HIV/AIDS, security and conflict: new realities, new responses

The nexus between conflict, security and HIV/AIDS transmission has been frequently detailed. Although, a number of alarmist messages have been expressed – such as decimating rates of infection amongst soldiers and the risks posed by HIV to the potential collapse of states – specific analyses of the impact of HIV in conflict and post-conflict situations have been thin on the ground. This has especially been the case regarding longer-term and structural impacts; and for human security and national stability.

The AIDS, Security and Conflict Initiative (ASCI) has sought to address these concerns. Indeed, as the final output of the four-year ASCI project this comprehensive paper aims to, as the authors state, provide a sound foundation for evidence-based HIV and AIDS policy development and programming - specifically across four conflict/security thematic areas:

• Military and uniformed services
• Humanitarian crises and post-conflict transitions
• Fragile and crisis states
• Cross-cutting issues, including gender, data collection and measurement, and media representation.

Such a thematic approach is borne out of the authors assertion that the problem of HIV and AIDS, conflict and security should not be analysed as a single overwhelming threat. Rather it should be understood as a composite of specific policy challenges, with effective responses within reach.

The authors principle findings/ recommendations include:

• The non-linear and reciprocal impacts of HIV and AIDS and state fragility make it extremely difficult to discern any causal links between the epidemic and national-level fragility. Prevailing indicators of state fragility fail to capture the impact of HIV and AIDS on local governance, human resources, service delivery and community survival
  
• Greater policy attention and service continuity is needed in post-conflict situations to respond to the complexities of context, increased population mobility, the demobilisation of combatants, disruptions in humanitarian provision to displaced persons and refugees in camp settings, and the overload of health and social services in areas of population return
  
• Develop command-centred approaches in the uniformed services - develop lines of accountability and enforcement mechanisms to prevent sexual violence within military institutions and to ensure remedies for HIV-infected survivors of rape and sexual violence committed by members of national, regional and mutinational forces, be they civilian, police or military
  
• Integrate HIV and AIDS prevention and response into disarmament, demobilisation and
  reintegration (DDR) programmes. DDR provides important entry points for HIV prevention, testing, care and treatment
  
• Increase continuity of HIV and AIDS responses during post-conflict transitions - this can be simultaneously a period of heightened risk for HIV transmission and of programmatic weakness because of discontinuities between emergency assistance and reconstruction and development efforts.