Discussion
12 Oct - 2 Nov 2021

Discussion Room

Welcome to the HHD Strategy 2022 - 2025 Discussion Room!

This discussion room aims to generate a broad action-oriented discussion across a range of thematic areas including strategic innovation, data, digitalization, energy, financing, pandemic preparedness and the response to COVID-19, and the climate emergency.   


Please respond to one or more of the following questions, and indicate which question you are responding to in your post. Don't forget to click on the "Comment" button:

  1. The UNDP Strategic Plan 2022 - 2025 identifies strategic innovation, digitalization, data and development finance as enablers for its implementation. How can these enablers strengthen UNDP’s HIV and health work?
  2. In the current context (growing multidimensional risk and multiple concurrent crises, climate emergency, multiple pandemics - HIV, COVID-19, TB, malaria, and gender-based violence), what are the lessons and learning from the three action areas of the HHD Strategy 2016 - 2021 that should inform the HHD Strategy 2022-2025?
  • Action area 1: Reducing inequalities and exclusion that affect health and drive epidemics
  • Action area 2: Promoting effective and inclusive governance for health
  • Action area 3: Building resilient and sustainable systems for health
  1. The UNDP Strategic Plan 2022 - 2025 refers to pandemic preparedness. What should UNDP be doing in this area?  

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Comments (31)

Karin Santi Moderator

Week 1 - Discussion Summary (12 - 18 October):  

 

Dear Colleagues,

Thank you for participating in the first week of this important discussion on the on the development of the new HIV, Health and Development (HHD) Strategy 2022 – 2025.  We had a very rich discussion with many thoughtful contributions.  I am going to do my best to try and provide a summary of some of the points raised.

1.       The UNDP Strategic Plan 2022 - 2025 identifies strategic innovation, digitalization, data and development finance as enablers for its implementation. How can these enablers strengthen UNDP’s HIV and health work?

@MegDavis, on behalf of the  Digital Health and Rights Project, reminds us that digitalization can present several opportunities (e.g., access to information and services),  but also significant challenges (e.g., discrimination, gender and/or racial bias in AI, online and offline violence) that need to be effectively addressed in order to promote development and access to rights while preventing further discriminatory practices and violence.

@Edward Mberu Kamau’s response focuses on the importance of data as an enabler and the need to support countries in data generation, analysis, publication and synthesis of knowledge and it's application while highlighting the work of the Special Programme for Research and Training in Tropical Diseases. Still on the issue of availability of data @Cristhian Jimenez raised the issue of availability of data to inform policies and practices that take into account sexual orientation, gender identity and expression (SOGIE).  He mentions the groundbreaking LGBTI National Survey that provides solid evidence on the impact of stigma and discrimination on LGBTI persons. @Boyan Konstantinov  also addressed this topic in relation to the LGBTI Inclusion Index  developed by UNDP and partners.  The Index seeks strengthen disaggregated data collection to promote inclusive development of LGBTI+ people and aims to measure the levels or inclusion (or exclusion) of LGBTI people across five strategic areas of development: personal safety and security, civic and political participation, economic empowerment, health and education. 

 

2.       In the current context (growing multidimensional risk and multiple concurrent crises, climate emergency, multiple pandemics - HIV, COVID-19, TB, malaria, and gender-based violence), what are the lessons and learning from the three action areas of the HHD Strategy 2016 - 2021 that should inform the HHD Strategy 2022-2025?

  • Action area 1: Reducing inequalities and exclusion that affect health and drive epidemics
  • Action area 2: Promoting effective and inclusive governance for health
  • Action area 3: Building resilient and sustainable systems for health

@Deogratias Mkembela commented from experience in Tanzania and raised a number of points for UNDP to consider including supporting governments to ensure meaningful engagement of all key and vulnerable populations, engaging political leaders, parliamentarians, communities, national and international partners, private sector, academia in policy and strategic dialogues; strengthening the capacity of relevant national authorities for multisectoral and multi-stakeholders coordination, and providing technical assistance in the development policies, strategies, guidelines and normative tools to guide programming in HIV, TB and malaria .

@Holly Mergler states that a tool that could be included in the new strategy is the Social and Environmental Standards, which includes a specific standard addressing community health and safety as well as other provisions relevant to health should form a . The standards provide integrated risk management tools, including guidance on meaningful stakeholder engagement , impact assessment (including health impact assessment), and approaches for managing these risks in an integrated manner. The SES tool can thus assist in ensuring health risks are considered across all our programming as well as guaranteeing that the HIV, health and development support takes into consideration other risks (e.g. environmental impacts, climate change, gender, human rights, etc).

@Mamisoa Rangers states that UNDP’s work on health should be viewed through inequality and governance perspectives while at the same time a greater focus on the intersection of planet and people I.e. on planetary health is needed.

 

3.       The UNDP Strategic Plan 2022 - 2025 refers to pandemic preparedness. What should UNDP be doing in this area? 

@Melanie Judge provides an in depth overview of the effect of structural inequalities barriers that impede the extent to which key populations  and LGBTI persons can make informed decisions about their health, sexuality and reproduction, as well as accessing basic health services. She proposes that solutions include progressive law reform, strengthened democracy and gender equality,  a  greater consideration of human rights and an openness to their expressed needs and lived realities. In a similar vein, @Juana Cooke  stressed that in pandemic preparedness national emergency responses and national protection schemes must be inclusive, rights-based and sensitive to key populations, people living with HIV and LGBTI persons.  While @Mabvuto Katwizi Kango raises the importance of legal preparedness stating that it establishes the institutional structures and formal processes through which governments respond to disease outbreaks; and sets limits for the exercise of coercive power over individuals and businesses in order to mitigate the risk of disease spread.   

 @MarkDibiase highlights the key role played by community-based organizations in pandemic preparedness and response (e.g. collecting data on vulnerable populations, ensuring access to information and services of these populations, among others); and UNDPs work to strengthen them and facilitate dialogue with governments. @Pedro Jose Reyes shared an example of the Inclusive Socio-economic Recovery programme implemented in Dominican Republic in response to the COVID-19 pandemic.   While Michael J Smith states that within the context of the COVID-19 pandemic UNDP must continue lead work on social protection instruments, generating evidence and research to quantify the impact of specific social protection instruments, He considers that UNDP has a crucial role to play in understanding the design and implementation features that maximize impact, for example evidence on ‘cash plus’ linkages to social behaviour change communication which is needed to further assert the contribution of social protection to address norms and behaviours exacerbating risk and exposure to disease.

We hope you continue to be part of this conversation as we hand over to @Cecilia Oh and Jeremy Pivor who will serve as moderators for the week 2 of the discussion.

