World AIDS Day, 1 December: a primary vehicle for AIDS awareness

1. World AIDS Day, 1 December:a primary vehicle for AIDS awareness • One of the most successful international days • People’s day: awareness-raising activities take place in almost every country • A significant media event • AIDS organizations mobilize • High-level government officials speak out • Donors commit funds

2. The World AIDS Campaign • Repositioning World AIDS Day to make it a longer campaign • Forcing discussion on emerging thematic issues • Providing a programmatic thrust to issues • Engaging new partners • Increasing community participation and ownership

3. World AIDS Day themes so far World AIDS Day declared by WHO in 1988 • 1988: A world united against AIDS • 1989: Our lives, our world – let’s take care of each other • 1990: Women and AIDS • 1991: Sharing the challenge • 1992: AIDS – a community commitment • 1993: Time to act • 1994: AIDS and the family • 1995: Shared rights, shared responsibilities • 1996: One world, one hope Children, young people and AIDS • 1997: Children living in a world of AIDS • 1998: Force for change – World AIDS Campaign with young people • 1999: LISTEN, LEARN, LIVE! World AIDS Campaign with children and young people Men and AIDS • 2000: AIDS: men make a difference • 2001: I care, do you? • 2002 and 2003 : Live and let live

4. Stigma and discrimination World AIDS Campaign theme for 2002-2003

5. Live and let live World AIDS Campaign slogan

6. Why stigma and discrimination Stigma and discrimination are major obstacles to effective prevention and care. If we do not address these issues, we will never succeed in our efforts. −Maria Tallarico, CPA Haiti

7. Why stigma and discrimination I believe that, worldwide, the most serious obstacle in the fight against AIDS is stigma and discrimination. Although the forms and context differ, stigma prevails. It affects the rights of PLWHA, societal coping mechanisms and caring for the sick. In most countries, it is a nightmare. - Abdalla Ismail, CPA Sudan

8. What is the campaign’s main objective? To help prevent, reduce or eliminate stigma and discrimination wherever they occur and in all their forms

9. Stigma • It is created by individuals and society • It builds on existing power relations • It builds upon and reinforces existing social inequalities and prejudices • It is perpetuated overtly and covertly

10. Health care Family Prisons The workplace Legal institutions (judiciary, legislative) Education Media Insurance/social benefits Existing laws Travel/migration Marriage Death Stigma and discrimination occur in different settings and services

11. Factors compounding stigma and discrimination • Gender • Sexual orientation • Race • Religious beliefs • Place of residence/profession • Social status

12. Is it just about PLWHA? • The campaign will address issues related to those who are both HIV-infected and -affected • The campaign will address specific stigma and discrimination faced by other populations, e.g. sex workers, men who have sex with men, and injecting drug users.

13. Internalized stigma ’Perceived’ and ’enacted’ stigma ’Perceived’ stigma refers to the shame associated with HIV and the fear of being discriminated against on account of the illness ’Enacted’ stigma refers to the actual experiences of discrimination Internalized stigma can be alleviated by strengthening the resolve, commitment and personalized perspective of PLWHA.

14. How to address internalized stigma • Address the problem programmatically • Build skills and capacity among HIV-infected and -affected people • Prepare people for voluntary disclosure • Establish an enabling environment • Develop support systems for individuals and groups • Put the responsibility where it belongs (examine personal/institutional roles)

15. Different approaches to reducing stigma and discrimination • Rights-based approach • Involvement of PLWHA at all stages, especially from the start • Individual focus • Collective focus • Policy-based vs. legal approach Approaches are complementary and inter-related. Each has a programmatic aspect. The advantages of all approaches need to be maximized. Approaches are complementary and inter-related. Each has a programmatic aspect. The advantages of all approaches need to be maximized.

16. Prejudice Prejudice thought thought Loss of human rights Loss of human rights Stigma Stigma attitude attitude result result Discrimination Discrimination act act The response has to be multi-pronged to break the vicious circle of stigma, discrimination and human rights violations

17. Campaign entry points can vary • All available entry points should be used • The different contexts for stigma and discrimination around the world must be taken into account • No matter which approach is adopted, it has to address the same main objective

18. Red Cross campaign Gov. prevention programmes Society’s leaders Media Journalists Global teamwork with different players UNAIDS campaign partner partner partner partner Measures & efforts Country-specific institutions NGO’s, government heads, Health Ministers, local institutions Influencers Influencers Measures & efforts Individuals Employees of institutions Hospital, health-care centres, schools, churches, the judicial system, companies PLWHA, their families, other society members

19. Global vs. local perspective • The UNAIDS campaign must be seen as an integral part of international efforts. • Target individuals and organizations have different needs and knowledge standards. • Local efforts may be linked to the UNAIDS theme but can also work completely independently, based on local circumstances and prejudices.

