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Regional Inter-agency Coordination Support Office (RIACSO), Southern Africa

Technical Consultation on Measuring Vulnerability in the Light of the HIV/AIDS Pandemic

HIV/AIDS and vulnerability: an overview of micro, meso and macro level implications

Prepared by TANGO International

9-11 September 2003

Johannesburg, South Africa

This document was first posted on the SAHIMS website:
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HIV/AIDS is currently one of the greatest threats to global development and stability. It is a long term humanitarian crisis that will last for decades. Since the emergence of the epidemic, more than 60 million people worldwide have been infected with the virus. Over 20 million have died. Of the 42 million people currently living with the virus, 28.5 million (71%) live in Sub-Saharan Africa with infection rates rising. Prevalence rates in Southern Africa are the highest in the world. UNAIDS estimates that almost 15 million people in Southern Africa were living with the virus at the end of 2001, and 1.1 million died of AIDS (UNAIDS 2002). The elderly now care for up to 8 million orphaned children by AIDS with little or no help (IRIN 2002). By 2010, AIDS will leave 20 million children under the age of 15 in Africa without one or both parents (UNAIDS 2002).

Transportation routes, poverty, civil conflicts and cultural practices regarding sexuality are the main causes for the spread of the disease. As impoverished families try to cope with the morbidity and mortality associated with the disease, a significant divestment of assets usually occurs, threatening the dissolution of the family unit itself. Community safety nets are slowly breaking down due to the number of households that require assistance in meeting care, food, cash and labor needs and their inability to repay assistance in kind. Community members that are left responsible for a large number of orphans are poor themselves, making care for these a children a heavy burden.

The crisis in Southern Africa highlights the complex interactions between HIV/AIDS, food insecurity and humanitarian action. An understanding of the complex and diverse ways that the epidemic affects micro, meso, and macro level conditions is necessary to understand how the pandemic is increasing underlying vulnerability and creating present and future emergencies. This expert consultation has been organized with the purpose to explore how HIV/AIDS impacts can be addressed in vulnerability assessments. This meeting is intended to review how HIV/AIDS is currently being integrated into definitions of vulnerability, how this is being measured, and what the potential indicators are for assessing impact.

The purpose of this paper is to present a general overview of the key issues that relate to HIV/AIDS and vulnerability, how this vulnerability manifests itself at multiple levels, and what measurement issues need to be taken into account to improve targeting and program impacts.

This paper begins by discussing why HIV/AIDS is different from normal food and livelihood insecurity shocks. This difference requires that we use a different kind of conceptual framework to look at HIV/AIDS, one that takes a multi-sector perspective into account. This discussion is followed by a review of the key issues that need to be considered in assessment and analyses that take place at the micro, meso, and macro levels. The paper concludes with a discussion of factors that need to be considered in the identification of indicators for the various levels.

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