Ecuador

Alliance linking organisation: Kimirina

Fabiana advises peers about safe sex and HIV at the Penthouse nightclub, Guayaquil, Ecuador © 2004 Gideon Mendel for International HIV/AIDS Alliance

Ecuador is located in the north-west of South America, sharing borders with Colombia, Brazil and Peru. There are four distinct geographic regions – coast, mountains, the Amazon and the Galapagos Islands – divided into 22 provinces. Ecuador’s 13,228,000 citizens are concentrated in urban areas (64%). One third of the population is under the age of 15, and almost 5% are over 65 years old. A million citizens have emigrated from Ecuador in the last few years, and 6.3% of the population migrates internally – the majority (65%) of whom are under the age of 30. Ecuador’s estimated HIV prevalence rate in adults is 0.3%.

As Colombia’s neighbour, Ecuador is caught up in the military and economic response to Colombia’s civil and drug wars. The wars also present a serious migration problem for Ecuador, with an estimated 1,000 Colombians entering Ecuador illegally each month, many of whom stay in Santo Domingo de los Colorados.

The intensified economic crisis that Ecuador has been experiencing since 1999 has exacerbated the spread of HIV. Over this period, there has been a sharp decrease in household incomes, levels of unemployment have risen dramatically, and levels of poverty throughout the country have increased significantly – most crucially in communities already highly vulnerable to infection, such as people who sell sex, migrants and urban populations.

The economic crisis has meant that people living with HIV cannot afford adequate nutrition, medical attention and medication. Last year, the government redirected funds away from public health. The scarce funds that have been allocated to these areas are directed toward the poorest sectors of society and only address their most basic health needs, ignoring the many Ecuadorian citizens whose income is judged to be just above that of the poorest.

What we do

The Alliance programme in Ecuador is part of the wider Frontiers Prevention Project (FPP). In Ecuador, the Alliance works in the following six cities and/or provinces: Quito, Guayaquil, Esmeraldas, Quevedo, Santo Domingo and Portoviejo. The Alliance programme works through our linking organisation, Corporación Kimirina, who in 2006 supported 40 local non-governmental and community-based organisations, along with some specialist HIV agencies and general agencies that are keen to incorporate HIV into their normal work. The programme focuses on three key populations: sex workers, men who have sex with men, and people living with HIV.

The Alliance and Corporación Kimirina’s work in Ecuador focused in 2006 on the following:

  • providing technical support (both programmatic and organisational) to our implementing partners
  • supporting the mobilisation of key populations
  • advocating for HIV prevention issues to be considered by local and national decision-makers
  • improving sexually transmitted infection and voluntary counselling and testing services for key populations.

What we have achieved

Coverage of key populations increased to between 70 and 80% as a result of reaching new and different organisations. For example, more isolated key populations were reached in rural and new urban areas.

The capacity of around 40 organisations increased as a result of Corporación Kimirina’s financial, administrative and technical advice. This has promoted the sustainability of such organisations after the Frontiers Prevention Project concludes in 2007. Approximately 80% of organisations supported in this way have implemented sustainable activities.

Corporación Kimirina and the Frontiers Prevention Project's direct involvement in national HIV law reform, in consultation with grassroot organisations, has led to new policies on HIV at national level, which has benefited a large number of people.

A combined advocacy effort in 2004 by Corporación Kimirina and partner organisations has resulted in the inclusion of sex workers in the national ‘free maternity programme’. This means that sex workers now receive free HIV and sexually transmitted infection testing.

Future plans

The Alliance, Corporación Kimirina and local partners will continue to implement the Frontiers Prevention Project in Ecuador until funding ends in 2007. Specific areas of focus will be:

  • increasing work with local committees and governments
  • developing a model for institutionalising agreements with local authorities
  • further support of key populations to ensure their involvement in a new green paper.

Kimirina has prepared an exit strategy and a sustainable plan for affected community-based organisations. This includes an increase of local authorities' involvement in the promotion of key populations' rights and their direct participation in decision-making spaces. The Alliance is working with Kimirina to identify new donors who would continue the work with key populations in Ecuador.