|Guidelines for HIV Interventions in Emergency Settings (UNAIDS - UNHCR - WHO, 1996, 59 p.)|
The key to an efficient and effective response to emergencies is preparedness. Preparedness means having identified in advance the human, material and financial resources required to respond to an emergency situation, and being able to draw on these resources as rapidly as possible. This implies having already established or identified the mechanisms for the release of the resources needed.
A needs and resources assessment should be conducted as early on during the emergency as possible. It is important to bear in mind that the assessment is not a one-time event, but a continuous process which should be undertaken throughout the emergency response operation.
The minimum package
Since in the initial, acute stage of an emergency only limited HIV prevention activities are feasible, it is proposed that the following should be priorities:
(a) safe blood transfusion;
(b) access to condoms;
(c) availability of materials and equipment needed for universal precautions to prevent the spread of HIV infection between relief workers and victims of the emergency, and;
(d) availability of basic relevant HIV/AIDS information.
This minimum package is designed to address these priorities for a population of 10,000 persons per month.
Requirements for accessibility/availability of the package
Having immediate access to the minimum package is vital and several options exist to ensure this:
· the materials and equipment in the package can be stockpiled;
· the agency can pre-negotiate agreements with suppliers in advance; or
· if there is no risk of delay in procurement and delivery, the items may be bought on the open market.
The choice of any of these options will depend on the concrete procurement and delivery conditions for each of the items in the package.
Mechanisms for release
According to which option has been chosen for ensuring the rapid availability of the minimum package, procedures and mechanisms for the release of the equipment and materials should be developed. The responsibilities involved should be clarified in advance, e.g. who activates the package (e.g. should it be one specific agency or should several/all agencies/organizations have direct access to the package?), who within the agency/organization should authorize the release? What procedures should be established to ensure effective and rapid release?
The process of implementing the activities related to HIV interventions in an emergency situation involves addressing fundamental issues of management and coordination which include:
· identification of the agents of implementation (UN agencies, NGOs, regional and local authorities, regional and local health structures)
· development of understanding with the agents of implementation for the acceptance of the minimum package and its incorporation into their standard packages which have already been developed for emergency situations.
As stressed, the key to a rapid and effective response is that all above arrangements are planned, and put in place beforehand.