[ HIV/AIDS is a multisectoral task ]

HIV/AIDS – more than a health problem

The social and economic consequences of the epidemic have become all too clear in recent years. They ruin many development efforts. In Africa, where 75 per cent of the affected people live, the productive population is being diminshed dramatically. In the beginning mainly men have suffered from the disease. Now women account for the majority of the infected persons. That has drastic impacts on the lives of children and teenagers. More and more are growing up without parents. At the same time, ever more of them are also affected directly by the epidemic. Poverty is growing along with the disease.

HIV/AIDS is no longer only a health problem. Its impacts are also seen in other sectors. Lost working hours due to the illness or death of family members as well as people's own sickness and limited efficiency result in considerable burdens on small and large, public and private enterprises alike. Teachers are lacking in schools. Public health services are over-strained by the great number of ill people. Appropriate treatment cannot be given due to the high costs of effective medications, the poor supply of necessary equipment for diagnosing and monitoring therapy, and the lack of functioning management structures.

At the same time, HIV/AIDS is still characterised by taboos. Its causes are denied, and there is no appropriate education. Preventive measures get underway only sluggishly, political decision-makers avoid clear public statements. Meanwhile, ignorance, wrong assumptions and sexual violence result in unprotected sexual intercourse. The following examples make clear that a start must be made at many places at the same time and in a focused way. Knowledge must be conveyed, personal involvement established, taboos got rid of, institutional and organisational capacities strengthened, network forming supported and negotiating positions developed.


Journalists support fight against HIV/AIDS

"We have used condoms for 600 years," says Imam Ousmane Chérif Madani Haidara in Bamako, the capital of Mali. Its use does not conflict with the laws of Islam. On the contrary, the religion stipulates that believers must look after their health. That implies that everyone has to use all means to avoid infection with AIDS. Imam Madani Haidara is regarded a progressive, and has great influence in the Sahel state. For the journalists taking part in a two-week workshop on 'Press reporting on HIV/AIDS in Francophone Africa', his statement was extremely important. Mostly, the local media carry the more conservative views of Muslim clerics.

The media can play an important role in educating people on the pandemic and telling them how to protect themselves. However, to be able to write more informative, more understandable and more effective reports on the disease, the journalists must first know the medical facts and jettison their own prejudices, insecurities and fears.

For this reason, InWEnt’s International Institute for Journalism (IIJ) has launched a number of advanced trainings intended to enable journalists to improve their level of knowledge about HIV/AIDS. Talks with the Imam are just as important as are meetings with infected people and AIDS orphans and the objective and undistorted clarification of the medical facts. Too often the media have spread rumours and prejudices that are counterproductive to fighting the pandemic.

The seminar in Bamako brought together 15 journalists from seven West African countries. As part of the programme InWEnt set up a mailing list which is used for a lively exchange of information among the course participants and with the lecturers. This network is to be expanded continually.


Teacher training makes HIV/AIDS a topic

The marked spread of HIV/AIDS affects the education system in Africa in several ways. Trained teachers are missing due to sickness and early death, pupils are traumatised by the loss of their parents and close relatives and can hardly cope with caring for their younger brothers and sisters.

Teachers, teacher trainers and authorities have so far arknowledged this challenge only hesitantly. At the same time, school and teacher training plays a key role in the fight against HIV/AIDS. That applies both to the prevention as well as the responsible and sympathetic dealing with people living with HIV/AIDS.

Efforts over many years to develop appropriate life skills-curricula and teaching materials, as well as the integration of HIV/AIDS in all classroom subjects have not resulted in the success everybody expected. In late 2003, InWEnt took a new approach by organising a regional dialogue with 60 specialists and managers from education ministries, teacher training institutions, teachers’ trade unions and NGOs. Participants from Kenya, Malawi, Mozambique, Rwanda, South Africa, Tanzania and Uganda analysed the causes of the unsatisfactory status quo in their countries and developed recommendations for more efficient initial and advanced teacher training in the HIV/AIDS sector.

Among other things, the participants advocated compulsory short-term, comprehensive and practical HIV/AIDS programmes for all current and future teachers. The programmes should not only impart well-founded knowledge and organisational and advisory skills, but also enable the teachers to become change agents for altering behaviour and contribute actively to tackling the pandemic.
Management and teaching staff engaged in teacher training (colleges, universities, advanced training centres) must be prepared for this task. Their institutions should become model ones of a sure and sensitive dealing with HIV/AIDS which, besides providing intensive education, advice and care, also organises cooperation with local communities.

