In May 1999, UNAIDS convened a meeting on ‘Care within the context of HIV/AIDS-related research in developing countries’ as part of a series of consultations on the ethics of vaccine trials and biomedical research. The meeting’s objectives were to develop a framework of care for participants in HIV/AIDS-related research in developing countries, as well as to clarify the appropriate responsibilities of the research institutions, health-care professionals, sponsors, communities and governments in the context of research ethics. This report is a summary of the issues discussed at the meeting and the conclusions reached, which included the agreement that the participants’ health and well-being must be the primary concern during HIV-related research and that this concern should prevail over any other concerns, including the interest of science. Based on this summary and the subsequent developments, UNAIDS (in partnership with its collaborators) will consider the development of a guidance document regarding the provision of care in HIV/AIDS-related research.

In many respects, Botswana is Africa’s success story. It is peaceful, democratic and prosperous. But it also has the worst AIDS epidemic in the world, with an adult prevalence rate estimated at 35.8%. This case study describes the response to this tragedy (which threatens to reverse all the country’s gains of the past decades) of one of the most important companies in Botswana—the Debswana diamond-mining company. The company started with an AIDS education and awareness programme, appointed full-time AIDS programme coordinators and developed an HIV/AIDS management policy. It conducted an institutional audit of susceptibility and vulnerability to HIV/AIDS, which is reported in some detail, together with findings and lessons learned. Debswana’s work on HIV/AIDS represents a ray of hope in a bleak situation and has much to teach the private sector in the region and, perhaps, globally.

Telephone helplines (also known as hotlines) are telephone lines set up to take calls from people seeking information on specific topics—such as (in the case of this Best Practice study) HIV/AIDS. Four programmes were chosen to illustrate the Best Practice criteria for helplines: the AIDS Helpline of South Africa’s Department of Health, the reproductive health and sexuality helpline offered by a New Delhi-based nongovernmental organization (NGO) called Talking about Reproductive and Sexual Health Issues (TARSHI), the National AIDS Hotline of Trinidad and Tobago, and the hotline run by Remedios AIDS Foundation of Manila, the Philippines. Together, they illustrate the principles that make helplines so successful in providing HIV/AIDS information and counselling, the challenges helplines face, and the creative approaches that can be taken to meet those challenges.

The purpose of the guidelines is to assist National AIDS Programmes (NAPs) and Ministries of Health in implementing second generation HIV surveillance systems through a logical and standardized process. More specifically, the guidelines are primarily addressed to programme managers, epidemiologists, social scientists and other experts working in or with national programmes on surveillance issues. They include the following: assessment, consensus, plan and protocol development, implementation and, finally, monitoring and evaluation.

The guide is designed to help country teams assist national governments in implementing the Declaration. It is based on 3 principles: implementation is a collective responsibility; the emphasis is on strengthening existing capacities, mechanisms and processes, and the Declaration is a unifying, motivational tool.

The World AIDS Campaign for the years 2002–2003 will focus on stigma and discrimination. The main objective of the campaign is to prevent, reduce and ultimately eliminate HIV/AIDS-related stigma and discrimination, wherever it occurs and in all its forms. Stigma and discrimination associated with HIV and AIDS are the greatest barriers to preventing further infections, providing adequate care, support and treatment and alleviating impact. Self-stigmatization, or the shame that people living with HIV/AIDS experience when they internalize the negative responses and reactions of others can lead to depression, withdrawal and feelings of worthlessness. Discrimination against those living with HIV/AIDS, or presumed to be infected is a violation of human rights. All individuals have a right to equal respect and dignity, whatever their health status. The aim of this conceptual framework is to: create a common understanding of HIV/AIDS-related stigma and discrimination; highlight some existing interventions targeting HIV/AIDS-related stigma and discrimination, and contribute to effective ways of preventing stigma and challenging discrimination when it occurs, and monitoring and redressing human rights violations.

This document examines the first large-scale HIV/AIDS/STI intervention programme to be implemented during a refugee crisis. It describes the intervention’s operational aspects, the observed impact and the effect this experience had on practices in other refugee situations, among both international and nongovernmental organizations (NGOs). It provides insights into the approaches for STI services that will be useful for reproductive health programme managers, as well as NGOs involved in relief operations. It will also be useful for district or regional health managers in identifying needed support systems for STI service delivery.

Improved information and informed analysis are critical for the development of expanded national responses to AIDS. Some countries have developed HIV surveillance systems and countries are increasingly collecting information on resources allocated for AIDS programmes and projects. Responding to the needs at the national and global levels for improved information and analysis, UNAIDS has embarked on an ambitious plan to establish an information system to support national AIDS responses. This document describes the historical development of the Country Response Information System (CRIS), and the related activities undertaken by UNAIDS in 2002 and 2003.

The theme of this report, Reaching out, scaling up, reflects a concern that has become increasingly important in the past few years. All too often, good local-level responses to HIV/AIDS—best practices, in other words—have remained local and small-scale. The many lessons learned have not been translated into bigger projects or wider coverage.

Drawing on the broad experience of UNAIDS, WHO and the International HIV/AIDS Alliance, the Handbook on access to HIV/AIDS-related treatment provides nongovernmental organizations, community-based organizations and groups of people living with HIV/AIDS with a practical resource for responding to issues of access to treatment for HIV/AIDS in developing countries. The handbook will: build practical skills among NGOs, CBOs and PLWHA groups by using participatory activities and sharing experiences; provide a training resource for NGO support programmes, training organizations and individuals; facilitate ongoing learning about the HIV/AIDS-related treatment work of NGOs, CBOs and PLWHA groups. The handbook is intended to assist groups in finding ways of understanding, planning and undertaking work on HIV/AIDS related treatment. It is suitable for use with people of varying levels of experience and offers flexibility to facilitators who need to gear their work towards specific schedules and situations.