42536 Public Disclosure Authorized W O R L D B A N K W O R K I N G P A P E R N O . 1 3 7 Strengthening the Education Sector Response to HIV&AIDS in the Caribbean Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized W O R L D B A N K W O R K I N G P A P E R N O . 1 3 7 Strengthening the Education Sector Response to HIV&AIDS in the Caribbean World Bank authors: Donald A. P. Bundy, Domenec Ruiz Devesa, and Tara E. O’Connell UNESCO Carribean authors: Paolo Fontani and Jenelle Babb PCD authors: Lesley Drake and Anthi E. Patrikios UNESCO/World Bank Partnership in Support of CARICOM Strategy in Education and HIV&AIDS THE WORLD BANK Washington, D.C. Copyright © 2008 The International Bank for Reconstruction and Development / The World Bank 1818 H Street, N.W. Washington, D.C. 20433, U.S.A. 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All other queries on rights and licenses, including subsidiary rights, should be addressed to the Office of the Publisher, The World Bank, 1818 H Street NW, Washington, DC 20433, USA, Fax: 202-522-2422, email: pubrights@worldbank.org. ISBN-13: 978-0-8213-7476-4 eISBN: 978-0-8213-7477-1 ISSN: 1726-5878 DOI: 10.1596/978-0-8213-7476-4 Library of Congress Cataloging-in-Publication Data has been requested. Contents Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Acronyms and Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix 1. HIV&AIDS in the Caribbean: The Potential of Education . . . . . . . . . . . . . . . . . . . . 1 2. Furthering the Dialogue: Establishing a Collaborative Framework in the Caribbean . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3. Port-of-Spain: Meeting to Define the Regional Response . . . . . . . . . . . . . . . . . . . . . 7 4. Actions at the Country Level: Jamaica, Guyana, and Saint Lucia . . . . . . . . . . . . . . 11 5. Next Steps at the Regional Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 6. Conclusions: The Way Forward . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Appendixes A. Five Essential Components for a Comprehensive Education Sector Response. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 B. The HIV/AIDS Response by the Education Sector: A Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 iii Acknowledgments T his report has been prepared by Donald A. P. Bundy (World Bank HDNED), Paolo Fontani (UNESCO Caribbean), Domenec Ruiz Devesa (World Bank LCSHE), Tara E. O’Connell (World Bank HDNED), Jenelle Babb (UNESCO Caribbean), Lesley Drake (PCD) and Anthi E. Patrikios (PCD). We gratefully acknowledge the support of CARICOM, especially Myrna Bernard and Edward Greene, throughout the processes described in this report. The document was peer reviewed by Alexandria Valerio (World Bank LCSHE) and Andy Chi Tembon (World Bank AFTH3). Feedback was provided by Eduardo Velez Bustillo (LCSHE), Mary T. Mulusa (World Bank LCSHH), John S. Osika (World Bank LCSHH), Cynthia Hobbs (World Bank LCSHE) and Angela Demas (World Bank LCSHE). v Acronyms and Abbreviations AIDS Acquired Immune Deficiency Syndrome AFTH3 Africa Region Human Development III BSS Behavioral Surveillance Survey CAPNET Caribbean Network of Publishers CAREC Caribbean Epidemiology Centre CARICOM Caribbean Community CCNAPC Caribbean Coalition of National AIDS Program Coordinators CIDA Canadian International Development Agency COHSOD Council for Human and Social Development CPCE Cyril Potter College of Education CPD Continuous Professional Development of (trained) Teachers CRN+ Caribbean Regional Network of Seropositives CUT Caribbean Union of Teachers DfID Department for International Development EDC Education Development Centre EduCan Caribbean Education Sector HIV&AIDS Coordinator Network EDUCAIDS UNAIDS Global Initiative on Education, HIV&AIDS EFA Education for All EU European Union FRESH Focusing Resources on Effective School Health FTI Fast Track Initiative GFATM Global Fund to Fight AIDS, Tuberculosis and Malaria GHARP Guyana HIV-AIDS Reduction & Prevention Project GIPA Greater Involvement of People with HIV&AIDS GoG Government of Guyana GoJ Government of Jamaica GTZ German Bilateral Cooperation HDNED Human Development Network, Education Team HFLE Health and Family Life Education HIV Human Immunodeficiency Virus IATT Inter-Agency Task Team IBRD International Bank for Reconstruction and Development IDA International Development Association IDPs International Development Partners ILO International Labor Organization JICA Japanese International Cooperation Agency LCSHE Latin America and the Caribbean Region Education Sector LCSHH Latin America and the Caribbean Region, Health Sector LRCs Learning Resource Centres MAP Caribbean Multi Country HIV&AIDS Program M&E Monitoring and Evaluation MoE Ministry of Education MoEC Ministry of Education and Culture MoEYC Ministry of Education, Youth and Culture MoH Ministry of Health vii viii Acronyms and Abbreviations MoHL Ministry of Health and Labor MoST Ministry of Social Transformation, Human Services, Family Affairs, Youth and Sport NAP National AIDS Programme NAPS National AIDS Programme Secretariat NCERD National Centre for Education Resources and Development NGO Non-Governmental Organization ODA Official Development