United Nations Development Programme
Project Document
HIV, Human Development and Mobility in Asia and the Pacific
Phase II
Expected RP Outcome(s): Enabling environment created and capacities of key regional and national stakeholders developed to respond to the human development, governance, human rights, gender and inter-country challenges of HIV/AIDS, mobility and trafficking
Expected Output(s):
1. Regional and national responses developed that enable the access of people on the move to HIV prevention, treatment, care and support services.
2. Innovative initiatives developed at regional and national levels that reduce the socio-economic vulnerabilities of migrants and trafficked women to HIV stigma and discrimination.
3. HIV integrated into MDG based national strategies, plans and multi-sectoral responses
4. Key stakeholders have access to strategic multi-country research, best practice tools and publications on HIV, mobility and trafficking
Implementing Partner/Executing Entity: UNDP Regional Centre in Colombo
Responsible Parties/Implementing Agencies: UNDP Regional Centre in Colombo
Agreed by (Government):
Agreed by (Implementing Partner/Executing Entity):
Agreed by (UNDP):
Government Endorsements
Endorsed by the Government of Signature & Title Date
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Abbreviations
ADB Asian Development Bank
AIDS Acquired immune deficiency syndrome
ASEAN Association of South East Asian Nations
AWHRC Asian Women’s Human Rights Council
AWP Annual Work Plan
BPAC Bureau Project Approval Committee
CARAM Asia Coordination of Action Research on AIDS and Mobility - Asia
CSO Civil Society Groups
GDP Gross Domestic Products
HIV Human immunodeficiency virus
ICAAP International Congress on AIDS in the Asia and the Pacific
ILO International Labour Organisation
IOM International Organisation for Migration
JBIC Japan Bank for International Cooperation
MDG Millennium Development Goals
PDA Population and Community Development Association
PLHIV People Living with HIV
RCC Regional Centre in Colombo
RPAC Regional Project Approval Committee
SAARC South Asian Association for Regional Cooperation
SPC South Pacific Countries
UNAIDS Joint UN Programme on HIV/AIDS
UNESCO United Nations Education, Scientific and Cultural Organization
UNODC United Nations Office on Drug and Crime
UNHCR United Nations High Commission for Refugees
UNRTF UN Regional Task Force
UNIAP UN Interagency Project on Human Trafficking
WB World Bank
I. Situation Analysis
UNDP Regional Programme on HIV, Human Development and Mobility in Asia and the Pacific (2008-2011)
Home to the second largest number of people living with HIV (4.9 million) and one of the fastest growing infection rates in the world, the Asia Pacific region has emerged as a new epicenter of the global HIV epidemic. Three countries of the region have HIV prevalence rates exceeding one percent of the population indicating a generalised epidemic. Even though the overall HIV prevalence is low at national level, many countries in the region are already experiencing severe concentrated epidemics among marginalised groups such as sex workers, injecting drug users and men who have sex with men.
While about 70% of the people living with HIV in the region are men, there is an alarming increase in the number of new infections among young women and monogamous wives who are often considered a low-risk group. The epidemics in the region are also characterised by severe stigma and discrimination, violation of human rights and extremely poor access to information and services including counselling, testing and life-saving treatment. The dynamics of the epidemics are strongly influenced by underlying socioeconomic factors that make people vulnerable to HIV infection. They include prevailing gender inequality, uneven distribution of resources and rapid economic changes without adequate social safety nets for the most vulnerable. The epidemic threatens to impoverish poor people further and intensify the already existing inequities related to gender, sexual orientations, rights, governance, livelihoods, and services
Two key socio-economic factors contributing to the growing HIV epidemic in the Asia Pacific region are the large-scale movement of people within and across national borders, and trafficking of women and girls. The region is home to the second largest cross-border movement of people. Over 50 million people[1] are on the move in Asia and the Pacific at any point in time and estimated 450,000 women and girls are trafficked in the region every year. Increasing infrastructure projects and unequal economic growth across the region is fuelling this national and cross-border movement of people, often in distress, without adequate informed choices and protection against HIV.
