Unaids

N ATIONAL H IGH S CHOOL MODEL UNITED NATIONS 35th Annual Conference • March 18-21, 2009

BACKGROUND GUIDE

The Joint United Nations Programme on HIV/AIDS Economic and Social Council Special Committees  2008-2009 International Model United Nations Association, Inc. Used and distributed under license.

N ATIONAL H IGH S CHOOL M ODEL U NITED N ATIONS The 35th Annual Conference • March 18-21, 2009

September 2008

Nick Stefanizzi Secretary-General Boston University

Rosa Akbari Director-General McGill University

Nancy Henry Conference Director

Dear Delegates, It is my pleasure to be the first to welcome you to NHSMUN 2009. My name is Deanna Maxfield, and I am the Under-Secretary-General (USG) of the United Nations General Assembly Special (UNGAS) Committees. I hope you’re excited to be at the NHSMUN conference in just a few short months.

Tufts University

Michelle Shevin Chief of Staff Barnard College

Cristina Rade Chief of External Relations Adelphi University

Ryan Burke Director of Security University of South Carolina

Matthew Low Under-Secretary-General University of California, Berkeley

Daniel Nowicki Under-Secretary-General Georgetown University

Deanna Maxfield Under-Secretary-General University of Southern California

Emily Robertson Under-Secretary-General Duke University

Lisa Cuesta Under-Secretary-General University of Pennsylvania

Jerry Guo Under-Secretary-General Dartmouth College

NHSMUN is a project of the International Model United Nations Association, Incorporated (IMUNA). IMUNA, a not-forprofit, all volunteer organization, is dedicated to furthering global issues education at the secondary school level.

In my non-NHSMUN life, I’m a junior majoring in public relations and minoring in international relations and business law at the University of Southern California. I play clarinet in the USC Trojan Marching Band. I love going to football games, traveling, and attending parties with my friends. When I go home to Salt Lake City, I enjoy skiing and hanging out with my three younger sisters. As USG of UNGAS, I spent last summer helping Directors develop their topic selections and editing Background Guides, including the one you’re about to read. I’m also responsible for welcoming Assistant Directors to staff and preparing them for their first year as NHSMUN staffers. During the conference, I’ll be roaming around among all of the UNGAS committee rooms to assist the Directors and Assistant Directors with whatever they need. If you have any questions about what I do as a USG, the conference in general, or anything else, feel free to pull me aside for a chat. I’m open to any of your questions, concerns, or comments. Your Director has worked very hard to prepare this Background Guide for you, so please read it carefully. If you have any questions about the topics or the conference in general, feel free to contact your Director or me. Good luck with your position paper, and I’ll see you in March! Sincerely, Deanna Maxfield [email protected] 801.557.6159 2826 Menlo Ave. Los Angeles, CA 90007

N ATIONAL H IGH S CHOOL M ODEL U NITED N ATIONS The 35th Annual Conference • March 18-21, 2009

Nick Stefanizzi

September 2008

Secretary-General Boston University

Rosa Akbari Director-General McGill University

Nancy Henry Conference Director Tufts University

Michelle Shevin Chief of Staff Barnard College

Cristina Rade Chief of External Relations Adelphi University

Ryan Burke Director of Security University of South Carolina

Matthew Low Under-Secretary-General University of California, Berkeley

Daniel Nowicki Under-Secretary-General Georgetown University

Deanna Maxfield Under-Secretary-General University of Southern California

Emily Robertson Under-Secretary-General Duke University

Lisa Cuesta Under-Secretary-General University of Pennsylvania

Jerry Guo Under-Secretary-General

Dearest Delegates, It’s hard to believe, but another year has passed, and another NHSMUN dawns upon us. My name is Molly Randall, and I am your Director for the 2009 UNAIDS Committee. This is precisely my umpteenth Model UN conference and my third time on UNAIDS. I know and love this committee and conference, as both a former delegate and a current staffer. Outside life at NHSMUN (which does, believe it or not, exist), I am in my second year at Georgia Tech studying international affairs and Spanish. Around campus, I work double duty as a secretary for the Athletic Association and as a DJ for our radio station, WREK FM. I have lived in Atlanta my entire life, so needless to say, I live on a strict diet of Coca-Cola, peaches, Chick-fil-A chicken biscuits, sweet tea, and Ludacris. I am a die-hard Radiohead fan, but my current obsessions range from Pink Floyd to NERD to Coldplay to Lil’ Wayne. I also enjoy long walks on…the Chattahoochee River with my ridiculous wiener dog Oscar and my infinitely more ridiculous group of friends. My friends and family often joke about my devotion to this conference and our topics, but learning about and fighting HIV/AIDS is something I am truly passionate about. The topics UNAIDS will discuss this March are “HIV/AIDS in the Sex Industry” and “The Spread of HIV/AIDS in Refugee Camps.” I am excited to debate these topics because of the range of issues they each encompass. Additionally, each of these topics forces us to not only look at HIV/AIDS from a medical perspective, but from social, economic, and political ones as well. One of my greatest joys of being on MUN staff comes from seeing the solutions you, the delegates, can develop for seemingly unsolvable problems. Writing this guide has consumed a good portion of my summer, and while it was a lot of work, I have gotten so much out of all of the research and re-drafting. Let this guide start your research, but do not let it confine it. Find interesting articles, older historical documents, pie charts, interviews, Bill O’Reilly clips, whatever it takes for you to remain updated and arrive prepared. I am also open to any questions you have; I check my email (probably a little too) regularly, and will get back to you with questions you have about anything. Can’t wait to see you and your work! Sincerely, Molly Randall [email protected]

Dartmouth College

1050 Martin Ridge Road Roswell, GA 30076 NHSMUN is a project of the International Model United Nations Association, Incorporated (IMUNA). IMUNA, a not-forprofit, all volunteer organization, is dedicated to furthering global issues education at the secondary school level.

The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

A NOTE ON RESEARCH AND PREPARATION Delegate preparation is paramount to a successful and exciting National High School Model United Nations 2009 Conference. We have provided this Background Guide to introduce the topics that will be discussed in your committee; these papers are designed to give you a description of the topics and the committee. They will not give you a complete description of the topic areas and they will not contain the most up-to-date information, particularly in regards to rapidly evolving issues. We encourage and expect each delegate to fully explore the topics and be able to identify and analyze the intricacies of the issues. Delegates must be prepared to intelligently utilize their newly acquired knowledge and apply it to their own countries’ policy. You will find that your nation has a unique position on the topics that cannot be substituted for or with the opinions of another nation. The task of preparing and researching for the conference is challenging, but it can be interesting and rewarding. We have provided each school with a copy of the Delegation Preparation Guide. The Guide contains detailed instructions on how to write a position paper and how to effectively participate in committee sessions. (Note: some position papers have unique guidelines that are detailed within respective committees’ Background Guides.) The Guide also gives a synopsis of the types of research materials and resources available to you and where they can be found. A brief history of the United Nations and the NHSMUN conference are also included. The annotated rules of procedure complete the Delegate Preparation Guide. An essential part of representing a nation in an international body is the ability to articulate that nation’s views in writing. Accordingly, it is the policy of NHSMUN to require each delegate (or double-delegation team) to write position papers. The position papers should clearly outline the country’s policies on the topic areas to be discussed and what factors contribute to these policies. In addition, each paper must address the Research and Preparation questions at the end of the committee Background Guide. Most importantly, the paper must be written from the point of view of the country you are representing at NHSMUN 2009 and should articulate the policies you will espouse at the conference. All papers should be typed and doublespaced. The papers will be read by the Director of each committee and returned at the start of the conference with brief comments and constructive advice. You are responsible for sending a copy of your paper to the Director of your committee. Additionally, your delegation is responsible for bringing a bound copy of all of the position papers—one for each committee to which your school has been assigned—to the conference (to be submitted during registration). Specific requirements of the bound copy have been sent to the faculty advisor/club president. In addition to position papers, each delegation must prepare one brief summary statement on the basic economic, political, and social structures of its country, as well its foreign policy. Please mail country summary statements to the Director-General of NHSMUN 2009 at the address below. All copies should be postmarked no later than February 16th and mailed to: Rosa Akbari, Director-General 3631 av. Henri-Julien Montréal, Québec H2X 3H4 Canada

Molly Randall 1050 Martin Ridge Rd Roswell, GA 30076

(Country Summaries)

(Position Papers)

Delegations are required to mail hard copies of papers to the Director-General and Directors. NHSMUN Staff will not consider e-mail submissions as an adequate substitution. Delegations that do not submit position papers to Directors or Summary Statements to the Director-General will be ineligible for awards. -3-

The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

COMMITTEE HISTORY The AIDS virus was first discovered in 1981. Since then, the pandemic and its related illnesses and medical problems have taken more than 25 million lives, and an additional 40 million live with HIV/AIDS. In the year 2007 alone, HIV/AIDS led to 2.1 million deaths, many of which were preventable (Evans). Because an overwhelming amount of HIV/AIDS cases are in the developing world, the virus affects not only individuals, but also entire economies and infrastructures of countries attempting to build and establish themselves in the global arena. The economic and social burden HIV/AIDS places on these poorest of countries makes it nearly impossible for them to compete with or even compare to more developed countries. Despite the problems HIV/AIDS presents for the world, the international community has come together to produce some progress (Evans). Though the international community had taken smaller-scale actions prior to 1994, the first milestone to counteract the AIDS epidemic occurred on 26 July 1994, when the United Nations Economic and Social Council (ECOSOC) produced Resolution 1994/24. This resolution created a new committee called the Joint and Co-Sponsored United Nations Programme on HIV/AIDS, later to be called the Joint United Nations Programme on HIV/AIDS, abbreviated UNAIDS (1994/24). The original cosponsors included a multitude of UN bodies and other affiliated organizations: the United Nations Population Fund (UNFPA), the United Nations Children’s Fund (UNICEF), the United Nations Development Programme (UNDP), the United Nations Educational, Scientific and Cultural Organization (UNESCO), the World Health Organization (WHO), and the World Bank (WB). Four more sponsors have joined since 1996: the International Labour Organization (ILO), the World Food Programme (WFP), the United Nations High Commissioner for Refugees (UNHCR), and the United Nations Office on Drugs and Crime (UNODC) (“Cosponsors”). The cooperation of all these groups allows UNAIDS to fully address the wide scope of HIV/AIDS-related issues and deal with them efficiently and comprehensively. In 2001, a follow-up session took place to discuss the HIV/AIDS battle in the new millennium. The Declaration of Commitment on HIV/AIDS was developed from the June 2001 United Nations General Assembly Special Session on HIV/AIDS. This declaration guides and streamlines efforts, supporting actions, and goals. The session, whose theme was “Global Crisis, Global Response,” also declared that HIV/AIDS was in fact an epidemic. Another session followed in 2006, where representatives discussed implementation of goals already developed. Various aspects were discussed, including prevention, care, treatment, support, human rights, reducing vulnerability and the burdens of children, increased research, and dealing with conflict areas (“Summary”). This session also produced the Political Declaration on HIV/AIDS, which addresses issues such as development, children, funding, treatment, feminization, regionalization, human rights, nationally sustainable plans, cultural barriers, education, pregnancy, nutrition, other illnesses like tuberculosis and malaria, the TRIPS Agreement and the availability of HIV/AIDS drugs, research, and non-governmental organizations (“Declaration”). The guidelines of UNAIDS’ plans of action are also heavily drawn from the Millennium Development Goals, outlined at the September 2000 UN Millennium Summit. UNAIDS acknowledges all eight of the Goals, but pays special attention to Goal 6, which aims to “Combat HIV/AIDS, Malaria, and Other Diseases.” Its target is to “have halted by 2015 and begun to reverse the spread of HIV/AIDS,” and it also notes that prevention is necessary along with care (“The Millennium”). In addition to individual actions, UNAIDS has also led important fights against HIV/AIDS, including the Global Coalition on Women and AIDS and the 3 by 5 Initiative, as well as streamlining the efforts of various organizations. UNAIDS is currently headed by Executive Director Dr. Peter Piot M.D., Ph.D., who co-discovered the Ebola virus in 1976. Piot became a member of the WHO’s Global Programme on AIDS in 1992. He joined

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The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

UNAIDS in 1995, shortly after the Programme’s creation. He also serves as an Under-Secretary-General for the United Nations (“Executive Director”). Under the Executive Director is the Secretariat, which is located in Geneva but works in more than 80 countries. The Secretariat has five focus areas: 1. Mobilizing leadership and advocacy for effective action on the epidemic, 2. Providing strategic information and policies to guide efforts in the AIDS response worldwide, 3. Tracking, monitoring, and evaluation of the epidemic- the world’s leading resource for AIDS-related epidemiological data and analysis, 4. Engaging civil society and developing partnerships, 5. Mobilizing financial, human and technical resources to support an effective response (“UNAIDS Secretariat”). UNAIDS also includes a Programme Coordination Board made up of representatives from the previously mentioned cosponsors, multiple NGOs, and 22 governments from around the world. All of these representatives gather every two years to update the Unified Budget and Workplan, a blueprint for the course of action for the next two years (“The Unified”). The global fight against HIV/AIDS is one that requires efforts from many different groups and sectors, focused into many of the problems the virus creates. Much progress has been made, due in part to the efforts put forth by UNAIDS and various NGOs, but countless more problems remain in the areas of both treatment and prevention. Despite this, some nations are actually beginning to see improvements in their HIV/AIDS situations, and through the current and future actions of UNAIDS, hopefully more will begin to see the same positive shift toward a world free of HIV/AIDS.