Assistance OVC Orphans and Vulnerable Children PAHO Pan-American Health Organization PANCAP Pan-Caribbean Partnership Against HIV&AIDS PCD Partnership for Child Development PCHA Presidential Commission for HIV&AIDS PCU Project Coordination Unit PLWHA People Living with HIV&AIDS SRH Sexual Reproductive Health STI Sexually Transmitted Infections TOR Terms of Reference UN United Nations UNAIDS United Nations Program on HIV&AIDS UNDP United Nations Development Program UNESCO United Nations Educational, Scientific and Cultural Organization UNFPA United Nations Population Fund UNGASS United Nations General Assembly UNICEF United Nations International Children’s Emergency Fund UNIFEM United Nations Development Fund for Women UNODC United Nations Office on Drugs and Crime USAID United States Agency for International Development UWI University of the West Indies VCT Voluntary Counseling and Testing Executive Summary U NAIDS estimates that the Caribbean Region is the second-most HIV&AIDS-affected region in the world after Sub-Saharan Africa. The Caribbean Community (CARICOM), has identified the need to strengthen the multi-sectoral response to the epidemic. In June 2005, the United Nations Educational, Scientific and Cultural Organi- zation (UNESCO) and the World Bank held a joint meeting in Washington, D.C., to develop a proposal for a regional dialogue to accelerate the education sector component of this response. At the center of the CARICOM plan for action is the development of a regional strategy, as well as national strategic plans, which emphasizes quality Education for All (EFA) and lifelong learning experiences as central to the Education sector response to the epidemic. Later in 2005, a team from CARICOM, UNESCO, the World Bank and the University of the West Indies met with representatives of government, civil society, and development partners at national and regional levels. A plan for action was developed through broad dialogue with representatives of Ministries of Education, national HIV&AIDS coordinating committees, and several regional institutions [CARICOM, Pan-Caribbean Partnership Against HIV&AIDS (PANCAP), Caribbean Epidemiology Center (CAREC), Caribbean Network of Publishers (CAPNET), Caribbean Coalition of National AIDS Program Coordinators (CCNAPC), Caribbean Regional Network of Seropositives (CRN+), and University of the West Indies (UWI)], as well as representatives of development partners in UN Country Teams and UN HIV&AIDS Theme Groups, including UNAIDS, UNDP, UNICEF, UNESCO, UNFPA, PAHO, ILO, UNIFEM, UNODC, and the World Bank. This consultative process led to the development of a Proposal for Action: Accelerating the Edu- cation Sector Response to HIV&AIDS in the Caribbean Region. In January 2006, the Fourth Caribbean Regional Consultation on the Education Sector’s Response to the HIV&AIDS epidemic was convened and hosted by UNESCO at Strawberry Hill, Jamaica, with participation from the CARICOM, Caribbean regional representatives of United Nations (UN) agencies and other development partners. This meeting endorsed the Proposal for Action as a basis for joint action going forward. Building on the momentum of the Strawberry Hill Meeting, a High Level Meeting of Ministers of Education and National AIDS Authorities, under the auspices of the CARICOM Council on Human and Social Development (COHSOD), was convened in Port-of-Spain, Trinidad and Tobago in June 2006. The Meeting resulted in the Port-of-Spain Declaration, which signified the commitment of CARICOM Ministers of Education to renewed efforts at accelerating the education sector response to HIV&AIDS in the Caribbean. The COHSOD Meeting highlighted an emerging consensus among regional development partners to continue dialogue and action on efforts at improved interagency coordination in accelerating the education sector response to HIV&AIDS in the Region. Follow-up discussion between government representatives and international development partners (IDPs) focused on how to intensify joint efforts in this endeavor. It was agreed that working together in a few focus countries would allow for greater consolidation and harmonization of national level responses, providing learning opportunities for taking plans to scale at the regional level. Initial efforts have focused on Jamaica, St. Lucia, and Guyana. The guiding principle in each country has been to support a sequential process in the education sector’s HIV&AIDS ix x Executive Summary response through the development of policy, strategy, and a costed work plan. To this end, joint UNESCO/World Bank missions were undertaken between May and November 2007 to Jamaica, Guyana, and Saint Lucia, with the purpose of assessing the state of the education sector response to HIV&AIDS in these countries, and moving forward at the country level taking into account the challenges and opportunities identified by the regional dialogue. While national level dialogue was specific in each country, the following key priority areas emerged across the three countries: (i) information and research; (ii) capacity building for planning, decisionmaking, and coordination; (iii) teacher education; (iv) addressing