Karin and Andrea

Karin Santi Moderator

Dear Colleagues,

Welcome to the e-discussion on the development of the new HIV, Health and Development (HHD) Strategy 2022 – 2025. My name is Karin Santi and I work with the HIV and Health team based in Panama covering the Latin America and the Caribbean region. I am very pleased to be co-moderating the discussion with @Andrea Balzano who is working with UNDP’s gender team based in New York. We are looking forward to receiving your input on the following discussion questions:

  1. The UNDP Strategic Plan 2022 - 2025 identifies strategic innovation, digitalization, data and development finance as enablers for its implementation. How can these enablers strengthen UNDP’s HIV and health work?
  2. In the current context (growing multidimensional risk and multiple concurrent crises, climate emergency, multiple pandemics - HIV, COVID-19, TB, malaria, and gender-based violence), what are the lessons and learning from the three action areas of the HHD Strategy 2016 - 2021 that should inform the HHD Strategy 2022-2025?
  • Action area 1: Reducing inequalities and exclusion that affect health and drive epidemics
  • Action area 2: Promoting effective and inclusive governance for health
  • Action area 3: Building resilient and sustainable systems for health
  1. The UNDP Strategic Plan 2022 - 2025 refers to pandemic preparedness. What should UNDP be doing in this area? 

This is a great opportunity to help shape UNDP’s programme priorities for the next four years. It allows us to on reflect recent trends in global health and development and to focus our efforts to better respond to the major challenges of our time

Please remember to indicate which question you are referring to in your response. You are also welcome to respond in a language other than English – the SparkBlue platform has a translate function (see the “Select your language” option at the top right of SparkBlue). Do reach out to us if you have any trouble posting.  FYI - Moderators for week 2 will be cecilia oh and @Pivor, Jeremy. Moderators for week 3 will be @Douglas Webb and @Christine Wellington Moore.

We are excited to hear from you and to be part of the discussion!

Karin and Andrea

Cristhian Jimenez

Dear Karin and Andrea,

Thanks for opening this e-discussion! My name is Cristhian Manuel Jimenez, and I work for UNDP Dominican Republic CO as a technical assistant of the Being LGBTI in the Caribbean Project. I will answer the first question.

  1. The UNDP Strategic Plan 2022 - 2025 identifies strategic innovation, digitalization, data, and development finance as enablers for its implementation. How can these enablers strengthen UNDP’s HIV and health work?

From Dominican Republic CO we hace two examplers:

Firstly, our recent LGBTI National Survey is the first study of his kind in Central America and the Caribbean region, that provides evidence of the impact that stigma has on LGBTI people, as well as the social and economic costs related to the exclusion and discrimination to which they are subjected, which requires joint action by State institutions, civil society, academia, faith-based organizations, the media and the private sector to promote inclusion and end inequalities experienced by LGBTI people.

Secondly, developing researches on how the pandemic has impacted LGBTI people and other groups in vulnerable situations is another good example from our CO. You can find the document here: REPORT ON THE IMPACT OF COVID-19 IN LGBTI PEOPLE IN THE DOMINICAN REPUBLIC. This report was highlighted by the UN Independent Expert on violence and discrimination based on sexual orientation and gender identity in his report to the UN General Assembly at its 75th session, October 2020, as a best practice that governments should implement worldwide (read the Expert report here).

Both reports have catalyzed the interest of many government institutions, CSO's, academia, private sector, international cooperation partners, and other stakeholders to promote LGBTI inclusive policies nationwide with UNDP cooperation.

Hope that these examples can be helpful for the discussion, feel free to contact me in case you have any inquiries (email: cristhian.jimenez@undp.org).

Pedro Jose Reyes

Thank you for the opportunity. My name is Pedro Reyes García from UNDP Dominican Republic where I work as technical assistant for inclusion and human rights. I understand that working from what works is an excellent strategy in order to be effective and efficient in our actions focused on caring for the health of people in general and in the context of HIV.

Taking into account that LGBT people, migrants from Haiti and other refugees are part of the key populations, and that the UNS has recommended including statistics on people with disabilities as a group vulnerable to HIV, from UNDP Dominican Republic we have developed several actions in response to the impact of the Covid 19 pandemic on the aforementioned groups. Within the actions we frame two main ones; 1. The Inclusive Socioeconomic Recovery program; and 2. The Project for Strengthening the Capacities of Peer Counselors who Provide their Services at PLWHA Care Centers.

In this sense, we highlight these two actions, the first because it acts directly on the determining factors of both individual and collective health of the people who belong to these groups and the second as a fundamental element that affects the results of the strategy 95 -95-95.

The Inclusive Socioeconomic Recovery element is implemented as a timely response to the negative impact on the socioeconomic factors of people from vulnerable groups that have micro, small and medium-sized enterprises, which were affected by the pandemic. This program achieves its mission through the strengthening of management capacities, reinvention of challenges and development of resilience skills and as a result in the medium and long term guarantees people's livelihoods. It is important to highlight that as a mechanism to guarantee the success and sustainability of the program, strategic alliances have been developed with different state actors, academia and civil society. For more information you can access: https://www.do.undp.org/content/dominican_republic/es/home/sustainable-development/Recuperacion-Socioeconomica-Inclusiva.html

Regarding the strengthening of the Capacities of the Peer Counselors who Provide their Services in the Centers of Attention for PLWHA, we can highlight the importance of strengthening the target population of this project; the counselor as an element of value in the clinical care services for PLWHA. And it is that in the cascade of activities within the national response to HIV, the peer counselor is the direct contact with our patients and guarantees us other actions such as the identification of the chain of contact, adherence to medical visits and treatment. Therefore, it is one of the most important elements in the service chain that historically has not been valued. Taking into account the above, UNDP RD has identified this opportunity to improve the national response to HIV in which we are currently working.

Soon we will issue more comments.

I hope you will enjoy and use. Thanks

Karin Santi Moderator

Dear @Cristhian Jimenez  and @Pedro Jose Reyes  thank you so much for your important contributions sharing examples from your work in the Dominican Republic.

Cristhian’s contribution focuses on the importance of data as an enabler to inform policies and practices that take into account sexual orientation, gender identity and expression (SOGIE).  He mentions the groundbreaking  LGBTI National Survey that provides solid evidence on the impact of stigma and discrimination on LGBTI persons.  The survey results were shared during a national launch event and meetings are underway with different government departments to advocate for SOGIE sensitive policies and programmes.   It would be interesting to hear from @Boyan Konstantinov about the  LGBTI Inclusion Index which proposes to identify data gaps and trends, and provide evidence to advance and support policy, with the broader aim of ensuring LGBTI inclusion in the 2030 Agenda for Sustainable Development.

