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On the Front Line : a Review of Policies and Programmes to Address HIV/AIDS Among Peacekeepers and Uniformed Services

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On the Front Line : a Review of Policies and Programmes to Address HIV/AIDS Among Peacekeepers and Uniformed Services UNAIDS SHR Report 10/1/03 3:02 PM Page A ON THE FRONT LINE A review of policies and programmes to address HIV/AIDS among peacekeepers and uniformed services UNAIDS Series: Engaging uniformed services in the fight against HIV/AIDS UNAIDS SHR Report 10/1/03 3:02 PM Page B UNAIDS/03.44E (English original August 2003) © Joint United Nations Programme on HIV/AIDS (UNAIDS) 2003 All rights reserved. Publications produced by UNAIDS can be obtained from the UNAIDS Information Centre. Requests for permission to reproduce or translate UNAIDS publications— whether for sale or for noncommercial distribu- tion—should also be addressed to the Information Centre at the address below, or by fax, at +41 22 791 4187, or e-mail: [email protected]. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of UNAIDS con- cerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or of certain man- ufacturers’ products does not imply that they are endorsed or recommended by UNAIDS in prefer- ence to others of a similar nature that are not men- tioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capi- tal letters. UNAIDS does not warrant that the information con- tained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. WHO Library Cataloguing-in-Publication Data UNAIDS. On the front line : a review of policies and programmes to address HIV/AIDS among peace- keepers and uniformed services. (Engaging uniformed services in the fight against HIV/AIDS) 1.HIV infections - prevention and control 2.Acquired immunodeficiency syndrome - prevention and control 3.Military personnel 4.Civil defense 5.Security measures 6.United Nations 7.Review literature I.Title II.Series. ISBN 92 9 173331 9 (NLM classification:WC 503.71) UNAIDS SHR Report 10/1/03 3:02 PM Page i CONTENTS Acronyms ii Foreword iii Executive summary 1 Introduction 2 HIV/AIDS and security 3 Vulnerability of uniformed services to HIV 4 HIV prevalence and the uniformed services 5 The impact of HIV/AIDS on security 7 The UNAIDS Global Initiative on HIV/AIDS and Security 9 International security: peacekeeping and HIV/AIDS 10 Coordination of HIV/AIDS initiatives in peacekeeping operations 11 HIV/AIDS awareness and prevention 11 HIV testing policy 14 Regional peacekeeping operations 15 National security: strengthening the national response 15 Sub-Saharan Africa 18 Eastern Europe and Central Asia 20 Asia 21 Latin America and the Caribbean 22 Conclusion 23 Recommendations 24 End notes 25 ON THE FRONT LINE i A review of policies and programmes to address HIV/AIDS among peacekeepers and uniformed services UNAIDS SHR Report 10/1/03 3:02 PM Page ii ACRONYMS APMMC Asia Pacific Military Medicine Conference AFRIMS Armed Forces Research Institute of Medical Sciences (Thailand) AU African Union CHGA Commission on HIV/AIDS and Governance in Africa COPRECOS Commission on AIDS control and Prevention in Latin American and the Caribbean Armed Forces CSIS Centre for Strategic and International Studies ECOWAS Economic Commission for West African States FHI Family Health International GAO United States General Accounting Office GIPA Greater involvement of people living with HIV/AIDS ICG International Crisis Group IEC Information, education and communication ILO International Labour Organization IOM International Organization for Migration KAP Knowledge, Attitudes and Practices MONUC UN Mission in the Democratic Republic of the Congo NATO North Atlantic Treaty Organisation NEPAD New Partnership for Africa’s Development NIC United States National Intelligence Council PSI Population Services International SADC Southern African Development Community SANDF South African National Defence Force STIs Sexually transmitted infections SRSG Special Representative of the United Nations Secretary-General TCC Troop-contributing countries UN United Nations UNAIDS Joint United Nations Programme on HIV/AIDS UNAIDS SHR UNAIDS Office on AIDS, Security and Humanitarian Response UNAMSIL United Nations Mission in Sierra Leone UNDP United Nations Development Programme UNDPKO United Nations Department of Peacekeeping Operations UNFPA United Nations Population Fund UNGASS United Nations General Assembly Special Session UNMEE United Nations Mission in Ethiopia and Eritrea UNMISET United Nations Mission in East Timor US DOD United States Department of Defense VCT Voluntary counselling and testing WHO SEARO World Health Organization for Southern and Eastern Asia Regional Office ON THE FRONT LINE ii A review of policies and