stigma, discrimination, and human rights, including attention to cultural differences. A number of activities have been agreed to address these priority areas of concern at national level. Regional priorities for action and next steps identified, included the following: ■ The Governments of Guyana, Jamaica, and St. Lucia agreed to further strengthen and expand the CARICOM Network of Education Sector Focal Points for HIV&AIDS (EduCan), facilitated by UNESCO and the Education Development Centre (EDC), to promote sharing of information and capacity building on national education sector responses to HIV&AIDS. This will be achieved, in part, by formalizing the post of HIV&AIDS Focal Point within the Ministries of Education where it is not yet for- malized, and mobilizing education sector resources to support this post. ■ A follow-up to the regional CARICOM Ministerial Meeting held in June 2006 is planned for May 2008. This “Port-of-Spain plus 2”meeting will serve to chart progress and decide next steps in continuing efforts to address the education sector response at regional level. The content and specifics of this meeting is being jointly planned with the CARICOM Network of Education Sector Focal Points for HIV&AIDS in dialogue with the CARICOM Secretariat and other regional partners in the response. ■ CARICOM supports region-wide participation in exchange visits between the Caribbean and the African Networks of HIV&AIDS Education Focal Points for knowledge sharing purposes. This is scheduled to begin with the participation of the Focal Points from Guyana, Jamaica, and St Lucia in the annual meeting of the Africa Focal Point Networks to be held in Nairobi, Kenya, in November 2007. In follow-up, Focal Points from the Africa Networks will attend the next scheduled meeting of the Caribbean HIV&AIDS Education Focal Points due to be held in the Region in 2008. ■ In follow-up to the meeting of Caribbean Ministers of Education on HIV&AIDS in Port-of-Spain, a joint CARICOM, UNESCO, World Bank, and University of the West Indies publication is being published. Challenging HIV & AIDS: A New Role for Caribbean Education focuses on the education sector response to HIV&AIDS in the Caribbean and includes all the technical papers prepared for the Ministerial Meeting as well as other recently produced, related materials. The expected publi- cation date is early 2008. This report presents the findings and outcomes of the three joint UNESCO/World Bank missions to Guyana, Jamaica, and St. Lucia, and elaborates on next steps identified for action at both national and regional levels. The report also sets these findings and next steps within the broader context of the Caribbean plan for action and presents in its appen- dixes sample resources to guide the development of a comprehensive response to HIV&AIDS by the education sector. CHAPTE R 1 HIV&AIDS in the Caribbean The Potential of Education A ccording to the United Nations Program on HIV&AIDS (UNAIDS), the Caribbean Region is the second most HIV&AIDS-affected region in the world after Sub- Saharan Africa. The epidemic threatens the continuing development of the region, yet in the Caribbean, as elsewhere in the world, schoolchildren are a “Window of Hope” into the future. Nearly all school age children are free of HIV infection and if they could remain free of infection as they grow up they could change the face of the epidemic within a generation. The priority placed on the education sector’s response is based on evidence that edu- cation contributes towards the knowledge and personal skills essential for the prevention of HIV, and protects individuals, families, communities, institutions, and nations from the impact of AIDS. Education helps to overcome the conditions that facilitate the spread of HIV and can create the understanding and tolerance that contribute to reduced stigma and discrimination against vulnerable and marginalised communities and people living with HIV. Education is an effective “Social Vaccine” against HIV&AIDS. The risk of HIV infection is more than halved for young people, particularly girls, who stay in school and complete a basic education. The Global Campaign for Education has estimated that some 7 million cases of AIDS globally could be avoided by the achievement of Educa- tion for All (EFA). But the capacity of the education sector to deliver the social vaccine is itself reduced by the impact of HIV&AIDS. The epidemic is damaging education sys- tems by killing teachers, by increasing rates of teacher absenteeism, and by creating orphans and vulnerable children who are less likely to attend school and more likely to drop out. 1 2 World Bank Working Paper Experience indicates that the education sector warrants special priority in the multi- sectoral response to HIV&AIDS because of its long term and inter-generational implica- tions for the development of society, but current evidence suggests that in the Caribbean region the education sector response by both countries and agencies is not being fully realized. Experience also indicates that the key determinant of effective action is strong leadership by the education sector, supported by national and regional policies that prior- itize the education sector response. However programs in the Caribbean have remained predominantly health-sector oriented. Up until 2005, most countries placed the high- est priority on health sector strengthening and interventions, and the establishment of systems to support treatment access, while not many countries had moved beyond awareness-raising for the general public.1 This report calls for a harmonized effort by coun- tries, regional institutions, and development partners to accelerate the education sector response to HIV&AIDS in the Caribbean. 