used to farming and staying in the camps meant that a whole generation lost out on those skills”, says Winifred Nalyongo, a livelihoods specialist with the United Nations Food and Agriculture Organisation (FAO).

In 2006, internally displaced persons began returning to or near their places of origins following the singing of a Cessation of Hostilities Agreement between the Government of Uganda and the LRA. The UN refugee agency (UNHCR) estimated that more than 70 per cent of all internally displaced persons had returned home or in transition camps in January 2009.

HIV and gender-based violence in early recovery settings

 It is in this early recovery setting that FAO has been working to re-establish the livelihoods of the communities impacted by the conflict through the Farmer Field and Life Schools (FFLS) and Junior Farmer Field and Life Schools (JFFLS) programmes. These involve a group learning process whereby women and men farmers learn valuable agricultural and life skills that allow them to improve their livelihoods and reduce their vulnerability to food insecurity, HIV and gender-based violence, among others.

Conflict and displacement are known to be factors in heightening exposure to HIV. In the Northern Ugandan IDP camps, alcoholism and sexual violence are widespread. FAO representatives indicate that forced in a situation of idleness and unable to feed their families men may become frustrated and turn to alcohol, thus exacerbating existing gender inequalities, making women and children more vulnerable to HIV.

Credit: UNAIDS

The UNAIDS/UNHCR policy brief on HIV and refugees mentions that, as refugees struggle to meet their basic needs such as food, water and shelter, women and girls are often forced to exchange sexual services for money, food or protec­tion. Children living without parental support, wheth­er due to separation from or death of family members, are also particularly vulnerable to sexual and physical violence and exploitation.

A 2005 UNICEF study in one of Northern Uganda’s largest IDP camps found that six out of ten women were physically and sexually assaulted by men.

According to a 2004-2005 Ministry of Health survey, HIV prevalence in the war-affected areas of Northern Uganda is at 8.3% compared to the national average of 6.4%.

Reducing vulnerability

FAO’s Farmer Field and Life Schools place strong emphasis on food security and self-reliance as a means to reduce vulnerability to HIV and gender-based violence. They emphasize farming as a business, encouraging members to generate money from their crops, but also teach valuable life skills such as gender sensitivity, child protection, hygiene, nutrition and HIV awareness. 

People living with HIV are encouraged to join the FFLS where they receive nutrition training, an important component in HIV positive living. They can also learn how to farm less labour intensive crops such as okra or vegetable gardens.

Learning new skills early on

In Dubaju village, FAO’s Junior Farmer Field and Life Schools help orphans and vulnerable children to become more self-sufficient and improve their food security. They also learn about staying healthy and protecting themselves from HIV through classroom-based discussions. For example, children learn how to protect crops from pests or treat diseased crops and draw parallels with how they can take care of their bodies and prevent themselves from becoming infected with HIV.

From left to right: Michael Sidibe, UNAIDS Executive Director; UN Secretary-General Ban Ki-moon; H.E. Amadou Toumani Touré, President of Mali and Global Fund Executive Director Prof. Michel Kazatchkine with the Born HIV Free signature book. Credit: The Global Fund/John Rae

The President of Mali, His Excellency Amadou Toumani Touré, is on a three-day visit to the United States to reinforce his country’s commitment to the AIDS response. The President is participating in the Global Fund’s Replenishment conference, taking place on 4 and 5 October and is meeting with a number of high ranking officials from the United Nations and the US administration. 

Public and private donors from over 40 countries will reaffirm their commitment to the work of the Global Fund by announcing funding pledges for 2011 to 2013 at the Global Fund’s Third Voluntary Replenishment and pledging conference which is being chaired by the UN Secretary General Ban Ki-Moon. The President of Mali will be the highest country representative at the conference and will bring a regional perspective to the proceedings. 