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The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

SIMULATION The National High School Model United Nations Conference requires that attendees take on a distinct role while in committee, representing not themselves but their assigned countries. NHSMUN 2009 will give delegates a chance to represent their countries’ or organizations’ beliefs and policies to the best of their ability, despite any conflicts that may arise with personal beliefs. Delegates should delve deeper than just a country’s recent UN actions by researching alliances and conflicts with other countries, the history of HIV/AIDS in the region, and how these factors affect their country specifically. This will allow for a more realistic experience in committee as well as a valuable opportunity to learn the importance of diplomacy. Our committee will run similarly to an actual session of a UNAIDS committee, with some obvious adjustments to facilitate academic simulation. NHSMUN 2009’s UNAIDS committee will be made up of ten UN bodies, several delegations from individual states, and five non-governmental organizations. The NGO delegations are: 1. 2. 3. 4. 5.

International Women’s Health Coalition, Action Against AIDS (Germany), Southern African Network of AIDS Service Organizations (SANASO), The Seven Sisters of Thailand, Bolivian Network of People Living with HIV/AIDS (REDBOL) (“The Joint United Nations”).

Though UN bodies and NGOs do not receive voting rights in actual UN sessions, each delegation at NHSMUN will receive one vote. The session will begin with a roll-call to determine the number of delegations present at each session. Then, the committee will vote on the order in which they would like to discuss the topics. If a delegate’s country or organization has been affected by one topic more than the other, they may try to set the agenda so that the committee discusses the topic of more concern first. It is important, however, that every delegation researches both topics equally. While in committee, delegates will discuss a topic in either formal or informal debate. Formal debate recognizes delegates from a speakers’ list to speak for a time pre-set by the committee and utilizes parliamentary procedure. Informal debate can occur either through moderated or unmoderated caucuses, both of which require a suspension of the rules. Moderated caucuses are generally a concise way for delegates to express their views to the entire committee during short, consecutive statements on a specific aspect of the topic for a pre-determined amount of time. Unmoderated caucuses, on the other hand, allow for group discussion and serve as a valuable form of debating when writing resolutions. With that said, pre-written resolutions, which cannot capture the ideas and opinions of the committee, are strictly prohibited at NHSMUN. Additional information on the rules of committee can be found in the NHSMUN Rules of Procedure. Thorough preparation for this committee is extremely important and will allow the committee to resolve the issues being debated on at the Conference. When preparing, it is important to remember that this guide is just the beginning of your preparation. Even after you are done writing your position papers, continue to research the global HIV/AIDS crisis by reading various news publications. Also, visit your library for academic sources on your delegation and the topics, as these are vital resources. These preparation techniques will dramatically enhance how you will contribute to the committee’s success. As your 2009 UNAIDS Director and author of this guide, I not only serve as the moderator of committee but also as a source of information. Do not be intimidated by either the Assistant Director or me , as we welcome questions, comments, and concerns before and during the Conference about the topics, the committee, or NHSMUN as a whole. I am excited to see the ways in which this year’s delegates approach and handle the chosen topics, because I know from experience how dedicated, hard-working, and imaginative NHSMUN participants are.

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The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

HIV/AIDS IN THE SEX INDUSTRY TOPIC A “Unfortunately the HIV/AIDS epidemic has singled out people-in-prostitution and sexwork as ‘carriers and vectors of the spread of HIV.’ Apart from the stigma already attached to their work, society has further marginalised them as core transmitters of HIV infection. It fails to recognize that they are but links in the broad networks of heterosexual transmission of HIV. Women-in-prostitution and sex work constitute a community that bears and will continue to bear the greatest impact of the HIVepidemic….” --Meena Saraswathi Seshu, “Sex Work and HIV/AIDS: The Violence of Stigmatization” (August 2003) INTRODUCTION Human Autoimmunity Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) is historically linked to vulnerable populations. The virus was first diagnosed among homosexual men in the United States in 1981. During this era, the disease was largely known as a disease that attacked homosexuals; until 1983 it was commonly referred to as Gay-Related Immune Deficiency (GRID). From the homosexual population, awareness of the virus spread to other marginalized groups, like drug users and sex workers, and then to the general population at large (“The History”). Despite its frequency at all societal levels today, there is often still a stigma associated with the virus. HIV/AIDS continues to be associated with vulnerable groups, like sex workers, who are often put at greater risk for contracting the virus. The aforementioned historical perception that HIV/AIDS is a virus spread solely by society’s lower strata is misguided. The pathological behavior of the virus, however, does mean that people who frequently have sex with many partners, like sex workers, do increase their chances of contracting the disease. This is because the virus can only be transmitted through bodily fluids containing HIV DNA, including blood, semen, vaginal secretions, and breast milk. Sex workers frequent exposure to others’ DNA as a result of multiple sex partners does therefore put this population at greater risk for contracting HIV (“The History”). According to the UNAIDS Guidance Note on HIV/AIDS and Sex Work, less than one-third of sex workers are currently receiving proper treatment and prevention methods for HIV/AIDS (“UNAIDS Guidance”). Additionally, the language concerning the root causes of the spread of HIV/AIDS, including sex work, was not included in the 2006 Political Declaration on HIV/AIDS, despite the clear need for aid and change to address this problem (A/Res/60/262). A recent report published by the International Red Cross and Red Crescent Societies states that HIV/AIDS is on the rise in marginalized groups such as drug users, sex workers, as well as those who live in areas of natural disaster (Evans). While workers in the sex industry are often considered a target group in the spread of HIV/AIDS, the risk of transmission is only significantly higher for this group when combined with other factors. In order to fully address this issue, this committee must examine both the social and the biological factors that put sex workers at risk of contracting HIV/AIDS. This vulnerable group will not receive equal treatment in the global fight against this virus until discriminatory beliefs and practices are eliminated. Sex workers must be given equal access to knowledge, preventative tools, and treatment measures. This group can only become empowered through the incorporation of its viewpoints into dialogues on HIV/AIDS prevention and the consideration of their unique situation when formulating HIV/AIDS policies. HISTORY AND DESCRIPTION OF THE ISSUE The sex industry has existed since the dawn of the sale of goods and services, and it continues to exist today despite illegality and moral outrage in many regions of the world. The term “sex worker” is preferred over the term “prostitute,” as the latter implies poor moral judgment when in fact many people do not view the sale of sexual services as perverse, and even more do not have a choice with regard to their entry into the sex

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The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

industry. Stereotypes often lead to a misinterpretation and oversimplification of reality, so using the correct terms remains important when studying this topic (“Introduction”). More people than just the customer and client are involved in a sexual transaction. Third parties are often used to facilitate or assist in the sale of sex; these can include “business owners, bar tenders, cleaners, taxi drivers, maids, receptionists, touts, security staff, [and] local vendors” (“Introduction”). Other groups, such as police services and local gangs, are often indirectly involved in the sex industry. Both groups serve dual roles as abusers and protectors of sex workers and are often also clientele (“Introduction”). Though sex work has always occurred, technology and cheaper modes of travel have made it more accessible than ever. Additionally, different types of sex work have expanded far beyond stereotypical street workers offering one-time services. A combination of domestic and sexual services are common in the Middle East and Africa; in this case, a woman (most commonly) may stay with a man for a period of time, providing him with house work and sexual services. This arrangement is generally more long-term than just one visit. Other sex workers serve in more specialized roles. Even more people work in the sex industry in ways that do not involve sex at all, such as stripping, adult film acting, and dancing. Many of the above-mentioned workers require special skills and may not necessarily involve penetration in their lines of work, thus excluding them from concerns about HIV/AIDS transmission among sex workers (“Introduction”). Because sex work is illegal in one form or another in most of the world, brothels and other institutions are often disguised as legitimate businesses, like bars and salons. No universal legal ruling on the sex industry exists, so levels of illegality vary from country to country. The highest level of illegality is prohibition, which means it is punishable by law to sell or receive sexual services. Prohibition is the law in countries like Shariapracticing Islamic countries, Thailand, and parts of the United States. The next level is criminalization, where association with the sex industry, such as recruiting or advertising, is illegal, but the sale of services is not. This is the case in countries of Western Europe and Latin America, as well as Canada and India. The most lenient level of legality is regulation of the sex industry, which retains requirements like health testing and screening and updated immigration status. Regulation of the sex industry occurs in parts of Australia, Germany, and the United States, as well as in Ecuador, the Netherlands, and Peru (“Introduction”). Laws against the sex industry generally discourage sex workers from getting tested and then treated for sexually transmitted infections (STIs), including HIV/AIDS, because of the fear of social stigmas and possible legal consequences. Many people argue, therefore, that sex work should be universally legal because of the possibility for increased control, regulation, and condom use; however, this might also increase society’s demand for this industry. Additionally, in many states where the sex industry is legal, such as Australia and the Netherlands, some sex workers still do not register themselves with the government (“HIV Prevention”). It is not the role of this committee to make legislative recommendations to governments, but rather to find viable solutions to this problem no matter the legislative status of the sex industry in a country. Sex W orkers Sex workers have traditionally been blamed for spreading HIV/AIDS, and while this taboo still exists, the tide is shifting on this idea. Many studies suggest that sex workers do not disproportionately contribute to the spread of the virus. Accurate information is difficult to acquire, however, due to marginalization of the group as a whole, as well as the illegality of sex work in many regions. Additionally, there is little to no information on male sex workers, not only because they are less common than female workers but also because it is generally more taboo for a man to enter the sex industry and they are simply afraid to come forward (Scaccabarrozzi). Sex workers are often inaccurately grouped with “high risk groups,” like intravenous (IV) drug users and men who have sex with men (MSM), despite the fact that these categorizations may overlap or be completely untrue (“AIDS”). Furthermore, tracking rates of transmission is an arduous task because it is difficult to lump all sex workers together. Different sex workers have different lifestyles, working and living environments, and resources available to them (“HIV Prevention”).