1. Department for International Development, World Health Organization/Pan-American Health Organization, Global Fund to Fight AIDS, TB and Malaria, Joint United Nations Programme on HIV/AIDS, and the World Bank (2005). CHAPTE R 2 Furthering the Dialogue Establishing a Collaborative Framework in the Caribbean I n June 2005, UNESCO and the World Bank held a joint meeting in Washington, D.C., to develop a proposal for a regional dialogue to accelerate the education sector response to HIV&AIDS in the Caribbean region through a comprehensive approach. An inclusive consultative process was undertaken involving representatives of govern- ment, civil society, and development partners at national and regional levels. In addition to UNESCO and the World Bank, participants included representatives of Ministries of Education, national HIV&AIDS coordinating committees and several regional institutions (CARICOM, PANCAP, CAREC, CAPNET, CCNAPC, CRN+, and UWI), as well as repre- sentatives of development partners in UN Country Teams and UN HIV&AIDS Theme Groups, including UNAIDS, UN Development Program (UNDP), UN International Children’s Emergency Fund (UNICEF), UN Population Fund (UNFPA), Pan-American Health Organization (PAHO), International Labor Organization (ILO), UN Development Fund for Women (UNIFEM), and Office on Drugs and Crime (UNODC). UNESCO and the World Bank, with the participation of UWI, undertook their first joint missions to Barbados, Jamaica, Guyana, and Trinidad and Tobago in November 2005, furthering dialogue at the country level. These missions resulted in greater demand at the national level for a regionally coor- dinated response to HIV&AIDS within the education sector. In response, representatives of CARICOM, Caribbean regional representatives of UN agencies and other development partners gathered in January 2006 at the Fourth Caribbean Regional Consultation on the Education Sector’s Response to the HIV&AIDS epidemic convened by UNESCO at Strawberry Hill, Jamaica. The Strawberry Hill Meeting strengthened dialogue at both the national and regional levels and laid the groundwork for CARICOM’s COHSOD meeting that followed in June 3 4 World Bank Working Paper 2006. The COHSOD high level Ministerial Meeting was held in Trinidad and Tobago and resulted in the Port-of-Spain Declaration, which signified the commitment of Ministers of Education to provide strong leadership in the area of education and HIV&AIDS. Opportunities for Supporting an Education Sector Response CARICOM established PANCAP in 2001, and developed a HIV/AIDS Regional Strategic Framework in 2002. The 2002 Havana Declaration of CARICOM Ministers of Education endorsed the need for a strong regional education sector response to HIV&AIDS building on regional efforts already underway under the leadership of CAREC, the CRN+, the Caribbean HIV&AIDS Youth Network, CCNAPC, and UWI program. Governments in the Caribbean Region have established National AIDS Authorities, developed National Strategic Plans for HIV&AIDS, and included HIV&AIDS in national education sector strategies. Education systems in the Region have begun to develop sectoral responses to HIV&AIDS, with good practices emerging in countries like the Dominican Republic, Jamaica, and Trinidad and Tobago. Caribbean regional representatives and other development partners have been actively involved in progressing the Caribbean education sector response to HIV&AIDS. Dialogue identified the following actions and inputs that provide a strong foundation for accelerating the education sector response to HIV&AIDS. Note that this is not an exhaustive list, and that a more detailed mapping is planned to provide clearer guidance for the program going forward: ■ The UNESCO Regional Office for the Caribbean is providing leadership and coordination through: ● Sharing and creating knowledge: publishing the review Education and HIV& AIDS in the Caribbean in 2003; promoting publication of materials through Caribbean Network of Publishers (CAPNET); disseminating quarterly up- dates on the regional education response; ● Supporting action at the country level: facilitating a model HIV&AIDS Response Team in Jamaica’s education sector as well as the implementation of EDUCAIDS for a comprehensive education sector response to the epidemic (see Appendix B for framework); promoting sector leadership at the country level in Jamaica, Trinidad and Tobago, St. Lucia and Guyana through the Advocacy and Leader- ship Campaign, implemented by the Education Development Centre (EDC); ● Promoting harmonization and dialogue: maintaining the inter-agency Strawberry