Research has shown that due to stigma and discrimination LGBTI persons are systematically excluded from opportunity in all facets of life, including education, employment, and health, which contributes to a higher probability of poverty, homelessness, and ill health.  @Pedro Jose Reyes shared an example of the Inclusive Socio-economic Recovery programme implemented in Dominican Republic in response to the COVID-19 pandemic.  In reference to the question on pandemic preparedness I would like to hear from colleagues on good practices to ensure that key populations are included and benefitting from social protection programmes.

I look forward to hearing from other colleagues,

Regards,

Karin

Boyan Konstantinov

Cristhian Jimenez , an important achievement, congratulations on the survey! And yes, as Karin mentions the LGBTI Inclusion Index which is developed by UNDP and partners, aspires to measure the levels or inclusion (or exclusion) of lesbian, gay, bi, trans and intersex people across five strategic areas of development: personal safety and security, civic and political participation, economic empowerment, health and education. The 51indicators are also compatible with the SDG target indicators.

As we write this, Professor Lee Badgett is finalizing the last of the five modules for the Index piloting this year.

The work on disaggregated data collection to promote inclusive development of LGBTI+ people has to continue and to be scaled up. I think we have an exciting opportunity to cross-fertilize the work with our efforts to promote digital technologies. The advancements in automatic data collection and analysis over the past few years may allow first and second tier data for the Index to be collected by software with little human engagement. New data generation, the third and most challenging tier is still likely to require significant human efforts.

The strategic setting on digital technologies in the new UNDP Strategic Plan, combined with a robust positioning of LGBTI+ work in the new HHD Strategy that we are discussing would guarantee UNDP's continued leadership in LGBTI+ rights, health and inclusive development. I will also share some thoughts about the opportunities in LGBTI+ work that go beyond the Index and data collection efforts.

Andrea Balzano Moderator

Thank you Karin Santi for the introduction and @Cristhian Jimenez  and @Pedro Jose Reyes for sharing the importance of UNDP's role as thought leader and advocate for inclusive public policies.  I am very happy to act as co-moderator of this discussion for the following week.

As a member of the Gender Team I can't resist inviting our colleagues from the Digital Team Carolin Frankenhauser and Keyzom Ngodup and the Gender Team Peace Kuteesa Nassanga to share their thoughts regarding Question 1, and particularly on how we can harness digitalization to strengthen our work on HIV and Health, but making sure we are not leaving anyone behind due to the existing digital divides (including the gender digital divide of course).

I would also like to bring in our colleague Brianna Howell to share some of the key data from the COVID-19 Global Gender Response Tracker - UNDP Covid-19 Data Futures Platform to enrich the discussion on Question 3 about pandemic preparedness.  The Tracker shows very clearly how lack of inclusion and diversity at the decision level, inevitably results in lack of inclusivity of the public policies designed and implemented.

Finally, I would like to encourage Country Offices, to share their wealth of experiences and lessons learnt on their work in the framework of the HHD Strategy 2016 - 2021 (Question 2).

I hope you can join this interesting discussion during the following weeks!

Andrea

Juana Cooke

Dear colleagues, greetings from Panama City, Panama.  

I would like to briefly comment on the question related to emergency preparedness:  "The UNDP Strategic Plan 2022 - 2025 refers to pandemic preparedness. What should UNDP be doing in this area?---

This speaks briefly to what Boyan Konstantinov   was mentioning, that data is necessary to promote inclusive development.  In many cases the information needed to obtain relevant data to inform decision-making processes lays within the key populations, people living with HIV and LGBTI persons. 

In order for national emergency responses and national protection schemes to be inclusive, rights-based and sensitive to key populations, people living with HIV and LGBTI persons, both national emergency plans and social protection schemes need to be designed accordingly.  Efforts should be made to advocate for the inclusion of LGBTI and key population CSOs and individuals  in their design, implementation and periodic evaluation. 

This could, for example, make it possible to develop preparedness plans that:

  • Understand that LGBTI seniors may be more isolated than other seniors, making it difficult for them to receive emergency messages;
  • Acknowledge that trans persons need to access shelters  in harmony with their gender identity;
  • That even in cases in which same sex couples are not  legally recognized-, these relationships should be acknowledged and allowed to maintain family unity not only in emergency response plans but also in any emergency protection systems that could be implemented;
  • That LGBTI persons experiences with government institutions may have been traumatic, making it difficult for them to trust the Police, Military or other public servants, even in the context of an emergency. 
  • Device mechanisms by which trans persons can access the totality of services made available in an emergency context, including access to menstrual health kits and access to abortion services in the face of gender-based violence. 

And design and implement social protection schemes that, for example :

  • Enable sex workers to access retirement and health plans;
  • Make it possible for same sex couples to receive pensions and social security benefits
  • Do not exclude persons who use drugs or take part in risk reduction programmes from accessing poverty reduction schemes

 

Mabvuto Katwizi Kango

The UNDP Strategic Plan 2022 - 2025 refers to pandemic preparedness. What should UNDP be doing in this area?  

Thank you for this opportunity.

Within the mandate of the strategy, UNDP could work towards ensuring that the law plays an important part in pandemic preparedness and response.  Rule of law offers an overarching framework to ensure health, justice and inclusiveness, even in the midst of a pandemic like COVID-19. Adherence to the rule of law means that law-making processes focused on public health emergencies and controlling infectious diseases need to be transparent, laws

should be publicly disseminated and enforced fairly, and when required, independently adjudicated through courts and tribunals that ensure the administration of law and its substantive content is consistent with international human rights standards. The rule of law is especially important as many public health measures, such as lockdowns and other restrictions on movement and activities during outbreak of infectious diseases, require community support to be fully effective. When state authorities overreach or discriminate, individuals need avenues to seek independent review of decisions that restrict their fundamental rights.

UNDP could also work with partners to enable countries have legal preparedness, i.e. countries have legal and policy frameworks that will help them handle pandemics. The law plays a critical role in preventing and mitigating health consequences of emergencies such as the COVID-19 pandemic in two important ways:

  1. it establishes the institutional structures and formal processes through which governments respond to disease outbreaks; and
  2. it sets limits for the exercise of coercive power over individuals and businesses in order to mitigate the risk of disease spread.

Good legal and policy frameworks contribute to the prevention of infectious diseases by improving access to vaccinations and by facilitating screening, counselling and education of those at risk of infection. Despite differences, all states need effective legal frameworks to deal with important public health challenges shared across nations and regions, especially during public emergencies such as infectious disease pandemics.

The Strategy could currently be referring more to response than preparedness, but UNDP can be doing both. The preparedness and response should be towards pandemics and not just COVID 19. The lessons learned from COVID 19 can be used to make the world better prepared for future pandemics. The work on preparedness should not be designed to be one-off, as pandemic preparedness is a continuous process of planning, exercising, revising and translating into action national and sub-national pandemic preparedness and response plans.

