>>>> Major National HIV/AIDS Programmes - AIDS in Emergency Settings(NACAES)
AIDS in emergency settings – the Ugandan situation
The importance and need to incorporate HIV/AIDS in programmes responding to emergency settings is acknowledged globally as a requirement for comprehensive responses (link www.humanitarianinfo.org/iasc and www.aidsandemergencies.org ). Similarly, Uganda's Revised National Strategic Framework ( NSF ) recognizes internally displaced persons (IDPs) and refugees as vulnerable groups and at high risk of HIV infections, given the social and economic upheavals in their communities, and recommends strategies for addressing these groups
The IDP policy implementation structures both at district and national level, provide a means to further these strategies. The high level visit by Dr Peter Piot the UNAIDS Director to Uganda and the response by the Government of Uganda underscored the need to focus more attention on the HIV/AIDS response in Northern Uganda. This was subsequently endorsed by the Uganda AIDS Partnership in 2004.
Preliminary data from the national sero-surveillance (2004/5) indicate that HIV prevalence in the North Central region stands at 9.1% as compared to 7% at national level, close to current ante-natal in HIV prevalence in Lacor hospital in Gulu, quoted at 11.5% (2004). The long lasting conflict in the northern part of the country has been identified as the most important factor, increasing the contextual and behavioural risk, exposing women, children and young people to HIV and AIDS, for example through transactional sex.
There are generally high levels of poverty in the northern region mainly due to conflict which deters many people from engaging into productive work. Life in displaced camps is also impacted on by poor health and distorted socio-economic systems. According to the Uganda Demographic Health Survey (UDHS) 2000 report, only 50% of health centres are properly functioning in the districts of Gulu and Kitgum. The April UN/Local Government/Uganda AIDS Commission mission visits to the region (Gulu, Kitgum, Pader and Lira) also noted inefficiencies of coordination and delivery of HIV/AIDS prevention and mitigation services as well as capacities to respond appropriately and effectively to the situation. This observation was contradictory to the presence of stakeholders working in the region. Networks of people living with HIV and AIDS were noted to be in formation stages with limited capacity to effectively participate in programme development, implementation and monitoring.
Uganda AIDS Commission, together with the Office of the Prime Minister has embarked on a process, linked with the IDP policy, the NSF and the District HIV/AIDS coordination guidelines to improve coordination of actors in the emergency affected districts in order to ensure comprehensive service delivery and access for internally displaced persons in Gulu, Kitgum, Pader, Lira, Apac, Katakwi and Adjumani. A National Committee was established with common agreement on its terms of reference and a desk review has been undertaken to culminate in an action plan for the Northern Region to achieve this objective.
