Responding to HIV and health in fragile states

More than half of the people living with HIV live in fragile states. The Alliance and the International Federation of Red Cross and Red Crescent Societies (IFRC) have embarked on a new partnership to build community capacity to respond to HIV and wider health issues in these countries.

Following conflicts and natural disasters*, health systems are weak or are quick to collapse as health workers flee, and supplies and equipment run out. Preventable diseases increase alongside malnutrition, and even where health services do exist people are too afraid to risk the journey to the clinic. Half of all under-five deaths and one-third of maternal deaths occur in fragile states.**

In these challenging situations, the international community is heavily focused on the humanitarian crisis with little attention given to HIV and the sexual and reproductive health challenges. Ignoring these issues can have a detrimental impact on the health of people living with HIV and can contribute to worsen the HIV situation among internally displaced people and other crisis affected populations. 

Collective experience

The new partnership between the Alliance and IFRC will leverage their extensive experience and service delivery platforms in humanitarian responses. Together, the organisations will develop sustainable community models for delivering access to HIV testing and treatment and to improve health outcomes in fragile states. 

This model will require a long-term investment into building strong and well-functioning local civil society organisations, including Alliance Linking Organisations, National Red Cross and Red Crescent Societies. 

“The IFRC is committed to harnessing locally-led responses and strengthening community involvement with health service delivery” said Bekele Geleta, Secretary General, IFRC. “Through our volunteer network and community-based platform for health service delivery, National Red Cross and Red Crescent Societies are strengthening community health systems. This partnership will contribute towards supporting essential community resources in critical situations.”

Integrating HIV and humanitarian responses

A shortage of healthcare workers in fragile states means it is essential to build the capacity of community resources. Health workers, volunteers and community leaders are the right people to deliver crucial, culturally sensitive health messages.

Alvaro Bermejo, Executive Director from the Alliance said, “Civil society organisations have local expertise, on-the-ground agility and established networks and can adapt to the changing circumstances. 

“We will be working to link local organisations and networks, including networks of people living with HIV, to national and local disaster preparedness training and systems so they are fully equipped to respond to the needs of communities in fragile states.” 

The two organisations will also be working with donors and partners who need to be able to react quicker and provide more immediate and flexible funding channels to enable civil society and other stakeholders to carry out a better-coordinated response. 

To mark the start of the partnership, the Alliance and the IFRC will jointly host (in partnership with the Islamic Republic of Afghanistan) a side event at the 67th World Health Assembly in Geneva. The event, entitled “Fragile states: boosting community systems for an effective health response”, takes place on Monday 19 May 2014 at 6pm. A reception will follow to mark the Memorandum of Understanding between the Alliance and IFRC. 

*Conflicts and disasters alone are not the only reason for state fragility. States can also be fragile due to lack of growth or chronic underperformance. Increased exposure to disease and high mortality rates can be both a contributing cause and consequence of state fragility.

**A fragile state is one where there is a fundamental failure of the state to perform functions necessary to meet the basic needs and expectations of its citizens.