Hill Consultation; supporting dialogue with the Caribbean Union of Teachers (CUT); and ● Supporting research: establishing a Commonwealth UNESCO Chair in Education and HIV&AIDS at UWI; evaluating African instructional materials in Guyana and Jamaica; conducting case studies including a regional survey of the “readi- ness” to respond of Ministries of Education. ■ The World Bank is providing financial and technical assistance for scaling up regional and national responses to HIV&AIDS through: ● Support to a number of regional agencies and the strengthening of PANCAP Secretariat through a regional HIV&AIDS project; Strengthening the Education Sector Response to HIV&AIDS in the Caribbean 5 ● Nine national individual country HIV&AIDS projects in Barbados, Dominican Republic, Jamaica, Grenada, Guyana, Trinidad and Tobago, Saint Kitts and Nevis, Saint Lucia, and Saint Vincent and the Grenadines under the Caribbean Multi Country HIV&AIDS Program (MAP) that provide support for a multi-sectoral response, including the education sector; and ● Education projects that have the potential to support key components of the HIV&AIDS response (such as, teacher training, school-community partnerships, institutional capacity building, instructional materials) in Grenada, Guyana, Jamaica, Saint Kitts and Nevis, Saint Lucia, and Saint Vincent and the Grenadines. ■ The ILO, together with representatives of country education teams, teacher unions and UNESCO, has developed guidelines for education workplace practices in the Caribbean Region. ■ UNICEF, UNFPA, PAHO, EDC, and others have supported the development of a regional Health and Family Life Education (HFLE) curriculum that is currently being piloted by CARICOM in 5 countries. ■ A number of bilateral partners including Canadian International Development Agency (CIDA), Department for International Development (DfID), the European Union (EU), German Bilateral Cooperation (GTZ), and United States Agency for International Development (USAID), are supporting financial and/or technical assistance to national and/or regional efforts. Challenges to the Development of an Effective Education Sector Response Dialogue identified the following key challenges to implementing an effective education sector response to HIV&AIDS at regional and national levels: a) The 2002 CARICOM Regional Framework Strategic Plan for HIV&AIDS does not address the role of education specifically, suggesting a need for stronger political leadership for the education sector at the regional level. b) National Strategic Plans for HIV&AIDS tend to be silent on the role of the education sector, and there is limited disbursement of HIV&AIDS resources by the National AIDS Authorities to the education sector. c) National education sector plans tend to be silent on the role of the sector in the HIV&AIDS response, and there is limited disbursement of education sector resources to support a sectoral response to HIV&AIDS. d) There is a lack of systematic development partner dialogue around the education sector response to HIV&AIDS. Framework for the Partnership between UNESCO and the World Bank In 2005, the UNESCO Kingston Cluster Office for the Caribbean and the World Bank Human Development Network (Education) formed a partnership in the Caribbean Region in the field of Education and HIV&AIDS. The foundation of this cooperation is laid out in Article 57 of the Charter of the United Nations, according to United Nations General Assembly (UNGASS) resolutions 50 (I) and 124 (III), recognizing both organiza- tions as part of the UN system. Furthermore, Article XI of the UNESCO Constitution 6 World Bank Working Paper allows for cooperation “with other specialized intergovernmental organizations and agen- cies whose interests and activities are related to its purposes” while the International Bank for Reconstruction and Development (IBRD)/International Development Association (IDA) Article of Agreement V, Section 8, calls for cooperation “with any general international organization and with public international organizations having specialized responsibili- ties in related fields.” The World Bank, in particular, stated in an April 12, 1989 Memo- randum of the President to the Executive Directors that “UNESCO and the Bank will share information on institutional policies and programs (. . .) while jointly sponsored activities and services provided by one institution to the other would be worked out on a case-by- case basis.” This partnership in the Caribbean is an additional dimension of the collaborative relationship already established between UNESCO and the World Bank in this Region. It is also grounded on the principles enshrined in Article 3.iv of the 2005 Paris Declaration on Aid Effectiveness, which calls for “eliminating duplication of efforts and rationalizing donor activities to make them as cost-effective as possible.” UNESCO and the World Bank have worked in close cooperation, both jointly and with the wider development community, on such global partnerships as EFA Fast Track Initiative (FTI), Focusing Resources on Effective School Health (FRESH), and the UNAIDS Inter-Agency Task Team (IATT) on Education in the