What impedes impact of HIV/AIDS intervention plan
Wednesday, 1 December 2010
Habiba Tasneem Chowdhury
Every year, countries, private and public sectors, professional and business organisations, media and academia across the world express their solidarity with the World AIDS Day on December 1 pledging renewed impetus on reducing stigma and discrimination and concentrating on the containment of the epidemic.
The theme this year is 'Universal Access and Human Rights'. It is evident that HIV/AIDS has reached a situation where it is concerned with human rights in the context of prevention, care and support and treatment. This also reflects global emphasis for reaching all segments of population with the needed services, as essentially the basic human rights paradigm. It simply translates into action that is concerned with the right to correct information in conjunction with the socio-cultural environment, the right to the needed services in user-friendly manner and the creation of enabling environment to reduce stigma and discrimination.
The key factor is vulnerability to risk of exposure. The Bangladesh country response initiated fairly early within the region in 1985 has progressed considerably in addressing the issues that determine the spread of the virus and the detriments towards containing it. The National HIV/AIDS and STD Policy and Strategy have undergone critical review and modifications that is based on evolving needs of the programme to provide the needed services. Involving stakeholder participation at all levels has successfully established unique and innovative approaches. Utilising alternative modalities that take cognizance of the socio-cultural and economical barriers, the national programme has launched the integrated approaches in 2004.
Expanding HIV/AIDS programme beyond the health parameters is a laudable initiative of Ministry of Health and Family Welfare, as it implicitly addresses issues of vulnerabilities especially, of young people and the gender concerns from all perspectives. The mass media campaign has very creatively branded HIV/AIDS through the slogan 'Banchtay Holay Jantay Hobay' (need to learn to survive) that has now become synonymous with the virus. As such the programme design is based on knowledge, attitude, behaviour and practice that protects individual from risk of exposure and encourages society to be compassionate and supportive.
However, within the context of the theme of human rights and universal access that alludes to population and geographical coverage the programme has missed a significant segment of population that is at risk due to their socio-economic marginalised status. The World AIDS Day is followed by the International Day of Persons with Disabilities on December 3. And the theme for this year is: 'Keeping the promise: Mainstreaming disability in the Millennium Development Goals towards 2015 and beyond'. The theme clearly indicates that persons with disability and their special needs are to be addressed in the context of mainstream human rights in all aspects. To ensure this process is embraced globally the Conventions on the Rights of Persons with Disabilities and its Optional Protocol was adopted by the UN General Assembly in 2006. Bangladesh signed the convention in 2007 and also ratified the optional protocol that creates an obligation for the country to uphold and follow the objectives of the treaty.
Despite the long drawn process of formulating the convention that was launched in 1982 through World Programme of Action there is no mention of HIV and AIDS in the definition of protecting the right of people with disability. The national HIV/AIDS policy, strategy, plan of action and programme does not directly address people with disability and in the Disability Welfare Act-2001, to protect and promote the rights of the people with disabilities the HIV/AIDS and reproductive health is incomprehensive. According to WHO 10 per cent of the world's population have disability and on the basis of this estimation approximately 15 million people with disability in Bangladesh do not receive the needs based health and reproductive health services for prevention of HIV/AIDS and sexually transmitted diseases.
It is indeed a paradox that the national programme is delivering customised services for different marginalised segment of population that are vulnerable through such remarkable initiatives, as youth friendly health services, drop in centers for harm and risk reduction for injecting drug users and female sex workers, treatment regimen and life skills education that prepares the young people for emotional and physical changes and the capacity to avoid risk and peer pressure. The National programme conducted survey on the situation and need for reproductive health services for young people and the findings helped develop innovative modalities to address demand driven services. But that the young people segment also consists of persons with disability has been conspicuously overlooked and the fact that people with disability in Bangladesh are economically marginalised compounds their vulnerability is not given due diligence.
The UNAIDS in response to the need for directives that is missing in the convention, formulated policy brief on Disability and HIV articulating the actions needed to increase the participation of persons with disabilities in the HIV response and ensure they have access to HIV services, which are customised to their distinct requirements. It elucidates the human rights standards but also raises queries whether people with disability are in reality at risk of exposure.
