Menahra

(EPP) Emergency preparedness plans to support the needs of PLHIV and PWUD during emergency responses.

The HIV epidemic, drug addiction difficulties, food insecurity, and weakened governance on emergency readiness and response have all been highlighted in during the COVID-19 pandemic. In countries afflicted by various disasters, it is necessary to incorporate HIV and drug use interventions into the broader disaster response. Pandemics and health emergencies like the current COVID-19 outbreak can cost many lives and pose additional risks to the macro and micro economies, and overall security and stability in many countries and communities. Ensuring continued access to health care during the emergency situation, including services for people who use drugs (PWUD) and treatment of drug use disorders is key to protect the health of populations. 

During a crisis, the effects of poverty, helplessness, and social unrest are amplified, making people more vulnerable to HIV, mental health issues, and drug addiction. As the emergency and the public health threat advance at the same time, families and communities become fragmented, jeopardizing strong relationships that are essential to support vulnerable populations. The social rules that govern behavior are frequently eroded. Women and children are more vulnerable to violence in such situations, and they may be forced to engage in sexual activity in order to get basic necessities such as food, water, or even security. Displacement may bring together communities with varying degrees of HIV prevalence. In such situations, the health-care system may be severely strained, and insufficient supplies may hinder preventive efforts. There is evidence of an increased risk of HIV transmission in many conflict zones through transfusion of tainted blood in combat conditions. In addition, the presence of military forces, peacekeepers, or other armed groups might be another factor contributing to increased transmission of HIV. Furthermore, those with drug addictions, particularly those who inject drugs, may be affected severely during such situations. Finally, stigma and prejudice associated with HIV, drug use and drug use disorders frequently restrict access to essential resources during the emergency including health treatment and social support. For all these reasons, people living with HIV (PLHIV) and PWUD find it more difficult to protect themselves, and they may be at higher risks. Therefore, it is important to ensure the continuity of adequate access to health and social services for these vulnerable groups to provide the continuum of care required.

Complex situations stemming from conflicts and natural or manmade catastrophes have become more common in the recent decades around the world. Between 2010 and 2021, many nations in the MENA region suffered various emergency circumstances, affecting about 35 million people[1]. Conflict, social instability, poverty, and helplessness are all factors that contribute to the rapid spread of HIV and other sexually transmitted illnesses, as well as heightened mental health issues in impacted areas. There were 240,000 individuals living with HIV/AIDS at the end of 2020, but no official estimations for people taking drugs in the region[2].

The only available technical guidance on managing HIV care and services in emergency settings was issued in 2010 by the Inter-Agency Standing Committee Task Force on HIV/AIDS (led by UNAIDS). However, the guidance was outdated, and does not provide clear guidance considering the new developments in HIV control, as well as many of the lessons learned from the COVID-19 pandemic on services adaptation and risk mitigations. As a result, many countries (including countries in MENA region), do not include mitigation plans targeting the vulnerable groups as part of emergency preparedness plans. The lack of inclusion of HIV in emergency planning may increase the risk of transmission during the acute phase of the emergency. The ability of these affected populations to respond to and recover from emergencies is heavily linked to their resilience and to what extent they are supported in a systemic manner.

Thus, MENAHRA planned situation assessments for Egypt, Jordan, Lebanon, Morocco, Tunisia and Yemen, that will reflect the context in the countries and would result in recommendations to support the needs of PLHIV and PWUD during emergency responses (including COVID-19 pandemic and other emergencies). The main objective for the situational assessment is to establish a baseline situation analysis (including gender analysis) to identify underlying inequalities and vulnerabilities influencing risk susceptibility of PLHIV, PWUD and their communities. The assessment will cover both risks and needs associated with PLHIV and PWUD in the country context, as well as the resources and tools available to manage and provide the services to these groups during an emergency situation.

Following the situation assessment, MENAHRA planned to develop  emergency preparedness plans (EPPs) to enable governments and partners, including NGOs, CSOs, and UN agencies, to deliver the minimum required multi-sectoral response to address the needs of people living with HIV (PLWH) and PWUD during different phases of emergency situations. EPPs are developed to minimize the adverse effects of a disaster, and to ensure that the organization and delivery of the emergency response is timely, appropriate and sufficient. These plans focused on the early preparedness measures, which should be integrated into existing plans and the use of local resources should be encouraged. Emergency preparedness focuses on strengthening resilience, especially on vulnerable households and communities, and building up local capacity to address the crisis (including pre-positioning of relief items and services).

MENAHRA finalized the development of all situation assessments and EPPs, where the EPPs for Lebanon and Yemen were validated and disseminated and the EPPs for Egypt, Jordan, Morocco and Tunisia are in the process of validation.

After the validation of each Country’s EPP, MENAHRA is conducting national trainings for the key stakeholders to provide guidance of the usage of the EPP and the integration of recommendations in the national plans.

Last month, on September 20 & 21, 2022, MENAHRA conduced a two days training in Lebanon, where the main goal was to enhance harm reduction CSOs and KPs capacities to be able to scale up their emergency response and enhance their resilience to future emergencies.  Key stakeholders attended the interactive training that defined the pillars of emergency preparedness, vulnerability and risk assessment, and defined the role of advocacy in emergency response and the process of influencing decision makers. In addition, the training highlighted the importance of innovation, communication, community participation and cooperation in emergency response. Guests from The International Federation of Red Cross and Crescent Societies (IFRC), Disaster Risk Reduction Directory at the Lebanese Red Cross, the Presidency of the Council of Ministers and the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) in Lebanon, presented their work during the training, and highlighted their lessons learned from the COVID-19 emergency response and the vital role of  strengthening collaboration and coordination at both the national and international level to enhance readiness for emergencies. 

Once the EPPs for the Egypt, Jordan, Morocco and Tunisia are validated and finalized, MENAHRA will proceed with conducting similar trainings on a national level.