20. Role of the UNAIDS campaign • Raise broad awareness with regard to the theme of stigma and discrimination • Be effective beyond 1 December 2003 • Initiate concrete changes on a global level • Initiate effective responses at the local level

21. Two-phase approach Phase I: Phase II: W O R L D A I D S D A Y of a variety of aspects related to stigma and discrimination Drive action at institutional levels Raise broad awareness Action- driven measures 2002 2003/4

22. Raise broad awareness: Promote understanding of the different aspects and ways in which PLWHA and their families are affected in their daily struggle against stigma and discrimination. Reach a broader understanding of why stigma and discrimination breach human rights. Reduce the number and frequency of discriminating acts worldwide. Action-driven measures: Document tangible improvements regarding human rights and legal perspectives on a local institutional level. Stimulate and support government and nongovernmental efforts to reduce the level of stigma and discrimination in-country. Empower PLWHA by showing them specific cases of where stigma and discrimination have already been reduced. Objectives of the two phases Phase II Phase I Sensitize a broad audience for aspects of stigma and discrimination and reduce their daily discriminative acts Generate tangible changes on an institutional level. Prove the effectiveness of Phase 1 with real success stories

23. PLWHA deserve it Only minority groups are facing the problem of AIDS Infection is one’s own fault We have to pay higher health-care costs because of PLWHA Punishment by God At least it reduces the population of developing countries Stigma Prejudice It is a developing world disease People die anyway, so why care too much Discrimination Medical care restrictions Legal system’s discriminatory judgements Denial of education Violation against minority groups Societal ignorance Finance restrictions No access to AIDS medications Workplace hiring/firing One-sided media coverage Key messages: exploring the themeof stigma and discrimination Goverment spends too much money on PLWHA

24. Which target groups are currently affected by these issues? • PLWHA and their families and communities • Government • Employees and employers • Children/youth • Faith-based organizations • Local AIDS organizations • Journalists • Health-care workers • Other NGOs

25. PLWHA/their families Members of society in developed countries Members of society in developing countries Media/journalists What are the assigned target viewpoints? PLWHA go through a process of grieving for their own lives, which eventually should lead to an acceptance of their diagnosis. However, even when people do manage to find a balance in their own lives, society and institutions often perpetuate the idea that those infected with HIV are lesser members of the community. What does this mean in terms of communication? We need a message that motivates PLWHA and their communities as well as all members of society worldwide which enables PLWHA to live their lives to the fullest. They marginalize the problem of AIDS and have no insights about the daily struggles and limitations confronting PLWHA, since prevention campaigns always focus on the details of infection. In developing countries, AIDS is often viewed as a punishment by God or a poverty- related disease. Do not have enough knowledge or background information about the daily struggle confronting PLWHA.

26. Hospitals Education Judicial system Private companies Health-care settings What are the assigned target viewpoints? PLWHA are not getting the same medical treatment as others, because of fear of infection. What does that mean in terms of communication? PLWHA are not being offered the same business and education opportunities, because there‘s a common lack of career thinking regarding PLWHA PLWHA are not getting the same justice as others. They do not have sufficient legal protection from violence and biased verdicts. We need a message that ensures broader access to all areas to let PLWHA live their lives PLWHA do not get the same respect as others because AIDS is sometimes seen as a punishment from God, particularly in relation to injecting drug users and men who have sex with men. Faith-based organizations PLWHA do not get the same opportunities in the workplace as others, because there‘s still the perception that it is not worth investing in people who will die anyway. PLWHA do not get the same treatment/access to antiretroviral programmes since therapies are costly and pharmaceutical companies are not willing to reduce prices for developing countries.

27. The potential core idea must be simple and flexible The challenges of defining a common platform for: • different areas related to stigma and discrimination • different age groups • women and men • different ethnic environments • different target groups • different socioeconomic contexts The future communication platform has to: • be an outstanding creative concept that generates impact without excessive spending • ensure regional executional adaptations • ensure a uniform worldwide tonality

28. means: personal empowerment of PLWHA and their families to believe in a better future sending a positive signal that underscores the importance of living life fully demonstrating the necessity of standing up and fighting for rights on a daily basis emphasizing a powerful will to live, despite HIV infection means: a message for institutions to ensure access to care for PLWHA a strong correlation with human rights inherent in ALL people a call to question everybody‘s daily thinking and behaviour a call to society worldwide for greater integration of, and compassion for, PLWHA The core idea let live! Live and

29. Why do we believe in this core idea? Because: • It is positive and motivating for all involved • It contains the most essential aspect related to AIDS: life. • It is based on the most relevant needs • It is flexible enough to use for specific and/or local issues and communication measures • It is relevant for all cultures, each gender, different age groups and socioeconomic contexts • It covers both civil and institutional domains

30. Global positioning Two-year objective Generate a broader global awareness of stigma and discrimination, and encourage social change. Conventions to break Several AIDS-related issues are often either communicated in a harmless way or operate with shocking and pessimistic images. Normally, they focus only on a narrow target group. Target insight Once PLWHA have accepted their destiny, their strongest wish is to live their life to the fullest. However, they struggle daily with the limitations caused by stigma and discrimination from other members of society. UNAIDS Live and let live Brand personality Empowering, caring, progressive, open-minded, touching and sensitive people Brand belief UNAIDS believes that stigma and discrimination against PLWHA is a violation of their human rights. UNAIDS also holds that stigma and discrimination are detrimental to HIV/AIDS prevention, care and support efforts. Part of an effective response to the HIV/AIDS epidemic includes improving the quality of life and reducing social vulnerability of all people.