Individuals with disability have not been included in HIV/AIDS prevention efforts because it is believed that they have little or no risk for HIV infection. The World Bank and Yale University Global Survey on Disability and HIV/AIDS have proved this assumption wrong - men and women with disabilities are more likely to be victims of violence and rape and less likely to be able to obtain protection and prophylactic care. Information and HIV/AIDS messages often do not reach people with disability because of extremely low literacy rates and access to media and even if these do translating them into individual change is fraught with obstacles.
In the Bangladesh country context gender is a cross-cutting agenda for human development but women with disabilities remain at risk of HIV infection due to lack of awareness, sexual violence and coercion and absence of social security and coverage by the traditional HIV/AIDS programmes. The situation is worsened because of dislocation and mobility due to loss of livelihood caused by environment degradation and climate change impact creating additional disability related burden and marginalisation for women with disability. There is tremendous paucity of research, study and data on HIV/AIDS and disability within the Bangladesh country programme. The National response has progressed in leaps and bounds becoming a model of integrated approaches and public-private partnership. But the rights based and universal access approach falls short of its fulfillment without inclusion of people with disability and the infrastructure, specific needs based service provision and access to those.
The National HIV/AIDS response and the Disability Welfare Act 2001 need now to include specialised services for people with disability as rights based approach into action beyond rhetoric. The process may begin with a survey to their vulnerabilities, the status of primary and reproductive healthcare services available to them and designing the life skills education and drop in centers specially tailored to their needs.
The themes of 'Universal Access and Human Rights and Keeping the Promise: Mainstreaming disability in the MDG Goals towards 2015 and Beyond' are two sides of a coin that deals with capturing the under-served yet susceptible segment of population to ensure protection, prevention, care and support and treatment as the citizen's right towards paving the path for achieving the MDG.
The writer is Chief Coordinator, Institute of Hazrat Mohammad (SAW), and can be reached at email@ihmsaw.org
Every year, countries, private and public sectors, professional and business organisations, media and academia across the world express their solidarity with the World AIDS Day on December 1 pledging renewed impetus on reducing stigma and discrimination and concentrating on the containment of the epidemic.
The theme this year is 'Universal Access and Human Rights'. It is evident that HIV/AIDS has reached a situation where it is concerned with human rights in the context of prevention, care and support and treatment. This also reflects global emphasis for reaching all segments of population with the needed services, as essentially the basic human rights paradigm. It simply translates into action that is concerned with the right to correct information in conjunction with the socio-cultural environment, the right to the needed services in user-friendly manner and the creation of enabling environment to reduce stigma and discrimination.
The key factor is vulnerability to risk of exposure. The Bangladesh country response initiated fairly early within the region in 1985 has progressed considerably in addressing the issues that determine the spread of the virus and the detriments towards containing it. The National HIV/AIDS and STD Policy and Strategy have undergone critical review and modifications that is based on evolving needs of the programme to provide the needed services. Involving stakeholder participation at all levels has successfully established unique and innovative approaches. Utilising alternative modalities that take cognizance of the socio-cultural and economical barriers, the national programme has launched the integrated approaches in 2004.
Expanding HIV/AIDS programme beyond the health parameters is a laudable initiative of Ministry of Health and Family Welfare, as it implicitly addresses issues of vulnerabilities especially, of young people and the gender concerns from all perspectives. The mass media campaign has very creatively branded HIV/AIDS through the slogan 'Banchtay Holay Jantay Hobay' (need to learn to survive) that has now become synonymous with the virus. As such the programme design is based on knowledge, attitude, behaviour and practice that protects individual from risk of exposure and encourages society to be compassionate and supportive.
