Investing in Human Development for an effective HIV Response Alka Narang UNDP India

1.Human Development & HIV 2.Understanding Bellary- A study 3.Recommendations The presentation

“The most basic capabilities for human development are to lead long and healthy lives, to be knowledgeable, to have access to the resources needed for a decent standard of living and to be able to participate in the life of the community. “ (UNDP) Human Development

Human Development and HIV HIV & AIDS Low Human Development Stigma loss of income low productivity poverty widows medical expendituredebt HIV & AIDS Low human development MigrationLimited access to knowledge & services Abuse and exploitation sex work gender inequality violence against women

Human Development Index & HIV

Understanding Bellary

Profile of Bellary district District economy based on agriculture Population million Rural - 65% One of 27 districts in Karnataka state Agriculture- 67% of labour force

Bellary…. An economic success story Rich in minerals Third richest district in the state 10 percent of the market for private aircraft

Construction work in Bellary

Bellary …..but is a backward district 3rd highest incidence of poverty 18th rank of 27 (Human Development Index) Performance on indicators of literacy, child sex ratio, age at marriage etc. lower than state average.

Bellary …..a backward district Inequalities within the district Scheduled Castes & Scheduled Tribes -36.5% Women worse off: female literacy only 45.2% -state average of 58.6%

Bellary …with high prevalence of HIV Among 4 districts worst affected by HIV - Adult prevalence 1.1 percent Low awareness of HIV & protection methods Reporting of multiple sex partners Priority district for HIV interventions (Source: District Situation Assessment, 2002)

Response in Bellary Walking the known path: District response to HIV Adopts targeted intervention approach Works with sex workers, high risk groups, young women and men Series of IEC initiatives  Increase in knowledge on HIV in gen. pop  Increase in services -testing, treatment available but….

Lakshmi sensitizes young girls about HIV & sexual health

Understanding Bellary UNDP commissions study to review: Quality of economic growth –inequality & poverty Human Development –education, health, gender, housing & sanitation Nature of governance Extent and adequacy of HIV interventions

Methodology Primary sources: paper, 2 surveys (600 migrant HHs & high risk groups), 9 focus group discussions, workshop, in-depth interviews Secondary sources: district data, desk and literature review, newspaper articles

Study findings Economic growth due to large scale mining Surge in Iron ore mining after 1999 Paucity of end users like large steel industries Devt. akin to “Dutch Disease” phenomenon Explosion in informal employment Dependence on temporary, mobile labour, children & women

Study findings Emergence of STD clinics around mining areas Emergence of `Neo rich’ Poor working conditions in most private mines Indications of abuse and exploitation esp. women & children High school drop out rates

Study findings Reports of over extraction - Mines & Minerals Regulation & Development Act (last amended in 1999) 50% of the 400,000 casual labour are children ( National Policy on Education- SSA) 5% of adult risk taking population Devadasi’s - significant numbers into sex work (Karnataka Devadasi Prohibition of Dedication Act, 1982)

Hulligamma was a Devadasi. She now works as a peer educator

In summary Growth pattern neither dependent on rapid human development, nor enhanced human development Economic growth - rise of the unorganized and informal sector, short-term income gains with less job security, increased mobility & labour migration Poverty remains high & economic inequality increases

Continued economic & social exclusion of backward classes Low status of women & poor welfare of children Significant increase in HIV interventions HIV & AIDS interventions outside of planning Significant presence of sex work In summary

Recommendations Increase efforts to link economic growth & investment in human development Improve quality of governance -enforce & implement existing policies/laws HIV programmes to ensure risk-vulnerability continuum & scale HIV to be integral to decentralized planning

Photos © UNDP/CHARCA/ Anirban Dutta/ Parthiv Shah