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The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

Some workers enter the sex industry as an escape from poverty or familial oppression, others by force (“Introduction”). Very few new sex workers know all of the associated risks, however, such as the transmission of HIV/AIDS. Once they have been in the industry for a while, workers become quite knowledgeable of safe-sex practices and can share these ideas with clients and other workers. Sharing of information spreads insight that many doctors refuse to reveal because of the taboo nature of the subject (Scaccabarrozzi). Sex work is not necessarily an automatic risk factor for acquiring HIV/AIDS. In fact, many workers are more likely to be aware of their status and to seek counseling and treatment. Sex work is, however, a risk factor for increased IV drug use, which contributes to the spread of HIV (Scaccabarrozzi). Other risk factors for acquiring HIV/AIDS, for both workers and clients, include: • • • • • • •

A history of other sexually transmitted diseases, Stigma and discrimination, which lead to violence and rape, “Multiple partners” and “inconsistent condom use,” especially in men who have sex with men, Migration, in which people seek employment or pleasure from the industry, and where healthcare is not as readily available, Human trafficking, where people are forced into the industry and stripped of their rights, Sex tourism, which involves people traveling for sex, especially to Asia and the Caribbean, where age of consent laws are lower; thusly, the rate of transmission is higher because of the risks of having sex with children (“HIV Prevention”), Illiteracy (“The Sex Industry”).

Furthermore, sex workers are not the only vectors, or pathways of spreading, for HIV. Many HIV positive clients are unaware of their HIV status until they donate blood or undergo an unrelated medical screening (Scaccabarrozzi). By this time, they may have spread the virus to sex workers or other partners. One example of this is a man acquiring the virus from a sex worker, and then having sex with his wife, who in turn spreads it to their newborn child through breast feeding. In most cases, all parties are unaware of the damage that has just been done (“The Sex Industry”). Extra Risks There are several sub-groups within the sex worker population that are particularly vulnerable to HIV infection for a variety of reasons. These groups include children, transgender workers, and workers in conflict or high-risk areas. Children are often in higher demand in sex work because of the belief that they are “safer” and free of disease. In reality, they are more vulnerable to diseases due to biological makeup and size, among other physical factors. If an adult has sex with a child, tearing of tissue is more likely to occur, which increases the chance of transmitting HIV. Furthermore, children are more at risk for transmission than adults “because children are weak, vulnerable and uninformed, and not in a position to seek out medical care if they become infected with a sexually transmitted disease.” In fact, it is estimated that more than seven thousand 10 to 24 year-olds become infected with HIV daily (“The Sex Industry”). Stigma and abuse are common among all groups of sex workers due to the taboo nature of the subject, but discrimination is disproportionately higher against transgender workers, who also face many other risks in the sex industry (“Introduction”). They are most commonly classified as male-to-female, female-to-male, or as another gender altogether, as is common in Asia. These people face double discrimination, both as transgendered individuals and as sex workers. This aspect opens them up to violence and rape, which increases the risk of spreading HIV. Additional risks include factors such as lower average rates of condom use (“Introduction”).

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The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

People living in areas of conflict face many risks, and the threat of HIV/AIDS only adds to that (Evans). They have less access to medical care and proper nutrition, exhibit high rates of drug use, and suffer from increased levels of poverty. Regions like this include war zones, refugee camps, and areas affected by natural disasters such as floods and earthquakes. The increased poverty and loss of livelihoods in these areas can lead to the birth of a sex industry, either through the need for income, in the case of the worker, or the desire for relief, in the case of the client (Evans). Girls and women are trafficked into the sex industry against their wills more often than men, often falsely promised a better life for themselves and their families. These females have little chance of escape and restricted access to health and prevention resources, putting them at greater risk of contracting HIV. Additionally, the men who often solicit these trafficked workers show greater demand for sex. Many clients of these trafficked women are members of the armed services, migratory truck drivers, and fishermen/port workers. There is a common assumption that these people are at extra risk for contracting HIV/AIDS from sex workers because they stop along their trips at prominent rest areas or ports seeking sex workers. New studies have shown, however, that along some highway routes in Africa, truckers make up only 30% of sex workers’ clientele. The majority of the workers’ clients were simply locals, including healthcare workers. These people are still at risk for contracting HIV/AIDS from sex workers, however, as they generally are on the road for long periods of time and often do not wear condoms when engaging in sex (“Africa: Sex”). Prevention Prevention can come in two different forms: efforts to prevent current sex workers from contracting HIV/AIDS, and efforts to prevent women from entering the sex industry in the first place. With the first strategy, there are several methods of preventing the spread of HIV/AIDS in the sex industry. These include: • • • • • •

Universal condom use, Avoidance of drugs and alcohol, Increased control over the working environment, Regular screenings for other STDs (“HIV Prevention”), Personal hygiene, Safer-sex practices (“Introduction”).

These measures can be implemented by supplying condoms, providing education, establishing sex worker groups and networks, attempting to eliminate social stigmas, and working toward the achievement of improved legislation to ensure the rights of workers (“HIV Prevention”). Discouraging or outlawing sex work generally does not significantly lower HIV/AIDS rates. In Goa, India, for example, HIV rates actually increased when the state outlawed sex work. Rather than taking this approach, involving sex workers in HIV/AIDS prevention campaigns leads to empowerment, lower infection rates, and better-educated citizens (“HIV Prevention”). There are many groups and NGOs working to do just that. The following programs are examples of ideas that have worked particularly well. Although condoms do not completely guard against the contraction of HIV, programs to increase condom usage can be instrumental in preventing HIV contraction. Thailand’s 100% Condom Programme has allowed the government to provide free condoms to all brothels and massage parlors, as well as making it legal to force clients to use them when engaging in sex. Condom use has increased dramatically and HIV/AIDS rates have plummeted since the program’s creation in the early 1990s. This program has been one of the most successful efforts in fighting HIV/AIDS both in and out of the sex industry and is the model for many other programs (“HIV Prevention”). Many times, the most successful programs are those on the grassroots level that allow sex workers to engage in peer education efforts. India’s Sonagachi program began in 1992 with the goal of empowering sex workers to help themselves through the three R’s: respect for sex workers, reliance on sex workers to run the

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The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

program, and recognition of rights. The program also targets condom use and socioeconomic problems; accordingly, HIV prevalence has dropped and condom use has risen 60% in India (“HIV Prevention”). Similarly, Kenya’s various peer support initiatives coordinate sex worker peer groups and condom promotion in the city of Nairobi. Thusly, Nairobi’s rate of HIV among sex workers has dropped from as high as 50% to 4% in a decade (“HIV Prevention”). In Brazil’s nationwide stigma reduction program, the government and several NGOs have partnered with sex workers to help fight HIV/AIDS. Prevention methods include encouraging sex workers to respect themselves and their clients by taking care of their health. Anti-stigma campaigns have included a cartoon character named “Maria Without Shame,” who encourages women’s empowerment on billboards, leaflets, bathroom walls, and stickers (“HIV Prevention”). This committee should note that many times STI prevention plans work best when sex workers are directly involved in rehabilitation programs, mass media campaigns, and the distribution of prevention methods and treatment to other persons living with HIV and AIDS (PLWHA). The inclusion of sex workers in these activities integrates them into the general population instead of further segregating and stigmatizing them. Also, other sex workers are more likely to seek treatment if a fellow sex worker is there to provide counseling and other services. As Meena Seshu, secretary-general of Sampada Grameen Mahila Sanstha (SANGRAM), an HIV/AIDS prevention, treatment and support organization, phrases it, “working with women in prostitution and sex work for the past eight years in the HIV/AIDS prevention programme has helped address our own double standards and bias while dealing with issues related to sexuality and prostitution” (Seshu 1). A second strategy for HIV prevention is to attack the sex industry at its root and try to prevent women from entering the industry in the first place. The organization End Child Prostitution, Child Pornography and Trafficking of Children for Sexual Purposes (EPCAT) seeks to end the plight of children in the sex industry through the “elimination of child prostitution, child pornography, and the trafficking of children for sexual purposes.” The Network on Sex Work Projects (NSWP) serves as a database, source of accurate information, and resource center for those both in and out of the sex industry (“Introduction”). Clearly, there are many strategies for decreasing the risks of HIV/AIDS in the sex industry. Unfortunately, many foreign aid programs – namely, the United States’ Global AIDS Act – exclude organizations that work with sex work firms from their funding. Some members of the international community have criticized these exclusive aid programs, claiming they violate human rights. As sex work is legal in many countries, including parts of the United States, many people feel that all people afflicted with HIV/AIDS, including sex workers, deserve the right to treatment. According to various organizations, differentiating sex work from other types of labor further stigmatizes workers, and “sex workers should be entitled to labor rights and occupational health and safety regulations like all other workers” (Seshu 2). Previous international funding has gone to “drop-in centers,” which provide testing, counseling, condoms, and other safe-sex resources. Sex workers assisted by empathetic health care workers run many of these centers. Unfortunately, because of a lack of funding, many of these centers have had to shut down. These centers are more difficult to operate in countries where HIV has severely impacted the sex industry and other social institutions, such as Brazil and Thailand (Scaccabarrozzi). The United States government also came under scrutiny for its US$15 billion President’s Emergency Plan for AIDS Relief (PEPFAR) program, which was authorized for a five-year term beginning in 2003. This program required that one-third of all donated funding go toward abstinence-only programming. Many studies have shown that teaching abstinence is ineffective and tends to increase unsafe sex practices and the spread of STIs and HIV/AIDS (“HIV and AIDS”). Uganda, for example, shifted from a very successful safe sex awareness program to an abstinence-only program in 2005 in order to receive US funds for much-sought anti-retroviral drugs to treat HIV-positive citizens. This shift coincided with a condom shortage and a noted increase in STI infections (Altman).

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Ultimately, sex workers tend to be more likely to respond to HIV/AIDS prevention campaigns than is much of the general population. This is evidenced by the drop in HIV/AIDS prevalence rates in countries such as Bangladesh, Benin, Cambodia, the Dominican Republic, and Thailand, where the epidemics are significantly driven by the sex industry (“AIDS”). The responsiveness of sex workers to prevention efforts demonstrates the importance of this topic. The committee should work to expand existing efforts such as the successful programs and campaigns listed above. The committee must also look at ways that current HIV/AIDS prevention and treatment efforts continue to ignore or discriminate against sex workers because of their vulnerable status. Therefore, UNAIDS must work to remove the barriers that sex workers face in seeking HIV/AIDS prevention measures and treatment, in order to ensure that this population is given the same opportunities and treatment as the general population. CURRENT STATUS Status of the Epidemic As of December 2007, there were 33.2 million persons living with HIV/AIDS (PLWHA) in the world. Of these, 30.8 million were adults, 15.4 million were women, and 2.5 million were children under the age of fifteen. The year 2007 also resulted in 2.5 million new infections of HIV/AIDS, of which 2.1 million were in adults and roughly 420 thousand were in children under the age of 15 (“2007 AIDS”). Unfortunately, 2007 also saw 2.1 million deaths of PLWHA, including 1.7 million adults and 330,000 children under the age of 15. These numbers added up to a reduction of 16% from 39.5 million people in 2006. According to the 2007 AIDS Epidemic Update, a joint report from UNAIDS and the World Health Organization (WHO), nearly 70% of these changes come from initiatives in six countries: Angola, India, Kenya, Mozambique, Nigeria, and Zimbabwe. The reduction in the number of new infections stems from a reduction of risky behaviors, including unprotected sex (“2007 AIDS”). Even areas with large sex industries, such as Sub-Saharan Africa and South-East Asia, are showing declines in overall prevalence of HIV/AIDS. One aspect that is increasing, however, is the feminization of the disease. Sixty-eight percent of PLWHA in Sub-Saharan Africa are women. In Thailand, 43% of new infections were among women, most of which were acquired from husbands who were infected through either paid sex or intravenouse drugs. This has a major effect on the sex industry, which is comprised mainly of women (“2007 AIDS”). Another issue of growing importance is that of intravenous (IV) drug users, who put themselves at risk of contracting HIV/AIDS through the sharing of dirty needles. IV drug users who also engage in sex work are especially common in Asia and Eastern Europe. Throughout Asia, there is a strong link between IV drug use and the sale of sex. More and more women are now injecting drugs. In China, for example, up to half of female IV drug users may also be sex workers. Additionally, male IV drug users often serve as clients for sex workers, but rarely wear condoms. AIDS rates in India are declining among pregnant women but are increasing in sex workers, IV drug users, and men who have sex with men; however, rates are decreasing in areas with prevention programs aimed at sex workers (“2007 AIDS”). HIV infection rates remain low among workers in the Middle East, but there is a large range in prevalence rates in Eastern Europe, with rates among sex workers ranging from less that 5% to nearly 25% in Ukraine alone. Condom use remains low while rates of other STIs remain high. In the Caribbean, a significant factor of HIV transmission is unprotected sex between workers and clients; however, condom use has increased in the Dominican Republic. The highest rates of transmission in South America are among men who have sex with men, many of whom are sex workers, and in Latin America, rates are high but declining due to condom use (“2007 AIDS”).