Moreover, prevailing gender inequalities and continued disempowerment are creating conditions that make women vulnerable to HIV and are pushing tens of thousands of women into severely exploitative situations such as trafficking and sex trade. In addition, the consequences of HIV infection often exacerbate disempowerment and drive women further into vulnerable situations. One such example is the unequal right of women to inheritance and property, which in many parts of the region has been severely aggravated by HIV. Burdened by the care of their spouses, illnesses and running the household, women are often denied their rightful access to property when their spouses die. Blamed, abused and expelled from marital homes, positive women are particularly vulnerable to exploitation and high risk behaviour to make ends meet. The situation is acute when the avenues for legal redress are meagre and land tenure options limited. Even where progressive statutory laws exist, accessing these rights is difficult for several reasons ranging from lack of awareness, lack of access to legal services, conflict between statutory and customary law and the existence of biased judiciaries.
The socio-economic inequalities that drive the HIV epidemic also drive mobility. Poverty, socio-economic instability, political unrest, unequal distribution of resources and natural disasters act as push and pull factors that force people to migrate, often without adequate preparations and knowledge about various potential risks associated with migration. Areas where such deep rooted vulnerabilities prevail are also prone to migration and human trafficking.
Though migration by itself is not a risk factor for HIV, the conditions under which people migrate often place them at high risk of HIV infection. With regard to trafficking, recent studies in the region show a strong correlation between trafficking and HIV. The factors that make women and girls vulnerable to trafficking are similar to those that make them vulnerable to HIV. As such, it is imperative that initiatives be targeted toward addressing the dual vulnerabilities of girls and women to HIV and trafficking[2]
Addressing these issues that are complex and intertwined with one another requires close, consistent and strategic focus on all three of UNDP’s HIV service lines: HIV and development, governance, human rights and gender.
With less than 10 years remaining until 2015, efforts towards achieving the MDGs need to accelerate as many countries in the region are falling behind their targets. Countries need to have national and sectoral strategies, plans and programmes in which the potential impact of HIV is addressed and effective HIV responses integrated. This is particularly critical given the potential negative impacts of HIV on efforts towards achieving other MDGs including poverty and hunger reduction, universal primary education, gender equality and empowerment of women, improving maternal and child health, and reducing tuberculosis. In this context, addressing HIV issues effectively could strongly contribute to advancing pressing national needs and priorities within the framework of MDGs.
Development of capacity to conduct comprehensive HIV/AIDS needs assessments and costing of HIV responses in the context of MDG is urgently needed in the region, which will enable countries to develop long-term plans, multi-sectoral responses and mobilise resources. Furthermore, the development of such capacity at national level would complement and strengthen efforts towards many regional HIV-related issues that the Regional Project is designed to address.
Mobile, migrant populations and HIV
The vulnerability of migrants to HIV arises mainly out of their extremely limited access to information and services on prevention and care during the entire process of their movement, from their countries of origin to transit and destination areas. Half of the people living with HIV in Bangladesh[3] and 80 per cent of the new HIV cases in Beijing[4] are migrant workers. Migrants also represent one third of the total number of PLHIV (People living with HIV) in Laos and the Philippines[5]. In Pakistan, as early as 1999, the majority of the people living with HIV were prospective migrants and migrant returnees[6].
The lack of adequate legal status for mobile populations worsens their vulnerability. Although trans-border economic cooperation is increasing and borders are becoming less of an obstacle to seeking a better life, an estimated 40 per cent of migrant workers are either undocumented or under-documented and thus have absolutely no access to social services.
The impact of HIV on mobile populations is visible at different levels. They are often burdened with the blame for spreading HIV - both for bringing HIV into the host countries and for taking it back to the countries of their origin. Studies in the region also illustrate that lack of legal rights in host countries makes them extremely vulnerable to discriminatory practices such as forced testing, violence and deportation. Migrants are also subject to compounded forms of discrimination and rights violation within and outside their communities. The prevailing gender inequalities expose migrant women to additional, compounded forms of discrimination and exploitation including sexual violence.
Migration can be a beneficial process, not only for individuals, but also for communities and nations, both of source and destination countries. Workers remittances play a crucial role in strengthening the economy of their countries and host communities. According to the International Organisation for Migration (IOM), worker remittances represent the second largest monetary trade flows globally, exceeded only by the petroleum industry. In Bangladesh, foreign employment is the second largest source of foreign exchange accounting for 32 per cent of its GDP, while in Sri Lanka it is the highest foreign exchange earner – mostly remitted by women- with a GDP share of 14 per cent. In Pakistan, remittances equal 44 percent of total merchandise exports. Though migrants contribute substantially to the economies of the communities and nations, both of the source as well as destination countries, their vulnerabilities to HIV and AIDS are not addressed commensurately through policies or programmes.
