Networking and Advocacy Key Policy Issues for HIV

Networking and Advocacy: Key Policy Issues for HIV, AIDS and Housing Advocacy, Strategies and Tools for Advocacy By: Eunice L. Kyomugisha SSA: UHSNET, Kampala, Uganda Presented at the HIV, AIDS and Housing Regional Workshop, Johannesburg, South Africa, September 15 th -19 th 2014

Presentation outline • About SSA: UHSNET • Understand HIV response in your country - Broad areas to assess HIV response • Key Policy Issues for HIV, AIDS and Housing Advocacy • Effective Strategies for Advocacy • Action Tools for advocacy • Benefits of networking • Challenges in networking

About the network • SSA: UHSNET is a network that brings together all stakeholders in the human settlements sector to more effectively address constraints to adequate housing, especially for urban slum dwellers. • Formally registered in 2010, the network is now comprised of 58 members including Civil Society organizations, Private Institutions and Professionals and Students • The Network’s key priority areas include research, networking, lobbying and advocacy, community mobilization, community empowerment , capacity building and sustainability

Understand HIV response in your country Broad Areas to assess HIV Response A) Surveillance of the epidemic: determining who is at risk and why, who is infected and why they became infected and the dynamics and behaviours that impact both prevention and care delivery. (What has been the contribution of SSA to this surveillance? ) B) Prevention: reducing the transmission of HIV which includes HCT, condom distribution, education and efforts to increase public awareness (Where have we come in as housing partners? )

Understand HIV response cont’d Broad Areas to assess HIV Response cont’d C) Treatment, Care and Support for PLWHA, a broad and crucial area that included access to health care, ARV treatment and prophlyaxis (prevention of onset) of opportunistic infections, counseling, home/clinic/hospital care and palliative (late stage) care. (Do we have a mandate here and what have we done? ) D) Research on HIV and AIDS and its impacts: work vital to providing up to date information about the positive and negative impacts of medication, behaviour – modification interventions, cultural factors and other matters and how they affect the positive and affected people (Which research on HIV and AIDS and Housing has SSA done and what were the findings on the impact? )

Understand HIV response cont’d Broad Areas to assess HIV Response cont’d E) Human rights of people living with HIV and AIDS: basically, this encompasses all the work done to fight stigmatisation and discrimination (What HIV and AIDS stigmatization and discrimination revolves around housing status and how has SSA intervened? ) F) Government coordination and planning: include national AIDS planning as well as community- based coordination and funding efforts (How has SSA been involved in this planning? What has been our best practices? )

Understand HIV response cont’d Broad Areas to assess HIV Response cont’d G) Policy Development: Putting into the “systems” all the above that are necessary to make change happen through governing principles, rules, regulations and laws. (What systems do we have in place and what have we done? )

Key Policy Issues for HIV, AIDS and Housing Advocacy at local, national and regional levels Why are we concerned about HIV and AIDS and Housing? • HIV and AIDS is a development issue – MDG No. 6 • The East African region, a high HIV prevalence region. Though the rates have reduced significantly in the last decade, the impact still remains high. • HIV and AIDS impacts on our development and human settlement sector. • The nature of the infection has shifted from specific groups to a generalized infection; different groups are all affected. • Our housing sector development work can put beneficiaries at risk or increase vulnerability e. g. construction of roads, formation of housing cooperatives, unplanned settlements, etc can open up an area for infection. • Without putting on HIV and AIDS lenses, our Housing Development sector can miss out on HIV and AIDS affected households and individuals

Key Policy Issues cont’d Summary of risk and contextual factors driving the HIV epidemic in Uganda. (Source: Ministry of Health, Uganda) Risk factors for HIV Transmission Contextual Factors for the HIV and AIDS Epidemic 1. Multiple sexual partner 2. Discordance and non disclosure Socio-cultural factors 3. No condom use 4. Marriage without testing Wealth and Poverty 5. Transactional sex 6. Blood Transfusion Low status of women and girls 7. Presence of HSV-2 & STIs 8. Intact fore skin Human rights, stigma & discrimination 9. Alcohol and Drug use 10. Behavior laxity due to ART Inequality to access to prevention, care and treatment 11. Mother to Child Transmission 12. Poor Housing

Key Policy Issues cont’d • In 2012, SSA together with Consultants from the Uganda AIDS Commission agreed that “poor housing” should be added on the list as a risk factor for HIV Transmission. • An analysis from the Table shows that all the contextual factors for the HIV and AIDS Epidemic in Uganda have a direct bearing on poor housing. The situation may be the same for other countries. This therefore calls for more research and strategic interventions in housing.

Greater risk for HIV and AIDS among Housing Cooperatives – Training Experience by SSA: UHSNET In 2011, areas where Housing Cooperatives were likely to have greater risk were revealed as follows: • Multiple sexual partners - Infected members join cooperatives, and engage in unprotected sex. • Discordance and non disclosure- Members in the housing cooperatives are not willing to disclose their HIV status • Alcohol and drug abuse- In meetings held every Sunday, members are free to come with their drinks including alcohol • Sharing of sharp objects – After meetings, women tend to go for unsterilized manicures in groups. • In the Housing Cooperatives, it is not mandatory to take an HIV test before one becomes a member and there is no law that stops members from relating like in some NGOs. • Accidents- These could pose a threat of an infection while working on projects like brick laying and there are no safety measures like first aid equipment in place • Wealth and poverty - Some rich members of the Cooperatives expect sexual favors when they help others financially.