Judit Rius Sanjuan

Dear Mabvuto Katwizi Kango, thanks for your excellent comment on the rule that the LAW can play on pandemic preparedness and response. The UNDP HHD team, we are working on strategies to promote legal and policy coherence to increase access to medicines and would like to connect to explore how we can strengthen this work. One of our most recent effort have been a webinar on the use of competition law with the Government of Namibia and the Namibia Competition Authority. You can find more information here: https://hivlawcommission.org/2021/10/01/undp-govt-of-namibia-namibian-c… 

Melanie Judge

Thanks for the opportunity to contribute. Here are some thoughts:

With a focus on LGBTI populations and pandemic preparedness, the disproportionate and specific impacts of Covid-19 have been well documented (see https://aqyi.org/resources/aqyi-report-young-and-outside-the-margins-impact-of-covid-19-on-african-lgbt/ ; https://outrightinternational.org/content/vulnerability-amplified-impact-covid-19-pandemic-lgbtiq-people). Strategies require consideration of these impacts and their implications for health and development outcomes. Research also shows that structural inequalities are exacerbated under pandemic conditions and related to increased securitisation (see https://www.amnesty.org/en/documents/act30/3443/2020/en/). This is compounded by the risk that attention will be redirected away from, rather than towards, structural impediments to more sustainable and equitable health systems and in the name of urgent Covid responses. In a time of pandemic, uncomfortable truths about enduring inequalities can easily be crowded out, whereas the varying vulnerabilities it exposes require pointed attention - so as to ‘build back better’ effectively, sustainably and transformatively. Poverty is a critical factor here, also because impoverishment intersects with other axes of exclusion (eg those related to SOGI, gender and/or racial discriminations) and these interlinkages require strategies that are both intersectional and multisectoral in approach.

Structural obstacles to equitable health access remain intact. These includes discriminatory laws, policies and political discourses that continue to criminalise and stigmatise LGBTI people. Increasingly accountable governance practices, alongside strengthened civil society efforts to hold states and their institutions to account, are important to advancing health systems that work for those who remain marginalised. Forging firmer connections between local knowledges/experiences and global levers of social, political and economic power, will enable marginalised communities to increasingly influence health and development agendas – not solely as beneficiaries, but also as shapers of development trajectories.

Digitisation and data are of course crucial, however, risk mitigation strategies are important in light of how new technologies are being mobilised against the advancement of human rights. This is seen in the backlash against sexual and gender rights gains, globally. The backlash includes a steep rise in the use of platforms by extremist political leaders and religious groups to promote bigotry, dehumanize persons based on their sexual orientation or gender identity (see https://www.ohchr.org/Documents/Issues/SexualOrientation/IESOGI/Reports_on_Gender_Final_Summary.pdf). It poses a risk to the rights of all women (including lesbian, bisexual and trans women) as it fuels violence and discrimination and strengthens global financing and organising to promote laws and cultural norms that are  both anti-LGBTI and anti-women (see https://www.dailymaverick.co.za/article/2021-08-18-ghana-ignores-united-nations-experts-appeal-to-drop-anti-lgbtqi-bill/ and https://www.opendemocracy.net/en/5050/trump-us-christian-spending-global-revealed/)

The reality is that, “There are likely hundreds of millions of LGBTI people in the world, nearly all of whom experience some degree of social exclusion” (Inter-Agency Regional Analysts Network, A Global Outlook on LGBTI Social Exclusion through 2030, 2018, p4). Attending to this exclusion recognises the role of institutions in allocating resources and assigning value in ways that systematically deny some groups equal recognition. We know that identity often forms the basis for such exclusion. Consequently, the purposeful inclusion of LGBTI populations in the future strategic outlook should also be informed by how the SDGs are made directly applicable to sexual and gender minorities, pointing to where some of the development blockages lie (See https://www.undp.org/publications/sexual-and-gender-minorities).

GBV continues to directly impact women, girls and LGBTI persons, compelling strategies to dismantle discriminatory gender and sexual norms (legitimised through problematic deployments of religion and culture), and to promote their full participation in social, economic and political life. Alongside needed reforms in the regulatory environment, system changes also concern transforming the unequal distribution of resources, capabilities and rights across multiple levels. Here, ethical and accountable governance is a gateway to more inclusive health and development systems, structures and practices. UNDP’s Inclusive Governance Project in the Africa region is a growing repository of learning in this area (see https://www.africa.undp.org/content/rba/en/home/library/the-inclusive-governance-initiative.html ).

Failing to addressing criminalization and other structural barriers will result in the response to HIV in Africa taking longer and costing more (see “Lessons learned from regional programming  with LGBTI and other key population groups in Africa  #WeBelongAfrica”). Structural barriers continue to impede the extent to which key populations can make informed decisions about their health, sexuality and reproduction, as well as accessing basic health services. Remedies include progressive law reform, strengthened democracy and gender equality, and greater consideration of human rights and the institutionalisation of structural inclusion. Also necessary is expanding the choices, participation and capabilities of key populations in respect of access to public services that are more relevant and responsive to expressed needs and lived realities.

 

Edward Mberu Kamau
  1. The UNDP Strategic Plan 2022 - 2025 identifies strategic innovation, digitalization, data and development finance as enablers for its implementation. How can these enablers strengthen UNDP’s HIV and health work?

Among the several ways to strengthen the availability and utilization of data is to provide a structured approach that will equip country programs with skills for data generation, analysis, publication and synthesis of knowledge and it's application. This ensures sustainability and reduced reliance on external experts, while producing locally relevant disaggregated data to drive the "leaving no one behind" clarion call. This is also in support of a key health system cross-cutting component and useful asset for addressing emerging and re-emerging global health crises. The staring point being the routinely collected program data of assured accessibility and quality. For over tens years, TDR has been leading an initiative on Structure Operation Research and Training (SORT IT) that is adaptable to diverse themes, diseases and geographic settings. The course delivery is currently piloting a virtual platform that would also support hydrid facilitation and mentorship. 

  SORT IT operational research and training (who.int)

Karin Santi Moderator

A big thank you to those colleagues that have contributed to the discussion.  @Juana Cooke stressed that in pandemic preparedness national emergency responses and national protection schemes must be inclusive, rights-based and sensitive to key populations, people living with HIV and LGBTI persons.  While @Mabvuto Katwizi Kango  raises the importance of legal preparedness stating that it establishes the institutional structures and formal processes through which governments respond to disease outbreaks; and sets limits for the exercise of coercive power over individuals and businesses in order to mitigate the risk of disease spread.   

While @Melanie Judge provides an in depth overview of the effect os structural inequalities barriers that impede the extent to which key populations  and LGBTI persons can make informed decisions about their health, sexuality and reproduction, as well as accessing basic health services. She proposes that solutions include progressive law reform, strengthened democracy and gender equality,  a  greater consideration of human rights and an openness to their expressed needs and lived realities.

