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Transport and HIV/AIDS: A survey of the issues at stake. Transport and Social Responsibility Thematic Group Julie Babinard (TUDTR) and Nina Schuler (TUDUR) May 5, 2004. Outline & Objectives. Summary review of issues and activities relating to HIV/AIDS in Transport

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transport and hiv aids a survey of the issues at stake

Transport and HIV/AIDS:A survey of the issues at stake

Transport and Social Responsibility Thematic Group

Julie Babinard (TUDTR) and Nina Schuler (TUDUR)May 5, 2004

outline objectives
Outline & Objectives
  • Summary review of issues and activities relating to HIV/AIDS in Transport
  • Jocelyne do Sacramento (AFTTR): Africa region experience on HIV/AIDS in Transport
  • Suggest areas where further work and exploration may be needed

Transport and Social Responsibility

aids hiv at a glance
AIDS/HIV at a glance
  • Unique disease (scale; incubation)
  • A threat to public health & economic development
  • Effects of infection felt at various levels (household; community; sector; country)
  • Occurrence  Treatment
    • Sexual transmission  use of condoms
    • Bloodstream  donor screening; needles sterilization
    • Mother to child
  • About 42 million people living with HIV/AIDS

Transport and Social Responsibility

adults children estimated to be living with hiv aids end 2003
Adults & Children Estimated to be living with HIV/AIDS, end 2003

EasternEurope & CentralAsia


North America

1.2 – 1.8 million

790 000 – 1.2 million

EastAsia& Pacific

520 000 – 680 000

700 000 – 1.3 million


350 000 – 590 000

North Africa & Middle East

South & South-East Asia

470 000 – 730 000

4.6 – 8.2 million


1.3 – 1.9 million

Australia & NewZealand


25 – 28.2 million

12 000 – 18 000

Total: 34 – 46million

Source: AIDS epidemic update, Dec. 2003. UNAIDS.

Transport and Social Responsibility

impact of hiv aids on transport
Impact of HIV/AIDS on transport
  • Role of transport for economic development
  • Compromises effectiveness & reliability of transport – decline in productivity
  • People at high risk and their families include
    • Construction workers
    • Employees who maintain infrastructure
    • Workers in railways, roads, airlines…
    • Professionals engaged in maintenance
    • Population living along roads & highways
    • Commercial sex workers
    • Locally based government employees
    • Mobile populations, refugees

Transport and Social Responsibility

transport and spread of hiv aids
Transport and spread of HIV/AIDS
  • Transport is major vector:
    • Movement of people
    • Behaviors associated with transport sector workers and transportation hubs

42% of truck drivers report indulging in commercial sex while traveling; 33% of those who have casual sex don’t use condoms

Survey results, Poland and Lithuania border areas (World Bank, 2003)

Transport and Social Responsibility


HIV Prevalence prior to and post construction/improvement transport corridors

Highway routes HIV prevalence prior to activity post activity

Myanmar:1997 Injecting drug users Injecting drug users

Mandalay-Muse HighwayHIV+, 1996 HIV+, 1998

  Mandalay 51% 88%

  Lashio 34% 74%

  Muse 86% 92%

China: 1996 construction Number of HIV+ Number of HIV+

Yunnan-Nanning, Guangxicases 1995 cases 1998

  Guangxi 10 525

Viet Nam: Number of HIV+ Number of HIV+

Highway one: Ho Chi Minh City cumulative cases cumulative cases


highway improvement1997 1998

  Hanoi 51-100 101-1,000

  Hai Phong 11-50 101-1,000

  HCMC >1,000 >1,000

Source: Lee-Nah Hsu (UNDP 2001)

the bank s response in a snapshot
The Bank’s response in a snapshot
  • Support HIV/AIDS prevention, care, mitigation from mandate to reduce poverty
  • Policy dialogue, lending, analytical work, and global programs
  • US$2.21 billion committed (Jan. 2004)
  • Multi-Country AIDS program for Africa
    • $1 billion to scale up existing activities and strengthen implementation
    • Flexible and rapid funding
    • Roughly half of MAP are allocated directly for use by communities and civil society
    • Sub-regional and cross HIV/AIDS initiatives through MAP 2 Ex: Abidjan-Lagos Corridor
  • Other region: Caribbean MAP; health projects focus on HIV/AIDS

Transport and Social Responsibility

the transport hiv aids response
The Transport HIV/AIDS response

Within World Bank

  • SSA
    • HIV/AIDS Abidjan-Lagos Transport Corridor project
  • SA
    • Indian Highway to HIV/AIDS prevention


  • UNDP: Multisectoral responses to Mobile Populations’ HIV vulnerability

Transport and Social Responsibility

mainstreaming hiv aids within transport
Mainstreaming HIV/AIDS within transport

Within World Bank

  • SSA
    • Ethiopian Road Sector Development Project
    • Mali Transport Corridors Improvement Project
    • Chad national Transport Program Support Project
  • MENA
    • The Djibouti International Road Corridor Rehabilitation Project
  • EAP
    • Cambodia Provincial and Rural Infrastructure Project (PRIP)
    • Papua New Guinea Highlands Highway Rehabilitation Project


  • UNDP: Preventing HIV/AIDS on road projects in Yunnan Province, China

Transport and Social Responsibility

implementing hiv aids measures within transport recommendations
Implementing HIV/AIDS measures within transport -- Recommendations
  • A transport response should include components that consider
    • How to change behavior/ conditions that affect behavior
    • Which groups to target
    • The sector entry points
  • Food for thought:
    • How to link transport with existing HIV/AIDS projects?
    • How to integrate HIV/AIDS into transport projects?
  • External partners/ resources: UNDP; USAID

Transport and Social Responsibility