Key Policy Issues cont’d SSA’s Experience with HIV and AIDS Policy Workshops and Conferences • • • In 2011, SSA participated in a Consensus Building Workshop for the Social Development Sector on HIV Prevention Strategy and Action Plan under the Ministry of Gender, Labour and Social Development. The need to include people living in slums, the homeless and the internally displaced as another special group in the HIV Prevention Strategy was pointed out and incorporated. In 2011, SSA participated in the UN Women Consultative meeting on the HIV and AIDS Prevention and Control Bill. SSA observed that part VI of the Bill (Discrimination on grounds of HIV Status) lacked a clause on Discrimination on grounds of housing status. SSA highlighted related housing issues of HIV and AIDS and gender which were incorporated in the Bill. In May 2014, the Parliament passed the Bill and President Yoweri Museveni signed the Act into law on July 31 2014. SSA has been represented in international AIDS Conferences. SSA contributed findings to a Publication by The National AIDS Housing Coalition (NAHC), Washington – More than just a roof over my head: Housing for People Living with HIV and AIDS around the World.

Key Policy Issues cont’d Key questions for HIV/AIDS mainstreaming in housing. • How does HIV/AIDS impact on the housing sector? • How does lack of adequate housing increase risk or affect care, treatment and support? • How does work in housing increase beneficiaries’ risks to HIV? • What can we do in our comparative advantage to reduce risks and mitigate impact of HIV and AIDS to those affected?

Summary of Key Policy Issues • • • There is need for comprehensive services such as health education, HIV Testing and Counseling, Case management, Mental health services, and Basic health care to be provided to PLWHA within informal settlements There is need for poverty alleviation programmes as a prevention measure to fight the spread of HIV in informal settlements The is need for alternative and affordable housing options, especially in urban areas and for PLWHA. There is need for gender equality with regard to women’s access to land property rights and particularly those affected by HIV &AIDS; this can be achieved through provision of legal and social services that protect the rights of PLWHA and which leads to improved health outcomes. There is need for legal and advocacy training programs that empower PLWHA and low income groups to protect their rights and interests. Improving women’s awareness on legal recourse to land housing is particularly important.

Effective Strategies for Advocacy Steps in planning and implementing advocacy Step 1: Select an issue or problem you want to address Step 2: Analyze and gather information on the issue Step 3: Develop an aim & objectives for advocacy work Step 4: Identify your targets Step 5: Identify your allies Step 6: Create action plan Step 7: Identify your resources Step 8: Implement, monitor and evaluate Implementation of advocacy by SSA Right to adequate housing for HIV &AIDS affected families SSA has conducted research and information gathering To improve the lives of persons living in slums HIV &AIDS affected families Network members and communities SSA mainstreaming plan Resource mobilization & partnership building Currently ongoing in SSA

SSA: UHSNET’s Strategic Advocacy in National AIDS Planning • As housing Advocates, SSA has been part of the national workshops that disseminate bills, policies and strategies on HIV by advocating for the inclusion of Housing Status as a key structural factor influencing HIV vulnerability and risk • SSA has invited parliamentarians and representatives from Ministry of Health and other stakeholders to be part of the yearly International AIDS day celebrations. • Government officials such as line ministries: Mo. HUD, Mo. H, Mo. FEP, Mo. GLSD, Parliamentarians and KCCA have been engaged in our events and informed about what we are advocating for, that is, housing for people living with HIV and AIDS. Support in form of donations, land housing has been pledged. • Dissemination of the Publication on HIV and AIDS and Housing has contributed to broader understanding of the link between HIV and AIDS and Housing among stakeholders

Action Tools for Advocacy • Policy analysis: SSA has advocated for policy improvement and implementation • A position paper: SSA has delivered position papers e. g. on evictions and increase for national housing budget • Using media advocacy: SSA has had extensive media engagement to influence the rights of the oppressed • Using Press Releases: SSA has responded to an action of Evictions. • Lobbying and face to face meetings: SSA has defended project proposals and won grants. • Use of Internet: SSA has a web site, advocates through its listserv and moderated the International AIDS Housing Round Table (IAHR) for Africa through yahoo groups.

Benefits of networking Successful networking helps to: • Accomplish something together which you could not accomplish alone • Strengthen advocacy • Influence others inside and outside the network • Broaden the understanding of an issue or struggle by bringing together different constituencies • Share the work • Reduce duplication efforts and wasting resources • Promote the exchange of ideas, insights, experiences and skills • Provide a needed sense of solidarity, moral and psychological support • Under certain circumstances, mobilize financial resources

The challenges of networking SSA Challenges • The HIV affected communities are many and can not all be reached by SSA –limited resources. • The political will is unpredictable and requires quite a lot of lobbying efforts and expertise. • Individual network member organizations have different mandates and interests and for effective scaling up of HIV and AIDS mainstreaming, continuous trainings are required but may not match the available resources. • Unmet high expectations from the HIV and AIDS affected communities at times turns into inactiveness among project beneficiaries. • Finalization and Implementation of national policies may take long, which stalls realization of some organizational outcomes e. g. the National Housing Policy still a draft.

Conclusion • The need to seek a policy change that involves persuading policy makers to see things from our point of view is a process that should not be broken. A legislation that would cater for the housing rights of those infected and affected by HIV and AIDS is important and is one of our strong advocacy messages. • Our sincere appreciation to Rooftops Canada, We Effect, UN Women, Comic Relief, French Embassy, Regional Partners, Government of Uganda, Network members and others for making the Lives of PLWHA better in Uganda. Your support is and will forever be tremendously applauded!

End Thank you