Caribbean. CHAPTE R 3 Port-of-Spain Meeting to Define the Regional Response I n June 2006, a CARICOM Ministerial Meeting was held in Port-of-Spain, Trinidad and Tobago, to specifically address the regional education sector response to HIV&AIDS. At the close of the Meeting, the Education Ministers and National AIDS Authorities present had recognized a framework for action as a resource tool to guide the education sector response to HIV&AIDS in the caribbean (see Appendix B) as well as issued the Port- of-Spain Declaration on the education sector response to HIV&AIDS: 1. We, the Ministers of Education of the Caribbean Community, along with repre- sentatives of National AIDS Authorities, and other representatives of governments, organizations and agencies participating in the Special Meeting of the Council for Human and Social Development (COHSOD) on Education and HIV and AIDS in Port-of-Spain, Trinidad and Tobago 9–10 June 2006; 2. Recall that the Nassau Declaration asserts that the Health of the Region is the Wealth of the Region; 3. Note with alarm that we are facing an unprecedented human catastrophe and that a quarter century into the pandemic, HIV and AIDS continues to inflict immense suffering on the countries and communities of the Caribbean, that a total of 300,000 persons live with HIV in the region, including 30,000 who became infected in 2005, that the disease is the major cause of death in persons between 15–35; and that the prevalence rate in women 15–24 years is at least twice as high as men of similar age group; 4. Recognise that the extensive national sub-regional and regional consultations under the joint collaboration of the Pan Caribbean Partnership Against HIV and AIDS (PANCAP) and UNAIDS were undertaken and resulted in recommendations and 7 8 World Bank Working Paper a roadmap for Universal Access to HIV and AIDS prevention, care, treatment and support 2006–2010; 5. Also recognise the political Declaration on Universal Access resulting from the High Level meeting of the United Nations General Assembly on HIV and AIDS, 2 June, 2006 as a basis for action; 6. Affirm that Education is a critical sector in the multi-sectoral response to HIV and emphasise our commitment to achieving the targets set for Education for All and the relevant targets in the Millennium Development Goals; 7. Recognise that comprehensive assessments of the impact of HIV on the education sector at country and regional levels are urgently required to inform the development of appropriate response strategies, and specifically those that focus on prevention; 8. Commit to the development and implementation of national and regional sectoral policies on HIV and AIDS and Education and the integration of such policies into national and CARICOM/PANCAP strategies; 9. Commit to the adoption education workplace policies guided by the ILO Code of Practice on HIV and AIDS and the World of Work and the ILO/UNESCO HIV and AIDS Workplace Policy for the Education Sector in the Caribbean; 10. Pledge to provide leadership for planning and implementation of national and regional sectoral responses and to facilitate accelerated access to resources from funds allocated for both education sector development and HIV and AIDS response; 11. Commit to the elimination of HIV-related stigma and discrimination in educational systems through leadership, policy, legislation, regulations and research, and in this regard, support the Champions for Change programme initiated by PANCAP; 12. Affirm the rights of people affected by and infected with HIV and promote their meaningful involvement in the education sector at all levels, including policy design and implementation; 13. Request the CARICOM Secretariat in collaboration with relevant stakeholders to develop a mechanism for accelerating implementation of GIPA principles in the regional response; 14. Endorse the development of professional and scholarly approaches to effective school health with urgent emphasis on HIV through training and research in selected regional institutions; 15. Commit to professionalising the fields of HFLE, school health and sex education with attention to HIV and AIDS, to ensure timely, universal coverage and the develop- ment of career paths in those fields; 16. Commit to extending and deepening the coverage and professional development of educators to implement HFLE and HIV and AIDS education programmes; 17. Endorse the establishment and support development of the Caribbean Network of HIV Coordinators in the education sector as a CARICOM-led regional resource; 18. Request the Network of HIV Coordinators to develop a model for partnership between Ministries of Education and national organisations of PLWHA, consistent with the GIPA principles; 19. Request the PANCAP to develop a regional strategic framework for the education sector response in the overall regional response to HIV and AIDS; Strengthening the Education Sector Response to HIV&AIDS in the Caribbean 9 20. Request the CARICOM Secretariat to establish a network and consultative mech- anism among development partners to increase efficiency and effectiveness of their contribution to the regional and national strategic plans for HIV