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Workshop Report


Orientation Workshop
2-6 May, Addis Ababa

Read the full text of the Workshop Report as a MS-Word file (1.4MB) or as an Adobe Acrobat file (710KB).

EXECUTIVE SUMMARY

PURPOSE OF PROJECT

The aim of this UNAIDS-led project, Aids in Africa: Scenarios for the Future, is to build a set of pan-African scenarios looking over a twenty-year time horizon, which will enable the key issues, challenges and dilemmas regarding HIV/AIDS to be surfaced and explored. These scenarios represent a unique opportunity to bring together divergent views and perspectives in order to create an informed and shared understanding of the issues involved and to help activate a broad-based response from all segments of society. The project has four distinct phases, with ongoing research, communications and administration activities continuous throughout. The orientation workshop is the first of three scenario-building workshops, and takes place in this initial phase. The fourth phase involves the launch and roll-out of the scenarios.

Process Overview: Building Scenarios

 

PHASE 1: ORIENTATION WORKSHOP

The emphasis of the first phase of the project is to undertake research in order to produce a clear understanding of the underlying issues, views and perspectives that different individuals identify about the HIV/AIDS epidemic in Africa and its development over the next twenty years. The purpose of the Orientation Workshop was to map out the issues and to produce a jointly owned overview of the problem and to examine in more depth different points of view. It also represents a crucial phase in building trust amongst the participants and with the Core Team and in securing the wider legitimacy, interest and usability of the scenarios themselves. This executive summary sets out what has been achieved and the next steps that need to be taken.

KEY FINDINGS:

The Orientation Workshop used a range of divergent exploratory processes to enable the critical issues spanning many subject areas to be identified and surfaced. The discussions were wide-ranging and frank and a number of undiscussed and ’undiscussible’ issues were raised, which have been set out in greater detail in the enclosed report. The critical issues were grouped into five main thematic areas or ‘domain groups’.

  1. HIV/AIDS Research and Implementation
  2. Demography
  3. Governance and Security
  4. Economic Development
  5. Socio-Cultural Diversity of Africa

Participants divided themselves into these groups to undertake more detailed analysis. Within each of the domain groups certain key variables—factors which are both highly uncertain yet likely to have high impact on how HIV/AIDS might evolve over the next 20 years—alongside many other factors that will also play a role have been identified. These key variables, and the focal questions raised by each group, are set out in the table below:

Domain Group Key Variable Focal Questions
HIV/AIDS Research and Implementation
  • Responsible global village
  • Strategies for treatment and care
  • Research capacity
  • Price level of pharmaceuticals
  • Development/ economic paradigms
  • Domestic and international mobilisation of resources
  • Policy grounded in African realities
  • What are the factors that prolong the lives of HIV+ persons?
  • Will there be commitment to development of vaccines and microbicides?
  • What is the role of African traditional medicine?
 Demography
  • Access to preventive and therapeutic technologies
  • Levels of infections and geographical variance
  • Orphans and vulnerable children
  • Migration (all forms)    
  • How can we prevent deaths?
  • How can we prolong healthy life?
  • How will demographic patterns unfold over the next 20 years due to HIV/AIDS?
Governance and Security 
  • Management capacity of African public services
  • Security: military and human
  • Transparency and accountability of NGOs, government and donors 
  • What is needed to improve human security?
  • Is good governance the solution in the fight against HIV/AIDS?
Economic Development 
  • Market access and regional integration
  • Extent of demographic impact on productive and social services sector and development
  • Extent of functional dialogue between civil society and government
  • Level of resource mobilisation  
  • What is the impact of HIV/AIDS on specific sectors of economic development?
  • Is the Poverty Reduction Strategy a rich enough development framework to generate enough resources to deal with HIV/AIDS?
  • What is the impact of HIV/AIDS on poverty?
Socio-cultural Diversity of Africa
  • Socio/economics and the poverty agenda
  • Religious and cultural values
  • Community coherence
  • Gender roles and the status of women
  • Stigma, discrimination and silence  
  • Focal questions not prepared due to time constraints

In addition to the key variables and focal questions identified, there were discussions about a number of issues that are not normally raised in relation to HIV/AIDS. Some of these issues have been explored in other meetings and fora, while other issues which have not been explored and—for a variety of different reasons—remain difficult to discuss are ‘undiscussibles’, relating to aspects of sexual behaviour, neo-colonialism, racism, etc. These issues cut across the domain groups, and the main themes are set out in the table below:

Context Undiscussed/Undiscussables
 NEO-COLONIALISM
  • Image of the continent and its marginalisation
  • Race relations and racism
  • Powerful countries’ support of arms trade
  • HIV/AIDS development in Eurasia: impacts on Africa
INTERNATIONAL DEVELOPMENT 
  • Debt burden
  • Impact of structural adjustment programmes and political transitions
  • Misguided development programmes
  • Lack of knowledge about the relationship between AIDS and poverty
ACCOUNTABILITY AND RESPONSIBILITY  
  • Lack of accountability of governments, NGOs, community, donors
  • Lack of evaluation
  • Personal ownership and responsibility
PAN-AFRICAN ISSUES 
  • Ethnic and national diversity of Africa
  • Effectiveness of national, pan-African and international institutions and multilateral structures
NATIONAL ISSUES 
  • Lack of trust between NGOs and governments
  • Incentive of NGOs to create distrust in government
  • Public/private partnerships at local level
  • Lack of incentives for politicians to deal with HIV/AIDS
SEXUALITY 
  • Sexual patterns/sexuality/stereotyping of African sexual activity levels/polygamy
  • Sexual networks/serial/open/closed relationships
  • Adolescent sexual health
  • Avoidance and denial/process of sexual interaction  
COPING MECHANISMS 
  • Poorly developed social security systems  
GENDER 
  • Lack of male involvement in home and community
  • Land ownership: appropriate legislation/lack of access, especially for women  
TREATMENT 
  • Strategies for introducing ARVs/treatment literacy
  • Availability of commodities, e.g. condoms, treatment
  • Discordant (HIV+/HIV-)couples
  • Impact of other diseases  
HIV RESEARCH 
  • Building capacity to conduct HIV/AIDS research and development
  • Approach to global public goods
  • Herbal medicines and traditional medicines
  • Risk return and immunity for developers of approved vaccines and new drugs  
ENVIRONMENTAL ISSUES  
  • Impact of environmental issues on HIV/AIDS
CULTURE AND BEHAVIOUR ISSUES  
  • Alcohol and its effect on sexual behaviour*
  • Impact of information and communications technology on behaviour*

* denotes added by Project Team

In addition to identifying the key variables, focal questions, and key ‘undiscussed/undiscussibles’, participants were asked to identify areas where further information is required, and linkages (action, reaction, cause, effect, two-way, one-way, etc.). They also sought to identify resources (persons, documentation, conferences) that could help in responding to understanding gaps. This detailed information is set out in the workshop report.

NEXT STEPS:

The Orientation Workshop was successful in achieving a common language and in commencing to develop an understanding of HIV/AIDS and its impacts from a variety of different perspectives across Africa and beyond. It has identified a wide range of relevant issues and variables that might be explored at the Scenario Building Workshop.

Whilst a number of undiscussed issues were raised, several of these have been explored in other fora and the challenge is to bring these insights into the ongoing dialogue between participants. The challenge is to be more selective about the key variables that will be used to build the scenarios and to focus on those that will be most critical in shaping the future—those with the highest impacts consequential for HIV/AIDS in Africa. There is also the challenge of sorting through the identified high certainty, high impact variables—some of which are linked to highly uncertain variables.

The aim is to continue to develop the exploration of the domains between now and the next workshop. This will help to ensure that the scenarios that are developed are firmly rooted in knowledge and understanding of the key relevant variables and their interrelationships, as well as the overall systemic dynamics.

Participants have been invited to enter into networking with one another and the Project Team. They have been enabled access to an e-workspace on the internet that will allow them to continue to dialogue. The Project Team will provide support to the participants as they undertake more focussed discussions and research on the areas identified as critical building blocks for the scenarios and explore the ‘undiscussible’ issues of relevance. Key topics requiring further reflection by each domain group (which will be supported by the Project Team) include:

  • Provide concise, precise synopsis of the existing perspectives relevant to the issues in each domain (in the form of a series of short papers);
  • List and prioritise the key variables that will shape and influence how these issues might play out over the next twenty years. In particular, research the high impact, certain variables and identify the possible end-states for each high impact, critical uncertainty variable;
  • Identify linkages to other domain areas;
  • Consider what is ‘undiscussible’ as opposed to ‘undiscussed at the workshop’ and suggest ways for exploring undiscussibles;
  • Contribute key findings to a two-way meeting involving representatives of all the domain groups which will aim to synthesise and prioritise key variables, linkages in to an initial ‘systems map’ that will be presented for discussion at the start of the Building Workshop. This meeting will also discuss and agree the way forward on critical ‘undiscussibles’;
  • Prepare a debrief of key learnings as pre-reading and possible presentation at the next workshop.

Information on the process and some of the documentation will also be available on this site, for universal access.


 
 
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