Report on the Global HIV/AIDS epidemic

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Report on the global HIV/AIDS epidemic - June 2000
Greater involvement of people living with HIV/AIDS - the GIPA principle
If anything, the involvement of HIV-positive people has become even more visible
and credible since 1995. This is when the community stepped up pressure to
increase access to highly active antiretroviral therapy - in memory of those who had
not survived long enough to benefit from it and out of solidarity with the millions who
still could not afford it.
Already in 1994, the GIPA principle was formally enshrined in the Declaration signed
by 42 nations at the Paris AIDS Summit. The signatory nations resolved to "support
a greater involvement of people living with HIV/AIDS through an initiative to
strengthen the capacity and coordination of networks of people living with HIV/AIDS
and community-based organizations".
This resolution was prompted by recognition that these groups had played a leadership role in increasing society's acceptance of those living with HIV, in reducing
their peers' infection rates, in mitigating the personal and social impact of the disease, and in fighting for their right to health care.
Community standards for care and support
Because community organizations play such an important role in care and support
for people living with HIV, they and their clients have a stake in how health sector
resources are allocated and distributed. Since 1997 UNAIDS has advocated that
communities, alongside other stakeholders, should be involved in developing standards for HIV-related care and support. The goal of this working partnership
between health planners and the local community (defined as a group of people
sharing the same geographic, cultural and economic environment) is to reach a consensus on meeting the needs and expectations of people with HIV that is perceived
as equitable and responsive to other equally important needs.
The process of discussing expectations and arriving at a consensus involves informing the participants about what support and resources the health system can potentially provide, sounding out the preferences of the community and identifying its
potential for contributing to care.
Attempts to formulate community standards for care and support have been completed with some success in Burkina Faso, the Central African Republic, Malawi and
in Phayao Province in northern Thailand. The process is not always easy; the inadequacy of knowledge about health care can be a limiting factor, for example.
However, the approach has enormous potential. Formulating community standards
makes it possible to identify the resources for care already available in the community and to determine how they could be used to better effect through support from
the formal health system. It also breaks the silence surrounding HIV and discourages
discrimination by sending the message that people with AIDS have a claim on solidarity and support.

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