The Global Fund provides a quarter of all international financing for AIDS globally, two-thirds for tuberculosis and three quarters for malaria. Ahead of the Conference, the Global Fund announced ahead that it will need 17 billion to sustain, and 20 billion to scale up the response to the three diseases. 

As well as participating in the conference the President of Mali met with the UN Secretary General to discuss building stronger relationships between the United Nations and Mali. He also met with Ambassador Eric Goosby, Global AIDS Coordinator with the U.S. Department of State. During their meeting Ambassador Goosby congratulated the President on Mali’s successes in responding to its epidemic. 

Mali has shown strong leadership in the response to the epidemic and investments are starting to show results––Mali has seen a drop of more than 25% in new infections and has reached 65% coverage of antiretroviral therapy. 

On the second day of his visit the President of Mali will meet Anthony Lake the Executive Director of the United Nations Children’s Fund.

A version of this story first appeared at www.unfpa.org 

The UNFPA-sponsored football tournament offered a way to get the attention of young people in northern Uganda. Photo: Stijn Aelbers/UNFPA Uganda

Although hostilities in northern Uganda ceased in 2006, the lives of young people, formerly targets for abduction by the Lord’s Resistance Army, have not been easy. During the conflict, which lasted more than 20 years, many children spent their early years confined to camps for displaced persons, while others were subjected to trauma, brutality and suffering as child soldiers.

Prolonged instability also took a toll on health and social support systems: reproductive health indicators in the sub-region are among the lowest in the country, and gender-based violence is common.

While the majority of youth—who comprise 56 % of Uganda’s population—live in poverty with few educational or employment opportunities, football is one thing that they can get excited about and that allows them to forget about their troubles. Florence, age 23, from a squad in Gulu District said, “If we come to play football we forget our problems at home. It is like stress management.”

At the Acholi Football Tournament, which took place in five districts, and was supported by UNFPA, the United Nations Population Fund, the goal was to do more than more than help young people relax. It also aimed to reduce teenage pregnancy and gender-based violence, two of the most serious problems in the area.

Referees, coaches, and team captains attended training sessions on the issues, and then became a resource for information, discussion, and guidance. Subsequent dialogue sessions reached some 1,200 players.

Top local officials awarded the winning teams with uniforms that read, “Say no to GBV (gender-based violence) and teenage pregnancy.” Health care workers were also on hand to answer questions and provide health counseling. Over the course of two days, some 10,000 condoms, most supplied by UNFPA, were distributed by health workers and peer counsellors as well as representatives of the Boda Boda Association, which employs many young men as motorcycle taxis drivers.

More than 800 individuals, mostly young men, took advantage of the free voluntary testing and counselling that was offered to allow them to check their HIV status.

Women were also on the pitch, although many are less experienced than their male counterparts, spectators say the buzz of the women’s matches created were a demonstration of the growing popularity and re-thinking of gender roles

A player from the Lalogi team said she has encountered negative attitudes. (See how these are addressed in a new electronic football game.) However, 21-year-old Rose said her husband was supportive: “He is happy that I play. I think he is here watching today,” she shouted over her shoulder as she ran onto the pitch for kick-off.           

H.E. Ismail Omar Guelleh, President of the Republic of Djibouti together with Mr Michel Sidibé, UNAIDS Executive Director. Credit: UNAIDS/P.Virot

Each year, there are more than 200 million people on the move. The UN estimates that between 20 and 30 million are migrants in irregular situations and that wars and conflicts have caused the displacement of 16 million refugees. 

Many countries around the Red Sea and Gulf of Aden are affected by intense poverty and violent internal conflicts. This has resulted in large numbers of migrants living in and around the ports. There is also a large community of mobile populations, including truck drivers, dock workers, port staff, security staff, ships crews and sex workers who can be at higher risk of exposure to HIV.

Poverty, social exclusion; separation from families and communities, loneliness, fear and marginalization can make mobile populations and migrants particularly vulnerable to HIV. The situation can also be aggravated by lack of access to HIV prevention, treatment and care services.