and AIDS and education, and to collaborate in the development of policies and the sharing of information and knowledge; 21. Agree to the inclusion of the education sector in the priorities identified in the review of the Caribbean Regional Strategic Framework for HIV and AIDS to be undertaken by PANCAP in 2006, recognizing that the education sector response to HIV and AIDS also provides an opportunity to address other significant health and life style issues, with special emphasis on prevention; 22. Agree to engage with CAPNET to develop national and regional publishing projects to ensure provision of quality and culturally sensitive instructional materials to support universal coverage of HIV and AIDS education and to infuse HIV and AIDS principles into new instructional materials; 23. Recognise the importance of mainstreaming gender in all materials and method- ologies used to address education with regard to HIV and AIDS; 24. Recommend that Ministers of Education continue to advocate for appropriate attention to HIV and AIDS issues and keep the HIV and AIDS high on the agendas of COHSOD and national parliaments; 25. Also call on all stakeholders to advocate for, and contribute to the mobilization of resources in support of the national and regional programmes that would advance the role of education in the accelerated approach to HIV and AIDS; 26. Request the Chair of COHSOD to ensure that the issues related to Education and HIV and AIDS are brought to the attention of Heads of Government for their endorsement and support; 27. Recommend that targets established in the Regional and National Strategic plans for Education and HIV and AIDS be aligned with those established by the national, sub-regional and regional consultations for HIV and AIDS prevention, care, treatment and support and the UNGASS targets for 2006–2010; 28. Ensure access to educational opportunities at all levels for children in vulnerable settings and conditions with emphasis on those affected or infected by HIV and AIDS; 29. Request of the Caribbean Examinations Council that all appropriate syllabuses and assessment procedures for the three levels of secondary examination be urgently reviewed to ensure that knowledge and skills that will contribute to the education sector response to HIV and AIDS are included. Additionally, a joint UNESCO/World Bank/UWI publication has been produced with the support of CARICOM. Challenging HIV & AIDS: A New Role for Caribbean Education focuses on the education sector response to HIV&AIDS in the Caribbean and will include all the technical papers prepared for the COHSOD meeting of Caribbean Ministers of Education, as well as other related materials. CHAPTE R 4 Actions at the Country Level Jamaica, Guyana, and Saint Lucia T he COHSOD Meeting highlighted an emerging consensus among regional devel- opment partners to continue dialogue and action on efforts aimed at improved inter-agency coordination in accelerating the education sector response to HIV&AIDS in the Region. Follow-up discussion between government representatives and international development partners focused on how to intensify joint efforts in this endeavor. It was agreed that working together in a few focus countries would allow for greater consolidation and harmonization of national level responses, providing learning opportunities for taking plans to scale at the regional level. The countries of Jamaica, St. Lucia, and Guyana were identified as countries in which to concentrate initial efforts. The guiding principle in each country would be to support a sequential process in the education sector’s HIV&AIDS response through the development of policy, strategy and a funded work plan. To this end, a joint UNESCO/World Bank mission was undertaken in May 2007 to Guyana (9th–10th) and Saint Lucia (24th–25th), with the purpose of assessing the state of the education sector response to HIV&AIDS in these coun- tries, and moving forward at the country level with consideration to the challenges and opportunities identified by the regional dialogue. The joint UNESCO/WB mission to Jamaica on May 7–8, 2007 represented a continuation of the existing cooperation between the two agencies in supporting the Jamaican Ministry of Education’s response to HIV & AIDS with UNESCO leading the initiative in this country under the banner of the UNAIDS Global Initiative on Education and HIV & AIDS (EDUCAIDS), for which Jamaica is one of four original pilot countries. A joint UNESCO/World Bank team led by Paolo Fontani (Education Program Manager for the Caribbean, UNESCO) and Donald A. P. Bundy (Lead Specialist, World Bank), with Jenelle Babb (Project Officer, UNESCO), Domenec Ruiz Devesa (Economist, World Bank), 11 12 World Bank Working Paper Joel Simpson (Assistant, UWI Commonwealth/UNESCO Chair in Education and HIV&AIDS and Health Promotion), Lesley Drake [Consultant, Partnership for Child Development (PCD)] and Anthi E. Patrikios (Consultant, PCD), visited Jamaica, May 7th–8th, 2007, participating in the National Strategic Planning Workshop on HIV&AIDS and Education. The team also took part in joint missions to Guyana, May 9th–10th, and Saint Lucia, May 24th–25th, 