HIV-Sensitive Social Protection for Impact Mitigation

HIV and AIDS can push people and households into poverty, in part by reducing household labor capacity and increasing medical expenses. In some cases, HIV-related stigma and discrimination marginalizes people living with HIV (PLHIV) and households affected by the virus and exclude them from essential services. Despite increased access to life-saving treatment, HIV and AIDS can increase individual and household vulnerabilities - hampering governments‘effort to meet the Millennium Development Goals.

The HIV-sensitive social protection to achieve Universal Access outcomes for HIV prevention, treatment, care and support, has emerged as a key strategy in AIDS responses. UNAIDS in its 2009-2011 Outcome Framework lists social protection for people impacted by HIV as one of the priority areas and cross-cutting strategies. There is widespread acknowledgement that HIV-sensitive social protection is a pre-requisite to strengthen impact mitigation, service delivery, and human rights.

There are several definitions of social protection. The State of evidence report of UNAIDS Social Protection Working Group defines social protection as “The objective of social protection is broadly to reduce the economic and social vulnerability of all poor and vulnerable groups and to enhance the social status and rights of marginalized people by providing social transfers, ensuring access, and equitable regulation, which can take many forms”.

The functions of social protection are (Source: Stephen Devereux and Rachel Sabates-Wheeler, IDS)

• Protective  - to protect basic needs and provide relief from deprivation (cash transfers)
• Preventive – prevent people at risk from falling into poverty (insurance, employment guarantee) 
•  Promotive – to enhance income and livelihoods (livelihood programmes, micro-credit)
• Transformative – to address social inequity and exclusion (law reforms, empowerment)

HIV-sensitive social protection denotes social protection that is integrated into the overall social protection policies and programmes and it is inclusive and sustainable. HIV-specific social protection denotes exclusive social protection schemes that are aimed at PLHIV and it is exclusive and unsustainable.

Despite the acute socio-economic vulnerabilities, the attention to strategically integrate HIV into appropriate social protection schemes (HIV-sensitive social protection) is very limited.  Existing social protection schemes either target the poor or workers, leaving a lot of HIV people unattended. While many existing social protection schemes were not set up with HIV as a primary focus, their potential to contribute to a comprehensive HIV response is increasingly recognized. Many countries in the world had various forms of social protection in practice for several years - in the form of social assistance, social insurance and social justice. Social assistance is mostly protective in nature. Social insurance denotes healthcare support, pension schemes, education schemes etc that are preventive in nature and will reduce the expenditure of households and hence their likelihood of falling into poverty. Social justice denotes measures that are transformative such as legal reforms, empowerment of communities, better human rights conditions etc.