A gist of the contents at the URL:
THE IMPLICATIONS OF HIV/AIDS FOR SOCIAL PROTECTION.
Rachel Slater, DFID, September 2004.
Contents
1.Introduction: why focus on social protection for HIV/AIDS?
2.What do we know about HIV/AIDS?
3.What do we know about social protection?
4.Assessing social protection interventions for HIV/AIDS.
5.Sequencing and prioritising social protection for HIV/AIDS.
6.Institutional roles: Who does what? Who can do what? And who should do what?
7.Conclusion: Policy recommendations.
8.References.
This paper makes the following policy conclusions and recommendations:
• Singling out the HIV/AIDS epidemic as a special and unique kind of crisis can be useful for directing resources and political attention towards dealing with the impacts of the epidemic. However, actual activities focusing on HIV/AIDS mitigation and coping should be part of larger programmes (for example those dealing with chronic illness or food security).
• Except in very specific circumstances, social protection mechanisms should target vulnerable people in order to reduce risks, some of which are the result of HIV/AIDS and some of which have other sources, rather than people affected by HIV/AIDS specifically/only.
• Support should be targeted to households and not just individuals, because of the problems that emerge when an AIDS patient dies and because, since it is generally orphans left behind, household recovery options are severely hampered.
• Direct targeting of HIV/AIDS orphans, as opposed to other orphans, raises equity and social justice problems and is, in many cases, inappropriate. HIV/AIDS orphans should be supported alongside other orphans who have similar needs, for example,with alternative curriculum and training at school to help them take on adult roles and responsibilities.
• Food for work (FFW) and cash for work (CFW) programmes can be appropriate for
HIV-positive but asymptomatic people, but these should be in parallel with other transfers, notably food and cash, for households that are labour constrained through morbidity or mortality effects. Running FFW and CFW programmes in parallel with food and cash transfers is important in preventing children, especially
orphans, from being forced into labour markets.
• Innovations in microfinance to support HIV/AIDS-affected and other vulnerable
households should be encouraged, accompanied by a careful consideration of the embedded inequalities in communities that may result in exclusion of HIV/AIDSaffected households.
• Various institutions have a role to play in contributing to or implementing safety nets. Outside HIV/AIDS-affected households and communities, other stakeholders,notably NGOs, governments and donors should scale up community safety nets without generating a ‘crowding out’ effect. Partnerships among NGOs, governments and donors are crucial in this respect.
• Better coordination is required among NGOs, governments and donors and could
be provided through a National AIDS Authority with a multi-sectoral mandate.
However, actual programmes and projects should be mainstreamed into sectoral
activities, in part to prevent HIV/AIDS exceptionalism.
• Social protection interventions should be designed around impact rather than
prevalence rates, and donors, governments and NGOs should ensure an
appropriate balance between prevention, care and recovery activities, whatever the prevalence rates.
• Donors and governments should acknowledge the policy choices that are made between fixed-life projects that promote people’s livelihoods through economic growth, and recurrent expenditure on social protection for households that cannot contribute to, and are unlikely to benefit from, economic growth. They should
recognise that the HIV/AIDS epidemic will create a long-term welfare bill and find ways of supporting this.