However, within the context of the theme of human rights and universal access that alludes to population and geographical coverage the programme has missed a significant segment of population that is at risk due to their socio-economic marginalised status. The World AIDS Day is followed by the International Day of Persons with Disabilities on December 3. And the theme for this year is: 'Keeping the promise: Mainstreaming disability in the Millennium Development Goals towards 2015 and beyond'. The theme clearly indicates that persons with disability and their special needs are to be addressed in the context of mainstream human rights in all aspects. To ensure this process is embraced globally the Conventions on the Rights of Persons with Disabilities and its Optional Protocol was adopted by the UN General Assembly in 2006. Bangladesh signed the convention in 2007 and also ratified the optional protocol that creates an obligation for the country to uphold and follow the objectives of the treaty.
Despite the long drawn process of formulating the convention that was launched in 1982 through World Programme of Action there is no mention of HIV and AIDS in the definition of protecting the right of people with disability. The national HIV/AIDS policy, strategy, plan of action and programme does not directly address people with disability and in the Disability Welfare Act-2001, to protect and promote the rights of the people with disabilities the HIV/AIDS and reproductive health is incomprehensive. According to WHO 10 per cent of the world's population have disability and on the basis of this estimation approximately 15 million people with disability in Bangladesh do not receive the needs based health and reproductive health services for prevention of HIV/AIDS and sexually transmitted diseases.
It is indeed a paradox that the national programme is delivering customised services for different marginalised segment of population that are vulnerable through such remarkable initiatives, as youth friendly health services, drop in centers for harm and risk reduction for injecting drug users and female sex workers, treatment regimen and life skills education that prepares the young people for emotional and physical changes and the capacity to avoid risk and peer pressure. The National programme conducted survey on the situation and need for reproductive health services for young people and the findings helped develop innovative modalities to address demand driven services. But that the young people segment also consists of persons with disability has been conspicuously overlooked and the fact that people with disability in Bangladesh are economically marginalised compounds their vulnerability is not given due diligence.
The UNAIDS in response to the need for directives that is missing in the convention, formulated policy brief on Disability and HIV articulating the actions needed to increase the participation of persons with disabilities in the HIV response and ensure they have access to HIV services, which are customised to their distinct requirements. It elucidates the human rights standards but also raises queries whether people with disability are in reality at risk of exposure.
Individuals with disability have not been included in HIV/AIDS prevention efforts because it is believed that they have little or no risk for HIV infection. The World Bank and Yale University Global Survey on Disability and HIV/AIDS have proved this assumption wrong - men and women with disabilities are more likely to be victims of violence and rape and less likely to be able to obtain protection and prophylactic care. Information and HIV/AIDS messages often do not reach people with disability because of extremely low literacy rates and access to media and even if these do translating them into individual change is fraught with obstacles.
In the Bangladesh country context gender is a cross-cutting agenda for human development but women with disabilities remain at risk of HIV infection due to lack of awareness, sexual violence and coercion and absence of social security and coverage by the traditional HIV/AIDS programmes. The situation is worsened because of dislocation and mobility due to loss of livelihood caused by environment degradation and climate change impact creating additional disability related burden and marginalisation for women with disability. There is tremendous paucity of research, study and data on HIV/AIDS and disability within the Bangladesh country programme. The National response has progressed in leaps and bounds becoming a model of integrated approaches and public-private partnership. But the rights based and universal access approach falls short of its fulfillment without inclusion of people with disability and the infrastructure, specific needs based service provision and access to those.
The National HIV/AIDS response and the Disability Welfare Act 2001 need now to include specialised services for people with disability as rights based approach into action beyond rhetoric. The process may begin with a survey to their vulnerabilities, the status of primary and reproductive healthcare services available to them and designing the life skills education and drop in centers specially tailored to their needs.
The themes of 'Universal Access and Human Rights and Keeping the Promise: Mainstreaming disability in the MDG Goals towards 2015 and Beyond' are two sides of a coin that deals with capturing the under-served yet susceptible segment of population to ensure protection, prevention, care and support and treatment as the citizen's right towards paving the path for achieving the MDG.
The writer is Chief Coordinator, Institute of Hazrat Mohammad (SAW), and can be reached at email@ihmsaw.org