@Edward Mberu Kamau’s response focuses on the importance of data as an enabler  and the need to support countries in data generation, analysis, publication and synthesis of knowledge and it's application. Edward also highlights the work of the Special Programme for Research and Training in Tropical Diseases.  @Boyan Konstantinov  also addressed this topic in relation to the the LGBTI Inclusion Index  developed by UNDP and partners.  The Index seeks strengthen disaggregated data collection to promote inclusive development of LGBTI+ people and aims to measure the levels or inclusion (or exclusion) of LGBTI people across five strategic areas of development: personal safety and security, civic and political participation, economic empowerment, health and education.

I look forward to hearing from other colleagues over the coming days

Karin

Meg Davis

Dear colleagues,

Thanks very much for the invitation to contribute to these important discussions. I am principal investigator of the Digital Health and Rights Project, a consortium of social scientists, human rights lawyers, and civil society organizations including people living with HIV from Bangladesh, Colombia, Ghana, Kenya, Norway, Switzerland, and Vietnam who are collaborating on research and policy recommendations to protect human rights in health in the digital age. We recently published two new working papers to share our initial analysis based on legal and policy analysis, and discussions with communities:

We share UNDP's excitement about the potential opportunities these new digital technologies offer for improved access to health information and services - especially for young women, people living with HIV, and key populations in low and middle-income country. We see them offering enhanced access to SRHR information and HIV services, as well as new platforms for solidarity, peer support, and rights-based advocacy.

At the same time, we are concerned that UNDP and other international partners must not uncritically promote these technologies in countries as 'silver bullets' in weak health and legal systems, without adequately addressing the risks, especially to women and marginalized groups. These include issues of discrimination, equity, algorithmic bias, online and offline violence, and more. We saw a disturbing example of this in Afghanistan, where digital ID systems including biometrics supported by the World Bank and other international partners were captured by security agents and used to target individuals. In Kenya, the high court has found that state rollout of digital ID systems were unconstitutional due to lack of data protection.

Under the circumstances, it's critical that the new UNDP strategy not promote a heedless rush into digitization without including robust, well-funded plans and adequate staffing to roll out the excellent new guidance on ethics and human rights in digital health, and ensure this is taken up in countries. We are all ready and happy to collaborate with UNDP in helping to ensure digital health rights is not just beautiful norms at the global level but are upheld and promoted at country levels too. 

in solidarity

Meg

Mark Dibiase

UNDP can play a key role in promoting pandemic preparedness, in particular on strengthening the role of communities. Research has shown that community-based organizations are integral to building trust between communities and government, and other stakeholders involved in the response, and to reaching the most vulnerable populations with information as well as quality health services. This is true of any health-related response, but COVID-19 has brought to the fore the need for governments to engage community organizations in order to reach marginalized communities and to have an effective outbreak response.   

In its partnership with the Global Fund, UNDP has strengthened community organizations working on HIV, TB and malaria programmes by, for example, improving understanding of financial planning processes, policies and budgetary documents; developing resource mobilization strategies; understanding of M&E and PSM frameworks; and development and implementation of advocacy strategies.  UNDP continues to hold space for critical dialogues on legal, policy and other barriers to accessing services.

One chronic gap for many countries is the lack of reliable data on key and vulnerable population HIV and TB incidence and prevalence. Community-led monitoring is one solution to address this gap and presents an opportunity to collect and analyze granular data, including on service disruptions or stock outs.  In the context of COVID-19, robust data is equally essential to inform programmatic and geographic priorities.  Donors should scale up funding and sufficiently invest in developing and strengthening community monitoring systems.

Another area to be strengthened is meaningful community participation in decision-making processes. Too often CSOs and community members are excluded from decisions which have direct impact on their access to and uptake of health services.  UNDP has a role to play in facilitating dialogue between government, CSOs and other partners and building trust and cooperation. Finally, documenting the lived experiences of communities and strengthening the evidence base on the impact of COVID-19 on vulnerable populations (the real effects of which will only be fully known over coming years), is another area where UNDP can contribute.

Andrea Balzano Moderator

At the end of the first week of our discussion @MegDavis, on behalf of the Digital Health and Rights Project, reminds us that digitalization can present several opportunities (e.g., access to information and services),  but also significant challenges (e.g., discrimination, gender and/or racial bias in AI, online and offline violence) that need to be effectively addressed if we want to support our partners to promote development and access to rights while preventing further discriminatory practices and violence (Question 1).

@MarkDibiase highlights the key role played by community-based organizations in pandemic preparedness and response (e.g. collecting data on vulnerable populations, ensuring access to information and services of these populations, among others); and UNDPs work to strengthen them and facilitate dialogue with governments (Question 3).

Thank you for this week of insightful comments and lessons learnt.  I hope the rest of the discussion includes more voices from the field, to enrich the development of the new HHD Strategy 2022-2025.

 

Deogratias Mkembela
  • The Government of Tanzania (GoT) has made great strides in scaling up of HIV interventions (prevention, care, and treatment) which reflects the consistent reduction of HIV prevalence over the past 20 years. Given the disproportionately high burden of HIV among the Key and Vulnerable Populations (KVP), a significant share of the investment goes to combination prevention interventions targeting these highly marginalized populations. Due to prevailing country laws, culture, norms and traditions, these groups are criminalized and experience stigma and discrimination which affects their access to HIV services. In realization of this, with support from UNAIDS (also with complementary support from other multilateral and bilateral development agencies), the government (under the leadership of Tanzania Commission for AIDS (TACAIDS) and in close coordination with National AIDS Control Programme-NACP) has been implementing activities that are geared towards creating an enabling environment for Key and Vulnerable Population (KVP) programming, including those that are centered on changing policies, guidelines, and service delivery standards. As a result of these efforts, HIV/AIDS Prevention and Control Act (HAPCA) No. 28 of 4 April 2008 was amended in the year 2019; age of consent for testing was lowered down to 15 years of age, and also HIV self-testing was included as part and parcel of standard care. However, several structural barriers still remain.   This phenomenon could partially explain why Tanzania did not achieve the global targets to reduce new HIV infections by 75% by the end of the year 2020.  The Global Prevention Coalition Report (2020) indicates that, from 2010 – 2019, the country-wide HIV response efforts have been able to drop new HIV infections by only 13% compared to the national goal – as per the 4th National Multisectoral Framework (NMSV IV) which set an ambitious target to reduce new HIV infections by 85% by the end of year 2023.  This calls for concerted efforts by the GoT to continuously assess the current prevention landscape and further institute policy changes at various levels to facilitate the smooth implementation of impactful interventions targeting KVP and general population.