Trafficking and HIV
Trafficking has been found to be integrally linked to migration. As in the case of migration, HIV and human trafficking also share a number of contributing factors such as gender inequalities, poverty, lack of economic opportunities for women, stigma and rights violation.
Though lack of adequate data remains one of the fundamental weaknesses in exploring the linkages between trafficking and mounting appropriate responses, recent studies[7] by Harvard School of Public Health in South Asia show a strong association between trafficking, HIV and multiple layers of gender inequality. The Mumbai study showed that 22.9 per cent of rescued trafficked women studied were HIV positive while the study in Nepal showed that 38 per cent of rescued women trafficked into sex work were positive. In Nepal, about 61 per cent of the girls trafficked into sex work before the age of 15 were found to be HIV positive, demonstrating the high vulnerability of young girls to both trafficking and HIV infection. The research also revealed that girls trafficked as minors were kept enslaved in brothels for longer periods compared to other sex workers and that each additional month of captivity increased their risk of HIV infection by 3 to 4 percent. Similarly a regional rapid assessment study by UNDP in South Asia showed an alarming trend of trafficking of girls and women and HIV.
The lack of safe, secure and legal channels for migration drives unsuspecting and uninformed women and girls into the hands of unscrupulous agents and traffickers who promise them ‘good jobs’ and ‘safe travel’ to sites of work. Taking advantage of increasing number of people in such vulnerable and often desperate situations, human trafficking has grown to become the third most profitable organised crime business following arms and illicit drug trafficking, with an estimated market value of USD 32billion[8].
Although women and girls are trafficked for various purposes such as marriage, sweat shop labour, factory work, domestic work, and construction work, sexual exploitation remains the single largest category of trafficking crime throughout the region. The growing HIV epidemic has contributed to an increasing demand among clients of sex work to recruit very young girls. For example, the average age of girls trafficked from Nepal to India decreased from 14-16 in the 1980s to 10-14 about a decade later.
Intended beneficiaries
The Regional Programme will benefit inter-governmental organizations such as ASEAN, SAARC and SPC, and national governments and civil society organisations in terms of enhanced capacity and resources, strategic policy and programme initiatives and cross-border collaboration and knowledge-sharing. The programme will seek to strengthen the institutional capacities of intergovernmental bodies and regional CSOs to enable responses that are sustainable beyond the project period. It will also benefit countries in the assessment, costing and design of multi-sectoral responses that address the development challenges of the epidemic.
The beneficiaries of the Regional Programme will be cross-border migrants, women and girls who are either trafficked, rescued from brothels or are vulnerable to trafficking and HIV who will benefit from an enabling environment for access to HIV prevention, care and support services. It will also benefit women and girls through models of legal and economic empowerment that make them less vulnerable to trafficking, distress migration and HIV.
II. Strategy
The UNDP Regional Programme on HIV, Mobility and Human Development is guided by the priorities and strategies laid out in the UNDP Strategic Plan and the UNDP Regional Programme for Asia and the Pacific 2008-2011 (RPD). The Strategic Plan sets the context of UNDP’s role in the global HIV response with specific reference to integrating HIV/AIDS concerns into national development processes, strengthening the governance component of AIDS responses, and promoting human rights and gender equality. Built on these corporate strategic directions, the RPD acknowledges the need for special attention to the trans-border challenges of HIV with a view to mitigating the impact of HIV/AIDS on human development.
The Regional HIV Programme meets all of the regionality criteria as outlined in the RDP. In particular, as the Regional Programme addresses HIV in the context of migration and trafficking of human beings which often transcend borders, joint and collaborative initiatives would be required between partners and countries at regional and inter-country levels to address the human development challenges posed by the epidemic. The Regional HIV Programme will focus on generating an enabling environment for reducing the vulnerabilities of people to HIV and trafficking and promoting safe mobility as well as for caring and supporting people living with HIV who may or may not have been migrants or trafficking victims. Regional and inter-country capacity will be developed to respond to the human development, governance and cross-border challenges of HIV/AIDS and mobility.