Based on years of experience in the sector of improving teaching quality, InWEnt’s Education Division supports this process by developing a suitable advanced training programme for administrative and teaching staff. Together with experts in the countries involved, InWEnt develops a standardised ‘blended-learning’ programme which should also interest teacher trainers in the vocational training sector.


AIDS is ruining Africa’s development achievements

In health care, InWEnt focuses on implementing programmes in sub-Saharan African countries, which is where most people infected with HIV live. The region also has the highest rate of new infections – mostly among young people, especially young women and their newborn children.

AIDS is ruining Africa’s development achievements to date. Life expectancy is dropping, economic performance is declining, production costs are rising. In South Africa, the gross national product in 2010 will probably be 17 per cent lower than it would have been without AIDS. In no other African country are there so many HIV-positive people as there are in South Africa. The infection rate among the 15-49 age group is more than 20 per cent.

The ‘UN Millennium Declaration’ and the German government's ‘Action Programme 2015’ are making fighting HIV/AIDS their top priority. At the same time, it will be imperative to develop a methodical approach for combating HIV and AIDS (co-ordinated with national programmes as well as those of UNAIDS / Joint United Nations Programme on HIV/AIDS and the World Health Organisation / WHO) that combines prevention and therapy.

InWEnt has in recent years integrated its engagement on HIV and AIDS in all its departments and day to day operations. In the Health Care Division the following programmes deal mainly with HIV and AIDS.
HIV/AIDS Online Course: As part of a programme for doctors, it offers foreign medical students in Germany seven modules on practically-oriented fundamentals and medical expertise for the prevention and treatment of HIV and AIDS. The course is given in German. It is currently being translated by partners in Vietnam and adapted to local needs. In future, the course may also to be implemented with other organisations – such as the German Development Service (DED).

Reproductive Health Care and HIV/AIDS: Besides sex education and the treatment of sexually-transmitted diseases, courses on Reproductive Health Care now focus on the subject of HIV/AIDS. The objective is to improve young people's access to information and services. The courses are implemented with expert partners in Niger, Cameron and Rwanda.

HIV and AIDS Management: The programme is aimed at persons in Southern Africa to qualify them for management of programmes on HIV/AIDS prevention and treatment. It conveys knowledge ranging from planning and situation analysis, the implementation of interventions and the development of training offers, to monitoring and evaluating HIV/AIDS programmes and quality assurance. The programme takes a multisectoral approach.


Dealing with HIV/AIDS at the workplace

Companies play an important role for an effective strategy against HIV/AIDS. In South Africa, for instance, a total of about eleven million people work in the formal and informal sector, the great majority of them in small to medium-sized enterprises. Since it is precisely the working age groups that suffer from the epidemic, the economic impacts will be disastrous in the long run. InWEnt banks here on sensitisation and training measures that reach a wide target group. The programmes are ‘Company strategies in dealing with HIV/AIDS for small to medium-sized enterprises (SMEs)’ and – together with DED – ‘AIDS Workplace Programmes in Southern Africa (AWiSA)’.

Workplace programmes (WPP), the challenges to medium-sized companies, and the prospects of successful implementation of such programmes were the focus of a workshop in Durban (South Africa). Representatives from seven sub-Saharan African countries had a week to compare notes and develop new strategies for implementing WPP.

A study commissioned by the South African Business Coalition on HIV/AIDS (SABCOHA) found that so far only 6.5 per cent of the country’s small companies and 51.7 per cent of the medium-sized ones had introduced workplace policies. Here, InWEnt uses a comprehensive range of instruments: For instance a risk assessment tool developed especially for the needs of SMEs enables managers to quantify the costs caused by the disease and the associated losses of productivity and profits.

Advisers of SMEs, trainers and managers of NGOs as well as representatives of the private sector are given training material developed especially for this purpose, called ‘Beyond the Balance Sheet’, which enables people involved in the management of the HIV und AIDS threat in small companies to better convey content to third parties.

The size of the problem is made more perceptible by addressing people’s senses with the help of ‘Industry Theatre’. It draws the attention of managements to HIV and AIDS. In a short play titled ‘Fire behind the mountain’, the disastrous impacts of the epidemic on their businesses’ staff and production situation are portrayed by using the example of a computer virus attack on a company’s data processing network. The play shows those responsible that doing nothing about the problem can threaten the existence of their business. It also arouses their willingness to open themselves to the taboo subject of HIV/AIDS. Subsequently, the training programme ‘Managing for Productivity’ prepares the ground for implementing workplace programmes.