| Risk factor
While there has been considerable discussion of development interrelations with HIV epidemics, programmes have mostly focussed on health related aspects. Development interventions against HIV are crucial because the Africa experience has shown that the health based ones have been unable by themselves to check the often rapid spread of the epidemic. As development projects against HIV/AIDS are still in their infancy, considerable groundwork has been necessary to clarify conceptual and operational frameworks, define a strategy, determine the best methods, experiment and draw lessons for full implementation.
...Contrary to common wisdom, development, per se, is not HIV neutral and can either contribute to the spread or to controlling the epidemic... It is increasingly clear that development is a double edged sword: it can fuel the epidemic or become a powerful weapon in combating it. This project focusses on both these aspects because they are linked.
...Development as primary prevention is rather like building codes and regulations whose objectives are, among others, to prevent as far as possible the risk of a fire starting and if it starts from becoming catastrophic and spreading to other buildings.
...The area of Mobility was identified by the Technical Support Group in each country as well as by ASEAN as of crucial importance in the region. The on-going infrastructure expansion and improvement combined with rapid socio-economic changes, growing rural-urban and inter-country linkages, represent potential opportunities for HIV to spread. Development interventions can modify the mode of functioning of mobility systems and their interface in such a way to reduce vulnerabilities leading to HIV infection.
...There was a need to first observe the situation in order to identify the relevant factors and trends through assessment surveys and then to define the appropriate new conceptual tools for further analysis and development of responses, example, switching from a migrant focus to uncovering the underlying mobility systems, the forces shaping them, the problems of those who stay and not only of those who move. Such efforts had to be combined with policy advocacy for national authorities and served as basis for building national and regional development centred responses, especially through partnerships with national or sector level decision-makers and the ASEAN secretariat.
...First, participatory methods involving all the actors (government, economic sectors, NGOs) have been privileged in order to promote partnerships leading to the actors evolving into stakeholders. Such methods imply considerable investment in working directly with the partners, at their pace and according to their needs and priorities in order for them to learn as they advance and gain confidence at working within the development paradigm.
Second, as the project shifted from the health to the development paradigm, it is entering uncharted territory, it was necessary to develop innovative approaches which are tested before adoption. Consequently, advances proceed according to a step by step approach building a knowledge base and an enabling policy environment through a dialogue between experts and decision-makers. Although time consuming, this method promotes effective partnerships, sustainable and lasting results.
This groundwork serves as a base for policy development and elaboration of new methodologies and strategies for development centred interventions against HIV as is shown in the model of the project...