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UN High Level M eeting on HIV /AIDS On 10-11 June 2008, speeches and reports from sex workers were featured during a civil society session of the High Level Meeting on HIV/AIDS. The themes of the Meeting included the decriminalization of sex work, sex workers’ human rights, and stigma and discrimination against sex workers. Several sex workers from around the world were in attendance at the meeting. They thanked United Nations Secretary-General Ban Ki-Moon for his support, but noted that there needs to be more substantial efforts with regard to marginalized groups like sex workers when addressing the issues associate with HIV/AIDS in order to fully confront the epidemic. By including sex workers in the meeting, initial progress has been made but further cooperation will provide invaluable insight and experience to the Meeting and stress the importance of community involvement (“Global AIDS”). The inclusion of sex workers in the UN High Level Meeting shows a policy shift toward greater inclusiveness of this population. A similarly encouraging shift was seen in the United States’ reauthorization of the PEPFAR plan on 16 July 2008 for an additional US$48 billion. This money no longer stipulates that abstinence-only teaching comprise one-third of spending, signaling a slight shift toward acceptance of sex practices (Physicians). Ongoing Problems Despite these signs of progress, there is still much for this committee to address. In Cambodia, for example, the government recently passed legislation under the United States’ influence that outlawed sex work. This has resulted in the arrest and detainments of sex workers throughout the country, and many have been beaten, raped, and denied the right to medical care by police. So far, three people have died and several have been denied the antiretroviral (ARV) treatments they must take in order to treat HIV/AIDS. In response to such instances of mistreatment, sex workers and empathetic advocates have joined together and written a letter addressed to Cambodia’s Ambassador to the UN in protest of these injustices (“Introduction”). According to UNAIDS, “a great deal can be done to control the spread of HIV and ease personal suffering if countries acknowledge the existence of sex work and respond to the need for HIV prevention, treatment and care of all those involved.” Unfortunately, many “legal, economic and social services” are still needed for sex workers, especially if they need assistance leaving the sex industry (“Sex workers”). Essentially, while great strides have been made in slowing the spread of HIV/AIDS both in and out of the sex industry, many more steps must be taken in order to completely halt the spread of the epidemic in the sex industry. BLOC POSITIONS Africa The HIV/AIDS rate is very high in all regions of the continent and among almost all populations, especially in Sub-Saharan Africa. Although HIV/AIDS infections are not limited to vulnerable populations in this region, some studies from the 1990s show that rates among street workers in East Africa were as high as 36% (Scaccabarrozzi). Many people turn to sex work because they are in desperate need of improving their financial situations and believe that there is no other way to do so. Even temporary or one-time sexual interactions to pay for basic needs in times of extreme poverty can lead to transmission. In Kenya, political violence following the December 2007 presidential election has increased the turmoil surrounding the sex industry. Consequently, there has been an increase in the number of female sex workers and an increase in the occurrence of violent sex acts. These factors could severely undermine Kenya’s efforts to slow the spread of HIV/AIDS, which have been fairly successful in recent years, especially in the sex industry (“Increase in”). In other African states, levels of HIV infection are as high as “73% among sex workers in Ethiopia, and 68% among those in Zambia” (“AIDS”).

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Asia This vast region is quickly becoming the focal point of observation and action in the global fight against HIV/AIDS for the following decade due to its huge growing population and the increasing prevalence of HIV/AIDS in the region. Sadly, there are already more than seven million people living with HIV/AIDS in Asia, and this number is increasing rapidly (“The Sex Industry”). Overall, a high proportion of Asian adults living with HIV/AIDS are in the sex industry, and historically, the virus was found in these populations before the general population, especially in countries like India and Thailand. Echoing the booming economy in China, the commercial demand for sex is growing, adding to the region’s growing epidemic (“AIDS”). Because HIV/AIDS is a relatively recent challenge in this region, governmental policies toward the epidemic, as well as the sex industry, tend to vary. In China, for example, STIs are common in the sex industry, and the government uses this as support for banning the sex trade. Thailand, by contrast, is often cited as a model for regulation. Since the government’s intervention in brothels, condom use has skyrocketed and STI rates have plummeted (“The Sex Industry”). In Tokyo, Japan, STIs such as Hepatitis C have been shown to go hand-inhand with HIV/AIDS. This suggests that programs aimed at treatment and prevention of the AIDS virus alone are not enough, but that more widespread health programs are needed in order to fully facilitate a healthy working environment for sex workers (Scaccabarrozzi). The risk factors for sex workers in Asia are the same as for other regions. For example, in Ho Chi Minh City, a study found that 49% of sex workers who used IV drugs were HIV-positive, as opposed to only 8% of non-IV drug users in the sex industry (“AIDS”). Eastern Europe and Central Asia Political and economic shift and unrest in these regions have caused the number of sex workers to increase in the past few decades. Nevertheless, HIV/AIDS rates remain relatively low. The prevalence of other STIs is higher, however, indicating unsafe sex practices. Many acquire HIV through IV drug use, which is extremely common. This risk factor is displayed in the discrepancies in Russia: in St. Petersburg, high drug use and a disorganized sex industry led to 48% of sex workers being HIV-positive. Adversely, in Moscow, which discourages IV drug use and organizes its sex industry more effectively, only 3% of sex workers are infected with HIV/AIDS (“AIDS”). When considering these countries’ policies, another important factor to consider is the amount of global trafficking that results from these sex industries. Officials estimate that 200,000 females, which represent onequarter of the total number of females trafficked throughout the world, are smuggled out of Central and Eastern Europe each year, the majority of whom become enslaved prostitutes (Podolsky). Therefore, efforts to prevent human trafficking within this region are of the utmost importance for this bloc. The Caribbean In this region as well, destitution leads to sex work. The world food crisis has further amplified this phenomenon. HIV/AIDS affects not only locals in the sex industry but also their tourist clients, who in turn export the virus to other countries. Creative measures are being taken to get people out of the sex industry, such as the Foundation for Reproductive Health and Family Education (FOSREF), which offers salsa lessons for aspiring dancers in Haiti as both a livelihood and possible career (“AIDS”). In the Caribbean, the HIV/AIDS epidemic is driven by sex work, mainly because of unprotected sex. The disease is also becoming increasingly feminized in the region, with one study showing that girls 15 to 19 years old were six times more likely to have the virus as men their age. Many young and indigenous people are driven to sex work because of poverty and the inability to find jobs, ultimately making them more susceptible to HIV/AIDS. Currently, many countries in South America are working to end child labor and discrimination

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against women in the work place, hopefully creating a better work environment and less risky forms of employment for sex workers (“HIV/AIDS and the World”). W estern Europe The HIV/AIDS rate within the sex industry is relatively low in this region, except among IV drug users (“AIDS”). This is most likely due to registry and regular testing. Rates are higher in men, however, due to lower rates of condom use and high rates of anal sex (Scaccabarrozzi). At a meeting among sex workers in Brussels in 2005, the European Conference on Sex Work, Human Rights, Labour and Migration made several recommendations. The board hopes these suggestions will lead to a change in overall European Union policy concerning sex work. The recommendations include providing greater transparency of the sex industry, emphasizing that sex work is legitimate work and that sex workers’ rights are human rights, and allowing sex workers to gather in groups to combat violence, social stigmas, and give the workers a voice. The Conference was held because of increasingly repressive sex work policies throughout the European Union (“Recommendations”). Latin America Recent studies of HIV prevalence among sex workers in this region have produced varied results. A 2005 study showed that sex workers accounted for one-sixth of all people living with HIV/AIDS in the region. A study in 2006 found that HIV prevalence among sex workers in South America was relatively low. A study in Peru showed a low instance of HIV but a high instance of other STDs like Hepatitis C. Despite these bits of information, concrete information on the region remains sparse (“AIDS”). Guatemala and Honduras have the highest instances of HIV/AIDS, at 2.5% of their population, yet these percentages are miniscule within the context of the global community. Therefore, Latin American countries do not need to focus on national efforts to regulate the sex industry as much as other countries do. The United States There is very limited information on HIV prevalence among sex workers in the United States because of government and private refusal to release it. This is because sex work is extremely taboo throughout the United States and illegal in many areas of the country. Sex workers are known to have high instances of other diseases like tuberculosis. In areas where sex work is legal, it is very regulated, which leads to extremely low rates of HIV/AIDS among these populations (Scaccabarrozzi). The United States has, as previously stated, recently received criticisms for its refusal to donate to organizations that deal with sex workers. According to critics, this is both hypocritical, as sex work is legal in the state of Nevada, and detrimental to the overall fight against HIV/AIDS. Many UN bodies and international aid organizations have criticized the United States for being the world’s largest donor, yet refusing to work with one of the world’s neediest groups concerning HIV/AIDS care (Watson). The United States’ views toward combating HIV/AIDS, however, may be changing. The nation’s government recently lifted a ban on persons living with HIV/AIDS entering the country, and later stated that the original policy did in fact hinder the overall HIV battle. Many experts, such as UNAIDS international task force co-chair Shaun Mellors of South Africa, who was previously banned from the US due to his HIVpositive status, see this as the first step towards a more open United States policy in not just confronting the virus as a whole, but also helping and dealing individually with the people living with it (Watson).

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COMMITTEE MISSION

The mission of this committee is not only to reduce and eliminate the spread of HIV/AIDS within the sex industry, but also to put an end to the misconception that all sex workers are carriers and spreaders of the virus. The committee should examine and compare programs that have and have not worked in the past as well as develop new strategies that best suit the needs of their country, body, or organization. The solutions should combat stigma and discrimination against sex workers and PLWHA in addition to providing methods of prevention. Delegates should also take into account the legal status of the sex industry and sex workers in their country, as well as the actual situation of the sex industry in their countries, regardless of legality. This will allow them to represent their governments’ views while still presenting concrete data, serving to show the multifaceted nature of the problems most nations face. Because of the unique structure of UNAIDS, which brings states, UN bodies, and NGOs together, delegates need to learn which NGOs and UN bodies are working within their borders, particularly those dealing with sex workers and HIV/AIDS. They should also research their countries’ relationships, if any, with the NGOs serving with them in the committee. When developing solutions, delegates should keep in mind a few important aspects: legality, social views of sex work and HIV/AIDS, and the status of the pandemic and existing programs in their country. HIV/AIDS rates can in fact be reduced, even in the sex industry, through condom promotion, prevention campaigns, and empowerment of sex workers. These programs can also reduce stigma and discrimination. The solutions the delegates develop should address both of these issues, while bearing in mind diplomacy, social perceptions, government actions, hard facts, originality, and costeffectiveness.