“It is essential that mobile and migrant populations living in and transiting through ports have access to HIV services and are included in national HIV plans,” said Michel Sidibé, Executive Director, of the Joint United Nations Programme on HIV/AIDS (UNAIDS). “Achieving universal access goals means making sure all sectors of society are reached, particularly people most vulnerable to infection.”

The Government of Djibouti, in close collaboration with UNAIDS, the International Organization of Migration, the Inter-Governmental Authority on Development (IGAD), and other partners, convened a meeting from 26-29 September 2010, which brought together leaders from Red Sea countries and other countries across Africa to address the issue of key populations at higher risk of HIV infection along the Red Sea and the Gulf of Aden ports.

“For us, this conference has been extremely instructive, we have learnt a lot from the experts, but particularly from people living with HIV who have come forward to tell us their stories,” said His Excellency Abdallah Abdillihi Miguel, Minister of Health of Djibouti. “This meeting has reinforced my conviction that we have to continue to work towards universal access to HIV prevention, treatment, care and support and make sure that everyone in need, even those most marginalised and vulnerable, has access to services.”

The experts and leaders agreed to take concrete actions to strengthen advocacy and leadership on HIV and mobility; integrate HIV and mobility into national strategic plans; ensure improved planning; enhance the capacity of civil society and partnerships with the private sector; and develop a common communication strategy with particular emphasis on human rights.

Woman participating in debate in Senegal. Credit: UNAIDS/P.Virot

The Global Power Africa conference opened on September 26 in Washington D.C. The event brought together women Members of Parliament and Ministers from twelve countries in Africa, to develop strategies to support the implementation of the UNAIDS Agenda for Accelerated Country Action for Women, Girls, Gender Equality and HIV at country level.

The meeting, held within the framework for the regional Partnership Of Women Elected/Appointed Representatives (GlobalPOWER®) program, was convened by UNAIDS in partnership with the Center for Women Policy Studies.

UNAIDS Deputy Executive Director, Management and External Relations, Ms Jan Beagle, opened the event by highlighting UNAIDS’ commitment to work with parliamentarians on developing strategic and results-oriented National Plans on HIV at country level.

“There is a lot of power in this room,” Ms Beagle remarked. “As women, you have the ability to speak for the marginalized – as Michel Sidibé says; you are the voice of the voiceless.”

Ms Beagle stressed the consensus on the need for women-centered approaches that emerged at the Millennium Development Goal summit held in New York 20-22 September. Participants at the summit underscored that without investments in women the MDGs would not be reached.

According to Ms Beagle, UNAIDS believes in the importance of linking gender to all MDGs, as part of the integration of responses to maximize resources for broader health and development outcomes—the AIDS plus MDGs approach.

“We must work with great diligence and care to elevate the status of women and to successfully reduce the burden of HIV.  Zero new infections!  Zero discrimination!  Zero AIDS-related deaths!,” Ms Beagle said.

Two students look at an image part of the joint Reuters and UNAIDS exhibition Time to Act, held at Moscow State University 21 September 2010. The exhibition was launched to coincide with the MDG Summit held at the United Nations in New York, 20-22 September 2010. UNAIDS\Kolomiiets

A new exhibition featuring images representing Russia’s HIV epidemic opened on 21 September at Moscow State University. The international news agency Reuters and the UNAIDS Regional Support Team for Eastern Europe and Central Asia partnered to display 35 of Reuters’ most compelling photographs.

Launched to coincide with the 20-22 September MDG Summit in New York, Time To Act gives a strong visual representation of the country’s epidemic. Its organizers hope the exhibition will provide visitors with an overview of the many sensitive issues facing Russia as it responds to its growing HIV epidemic.

Taken by seven photographers over the past 12 years, the photographs capture the scale and scope of the epidemic in Russia, from civil society protests and children orphaned by AIDS to the struggles encountered by key populations at higher risk.

