Humanitarian Programming

We ensure that our humanitarian programmes reduce vulnerability to HIV infection and address the needs of PLHIV and affected communities.

Increasingly, attention is being directed to addressing vulnerability to HIV infection and the effects of HIV in emergency settings, including natural crises such as droughts and earthquakes, as well as situations of armed conflict. Humanitarian work in emergency settings has much in common with development work, where programmes address the water and sanitation, food security, housing and healthcare needs of people who are not displaced from their homes.

The Inter-Agency Standing Committee's Guidelines for HIV/AIDS Interventions in Emergency Settings (the Guidelines) utilise a range of strategies to address vulnerability and the effects of HIV/AIDS, including HIV-specific responses such as making condoms available, integrating HIV within sexual health and wider primary health programmes and mainstreaming HIV (for example, taking HIV into consideration when planning water and sanitation facilities).

The Guidelines provide detailed guidance for considering the HIV dimensions of emergencies in the preparedness phase, minimum responses in the midst of emergencies and comprehensive responses in the stabilised phase, in each of the following sectoral responses:

  • coordination
  • assessment and monitoring
  • protection
  • water and sanitation
  • food security and nutrition
  • shelter and site planning
  • health
  • education
  • behaviour change communication and information, education and communication (IEC), and
  • HIV in the workplace.

The extent to which it is possible to mainstream HIV in an emergency setting depends upon the stage of the emergency. In the emergency preparedness phase, depending on the different role of NGOs, preparation for an effective response to HIV in emergencies should include:

  • developing indicators and tools for assessing HIV risk and vulnerability in a given context
  • including HIV in humanitarian action plans and training relief staff on HIV, gender and non-discrimination
  • protecting and promoting the human rights of PLHIV and affected communities, including minimising the risk of sexual violence, exploitation and HIV-related discrimination, and
  • planning interventions, developing resources and training staff on the special needs of PLHIV and affected communities in each of the areas of sectoral response outlined above.

The Guidelines provide minimum standards for responses in the midst of emergency and comprehensive responses for the stabilised phase of emergencies, in relation to each of the sectoral responses outlined above. Different aspects of each of these responses can be adapted to respond to the ways that HIV has affected the lives of individuals, families and communities in emergencies. The following are some examples.

Targeting food aid to HIV-affected households is complex, given that the vast majority of people in developing countries are not aware of their HIV status, both because of a lack of availability of testing and fear of testing due to the stigma associated with HIV. When providing food security and nutrition programmes, food aid needs to reach PLHIV and affected communities and the nutritional needs of PLHIV need to be addressed. In order to do this, we need to:

  • target food-insecure individuals, regardless of their HIV status, paying attention to female-, child- and elderly-headed households, families supporting OVC and families caring for chronically ill persons
  • ensure food aid does not increase stigmatisation when provided to PLHIV and affected communities
  • plan food baskets that accurately reflect the dietary and nutritional needs of PLHIV, including adequate intakes of energy, protein and micronutrients essential to coping with HIV and fighting opportunistic infections, and
  • strengthen community capacity to respond to the needs of PLHIV and affected communities, including ensuring access to programmes designed to address long-term food insecurity.

Sites in emergencies may take the form of dispersed settlements, mass accommodation in existing shelters or organised camps. When planning sites and providing shelter, we need to consider safety and access issues for PLHIV and affected communities, including:

  • layout of shelters and location of, and access to, facilities that reduce the physical risks for women and girls, such as separate toilet blocks for men and women, and
  • layout of shelters and location of, and access to, facilities that address the vulnerability of separated children, especially girls and female-headed households, PLHIV and/or those with chronic health conditions.[v]

When providing health programmes, NGOs need to integrate HIV prevention and ensure access to basic health care for PLHIV and those vulnerable to HIV and its consequences, including:

  • ensuring access to basic health care for PLHIV and those vulnerable to HIV and its consequences
  • ensuring a safe blood supply and implementation of universal infection control
  • securing condom supplies, together with effective condom distribution and appropriate information for their effective use
  • ensuring comprehensive management of STIs, reducing their incidence by preventing transmission through safer sex promotion and treating curable STIs to reduce their prevalence
  • ensuring appropriate care for people who inject drugs, including risk reduction information and access to needles and syringes
  • ensuring safe and clean delivery of babies, and managing the consequences of sexual violence.