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THE SPREAD OF HIV/AIDS IN REFUGEE CAMPS TOPIC B “Displaced populations are now integral to the policies and guidance of the other nine UNAIDS co-sponsor agencies and the UNAIDS Secretariat.” –António Guterres, UN High Commissioner for Refugees. November 2007 (“World AIDS Day”) INTRODUCTION

There are currently more than 32 million refugees, asylum-seekers, internally displaced persons, stateless persons, returnees, and other persons of concern in more than 110 countries worldwide (“Basic Facts”). Refugees, and the other groups mentioned above, are an outstandingly large population facing innumerable obstacles. One agency alone cannot handle all the burdens of dealing with such a huge number of people. Several organizations have joined together to help these groups, including the Office of the United Nations High Commissioner for Refugees (UNHCR), the United Nations Educational, Scientific, and Cultural Organization (UNESCO), the United Nations Children’s Fund (UNICEF), and dozens of non-governmental organizations (NGOs) (“Basic Facts”). One problem facing refugees that is especially dangerous is the added risk of spreading and/or contracting HIV/AIDS. This topic is extremely important for UNAIDS to address. Refugee camps serve as possible breeding grounds for HIV/AIDS due to several factors. The camps often have disorganized layouts and are overcrowded. There are added security risks and increased levels of poverty and drug use. Finally, there is a loss of stability, healthcare, education, and in some cases, human rights (“Anatomy”). HIV/AIDS should not be added to all of the other challenges that refugees have to confront. With prevention campaigns, added security, and education systems, being a refugee even in an area with a high instance of HIV/AIDS is not necessarily a death sentence. The eventual goal in dealing with refugees should be returning them to their countries of origin or resettling them in another country; the goal of this committee in particular should be to ensure that refugees do not contract HIV while transitioning into more stable positions HISTORY AND DESCRIPTION OF THE ISSUE Refugees camps are the most common environment for refugees in emergency situations, as large groups of people naturally come together out of convenience and safety. These camps often grow too large too quickly. If a camp reaches hundreds of thousands of people, agencies usually attempt to divide it into smaller groups of 10 to 20 thousand people each to make it more manageable. Smaller groups also lead to fewer risks, including the spread of disease. Unfortunately, the most efficient and safest design of a camp is nearly impossible to achieve, because most refugees just settle on a site without premeditated planning. Camps Despite this, camps should follow a basic design. The following specifications do not describe all refugee camps, but rather ideally designed ones. They should be built away from disease-spreading insects’ breeding grounds. All camps should have access to roads; this way, vehicles can enter and bring important medical supplies and food. Roads are also a matter of hygiene and safety, as paths become overused. A welcome or reception center keeps track of the number of refugees in camps as well as different populations, like men,

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women, and children. The center also allows refugees to receive an overview of the rules of the camp and an initial medical screening, which would indicate which refugees have HIV/AIDS (“Anatomy”). Public toiletry units should be well-lit so that they are safe to use, especially for women at night, in order to avoid assault and rape. Toilets should also be built away from water and food supplies. If they are built too close, cholera can be a big problem for camps because it comes from consuming contaminated food and water. Cholera outbreaks can be especially severe in refugee camps because everyone eats essentially the same food and because cholera must be treated almost immediately. The health centers in camps are sometimes better than those of host communities, so they are often opened to the public. The centers generally have a stock of about 50 essential drugs for common, treatable illnesses. Smaller health posts are set up throughout the camp and are equipped with nurses to treat minor ailments. International health guidelines state the minimum water requirements as one gallon per person per day. If there is no local water source, it must be shipped in. Food is distributed in weekly rations, and food that needs to be cooked is generally preferable because, according to research, women commonly prepare it and distribute it more evenly than men would (“Anatomy”). It is considered a serious issue when malnutrition reaches 10% in a camp with a pre-existing epidemic, such as HIV/AIDS or malaria. Breastfeeding is encouraged because women who breastfeed their babies may receive more food rations; however, HIV-positive women who breastfeed without the proper medicines may pass the virus onto their babies, and the correct medicines are rarely available on-site. Although morbid, death rates are tracked at refugee camps for data purposes. No more than one per ten thousand people should die per day, and five or more is considered a serious emergency (“Anatomy”). Security is also a big issue in camps. Host governments and local militia share some of the responsibility for ensuring personal safety, like controlling the increasing levels of rape among women, but aid agencies also try to keep camps from becoming too highly militarized. Some camps use barbed wire as border protection, but this generally leads to increased violence, bloodshed, and chance of spreading disease because of the increased militarization of these camps. Education should be and sometimes is attempted in camps as it maintains normalcy and encourages proactive development, but schools are often under-equipped and quickly become overcrowded. Refugees may spend as little as a few weeks in a camp, but some camps, such as those in Palestine, may house refugees for decades at a time. For this reason, it is important to provide as normal and stable a life as possible for refugees during their stay in camps (“Anatomy of a refugee camp”). Refugees The term “refugee” has come to encompass more than just a person who flees from his/her country of citizenship to a different state. Several types of refugees are listed in the 2007 Global Trends Report from the UNHCR. A refugee is defined as someone who has been forced to leave his or her home due to conflict situations, political, religious, or social persecution, or natural disaster. These include actual refugees, or those recognized by the original 1951 Convention relating to the status of Refugees, its 1967 Protocol, the 1969 Organization of African Unity (OAU) Convention Governing the Specific Aspects of Refugee Problems in Africa; those under the UNHCR Statute, in which UNHCR assumes responsibility for refugees; those under temporary or complementary protection from the United Nations; and those previously defined in the “other” category, who are now recognized as people in “refugee-like” situations (“2007 Global Trends” 1-3). Refugees also include asylum-seekers, or people whose applications for asylum or refugee status are still pending, meaning people who have applied to officially become refugees. Similar to refugees are internally displaced persons (IDPs), who been forced to leave their homes for similar reasons as refugees but who have not crossed international borders. The last two categories of people are stateless persons, who lack nationality, have undetermined nationality, or are not considered nationals by any state, and others, which encompasses all people who do not fit the above categories but have received UNHCR’s assistance (“2007 Global Trends” 4-6).

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The overall number of these people dropped from 32.9 million in 2006 to 31.7 million in 2007, a 3% decrease. The year 2006 also marked the first time this decade that IDPs outnumbered refugees. The number of stateless persons nearly halved from 2006 to 2007, dropping from 5.8 million to 3 million; however, definitive statistics on statelessness are difficult to gather because of illegality. Some people are born in countries in which their ethnic group is not nationally recognized and are therefore denied citizenship. Fiftyfour states reported information last year, and the overall drop in the number of stateless people is due in part to new legislation recognizing previously stateless persons in Nepal and Bangladesh as citizens. The regions with the most IDPs in 2007 included many African nations, along with Colombia, India, and Sri Lanka. There was also an increase in the refugee and IDP situations reported in Afghanistan, the Central African Republic, Chad, and Yemen, while significant progress was made in Lebanon and Nepal (“2007 Global Trends” 8-9). The top countries of refugee origin in 2007 were Afghanistan, Colombia, Iraq, and Sudan, with high numbers also found in the Democratic Republic of the Congo, Somalia, and Thailand. Adversely, the top host countries of refugees in 2007 were Chad, the Islamic Republic of Iran, Germany, Jordan, Pakistan, People’s Republic of China, the Syrian Arab Republic, the United Republic of Tanzania, the United Kingdom, and the United States. The top countries chosen by asylum-seekers in the same year were Canada, France, Greece, South African, Sweden, the United Kingdom, and the United States (“2007 Global Trends” 14). According to the 1951 Convention, several rights of refugees should be guaranteed. These rights are “health, equality and non-discrimination, privacy, liberty and security of the person, information, participation, work and education” (“Policy Brief”). Additionally, host countries should provide these rights, as hosts are responsible for providing protection to refugees (“Measuring Protection”). Unfortunately, refugees are all too frequently denied these basic rights as well as others. The latest denial of refugee rights comes in the form of travel restrictions on people living with HIV/AIDS (PLWHA). This could potentially hinder HIV-positive refugees’ efforts to leave or enter a country. Eleven countries–Armenia, Colombia, Iraq, Oman, Qatar, the Russian Federation, Saudi Arabia, the Solomon Islands, South Korea, Sudan and Yemen–ban the entry of HIV carriers because of economic and health concerns (“UN Calls”). The United States just lifted its own ban in July 2008 (Physicians). This is proving to be a major problem because many of these countries are either top producers or hosts of refugees. United Nations Secretary-General Ban Ki-Moon and nearly four hundred NGOs have publicly criticized the 74 countries that currently have these types of restrictions, though only 12 of the aforementioned countries fully bar the entry of PLWHA. Their criticisms include human rights abuses and hypocrisy, stating that these countries let their own citizens who are HIV-positive travel internationally (“UN calls”). Specific Needs and Challenges Though all refugees face challenges, including the possibility of contracting HIV/AIDS, several groups are in high-risk situations for contracting the virus. Women are at extra risk because they have been “stripped of the protection of their governments, their homes, and often their family structure” (“Measuring Protection”). Additionally, social and cultural norms often sustain gender roles based on issues associated with HIV/AIDS. These include the misconception that women are the “carriers” of HIV, the higher number of female sex workers, and women’s general vulnerability when confronting the virus, such as rape and men’s common refusal to wear condoms. All of these factors lead to the increasing feminization of the virus, and even when everything else in refugees’ lives has experienced upheaval, the women’s roles remain largely the same (“UNHCR”). UNHCR has made several attempts to increase the resettlement of refugee women, especially in Africa, due to high levels of sexual and gender-based violence (SGBV) (“Measuring Protection”). This is because women and children are open to exploitation, such as human trafficking, forced labor, sex work, and a lack of economic resources, as well as violence (“Policy Brief”). In fact, “women often face a double-risk of contracting HIV, due to biological, social, and economic vulnerability and vulnerabilities caused by conflict situations” (“Educational Responses”). Women may become separated from family and face new hardships with a lack of familiar social structures. Furthermore, increased rapes and SGBV lead to increased rates of sexually transmitted infections (STIs), including HIV/AIDS (“Educational Responses”). Unfortunately, rape has become “a way of life” for some women, especially in violent conflict regions like Darfur, where almost

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all women have been raped or experienced some form of SBGV (Robertson). Girls as young as toddlers are being raped, and men often are not willing to defend them for fear of being killed. This not only leads to a spike in the spread of HIV among refugees, but also an increase in unwanted children. Many women simply abandon their babies because of the stigma attached to a child conceived by rape (Robertson). In 2001, UNHCR drafted five Commitments to Ensure Women’s Protection. These methods for protecting refugee women are: 1. 2. 3. 4.

The participation of women in management committees, Individual registration of all refugee women and men, Developing strategies to address sexual and gender-based violence, Ensuring refugee women’s participation in management and distribution of food and non-food items, 5. Provision of sanitary materials to all women and girls. These methods not only help to physically protect refugee women, but also help to prevent them from contracting HIV/AIDS (“Measuring Protection”). Because these commitments are so integrally linked to the fight against HIV/AIDS, this committee must examine how they are being carried out, and include these considerations and concerns in any solution it drafts. Children also have special needs as refugees. Children under the age of 18 represent 44% of all refugees (“Measuring Protection”). Refugee children as a whole must face a difficult situation, but orphans are in an especially severe predicament because they are unable to care for themselves. Many children are orphaned by HIV/AIDS. A recent study found that out of the 17 countries with more than 100 thousand AIDS orphans, 13 are on the verge of emergency or armed conflict, creating major possible refugee situations. Girls often face even more challenges than boys due to traditional female roles, meaning they may be forced to take over household activities. For many girls, this means leaving school, or if not, facing stigma both in and out of the learning environment. Studies have shown that women who stay in school longer are less likely to contract HIV, so refugee girls who are unable to attend classes are at a greater risk (“Educational Responses”). Another issue with children is breastfeeding. According to UNHCR, “5 to 20% of infants born to HIVinfected women will acquire the infection through breast feeding” (“HIV and Infant”). Breastfeeding can help guard against malnutrition and disease, however, two problems to which refugees in camps are dangerously prone. Ensured medication is one way to reduce the risk of transmission, via either antiretroviral treatment for the mother or antiretroviral prophylaxis for the infant during breastfeeding (“HIV and Infant”). Access to this medicine, however, is often restricted for refugees. The UNHCR has studied various groups of refugees to determine which are the most vulnerable in order to most accurately and effectively deliver aid. Thus, the body has written several priorities for protecting refugee children. Unaccompanied and separated children are difficult to protect because they are hard to track and rehabilitate. They are also more vulnerable, and organizations have very low success rates in keeping them safe. Children, especially girls, are more open to sexual exploitation, abuse, and violence. This can lead to the increased spread of HIV/AIDS. One study showed that as many as 65% of SGBV cases reported received treatment. Children are also open to military recruitment. They are often picked up by militiamen at the camps or after they have returned home. In military training, the boys are brainwashed into being violent, and many of the girls are forced into sex slavery, which spreads HIV/AIDS unnecessarily and violently. Adolescent refugees are regularly more at risk than children because they are often sexually active, and they are referred to as the “forgotten group” because much of the focus is on younger children. These risks combined make them more likely to spread and contract HIV/AIDS. Despite all of the challenges refugee children face, there is hope for keeping them free of HIV. Studies have shown that education helps keep children safe by ensuring a more developmentally stable environment. Unfortunately, an estimated one-third of refugee children do not attend school (“Measuring Protection”).