 

The following are key interventions for HHD 2022-2025 strategy I am proposing:

 

  • It is critical for UNDP to continue supporting the Government of Tanzania to establish meaningful engagement of all KVPs through KVP forum in designing, implementation, monitoring, and evaluation of services. UNDP to support development of KVP guidelines development and review, M&E tools development and reviews, Integrated biological behaviour Survey and Size estimates of KVP (including mapping and enumeration). Lastly increasing access to health commodities for prevention and treatment purposes through promotion of local production.

 

  • Engage, mobilize, and sensitize political leaders, parliamentarians, communities, national and international partners, private sector, academia in policy and strategic dialogues, including on the 2021 Political Declaration and the 2021/2026 Global AIDS Strategy to end AIDS
  • Strengthen the capacity of relevant national authorities (including sharing of best practice, south learning) for multisectoral and multistakeholders coordination, accountability, and strategic planning at national and subnational levels (Regional and LGAs), including private sector, to mainstream, scale up and sustain the gains achieved through programmes in HIV, TB and malaria responses, with special focus on populations left behind
  • Provide technical assistance in the development policies, strategies, guidelines and normative tools to guide programming in HIV, TB/HIV, TB and malaria and build capacities (trainings, mentorships, supportive supervision) deliver quality services and reach out populations left behind
  • Promote Innovation and Digital Transformation
  • Advocate for and ensure the continuity of essential HIV services during health emergencies including the COVID19 pandemic
  • Strengthen Public, Partnership partnerships for HIV, TB and Malaria,
  • Engage and empower people living with HIV, people affected by HIV, TB and Malaria and their networks/associations, key and vulnerable populations, and indispensable decision makers for the HIV response for the domestication of the 2021 Political Declaration and the 2021/26 Global AIDS Strategy to end AIDS and the sustainable development agenda of ending the three epidemics
Michael J. Smith

Dear all,

Many thanks for the opportunity to contribute to this innovative process. 

Let me start by saying, identifying strategic innovation, digitalization, and data as hallmarks within the UNDP Strategic Plan 2022-2025 is crucial. Often, WFP field staff have cited the lack of access to reliable data as a key impediment to our work on the global AIDS response.

In a recent two-week workshop hosted by WFP, ILO, and UNAIDS on HIV-sensitive social protection with CSOs, numerous participants highlighted the urgent need for systematic, data-driven processes for identifying beneficiaries in need of social protection.

Participants also highlighted a paucity of available data when it comes to extant evidence on the adequacy of social protection coverage for the most vulnerable, such as individuals and households dealing with HIV. Bolstering national registries was also identified during the workshop as a key next step. 

The lack of data is also a common scenario in emergency or humanitarian situations. For example, internally displaced persons and refugees (or forced migrants) are usually not systematically included in HIV surveillance systems, nor consequently in prevention activities. Standard surveillance systems that rely on functioning health services may not provide useful data in many complex emergency settings. There must be improvements in this area to have a more accurate sense of the situation. 

In the context of the current COVID-19 global pandemic, global social protection responses have been unprecedented in both speed and scope. However, there continue to be severe shortcomings in how social protection adjoins with the public health sector to offer a coherent approach to address epidemics and the additional aggregate needs, risks, and vulnerabilities that they cause as syndemics. To address this gap, WFP has progressively scaled up its work in social protection, supporting over 80 countries to develop, adapt, or expand social protection to support the most vulnerable. In order to cope with syndemics, social protection must be central to the global response, offering properly phased, layered, and sequenced programming that is adequate and comprehensive across the life course.

WFP has begun to develop an epidemiologically smart social protection framework and will submit a manuscript to a peer-reviewed journal to substantiate this agenda. The paper has introduced an epi-smart framework, representing a novel effort to bridge public health and SP sectors in the context of large-scale infectious diseases. It provides a substantial contribution to public health, by collating the evidence demonstrating social protection's role in epidemics and the potential to enhance such a role by adopting a systematic approach across a continuum of care that links efforts from both sectors.

Finally, UNDP must continue to convene a wide array of stakeholders in terms of partnerships, like UNAIDS, but also programming. UNDP must continue to drive work around social protection instruments, generating evidence and research to quantify the impact of specific social protection instruments, such as school feeding, PWPs, and social health insurance, moreover when they are used in tandem, considering the historical and growing attention given to unconditional cash transfers. UNDP has a crucial role to play in understanding the ‘enabling’ design and implementation features that maximize impact. For instance, evidence on ‘cash plus’ linkages to social behaviour change communication is needed to further assert the contribution of social protection to address norms and behaviours exacerbating risk and exposure to disease.

Hope this helps! 

Best,

Michael 

Mamisoa Rangers

Good evening from Luanda. My name is Mamisoa Rangers, DRR for UNDP in Angola. Responding to question 1, I would say first that after Covid-19 and after the BLM movement, we have the duty to innovate. At the same time, our entry points into health remain relevant, and were heightened by the pandemic. These are inequality and governance. So I see these two streams as still core to our engagement. At the same time, we need to do more at the intersection of planet and people I.e. on planetary health. From an operational point of view, I would like us to move beyond procurement support services and grow our role on health policy from the angle of inequality, governance and planetary health. 

Holly Mergler

Dear Colleagues,

Thanks so much for the opportunity to contribute to this discussion and the shaping of the Strategy. I wanted to share a few thoughts related to question two and multi-dimensional risks that require integrated solutions.

One tool that UNDP has that could be incorporated in the Strategy is our Social and Environmental Standards, which includes a specific standard addressing community health and safety as well as other provisions relevant to health. The standards provide integrated risk management tools, including guidance on meaningful stakeholder engagement (which I see has been raised several times in the discussion), impact assessment (including health impact assessment), and approaches for managing these risks in an integrated manner. Therefore, the SES help to ensure health risks are considered across all our programming as well as ensuring our HIV, health and development support takes into consideration other relevant risks (e.g. environmental impacts, climate change, gender, human rights, etc). The SES also provide an approach  that can be applied to help our partners address these multi-dimensional risks in an integrated manner. 

The new Strategy provides an opportunity to link with the SES and an entry point for strengthening our internal capacities, tools, and processes for ensuring health risk is a key element of risk-informed development and UNDP programming. For example, there is currently a cohort of colleagues being trained on SES Standard 3 as part of a GPN SES Training of Trainers. Once certified, they will become part of a growing cadre of experts that can support integrated risk management in our programming, including health risks. @David.Maier may also have points to add. 

I hope this might be helpful and thanks again for the opportunity to contribute!

-Holly

Timothy Hudson David Culasino Carandang

Greetings from the Philippines! Good day, I'm Timothy Carandang, an underboard doctor working as an evidence reviewer for our local COVID CPG and a member of the Planetary Health Philippines. 