Many of the images on display are striking but they communicate the reality of the challenges Russia and the Eastern European and Central Asia face in responding to HIV,” said Dr Denis Broun, Director of the UNAIDS Regional Support Team for the region. Information on HIV and how it is prevented should be provided coherently by health facilities, the media, schools and universities—this exhibition is a good example of making HIV awareness persuasive and informative.

The photographs are paired with statistics that provide information on the epidemic and its trends in the region. According to UNAIDS, an estimated 110 000 people were newly infected with HIV in the region in 2008, bringing the number of people living with HIV to 1.5 million.

“Young people and other visitors can’t stay indifferent after seeing the exhibition,” said Elena Vartanova, the Dean of Moscow State University’s Journalism Department, the host of the exhibition. “The images urge us to think and to take actions towards stopping the spread of the HIV epidemic.”

Time to Act runs until 29 October 2010.

Sierra Leone's Foreign Minister Zainab Hawa Bangura at the 2010 MDG Award Ceremony, 19 September 2010.

At a ceremony on the eve of the 2010 Millennium Development Goals Summit, held in New York from 20-22 September, the Government of Sierra Leone was presented with an MDG Award for its leadership and progress towards achieving MDG 6, to stop and reverse the spread of HIV by 2015.

The MDG Awards Committee was impressed by Sierra Leone's efforts in developing an innovative and comprehensive national HIV strategy and, in particular, the high-level political commitment and involvement of Sierra Leone’s President, H.E. Ernest Bai Koroma, who chairs the country’s National AIDS Council (NAC).

Under the leadership of the NAC, the technical coordination of the National AIDS Secretariat and the engagement of multi-sector partners, Sierra Leone’s HIV prevalence has stabilized, as highlighted in UNAIDS’ special publication for the MDG Summit, MDG 6.

Partners credit a national commitment towards advancing the greater involvement of people living with HIV in the response and the scale up of HIV prevention, treatment, care and support services as key contributors to Sierra Leone’s progress on MDG 6.

“In a post-conflict country with a host of development challenges, the MDG Award is evidence of dedicated national leadership and true partnership,” said UNAIDS Country Coordinator, Mulunesh Tennagashaw. “The Award is an inspiration for all partners, and it will help drive us towards reaching greater results.”

With the development of a new National Strategic Plan on AIDS, the government has set its sights on zero new HIV infections by 2015.

The MDG Award was presented to Foreign Minister Zainab Hawa Bangura. The Awards are held annually to support and raise awareness of the MDGs by providing a high profile platform to honour and celebrate exemplary efforts by national governments and civil society stakeholders in advancing the achievement of the MDGs.

On the concluding day of the UN Millennium Development Goals Summit, United Nations Secretary-General Ban Ki-moon launched the Global Strategy for Women’s and Children’s Health, a concerted effort to save the lives of more than 16 million women and children.

In support of the Secretary-General’s new global strategy, foundations, civil society, private sector companies and other partners pledged more than US$ 40 billion in resources for women’s and children’s health.

“The 21st century must be and will be different for every woman and every child” said Secretary-General Ban in a press release announcing the strategy.

A high level panel was convened on 22 September to discuss the strategy. Participants included H.E. Wen Jiabao, Premier of China, H.E. Paul Kagame, President of Rwanda, H.E. Mizengo Pinda, Prime Minister of Tanzania, and H.E. Hillary Clinton, U.S. Secretary of State.

International organizations including UNAIDS, UNICEF, UNFPA, WHO and the World Bank were in attendance and are collaborating on a new initiative to mobilize political and operational support.

“I am committed to the Secretary-General’s strategy on women’s and children’s health—the response to his call is unprecedented,” said Mr Sidibé. “It is clear we must leverage investments in the HIV response to support progress across all the MDGs.”

The Global Strategy for Women’s and Children’s Health is a roadmap that identifies the financial and policy changes needed as well as critical interventions required to improve health and save lives.

