Lao PDR

Responding to HIV/AIDS

Within the complex socio-economic milieu of South East Asia, the challenges of developing effective and multi-sectoral national responses to HIV/AIDS are immense. The causes and consequences of HIV epidemics in the region are closely linked and rooted in development challenges such as poverty, unemployment, gender inequality and social marginalization. Experience indicates that in order to develop effective policy and programme responses to the epidemic, a strong human development perspective needs to augment public health approaches. Since vulnerability to HIV is fueled by an atmosphere of fear, denial, stigma and discrimination, a range of issues from the social, cultural, psychological, economic, legal and ethical spheres need to be addressed.

In the Lao PDR, the HIV+ seroprevalence is low (estimated 0.1%) but HIV/AIDS is a growing concern, since the country is surrounded by nations with higher HIV+ rates (Cambodia, China, Thailand, Vietnam and Myanmar). The steady increase of population mobility, tourism, urbanization and seasonal migration between countries makes the Lao PDR even more vulnerable to the epidemic. High numbers of school dropouts with limited access to vocational and higher education or meaningful employment are also important factors. The low socio-economic status of women is an additional factor that further compounds HIV vulnerability.

The National Committee for the Control of AIDS (NCCA) has developed and launched the National Strategic and Action Plan on HIV/AIDS/STI 2006-2010 which will serve as a tool to guide all partners engaged in the national response on HIV/AIDS.

Enhancing Capacity for a Multi-Sectoral Response to HIV/AIDS in the Lao PDR

UNDP's HIV/AIDS programme entitled "Enhancing Capacity for a Multi-Sectoral Response to HIV/AIDS in the Lao PDR" was signed in October 2005 after a long formulation process where all relevant partners were consulted and where gaps to complement other activities in the field of HIV/AIDS were identified. This programme seeks to challenge the complacency towards HIV/AIDS that exists in many countries with low HIV prevalence. This programme’s right-based approach prioritizes the leadership roles of a wide range of stakeholders including the meaningful involvement and empowerment of people living with HIV/AIDS (PLWHA)
This 3-year project (2006-2008) will help strengthen the Lao PDR’s national response to HIV/AIDS through:

• A mobilized group of decision makers trained and supported to mainstream HIV/AIDS responses within the scope of their work and portfolios;
• An engaged and strengthened National Committee for the Control of AIDS serving effectively as overarching decision-making body, and providing policy guidance and oversight to a sustained, multisectoral response;
• Expanded capacity of the National Committee for the Control of AIDS Bureau to strategically plan, manage, monitor, evaluate and report on execution of multi-sectoral programmes;
• Improved capacity of the Centre for HIV/AIDS/STI (CHAS) as well as Provincial and District Committees for the Control of AIDS (PCCAs and DCCAs) to plan, manage and report on qualitative field programming;
• A model mainstreaming pilot on HIV/AIDS developed and documented in collaboration with the Ministry of Agriculture and Forestry and National Committee for the Control of AIDS for further replication by other line Ministries

The project strategies include:

• Mainstreaming and integrating responses on HIV in different line Ministries through multi-sectoral working groups and interaction platforms
• Greater involvement of people living with HIV/AIDS (GIPA) and partnerships bringing PLWHA organizations and government together for a meaningful involvement of PLWHA;
• An effective advocacy and communication strategy developed and implemented at national and provincial government levels across various line Ministries
• A macro level impact of this project will stem from the component titled, ‘Leadership for Results’, which will seek to strengthen the HIV/AIDS responses that are being undertaken at national level by building leadership capacity and organisational effectiveness among leaders, decision makers and opinion makers, who will lead responses. The programme aims to develop networks of innovative leaders from all sectors and all sections of society who can work together to create a response that is nation-wide, multi-sectoral and sensitive to the needs of those infected and affected.

One of the main value additions of this programme will be that it seeks complimentarity with and avoids duplication of activities undertaken by ongoing grassroots initiatives on HIV/AIDS by other national, UN and international agencies. This will be achieved mainly through a sharp and strategic focus on Upstream Advocacy and Capacity Enhancement of Leaders.
Strategic Outcome Indicators of this programme will include the following:

• Committed network of Leaders from across different Ministries, agencies and organizations undertaking a series of sustained ‘breakthrough’/pioneering initiatives on HIV related issues in Lao PDR
• Delivery effectiveness, strategic vision and knowledge base of Provincial and District Committees for the Control of AIDS enhanced through targeted skill development programme
• Innovative field-programmes pilot-tested with the Ministry of Agriculture and a template developed for undertaking similar cross-sectoral projects on HIV/AIDS with other Ministries based on lessons learned and through exposure to new thinking on HIV mainstreaming
• People Living with HIV/AIDS empowered through Greater involvement of people living with HIV/AIDS (GIPA) strategies being made mainstreamed within all HIV/AIDS responses/initiatives in the country.
• A self sustaining model for upstream policy advocacy and downstream pilot intervention pioneered in Lao PDR’s response to HIV/AIDS