I will answer the question: 

The UNDP Strategic Plan 2022 - 2025 refers to pandemic preparedness. What should UNDP be doing in this area?  

Applying the syndemic hypothesis of Talman, Bolton and Walson (2013), the UNDP should address issues in land degradation resulting to food insecurity, identified to be one of the major factors increasing the internal and external vulnerabilities of communities and households and decreasing their coping capabilities. These imbalance then causes changes in socio-sexual behavior which contribute to the increase of HIV transmission and infection. A paradigm shift from the traditional medical view, which is too narrow from a planetary health perspective, to a more inclusive planetary view should be adapted to address ultimate upstream factors complexly interacting, such as climate change and stability of governments. Only then can we be more equipped for pandemic preparedness.

Thank you for the opportunity to contribute. 

Reference: Talman A, Bolton S, Walson JL. (2013). Interactions between HIV/AIDS and the environment: toward a syndemic framework. Am J Public Health. 103(2):253–261.

 

cecilia oh Moderator

Dear colleagues

We are pleased to start Week 2 of the e-consultation for the development of the new HIV, Health and Development (HHD) Strategy 2022 – 2025. My name is Cecilia Oh; I coordinate the work related to innovation and access to health technologies in the HIV and Health team, based at the UNDP Bangkok Regional Hub. My co-moderator is Jeremy Pivor, who is the Senior Program Coordinator of Planetary Health Alliance, at the Harvard TH Chan School of Public Health.

Many thanks to the moderators, Karin Santi and Andrea Balzano, and all contributors in Week 1 for kicking off the discussion. We hope to take forward a similarly rich conversation! As with Week 1, we are keen to hear your responses to the 3 questions that Karin has outlined above (which are also highlighted at the top of the page).

We thought it might also be interesting to ask if you have additional insights to share on collaboration and partnerships. For example, what kinds of collaborations have yielded results and impact in your work, and why?

Remember to indicate which of the three questions you are responding to. And you can also use the translate function to respond in another language (see the “Select your language” option at the top right of SparkBlue). 

We look forward to hearing from you.

Cecilia and Jeremy

Belynda Amankwa

Some learnings and insights from implementation of the  Access and Delivery Partnership  (ADP) a UNDP led collaboration between WHO, TDR, PATH aimed at strengthening effective access to new vaccines, diagnostics, medicines for malaria, TB and NTDs, could be useful as we develop the new HHD strategy.

Some of these key learnings highlight the importance of :

  • Partnerships. Harnessing partnerships with both traditional and non-traditional partners will help to magnify our impact.  As exemplified by the ADP which is made up of four partners- UNDP, WHO, TDR and PATH who work within the partnership based on their varied comparative advantages
  • Programming based on unique country contexts. ADP has been very deliberate about enhancing country ownership and sustainability. This has been done by developing context and country specific integrated and coherent solutions based on country priorities. This approach helps to enhance sustainability of Interventions.
  • Utilizing multi-sectoral platforms Convening key stakeholders across sectors and supporting capacity building across sectors sustains gains. Through ADP's support for multi-sectoral platforms and capacity strengthening, national partners in Ghana equipped with the skills and tools acquired through ADP  formed  the  SAVING Consortium to identify and address implementation challenges for the efficient and effective delivery and uptake of the malaria vaccine and any other medical interventions.
  • Digitization
  • Strengthening the use of digitization yields multiple benefits. This is well illustrated by ADP's support to Ghana's Food and Drugs Authority for the development of the med safety app which even though was designed originally for reporting adverse drug reactions is currently proving useful for the reporting of adverse reactions following COVID-19 vaccinations.
  • South -south learning:  Countries with similar contexts can learn very much from each other and benefit from available expertise within their countries. ADP by its nature works across different countries and contexts and deliberately creates opportunities for south -south collaboration and learning. This kind of learning has proven to be sustainable and very beneficial

Furthermore to respond to Q3

  • UNDP's pandemic preparedness should focus on strengthening health systems to make them "pandemic proof" so that countries are able to continue essential health service provision for TB, Malaria, HIV and NTDs even during pandemics
Yuria Celidwen

Dear Community, 


Exciting to see how we move forward much more powerfully together. 


One key question that we need to address in our conversation on health is how Indigenous wisdom can be of extraordinary help to find solutions for resilience. Research has shown that Indigenous Peoples have the least access to health, education, and services worldwide, and yet their resilience towards health and climate crises is outstanding. Much has been said about how the Agenda 2030 "Leaving No One Behind" motif has actually left out Indigenous Peoples, and yet the communities find paths to strength. Today, there is a promise of inclusion in all our international cooperation efforts, and following on this, the key factors of strong family bonds, community responsibility, and ecological land management of Indigenous Peoples are to be taken a seat in all our decision-making processes. 

 

cecilia oh Moderator

Thank you colleagues for your insights! Belynda Amankwa for your insights on partnerships and cross sectoral collaboration, arising from the ADP experience. Such relationship building also acknowledges that health policy and programming needs to be multi-sectoral and inclusive. This also speaks to the point made by Yuria Celidwen for Indigenous Peoples to have a role in decision-making processes. If we are to leave no one behind, we need to address how we take account not only of the impact of our work on communities, but also of how their knowledge and experiences can strengthen our work. Timothy Hudson David Culasino Carandang also raised the point of a paradigm shift towards a planetary health perspective, if we are to effectively tackle complex interactions of upstream factors that will affect health, and how we build resilient and sustainable systems for health. 

I look forward to hearing from other colleagues. 

Mesfin Getahun

The UNDP Strategic Plan 2022 - 2025 identifies strategic innovation, digitalization, data and development finance as enablers for its implementation. How can these enablers strengthen UNDP’s HIV and health work?

Lessons from the recently concluded Linking Policy to Programming project that was implemented in five countries of the Southern African Development Community (SADC) demonstrated the importance of a community driven approach in the design and implementation of innovative approaches particularly in digital spaces. Young people in Zambia, Madagascar, and Zimbabwe how with limited support and guidance they will be able to create their own digital spaces, develop the necessary messages and disseminate it within their own community. These are often in the form of simple but powerful platforms such as WhatsApp groups, podcasts, digital publications, etc. While such initiatives proved their relevance in getting messages within the community and their allies, some limitations were also observed. A significant limitation related to this is the challenge of expanding such platforms beyond communities and allies and reaching out to policy and decision makers. While continuous information sharing and awareness creation within communities remains an important result of these digital platforms, achieving the desired result in addressing inequalities requires expanding the reach of the platforms to decision makers at different levels. In this regard, it is important to work with communities, particularly young people, on strategies of bridging this gap and ensuring that the messages of the young people reach decision makers. Strategies for achieving this will require, among others, strengthening the link/integration of HIV and health interventions with other UNDP programs, making use of in-house resources such as the innovation labs and creating linkages with other existing digital spaces including in the academia.   

