|Guidelines for HIV Interventions in Emergency Settings (UNAIDS - UNHCR - WHO - OMS, 1996, 59 p.)|
Over recent decades the world has experienced a great number of emergencies,1 both natural and man-made, that have caused massive social and political disruption and trauma to vast numbers of people. According to UNHCR, there are at present some 40 million people worldwide who have been driven from their homes by emergencies caused by natural disasters such as earthquakes, drought or floods, or else by war and civil strife, and who are living as refugees in foreign lands or as displaced persons within their own countries. Some have remained in this precarious situation for 20 years or more as the conflicts that drove them from home have not been resolved and the refugee camps to which they went have become more or less permanent settlements.
1 UNHCR has, in a training course, defined refugee emergency as any situation in which the life or well-being of refugees will be threatened unless immediate and appropriate action is taken, and which demands an extraordinary response and exceptional measures. WHO has a working definition of emergency as being a sudden occurrence demanding immediate action, that may be due to epidemics, to natural or technological catastrophes, to strife, or to other man-made causes.
For those whose job it is to respond to an emergency, the most immediate concern is the people who are at risk of imminent death from injury, starvation, exposure or disease, and priorities for action are largely dictated by this concern. In the late 1970s/early 1980s, a new element entered the scene: HIV/AIDS. WHO estimates that, by late 1995, at least 20 million people worldwide have been infected with the human immunodeficiency virus (HIV) that causes AIDS - a figure that is expected to rise to 30-40 million by the year 2000.
Until recently, HIV/AIDS prevention has not been seen as a priority in emergencies, especially in the early acute phases, because it is not an immediate threat to life. However, the Rwanda crisis in 1994 signalled the need for a change of attitude. Never before had there been an emergency of such magnitude in a country with such high HIV prevalence, and it soon became clear that the epidemic posed a threat that could not simply be ignored until some sort of stability was re-established.
The purpose of these guidelines is to enable governments and cooperating agencies, including the United Nations agencies and NGOs, at the earliest opportunity, to adopt the measures necessary to prevent the rapid epidemic spread of HIV in emergency situations, and to care for those already affected. They can also be used for fund-raising.
The guidelines necessarily address a wide and diverse audience and users are asked to bear with the information that is not relevant to their particular needs.