programmes to address HIV/AIDS among peacekeepers and uniformed services UNAIDS SHR Report 10/1/03 3:02 PM Page iii FOREWORD The fight against HIV/AIDS received a major peacekeepers and uniformed services is a boost when, in 2000, the United Nations desk review of policies and programmes being Security Council recognized HIV/AIDS as a undertaken to address HIV/AIDS among the uni- threat to human and global security, and called formed services around the world. It provides an upon the international community to develop overview of the actions taken by the UNAIDS programmes aimed at addressing HIV/AIDS Office on AIDS, Security and Humanitarian among peacekeepers. Response (SHR) to support countries in meet- ing their commitments. However,while it may be valuable to have United Nations HIV/AIDS prevention and education It is evident that, while great strides have been programmes within peacekeeping missions, a made in addressing HIV/AIDS among the uni- more sustainable approach would be for nation- formed services, a lot more work needs to be al uniformed services to integrate HIV/AIDS done to successfully mitigate the impact of the within their existing programmes, as part of an epidemic on national and international security. overarching national HIV/AIDS strategy. This In this respect, we urge all stakeholders involved approach was endorsed in 2001, when the UN in the fight against HIV/AIDS to pay particular General Assembly Special Session on HIV/AIDS attention to the recommendations outlined in adopted the Declaration of Commitment on this review. HIV/AIDS, whereby Member States committed themselves to developing policies and pro- grammes targeting the uniformed services. Ulf Kristoffersson On the front line: A review of policies and Director, UNAIDS Office on AIDS, Security and programmes to address HIV/AIDS among Humanitarian Response (SHR) ON THE FRONT LINE iii A review of policies and programmes to address HIV/AIDS among peacekeepers and uniformed services UNAIDS SHR Report 10/1/03 3:02 PM Page 1 EXECUTIVE SUMMARY • International security, with the focus on sup- porting HIV/AIDS interventions within In 2000, the United Nations Security Council United Nations peacekeeping operations. recognized HIV/AIDS as a threat to interna- tional and national security, with serious impli- • National security, targeting uniformed services cations for individuals, communities and States. with particular emphasis on young recruits, It also acknowledged the particular susceptibil- future peacekeepers and demobilizing person- ity of peacekeeping personnel to both con- nel. tracting the virus and transmitting it to the wider population. • Humanitarian response, which focuses on vulnerable populations in crisis settings and In June 2001, the United Nations General humanitarian workers. Assembly adopted the Declaration of Commit- ment on HIV/AIDS, whereby Member States As part of its national security initiative, committed themselves to developing and/or UNAIDS SHR, in collaboration with UN Theme strengthening national programmes targeting Groups, is providing support to countries for the uniformed services to address HIV/AIDS the development and/or strengthening of awareness, prevention, care and treatment. national responses targeting national uniformed services and, in particular, young recruits, demo- In response to the UN Security Council and the bilized personnel and peacekeepers. Declaration of Commitment on HIV/AIDS, the Approximately 45 countries worldwide are cur- UNAIDS Office on AIDS, Security and Humani- rently supported through the Initiative on tarian Response (SHR), formerly known as the HIV/AIDS and Security. Humanitarian Unit, created the Global Initiative on HIV/AIDS and Security, in partnership with Although much progress has been made in the its Cosponsors and other partners, including the response to HIV/AIDS among peacekeepers and UN Department for Peacekeeping Operations national uniformed services, the epidemic contin- (DPKO), to respond to HIV/AIDS among uni- ues to grow, affecting national, regional and even formed services worldwide. international security. The current efforts of the international community, Member States, partners This initiative focuses on mitigating the impact of and uniformed service personnel must be HIV/AIDS in three core areas: strengthened in the face of this growing challenge. ON THE FRONT LINE 1 A review of policies and programmes to address HIV/AIDS among peacekeepers and uniformed services UNAIDS SHR Report 10/1/03 3:02 PM Page 2 INTRODUCTION overall preparation for participation in peace- keeping operations. Men and women in the uniformed services, including defence and civil defence personnel as The Security Council asked the UN Secretary-
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