Kathy Ward

[With regard to the UNDP strategic plan’s focus on innovation and digitalization and UNDP’s HIV and health] In the course of the COVID-19 response we have seen dramatic increases in the uptake of health technology and other innovations to maintain access to critical health information and services. As we move into the next phase of that response and efforts to build better systems going forward, there is a great opportunity for UNDP and all of us to build on those gains made, to ensure innovative new practices become part of the standard set of tools available to connect people with the HIV and health services they need.

David Sunderland

From a UNFPA perspective, sharing the UNAIDS Division of Labour co-convenor role with UNDP for prevention among key populations, we support previous comments in this area but would emphasize a focus on YOUNG key populations who can be leaders in terms of innovation, digitalization and data.  Young key populations are a group very much left behind in the response not only in leadership but in programming and access to appropriate and non stigmatized services.  Not forgetting the impact on certain young groups - in sub-Saharan Africa, adolescent girls and young women account for 25% of all new HIV infections despite representing just 10% of the population.

The Global HIV Prevention Coalition (GPC) is cited in some other comments along with concerns about the impact of COVID-19 on prevention.  There was a 22% decrease in people getting tested for HIV compared to 2019, and an 11% decrease in people accessing HIV prevention services. The pandemic has also deepened inequalities within and between countries, and people living with, key populations and others at risk of HIV and TB have been affected – relating directly to the proposed Action area 1 on inequality.

For Action area 3, Building resilient and sustainable systems for health, another point that UNFPA would emphasize is HIV integration.   Integration of HIV with other health services and critical functions, including those related to data and strategic information, health governance, financing, and policy frameworks, helps leverage efficiencies and synergies. Integration and access to social protection services are critical for a sustainable, successful HIV response.  We hope this will be adequately mentioned.  The Global AIDS Strategy notes that when integrated service packages are tailored and delivered in ways that place people at the centre, they can help rapidly reduce inequalities in the HIV response as well as support Universal Health Coverage.  This leads to improved quality of care and clinical outcomes, greater engagement, and improved user satisfaction and targeting of resources.  Community-led responses, in particular, help to reduce HIV-related inequalities by enabling the tailoring of approaches to meet the needs of the people who need services the most. Furthermore, communities are essential to the effective governance of systems for health, with the efforts for primary health care and Universal Health Coverage highlighting inclusive governance as critical to ensuring effective and sustainable health systems.
 
UNDP’s strong role working with the Global Fund is highly appreciated in the Joint UN Programme on HIV/AIDS.  Perhaps more emphasis could be placed in the 2022-2025 Strategic Plan on the possibilities – working with UNAIDS Secretariat, WHO, the World Bank, other Cosponsors  and civil society organizations – on supporting a more coherent and inclusive partnership.

Judit Rius Sanjuan

Thanks for the opportunity to contribute to this important discussion. Within the scope of work I do (law and policy for innovation and access to medicines and other health technologies), I think there is an important need for UNDP to have a focus workstream of support to countries dealing with gaps and inequities, specially countries considered "middle income countries" (MICs). MICs have for a while fallen outside the more mainstream access strategies, and I think the access inequities growing during COVID-19. Happy to provide more context/content if useful. Please find below a blog at BMJ I co-authored a while ago (before joining UNDP) but that I think still holds on: https://blogs.bmj.com/bmj/2014/10/10/judit-rius-sanjuan-and-rohit-malpani-the-price-of-joining-the-middle-income-country-club/ 

Jeremy Pivor Moderator

Thank you for your wonderful contributions today! Two key overlaps included the importance of including young people as well as community-driven participatory approaches in the design and implementation of digital spaces as well as leading in innovation, digitalization, and data.

Mesfin Getahun shared lessons learned from the Linking Policy to Programming project that was implemented in five countries of the Southern African Development Community (SADC). Young people with limited support and guidance were able to create their own digital spaces, develop the necessary messages and disseminate it within their own community. However, some limitations were found including challenges scaling these digital spaces to other communities as well as bridging these spaces to policy/decisionmakers. To build these bridges and reduce inequalities, Mesfin proposes working directly with communities through building links between other UNDP programs, making use of in-house resources, and collaborating with other existing digital spaces. David Sunderland, from the perspective of UNFPA, agreed with the importance of focusing on young people as a key population particularly since they have been historically left behind in leadership/programming opportunities while being the ones with the least access to programs and services. Kathy Ward emphasized the opportunities for UNDP to build upon the utilization of digital resources particularly those that were increasingly used during the pandemic for accessing critical health information and services. UNDP should ensure that these innovative digital practices become a standard set of tools to connect people with the services they need.

Related to action area 1 of the HHD Strategy 2016 - 2021, David Sunderland raised the important point that the pandemic has impacted people accessing HIV prevention services as well as deepened inequalities within and between countries. As it pertains to action area 3, UNFPA emphasizes the importance of HIV integration with other health services and related critical functions including data, governance, financing, and policy to leverage efficiencies and synergies. This must be community-led and place people at the center to ensure efforts are context-specific.

Finally, UNDP should continue building on their work with the Global Fund and place more emphasis on supporting more coherent and inclusive partnerships.

 

Thank you for these comments. It seems like building resilience among communities, UNDP programs, etc. is a common theme in light of the pandemic. The pandemic is just the latest in a series of planetary emergencies including climate change, biodiversity loss, pollution of air, water, and soil, that will have global ramifications for the work of UNDP HHD. In your comments to the main questions, consider how UNDP can play a role in both mitigating and adapting to these planetary health emergencies.

Joram
  1. The UNDP Strategic Plan 2022 - 2025 refers to pandemic preparedness. What should UNDP be doing in this area?  

Speaking specifically to HIV programs, part of pandemic preparedness involves developing a plan for sustained service delivery in fragile and humanitarian settings

Disruptions to HIV service delivery are likely to be experienced during insurgencies/civil unrest that can lead to displacement of people, elections, flooding, cyclones, outbreaks such as COVID 19, among others. These disruptions may further drive the epidemic through fueling of rape, child/forced marriages, sexual assault, offenses and exploitation, child labor and denial of resources. UNDP would work with stakeholders (MOH, partners, communities) to strengthen implementation of adaptive strategies to ensure uninterrupted service delivery. These include:

Community HIV prevention: Use of community’s own resource persons (CORPS) in prevention counselling, condom provision, screening and management of STIs, distribution of HIV self-testing kits

Decentralized ART distribution: Home ART initiation, integrated outreaches, community ART groups, community pharmacy refills, peer-led ART distribution, ARV pick up by treatment supporter and multi-months ARV distribution.

Referral and linkages: Linkage of people living with HIV to community psychosocial support groups, OVC and GBV support and household economic strengthening programs


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