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EFA vs. HIV-AIDS. Gudmund Hernes International Institute for Educational Planning UNESCO, Paris. THE STATUS OF THE EPIDEMIC. The epidemic is not leveling off, even in the most affected countries More than 9 of the 10 of the 40 million now affected live in developing countries.

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Efa vs hiv aids l.jpg


Gudmund Hernes

International Institute for Educational Planning


The status of the epidemic l.jpg

  • The epidemic is not leveling off, even in the most affected countries

    • More than 9 of the 10 of the 40 million now affected live in developing countries

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The epidemic is becoming truly global

  • By December 2002 42 million people were living with HIV/AIDS , up from 36.1 million in 2000

  • All regions of the world are affected

  • Most devastating in Africa, but Caribbean strongly affected

  • Increasingly taxes the economies and public health systems of countries such as China, Russia, Ethiopia and Nigeria – and Indonesia can now be added to the list

  • Though India’s national prevalence figure is less than 1%, after South Africa it has the second largest number living with HIV.

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The impacts are spreading more widely

  • WFP : HIV/AIDS decreases productivity, exacerbates malnutrition and increases fatigue facilitating a more rapid progression to AIDS

  • These factors undermine a person’s ability to provide enough food for themselves and his/her family

  • Just as wars, HIV/AIDS can force families to sell off productive assets, like cattle and crops, can force them to spend their savings on food and medicine, and to withdraw children from schools to care for sick adults

  • Lack of food increase likelihood for high-risk behavior to survive, such as trading unprotected sex for food.

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Some of the most affected countries are approaching a state of social breakdown

  • Life expectancy falling: Sub-Saharan Africa now 47 years – without AIDS 62 years

  • Exceptional impact on the economy

    • Loss of productivity by loss of the most productive

    • Increasing burden of caring for sick and tending for orphans

  • AIDS is wiping out decades of investment in education and human development

  • Sub-Saharan Africa: growth may be reduced by a quarter over the next 20 years

  • Not even rich countries could afford treatments on a scale needed in those countries

  • Replacement of professionals increasingly difficult – eroding access to educating: the capacity to cope may be overwhelmed and the social may fabric unravel.

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Children are at risk on an unparalleled scale of social breakdown

  • Millions already infected – in some countries more than a third of 15-year olds will die of AIDS related illnesses in coming years.

  • Millions more becoming orphans – more than 30 millions in 10 years

  • Many will grow up deprived, desocialized and disconnected

  • Classes will be dropped and schools will close many and will get a poorer education

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The epidemic is becoming feminized of social breakdown

  • 2002: The first year when the number of women infected equaled the number of men

  • In Sub-Saharan Africa, fully 58% infected are now women – often at a tender age.

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What can be done? of social breakdown

  • There is no cure

  • A vaccine is not in sight

  • Treatments are too costly in the countries most affected

    - only 30,000 on ARV treatment of 30 million in Africa – 1 treated out of 1000 infected

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The need for preventive education flows from the types of ignorance associated with the epidemic

  • Most of the infected do not know it

  • The sparse knowledge in developing countries about the nature of the disease

  • Misconceptions about the disease lead to counterproductive behavior

  • Faulty knowledge results in prejudice and discrimination

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Millions know about the virus and the risks – yet do not adopt safer practices

  • Prevention must address mentalities…

  • ...and the culture within which they are embedded – otherwise new knowledge is undercut by established belief systems

  • Changes in conceptions and attitudes require targeted messages and effective communication

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Lessons from Uganda, Senegal, Thailand, Brazil

  • If done right it works

  • If done immediately it has long term impacts

  • If done massively, it can turn the tide

    Preventive education must

  • Generate attitudes, provide skills and sustain motivation to reduce risk and vulnerability

  • Focus not just on attitudinal but also organizational change

  • Start before the epidemic is out of control.

    Kofi Annan: ”All cultures will be pushed to put cultural mores aside to save lives”

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Why education works CONTROL

  • Incomparable reach – even where low enrolments and high drop-out rates, schools reach children, families and communities like no other institution – even the young most at risk

  • Education prerequisite for knowledge (literacy)

  • Education fundamentally enters every communication on prevention

  • Intrinsic to every program on prevention and care

  • Necessary for reducing stigma and discrimination

    Education protects – the more ED the less HIV

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BUT: Prevention programs are slow in stemming the epidemic CONTROL

  • Behavior change are hard to achieve

  • And are slow to take effect

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  • Still too much focus on school health programs

  • Projects often separate, uncoordinated and of short duration

  • Not explicit about implications for personal living

  • Not yet supported by necessary resources and materials

  • Mostly directed towards young – not enough towards functioning of the education system

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WHY 2: The rationalistic bias CONTROL

  • Curriculum driven by model of man as calculator of risks and volitional actor

  • Often overlooked the affective , the emotional and irrational

  • Not capitalized on social embedding of individuals

  • Seldom drawn in local cultures, values, meanings and identity

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The double task CONTROL

  • Maximize impacts of education on epidemic

  • Minimize impacts of the epidemic’s on education

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What is to be done CONTROL

  • Anticipate what will happen

  • Forestall undesirable situations

  • Manage the circumstances that arise

    • Enable education to pursue its essential goals: learners learn and teachers teach in an environment that supports learning

    • Use the sector to slow the spread

    • Provide care and support to the affected and infected

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Change the perspective CONTROL

  • From dejected and depressed about what undercuts education to seeing opportunity in crisis

  • HIV/AIDS forces us to do what w have long said we will do but have postponed

  • More costly the longer we wait

  • Said “EFA!” – cannot stop epidemic without it!

  • Said advance human rights – cannot stop the epidemic without stopping stigma and discrimination

  • We must address the many benefits that can flow from our common calamity!