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Joint United Nations Programme on HIV/AIDS

Many people mistakenly believe that hosts of refugees face added risks in the spread of HIV/AIDS. Hosts include people who live around, in, or near the communities surrounding refugee camps. Despite many hosts’ fears, UNESCO states that “it is a common misconception that refugees pose a threat to host communities. Data indicate that refugees often migrate from countries in areas of conflict with lower HIV prevalence to more stable host countries with higher HIV prevalence” (“Educational Responses”). Unfortunately, this misconception adds to the stigma that refugees already confront, thereby hindering many HIV-positive refugees’ healthcare needs (“Educational Responses”). According to the 1951 Convention, the 2001 Declaration of Commitment on HIV/AIDS, and the 2006 Political Declaration on HIV/AIDS, host governments should incorporate refugees into pre-existing aid programs. This includes programs targeted at preventing the spread of HIV/AIDS (“Refugees”). Regrettably, many host countries cannot deal with the special needs of refugees living with HIV because they are already heavily burdened with the HIV-related needs of their own citizens. Harder still for host countries to deal with is the fact that the majority of refugees lives not in the camps themselves but in the surrounding communities, and may stay there for longer periods of time. The average length of a refugee stay has increased from nine years to 17 years over the past decade (“Policy Brief”). Ultimately, the HIV risk to host communities from refugees, and vice versa, depends on how heavily the refugees interact with the people in the communities. This contact is usually frequent and sustained over many years, so denying refugees access to adequate HIV/AIDS care also denies the surrounding communities the same right (“Educational Responses”). The final high-risk group for refugees is those living in urban environments. Urban refugees, of all ages and genders, often have the toughest circumstances, facing increased discrimination due to the lack of a homogeneous camp environment. These refugees are repeatedly falsely blamed for crime and the spread of numerous diseases, including HIV/AIDS. This discrimination and false accusation all too frequently spills over into schools; therefore, the rights of PLWHA and refugees must be included in school curricula, especially in areas with high numbers of refugees (“Educational Responses”). Pros and Cons of Refugee Living Serious HIV/AIDS-related problems facing refugees still include mandatory HIV testing, stigma and discrimination, and issues with resettlement (“Measuring Protection”). As stated before, refugees often face added risks of contracting the virus for various reasons, including: the “loss of livelihoods and basic services,” the increased vulnerability of women and girls, the increasing sexual violence against women and girls, in that rape is now “a weapon of war,” the lack of social networks and institutions to provide regulation and stability, the exposure to trauma that can increase levels of alcohol and drug use, and the limited education and healthcare facilities that undermine HIV prevention campaigns. Though these may seem like insurmountable challenges, long-term studies have found that living in refugee camps may provide refugees with more benefits in preventing the spread of HIV/AIDS than do many surrounding host communities. These possible benefits consist of the reduced mobility and relocation to high-prevalence urban areas in search of employment, as may have been the only option before living in a camp; the isolation of refugees from outside populations and possible threats, as many camps are in remote locations; and better sources of protection against contracting HIV/AIDS than surrounding host countries or countries of origin (“Educational Responses”). Unfortunately, as with many aspects of refugees’ lives, these benefits can be inconsistent or absent in some cases. They can even serve as double-edged swords; for example, an isolated camp may seem well-protected, but may also be less equipped to handle an outbreak of HIV/AIDS if it lacks access to medical supplies. Solutions and Prevention The ultimate goal for refugees is not to be safe in camps, but to find permanent residence outside the camps. The following methods represent various means of resettlement:

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The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

1. Voluntary repatriation, or returning willingly to the country of origin. This solution is often durable and has many benefits for refugees, including a sense of familiarity. 2. Resettlement in another country, which is ideal for protection and allows host nations to share refugee burdens, but does not require that refugees take on the identity of the host country. 3. Local integration, which involves gradually conforming to the society of the host country and eventually gaining nationality there. This option is chosen if the refugee desires to be completely detached from his or her country of origin (“2007 Global Trends” 10-11). Unfortunately, the opportunity to take one of these routes may take years to arise, so temporary solutions and attempts at preventing the spread of HIV/AIDS are necessary. UNHCR currently has five regional HIV/AIDS coordinators: four in Africa and one in Asia. UNHCR recently undertook training for PostExposure Prophylaxis (PEP) in order to address violence, protection, and HIV/AIDS. PEP is a medical treatment that allows rape victims and those who have had unprotected sex to protect themselves against the virus, even after the event has already taken place. The methods learned in these training sessions, which took place in six countries, could cut down on the number of HIV infections among refugees, especially from SGBV. Since 2005, UNHCR’s focus has been on gathering accurate data to better streamline aid efforts and to avoid misconceptions. To do so, they have conducted behavioral surveillance surveys to track HIV/AIDS risk factors. The following data represent the findings of one study among refugees in Mozambique: • • • • •

25% have had HIV testing, 94% have a high level of both understanding and preventing AIDS, 10% have been raped, 7% of women used condoms in “non-regular relationships,” 46% of men used a condom in their last “non-regular relationship.”

Mixed findings like these demonstrate to the committee that the gender discrimination and disparities are still intact, as women are clearly still pressured not to use condoms. Many camps, thanks to HIV prevention campaigns and camp activities, however, are now experiencing lower HIV prevalence rates than surrounding communities. One example of this is the Kakuma camp in Kenya, which has a 5% prevalence rate, as opposed to the nearby town of Lodwar, which has a 16.5% prevalence rate, more than triple that of the camp. The populations mix with each other, so it is beneficial for refugees to receive not only camp-driven prevention efforts, but nationally based ones too (“Measuring Protection”). The programs that work best for attaining wide-reaching HIV prevention are the nationally-based ones already in place in the host country with adjustments made for refugees. Integrating refugees into existing HIV/AIDS programs instead of creating special ones helps reduce social stigmas (“Policy Brief”). To accomplish this, civil society and aid organizations in the host country should advocate legislation to further help refugees, which should diminish discrimination (“Refugees and”). Regional efforts to address larger numbers of people at once have also proven effective. They maintain cohesion, foster diplomacy, and create an effective way of dealing with migrant and mobile refugees. One example of this is central Africa’s Great Lakes Initiative on AIDS, which has lowered health costs and assisted refugees when they cross borders. For monetary purposes, Zambia has come up with a new solution to confront HIV/AIDS by combining development and humanitarian funding to create the largest amount of aid possible for its refugees, and has thus been able to implement an HIV/AIDS program for them (“Policy Brief”). Education Most experts, UN bodies, and NGOs agree that education is the most effective way to prevent the spread of HIV/AIDS in refugee camps. These entities view education not only as a right, but as a necessity. The UNHCR concurs on the importance of HIV/AIDS education, as only prevention methods coupled with education can bring about true stability. The 2000 Dakar Framework for Action: Education for All Report states that signatories should “implement as a matter of urgency education programmes and actions to

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The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

combat the HIV/AIDS pandemic” (“Educational Responses”). Higher levels of education, especially among women, have been shown to produce lower levels of HIV/AIDS and fewer risky sexual behaviors. Researchers have documented such results in the Democratic Republic of the Congo, Rwanda, Tanzania, and Uganda. When refugee girls were able to stay in school longer, it lowered their chances of contracting HIV later in life. Unfortunately, primary education itself is often unavailable in refugee camps, so HIV/AIDS curricula may be out of the question, as this generally comes in secondary school. Additionally, many refugees simply do not or cannot go to school: In the 1980s and 1990s in Mozambique, 45% of all schools were destroyed, and in 2000 in Colombia, 85% of children in camps did not go to school (“Educational Responses”). In response to this, UNESCO has drafted HIV/AIDS educational guidelines for refugees, which include: 1. “Policy, management, and systems,” which makes sure education guidelines fit with country policy as well as HIV/AIDS programs already in place. 2. “Quality education (including cross-cutting principles)” that is “scientifically accurate and socially appropriate,” and that teaches the social aspects of the disease such as gender equality as well as basic academic cores. 3. “Content, curriculum and learning materials,” which takes into account the learning levels of students and the availability of resources. 4. “Educator training and support” that makes sure the teachers are competent in both curriculum and language. 5. “Approaches and entry points,” which states that education should go further than the classroom to include food programs, extracurricular activities, and adult/life skills classes (“Educational Responses”). All of these rules are designed with refugees in mind to ensure that it is easier for them to stay in school and ultimately reduce their chances of contracting HIV/AIDS. One of the recreational activities that has worked in several cases is “Right to Play,” which supports games in refugee camps throughout Africa. Another is “Live Safe, Play Safe,” which involves education and games to help young people learn about HIV/AIDS. This is accomplished through role-playing, group discussions, and activities; as a result, young people develop negotiation skills and assertiveness as well as an understanding of peer pressure and the issues of PLWHA. Moscow’s Magee Woman Care International, one of UNHCR’s partners, carries out another effective program. It addresses care for urban refugees and high-risk groups, like women of childbearing age, defined as ages 15-49. The education plan, delivered in the classroom and by trips to centers, includes information on prevention, risk, and transmission of HIV/AIDS. Surveys after the class have shown not only increased levels of awareness and knowledge, but also a change in risky behavior among teenagers (“Educational Responses”). UNHCR The UNHCR is one of the cosponsors of UNAIDS and worked with the body prior to becoming an official cosponsor. It has developed an AIDS unit with experts dispersed around the world. Programs focused on preventing HIV/AIDS among refugees now operate in Africa, the Americas, Asia, Europe, and the Middle East. These programs include “assessments, voluntary counseling and testing, prevention of mother-to-child transmission, HIV prevention, development and dissemination of information-education-communication materials, and monitoring and evaluation” (“UNHCR”). Together, the UNHCR and UNAIDS have developed information, statistics, and expertise in dealing with the varying issues of HIV/AIDS and refugees. They also have jointly produced a series of behavioral surveys that aim to dispel myths and misconceptions about both refugees and PLWHA. Gradually, the UNHCR’s focus has shifted and continues to shift from just providing aid to camps to more widespread efforts, including returnee locations and urban areas (“UNHCR”). In addition to UNAIDS’s and UNHCR’s combined efforts, several NGOs have established

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The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

working relationships with the two bodies. These most recently include the Norwegian Refugee Council, the Protection Surge Capacity Project through the International Rescue Committee, and the Resettlement Deployment Scheme through the International Catholic Migration Commission (“Measuring Protection”). CURRENT STATUS Though there are obvious benefits to testing each and every refugee for HIV when he/she enters a camp, both UNAIDS and the WHO have deemed mandatory testing a violation of human rights, except in the case of testing blood for transfusions. Additionally, just testing a refugee will not prevent the spread of the virus; only further protective measures can accomplish this. That being said, both the camps and the surrounding host countries may provide Voluntary Counseling and Testing if the resources and capacity to provide this service exist (“HIV Testing”). According to the 2008 Report on the global AIDS epidemic, a human-rights-based approach to treating HIV/AIDS is more effective in treating marginalized populations, including refugees and migrants. If programs focus more on allowing refugees and other marginalized groups to realize their rights and gain access to them, it is the hope of UNAIDS and its cosponsors that the spread of HIV/AIDS will slow if not reverse. By accessing their rights not only as refugees or PLWHA, but as humans, refugees affected by HIV/AIDS will likely have more access to health care, employment, participation in local decision making, and ultimately lowered stigma and discrimination. All of these factors combined will allow lower rates of HIV/AIDS to flourish not only in refugee camps but also in the surrounding communities, as studies have shown that they are deeply interconnected (“2008 Report”). In the 2007 Policy Brief from UNAIDS considering Refugees and HIV, the body outlines several goals and actions for facilitation of the care of refugees affected by HIV/AIDS and international partners. The body’s aspirations are to: • •

•

“Advocate and support governments to meet their international obligations under refugee and human rights law and implement strategies that reflect best practices in responding to the HIVrelated needs of refugees and host communities,” “Encourage governments to consider the needs of refugees in preparing funding proposals, provide resources for incorporating these needs into national HIV and health policies and programmes, and ensure that funding conditions do not prevent funds from being simultaneously used for refugees and host communities,” “Support governments in norm setting and identifying packages of services for refugees and in developing effective systems for data collection and analysis, and using data to inform policies and programmes” (“Policy Brief”).