The UN estimates that from 2011 to 2015 by implementing the Global Strategy many far-reaching gains will be made, from averting the deaths of 15 million children under five to preventing 740,000 women from dying of pregnancy and childbirth-related complications.

Read Press Release here.

If the global HIV epidemic is to be curbed, links between HIV and reaching other Millennium Development Goals (MDGs) need to be explored, strengthened and leveraged. This is the key conclusion emerging from a new publication by the United Nations Development Programme (UNDP) released today at the UNAIDS hosted MDG Summit side event – AIDS plus MDGs: Delivering results towards our shared commitments.

The publication, The ‘AIDS and MDGs’ Approach: What is it, why does it matter and how do we take it forward?, highlights changes in the health and development landscape resulting in a need to re-think the relationship between HIV and the MDGs. This approach effectively addresses both the short- and long-term challenges and impacts of the HIV epidemic while promoting the attainment of wider health and development goals.

Drawing on recent research, programme experience, and country progress reports, the paper outlines three important elements: understanding how HIV and the other MDGs impact one another; exchanging programmatic lessons across HIV and the other MDGs; and, creating synergy and increasing cost-effectiveness through strategies that simultaneously address HIV and other MDGs.

“From the earliest days of the global AIDS epidemic, many have recognised that effective responses must combine biomedical and behavioural interventions with multi-sectoral strategies that address human rights and the underlying socio-economic conditions that shape vulnerability,” said Jeffrey O’Malley, Director of UNDP’s HIV/AIDS Practice.

“The MDG Summit signifies an exciting and historic opportunity to reaffirm commitments to address health and development together, and to exchange important lessons between the response to HIV and action to address other MDGs,” he said.

The report highlights case studies of how cross-MDG synergy can be promoted. For example, in Malawi’s Zomba district, the World Bank implemented a cash-transfer programme to encourage girls’ school attendance. A recent study showed a 60% decrease in HIV and other STI risk among participants. The girls were also more likely to stay in school, have a smaller age gap with male partners, and delay marriage.

The project demonstrates how leveraging the links between HIV and a range of other development issues can spur significant and accelerated progress towards multiple MDGs at once.

Mr George Goldsmith, Chairman and Founder, Tapestry Networks, and Ms Jan Beagle, Deputy Executive Director Management and Programmes Branch, UNAIDS, 22 September, 2010.

Today 300 Heads of States and Governments, chief executives, civil society leaders and Heads of UN agencies participated in the United Nations Private Sector Forum on the Millennium Development Goals (MDGs), chaired by UN Secretary-General Ban Ki-moon.

The objective of the meeting was to identify concrete actions the private sector can take to help close MDG implementation gaps over the next five years. Among the topics addressed by the forum was maternal and child health and HIV, as well as empowering women and achieving equality.

“We depend on the resources and capacity of the private sector to achieve the Millennium Development Goals. The private sector has the lead on innovation,” said Secretary-General Ban Ki-moon.

Companies committed to conduct business in a responsible manner, aligned with fundamental environmental and social values and the Secretary-General called upon the private sector to invest in new and creative ways to capitalize on innovations, products and services to benefit the poor.

“UNAIDS strongly believes that without action to promote the rights of women and girls, the AIDS response has no hope of reversing the epidemic,” said Jan Beagle, UNAIDS Deputy Executive Director, Programmes and Management Branch.

“Governments, civil society and the private sector must come together to ensure that women and girls have universal access to HIV prevention, treatment, care and support,” she said. “We must have zero new infections, zero discrimination and zero AIDS related-deaths among women and girls.”

The United Nations is strengthening its capacity to engage and partner with the private sector. UN agencies, funds and programmes have a number of partnership opportunities for businesses to leverage their relative strengths, resources and competencies in support of achieving the MDGs.

Further information on these and other UN–business partnerships that could benefit from additional corporate engagement and support can be found at business.un.org.