Together, these proposed actions reach out to UN bodies, NGOs, and countries in ways that UNAIDS believes will best allow them to further the rights of refugees, especially when seeking to treat HIV/AIDS. They provide a solid outline for government action without fully mandating what the governments should do, allowing maximum fluidity in dealing with existing HIV/AIDS programs concerning refugees. UNHCR currently has projects in more than 70 countries dealing with HIV/AIDS and refugees. Over the past year, the body has been able to expand upon its programs, with much progress in the fields of testing, prevention of mother-to-child transmission, and providing antiretroviral treatment. The programs for the next few years include a focus on sexual and gender-based violence, in reaction to the increasing feminization of the virus (“World AIDS Day”). One program that has affected the lives of refugees and returnees is street theater in Nepal. The country is recovering from decades of conflict and is also battling the HIV/AIDS epidemic. A program funded through both UNAIDS and the British government uses the popular, accessible medium of street performances to inform people about the dangers of HIV/AIDS, how it is transmitted, and how to prevent it. The audiences were able to connect better with the stories told rather than just listening to

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Joint United Nations Programme on HIV/AIDS

a lecture. Since the performances began, more and more people have begun to seek advice from HIV/AIDS treatment centers (Gurung). BLOC POSITIONS Africa Africa contains more refugees and displaced persons per capita than any other continent. Despite this, and the additional challenges of extreme poverty, major areas of conflict, and the world’s highest HIV/AIDS rate, Africa continues to introduce progressive policies toward refugees and refugee camps. Though host communities are strained, new international groups such as the African Union and sub-regional organizations continue to work together in an attempt to deal with the problems facing refugees, PLWHA, and those who are both. The continent also conducts much research and puts much effort into the area of refugee rights, which are too frequently denied. There are currently more than 50 NGOs from a range of faiths, backgrounds, missions, and geographical regions working in the continent to aid in the plight of refugees, including groups focused on legal rights, the abolition of torture, and medical needs (“Refugee Right”). Much of Africa’s refugee policy is guided by the Convention Governing the Specific Aspects of Refugee Problems in Africa. This document focuses on defining refugees, non-discrimination, voluntary repatriation, correct documentation, cooperation with international organizations (including UNHCR), and settlement of disputes (“Convention”). However, because the document was drafted in 1969, it does not contain specific information on dealing with refugees affected by HIV/AIDS. Asia Asia currently has more than five million PLWHA, and the area of highest prevalence is Southeast Asia (“UNAIDS Country”). One of the biggest problems confronting Asian refugees is injecting drug use. Many do not feel that HIV/AIDS is a threat to them, and their drug use not only makes them more vulnerable to the virus but also drives away any likelihood of regaining employment. This can be a major problem for host countries because drug-addicted refugees bring with them not only their addictions but also a higher chance of contracting or spreading HIV/AIDS (“Pakistan: Drug”). In 2005, UNHCR allocated funding for several programs in Asian countries. In Bangladesh, which hosts tens of thousands of refugees from Myanmar, education and communication programs have been put in place, as well as staff training about other STIs. In India, programs are focused on urban refugees in Delhi, especially in the areas of health management and voluntary testing. Urban refugees are also the focus in Jakarta, Indonesia, with funds going to existing programs concerning peer education about HIV/AIDS. Nepal is home to several Bhutanese refugee camps as well as the Tibetan transit center in Kathmandu. Much has been accomplished over the past three years in this country, including STI treatments for men, behavioral surveillance surveys, mobile testing units, and a program which allows HIV/AIDS information to be distributed with food. In Thailand, not only have voluntary counseling and testing (VCT) services been expanded, but cartoons and leaflets with information about HIV/AIDS have also been translated into more languages so that they can reach broader groups of refugees, including those from Myanmar (“Refugees, HIV and AIDS”). Europe Europe is one of the most popular regions for people seeking refuge and asylum. The year 2006 alone saw nearly one million applications for refugee status in Europe. In addition to being one of the largest host regions for refugees, many of the developed governments, including members of the G8, provide funding for international aid programs. Many of Europe’s refugee operations are in areas recovering from and, to some extent, still experiencing conflict, including the Balkans and the Caucuses region.

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The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

In the more developed Western European countries, refugees from all over the world, but especially Africa and the Middle East due to geographical proximity, try to start better lives for themselves in this economically flourishing region. Nevertheless, the refugees remain at risk for contracting HIV/AIDS. UNHCR and UNAIDS have multiple programs focused in Eastern Europe. In Russia, the organizations introduced programs that provided education on HIV/AIDS to young refugees while remaining consistent with already existing programs. Posters and other mass media campaigns in urban areas also targeted general hygiene, STIs, and reproductive health. In Armenia, a joint effort between UNHCR, UNAIDS, and the United Nations Population Fund (UNFPA) targeted increasing awareness of NGOs that help people at high risk for contracting HIV/AIDS, including refugees (“Refugees, HIV and AIDS”). United States On 24 July 2008, the United States government approved legislation that would broaden its efforts in the global fight against HIV/AIDS. The new bill more than triples the funding of President George W. Bush’s original idea, the President’s Emergency Plan for AIDS Relief (PEPFAR), and branches its focus from SubSaharan Africa to other affected regions like the Caribbean while continuing to provide a large amount of funding to Sub-Saharan states. Also included in the bill is a measure that would make it easier for PLWHA to enter the United States, ultimately making it easier for refugees to seek asylum in the country (“House Passes”). COMMITTEE MISSION The mission of this 2009 UNAIDS committee is not only to combat the spread of HIV/AIDS in refugee camps but also to discover the root causes of the spread in order to further prevent it. In order to accomplish this, the committee must thoroughly examine the refugee camps themselves, the refugees living in the camps, and the risk factors that specifically pertain to refugees and allow the virus to continue to permeate these populations. Delegates must remember that while refugees are a marginalized group even among PLWHA, they should still receive full human rights, especially access to adequate healthcare and HIV/AIDS treatment, even in situations of extreme poverty, violent conflict, and dire need. Together, UNAIDS, the WHO, and UNHCR have worked to develop a more human-rights-based approach to dealing with HIV/AIDS in refugee camps. While these goals are admirable and attainable, delegates should keep the details of life in a refugee camp in mind. Solutions should not only address the short-term details of HIV/AIDS treatment, such as transporting ARV treatment to camps and testing, but also long-term battles such as the added discrimination that HIV positive refugees and returnees face. Delegates should know whether there are any existing refugee populations in their countries or nations surrounding their countries and should know their governments’ policy regarding refugees. It is also important to keep in mind social views toward refugees and PLWHA, as these aspects will undoubtedly guide the direction of the solutions proposed. Ultimately, solutions should keep in mind the broad scope of challenges that refugees affected by HIV/AIDS must deal with on a daily basis, as well as those the governments, NGOs, UNAIDS cosponsors, and aid organizations attempting to help them face. Only through open communication from all bodies involved, participation of refugees and assurance of their rights, and cohesion with programs already in place can the spread of HIV/AIDS in refugee camps be reversed.

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Joint United Nations Programme on HIV/AIDS

RESEARCH AND PREPARATION QUESTIONS As mentioned in the Note on Research and Preparation, it is imperative that delegates answer each of these questions in their position papers. TOPIC A 1.

How does the prevalence of HIV/AIDS in your state’s general population compare to that of sex workers in your state?

2.

What is the sex industry’s level of legality in your state? What are some of the benefits and disadvantages of this?

3.

What are some industry-specific issues in your country? For example, is intravenous drug use common, or are children sex workers in high demand?

4.

What legislation and/or programs, if any, does your state have concerning HIV/AIDS, the sex industry, or sex workers? What do these laws and programs entail, and how do they affect your country’s sex industry, healthcare system, education, and other institutions?

5.

Do you have any solutions that would both recognize the sex industry as a legitimate one while respecting individual states’ rights, as well as addressing HIV/AIDS?

TOPIC B 1.

Do your country or any surrounding countries have refugee camps within their borders? Are these camps established because of political conflict, environmental disasters, or other reasons?

2.

Is the rate of HIV/AIDS significantly higher in these camps than in the surrounding population?

3.

Is adequate healthcare provided in these camps? Adequate protection from both internal and external threats? Is there access to contraceptives?

4.

How has your country dealt with refugees in the past? If it has not had to, how has it voted on various UN procedures dealing with refugees?

5.

Does your country favor short-term plans for immediate refugee assistance, or longer-term plans for reintegration?

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The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

IMPORTANT DOCUMENTS The following documents have been hand-selected by Directors to further aid in delegate preparation. Please make a concerted effort to read and analyze these documents prior to the conference. TOPIC A “Position Statement on Condoms and HIV Prevention.” United Nations Population Fund. New York: July 2004. Position statement on a key element of preventing HIV/AIDS among sex workers. Good outline of how policy-making should take condom use into account and treat this often-complicated issue. Seshsu, Meena Saraswathi. “Sex Work and HIV/AIDS: The Violence of Stigmatization.” UNAIDS Global Reference Group on HIV/AIDS and Human Rights. New York: 25-27 August 2003. This article gives a woman’s (who has worked with sex workers) perspective on other women in the sex industry, and sheds light on the myths and misconceptions that often lead to further stigmatization against them. UNAIDS/05.18E. “Intensifying HIV Prevention: UNAIDS Policy Position Paper.” Aug. 2005. Policy paper on HIV prevention that should be applied to this topic. A good source for current UNAIDS position on how to work toward preventing HIV/AID contraction among all populations TOPIC B “Educational Responses to HIV and AIDS for Refugees and Internally Displaced Persons.” UN Educational Scientific and Cultural Organization, UN High Commissioner for Refugees. New York: Jan. 2007. A discussion paper on educational responses to HIV/AIDS for refugees and IDPs, directed towards decision-makers. Because it’s intended for policy-makers, this document will be crucial for delegates as they brainstorm practical policy-oriented solutions. “Guidelines for HIV/AIDS in Emergency Situations.” Inter-Agency Standing Task Force. 2008. UNAIDS. 17 Sept. 2008 . An excellent resource for delegates, these guidelines will apply in many situations that also involve refugees, and include a section geared specifically towards refugees. Good explanation of how the UN currently works to integrate HIV/AIDS concerns into refugee situations. This will allow delegates to weigh strengths and look for weaknesses in current response systems. “HIV and Refugees.” UNAIDS. New York: 2007. Outlines UNAIDS policy towards refugees and HIV/AIDS. A must-read. Excellent information about the general situation faced by refugees when dealing with HIV/AIDS, as well as specific examples in problem regions. “UNAIDS/IOM Statement on HIV/AIDS Related Travel Restrictions.” UNAIDS, International Organization for Migration. New York: June 2004 Provides a review and subsequent recommendations regarding HIV/AIDS related travel restrictions, one of the more complicated issues in this topic. The issue of travel restrictions is one that could lead to dissension between Member States on committee, and thus should be considered before debate opens.

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The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

BIBLIOGRAPHY COMMITTEE HISTORY 1994/24. “Joint and co-sponsored United Nations Programme on the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome.” 26 July 1994. This work from ECOSOC established UNAIDS. A/RES/60/262. “Political Declaration on HIV/AIDS.” 15 June 2006. This document ensures nations’ political commitment to the AIDS virus. A/RES/S-26/2. “Declaration of Commitment on HIV/AIDS.” 2 Aug. 2001. This resolution came after the 2001 UN General Assembly Special Session on HIV/AIDS in 2001. “Cosponsors.” UNAIDS. 18 June 2008 UNAIDS. 27 Sept. 2008 . This page from the UNAIDS website states the cosponsors of the body and how they interact with UNAIDS. “Declaration of Commitment on HIV/AIDS.” UNAIDS. June 2001. UNAIDS. 27 Sept. 2008 . This article explains both the 2001 Declaration on HIV/AIDS and its follow-up session in 2006, which produced the Political Declaration on HIV/AIDS. “Executive Director.” UNAIDS. 2008. UNAIDS. 18 June 2008 . This page on UNAIDS describes the life and role of the body’s leader, Dr. Peter Piot. “Summary of the Declaration of Commitment on HIV/AIDS.” UNAIDS. Geneva: 25-27 June 2001. . This report summarizes the goals and intentions of the Declaration of Commitment on HIV/AIDS, drafted after the Millennium Summit. “The Millennium Development Goals Report.” United Nations. New York: 2005. . This book contains information and updates on all 8 of the Millennium Development Goals. “The Unified Budget and Workplan.” UNAIDS. 2008. UNAIDS. 18 June 2008 . This page outlines the budget of UNAIDS and the meetings held every two years. “UNAIDS Secretariat.” UNAIDS. 2008. UNAIDS. 18 June 2008 . This article explains the make-up of the UNAIDS Secretariat and the work it carries out. SIMULATION “The Joint United Nations Programme on HIV/AIDS: Composition of the Programme Coordinating Board.” UNAIDS. 29 Apr. 2008 UNAIDS. 27 Sept. 2008 . This site explains the functions of the PCB as well as its members for this year.

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TOPIC A UN Sources “2007 AIDS Epidemic Update.” UNAIDS. Geneva: Dec. 2007. This extensive report contains hundreds of statistics about infection rates of HIV/AIDS from around the world and broken down regionally. A/Res/60/266. “Political Declaration on HIV/AIDS.” 15 June 2006. This is a GA resolution that reaffirms the global commitment to fighting AIDS and stressing the status of the HIV/AIDS virus as an epidemic. “HIV/AIDS and the World of Work in Latin America and the Caribbean: Opportunities and Change.” UNAIDS/ ILO. Genva: 6 May 2006. This joint report documents labor struggles throughout Latin America and the Caribbean and how they contribute to the HIV/AIDS crisis. Seshu, Meena Saraswathi. “Sex Workers and HIV/AIDS: The Violence of Stigmatization.” UNAIDS. Geneva: 2003. Report detailing the negative impact of stigmatization in the sex industry related to HIV infection rates. “Sex workers and clients.” UNAIDS. 2008. UNAIDS. 22 July 2008 . An article on the UNAIDS website that gives an overview of sex workers, their clients, and what is being done to deal with the HIV/AIDS problem in the industry. “UNAIDS Guidance Note: HIV and Sex Work.” UNAIDS. Geneva: April 2007. This report is UNAIDS’ response to the HIV/AIDS epidemic within the sex industry and gives its “three pillars” method of dealing with it. Non-UN Sources “AIDS and Prostitution.” Avert. 2008. Avert. 19 June 2008 This page on the Avert organization’s website gives an overview of the dangers of the virus within the industry, as well as several bloc positions from around the globe. “Africa: Sex by the Side of the Road.” AllAfrica.com. 5 Aug. 2008. AllAfrica.com. 7 Aug. 2008 . This news article talks about the added risks that truckers face in contracting HIV/AIDS from sex workers. Altman, K. “US Blamed for Condom Shortage in Fighting AIDS in Uganda.” New York Times. 30 Aug. 2005. Article explaining the role of PEPFAR in contributing to the condom shortage in Uganda. Evans, Robert. “AIDS rates growing among drug users, gays-report.” Reuters. 25 June 2008. Reuters. 26 June 2008 . This news report shows that many of the traditional high-risk groups for contracting HIV/AIDS are still at risk, more so than ever. “The History of HIV and AIDS in America.” Avert. 8 Sept. 2008. Avert. 26 Sept. 2008 . Concise outline of the rise and spread of the HIV/AIDS virus.

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“HIV Prevention and Sex Workers.” Avert. 8 August 2008. Avert. 17 September 2008 This report gives a brief update on how HIV/AIDS continues to spread within target groups. “HIV and AIDS in Uganda.” Avert. 14 Sept. 2007 Avert. 27 Sept. 2008 . Comprehensive look at the situation of AIDS prevention in Uganda, examining the successes and failures of various policy changes. Huang, Yingying, Gail Henderson, Suiming Pan, and Myron Cohen. “HIV/AIDS Risk Among Brothel-Based Female Sex Workers in China.” Sexually Transmitted Disease. 31.11 (2004): 695-700. This article focuses on the importance of ethnographic, socio-culturally aware response to HIV/AIDS among sex workers based in brothels. “Increase in Commercial Sex Work, Sexual Violence in Kenya Following Violence Will Undermine HIV/AIDS Efforts.” Medicalnewstoday.com. 5 Aug. 2008. Medicalnewstoday.com. 27 Sept. 2008 . This article examines the link between political violence and sexual violence in Kenya, which could unfortunately devastate HIV/AIDS prevention programs. “Introduction to the issues regarding sex work.” Network of Sex Work Projects. 5 Aug. 2008. Network of Sex Work Projects. 17 Sept. 2008 . This organization’s website gives a detailed look into the often-complex world of the sex industry. Physicians for Human Rights. “Africa: Pepfar - $48 Billion Landmark Bill Reauthorized.” AllAfrica 16 July 2008. 24 Sept. 2008 . Article detailing the renewal of the United States PEPFAR plan and the new stipulations of this bill. Podolsky, Gary. “The Dark Side of Travel: The Sex Trade.” International Society of Travel Medicine (ISTM). 2006. ISTM. 27 Sept. 2008 . An important article when considering the instances of forced sex work in relation to the sex industry. “Recommendations of the European Conference on Sex Work, Human Rights, Labour and Migration.” International Committee on the Rights of Sex Workers in Europe. Brussels: 2005. This report talks about the 2005 European Conference which allowed sex workers to have a voice throughout parliaments in Europe and demand rights and protection. Scaccabarrozzi, Luis. “Sex Workers and HIV.” The Body: The Complete HIV/AIDS Resource. 2006. The Body. 27 Sept. 2008 . This article gives a good overview of HIV/AIDS within the sex industry, providing statistics from individual countries as well as methods of preventing the further spread of the virus. “The Sex Industry.” Network for Good. 2007. Network for Good. 26 June 2008 . This website gives valuable insight into the plight of children in the sex industry, as well as organizations attempting to help sex workers and the HIV/AIDS crisis around the world. Watson, Julie. “Activists, UN wants HIV travel restrictions erased.” Denverpost.com. 2008. Associated Press. 6 Aug. 2008 . This news article explains the United States’ recent decision to lift its band on HIV-positive people entering the country, and explores how this might change the fight against HIV/AIDS.

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The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

TOPIC B UN Sources “2007 Global Trends: Refugees, Asylum-Seekers, Returnees, Internally Displaced and Stateless Persons.” UNHCR. June 2008. This report from UNHCR gives an in depth view of statistics and movements of refugees throughout 2007. “2008 Report on the global AIDS epidemic.” UNAIDS. New York: July 2008. This extensive new report contains information on human rights based approaches to treating the root causes of the spread of HIV/AIDS in refugee camps. “Basic Facts.” UNHCR. 2008. UNHCR. 6 July 2008 . This page on UNHCR’s website gives a good starting point for statistics on refugees. “Educational Responses to HIV and AIDS for Refugees and Internally Displaced Persons: Discussion Paper for Decision Makers.” UNESCO. New York: Jan. 2007. This report delivers statistics on high-risk groups of refugees and information on the protection and benefits of a solid education, including HIV/AIDS awareness. Gurung, Nini. “Street theatre helps spread HIV/AIDS awareness in Nepal.” UNHCR. 3 Dec. 2007. UNHCR. 29 July 2008 . This news article tells about an effective program in Nepal that uses street performances to education people about HIV/AIDS. “HIV and Infant Feeding: Framework for Priority Action.” 30 June 2004. This guide tells of the benefits of breastfeeding and the risks of doing it if the mother has HIV. It also gives simple solutions to this problem. “HIV Testing in refugee situations—Reproductive Health in refugee situations: an Inter-agency Field Manual.” United Nations High Commissioner for Refugees. New York: 1999. This chapter within a massive field guide provides information and international opinions on HIV testing in refugee camps. “Measuring Protection by Numbers.” United Nations High Commissioner for Refugees. New York: Nov. 2006. A report from UNHCR about the protection of refugees, as well as risks and projects that have worked. “Policy Brief: HIV and Refugees.” UNAIDS. New York: Jan. 2007. This briefing hints at solutions for refugees confronting HIV/AIDS as well as giving the rights of both refugees and their hosts. “Refugees and internally displaced people.” UNAIDS. New York: 6 July 2008. This page gives information on the legislative requirements of hosts and how civil society can help bring about this legislation. “Refugees, HIV and AIDS: Fighting HIV and AIDS Together with Refugees.” United Nations High Commissioner for Refugees. New York: 2005. This report from UNHCR gives updates on programs dealing with refugees and HIV/AIDS from around the world. “UNAIDS Country Responses: Asia.” Asia. 2008. UNAIDS. 31 July 2008 . This page on the UNAIDS website gives facts about the AIDS epidemic in Asia. “UNHCR: Office of the United Nations High Commission for Refugees.” Cosponsors. UNAIDS. 6 July 2008

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The 2009 National High School Model United Nations

Joint United Nations Programme on HIV/AIDS

This page on UNAIDS’ website gives background information on one of its cosponsors, UNHCR. “World AIDS Day: UNHCR chief pledges to continue fight against HIV/AIDS.” United Nations High Commission for Refugees. New York: 30 Nov. 2007. This news article updates UNHCR leader Antonio Guterres’ continued commitment to the plight of refugees dealing with HIV/AIDS. Non-UN Sources “Africa: Pepfar - $48 Billion Landmark Bill Reauthorized.” AllAfrica. 16 July 2008. Physicians for Human Rights. 24 Sept. 2008 . An article detailing the renewal of the United States PEPFAR plan and the new stipulations of this bill. “Anatomy of a refugee camp.” CBC News. 19 June 2007. CBC News. 1 July 2008 . A good overview on the workings, layout, and requirements of a working refugee camp. “Convention Governing the Specific Aspects of Refugee Problems in Africa.” Organization of African Unity. Addis Ababa: 10 Sept. 1969. This document establishes African policy regarding refugees. “House Passes Broader Plan to Fight AIDS.” Washington. 25 July 2008. The New York Times. 26 Sept. 2008 . This news article reports on a US bill that will increase funding to fight HIV/AIDS internationally. “Pakistan: Drug injecting refugees vulnerable to HIV infection. Plus News. 18 September 2006. IRIN. 31 July 2008 . This news articles tells the dangers of injecting drug addiction in Asia and its relation to HIV/AIDS. “Refugee Rights in Africa.” International Refugee Rights Initiative. July 2008. International Refugee Rights Initiative. 31 July 2008 This website gives information about current aid projects in Africa for refugees. Robertson, Nic. “Rape is a way of life for Darfur’s women.” CNN: World. 19 June 2008. CNN.com. 7 July 2008 . This article tells the atrocities of sexual violence among the refugee women in Darfur, Sudan. “UN calls for lifting restrictions on HIV carriers.” AFP. 10 June 2008. AFP. 26 Sept. 2008 . This article talks about the travel restrictions on PLWHA.

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