2007, with the purpose of assessing the state of the education sector response to HIV&AIDS in these countries, and to progress work in accordance with the challenges and opportunities identified by the regional dialogue. A summary of the coun- try mission reports follows. Jamaica National Context and Diagnosis The Ministry of Education and Youth (MoEY) (formerly Education, Youth and Culture) was designated a line Ministry under the Jamaica HIV&AIDS/Sexually Transmitted Infec- tions (STI) National Strategic Plan (2002–06). In 2002, the Ministry of Education, with support from UNICEF, established the post of a National Coordinator for HIV & AIDS education, housed in the Guidance and Counselling Unit of the Ministry. The National Coordinator remained primarily an ad hoc position until recently when it was made part of the permanent staffing structure. With support from UNESCO, through the Japanese Funds-in-Trust for capacity building of Human Resources, the MOEY in 2003 was able to expand it response through the establishment of an HIV&AIDS Response Team, com- prised of six Health Promotion Officers (HPOs) in each of the Ministry’s six regions and a project officer at the central level and supported by the Japan International Cooperation Agency (JICA) through a senior volunteer at the central level and volunteer counterparts to the HPOs in the six regional offices. The MoEYC has an established work plan under the National Strategic Plan with defined objectives, strategies and activities geared towards the implementation of its National Policy for the Management of HIV and AIDS in Schools, the promotion of the revised, life-skills based Health and Family Life Education (HFLE) curriculum in schools, the capacity building of school-based Health Advisory Committees for implementing a holistic HIV&AIDS program within the school community, as well as the promotion of HIV&AIDS prevention education in the workplace through the Min- istry’s Workplace Committee. The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), UNESCO, UNICEF, PAHO, and the World Bank provide support to this team, the contributions of which are coordinated by the MOEY in a donor coordination mech- anism chaired by the Deputy Chief Education Officer for Curriculum and Support Services of the Ministry. Under the 2002–06 HIV & AIDS/STI National Strategic Plan, the MOEY identified the following objectives: 1. To regain momentum on the HIV&AIDS/STI component of the Health and Fam- ily Life Education programme. 2. To produce appropriate learning/teaching materials to generate awareness. 3. To provide training for improved teacher competence in HIV&AIDS education delivery and for peer education. Strengthening the Education Sector Response to HIV&AIDS in the Caribbean 13 4. To increase awareness among MOEY[C] personnel and stakeholders of the need for adopting HIV&AIDS/STI programmes and workplace policies. Strategy and Policies With continued support from the Japanese Government the initial two-year capacity building project by UNESCO was renewed with Jamaica joining Cambodia, Moldova and Namibia in the first wave of EDUCAIDS countries in the UNESCO-led global UNAIDS initiative. Under the EDUCAIDS project the Ministry of Education Jamaica will focus on professional development, strategic planning and the design and production of instruc- tional resources and integrate the essential components for a comprehensive education sector response as outlined in the EDUCAIDS Framework for Action designed as a resource to help guide Ministries of Education in developing and implementing a com- prehensive response to HIV & AIDS (see Appendix A). With UNESCO’s support, the Jamaica Ministry of Education (MoE) has drafted a 5-year, costed National Strategic Plan on HIV & AIDS for the education sector that will include fostering the implementation of the HFLE curriculum, improving teacher’s competence on HIV&AIDS and implementa- tion of the revised sector policy for the management of HIV and AIDS in schools. Concluding Observations The mission team participated in the National Strategic Planning Workshop as observers. The workshop was highly interactive and referenced good practice examples that have emerged from the South African experience. The lack of a comprehensive policy on education and HIV&AIDS for the broader edu- cation sector—including HIV & AIDS as a workplace issue, was identified as a national constraint. The proposed joint activities will enable the elaboration of a sector strategy on Education and HIV&AIDS with the participation of all relevant stakeholders. The officials present at the workshop proposed a number of regional initiatives including: (i) exchange visits of Caribbean HIV&AIDS Focal Points to Africa and return exchanges of African HIV&AIDS Focal Points to proposed meeting of the Caribbean Network of HIV&AIDS Education Focal Points planned for February 2008; and (ii) a follow-up to the CARICOM Ministerial Meeting in Port-of-Spain is to be planned for June 2008. Jamaica has agreed to host this meeting. Guyana National Context and Diagnosis As is the case in other countries of the Caribbean, the Guyana MoE has an HIV&AIDS Coordinator; a position funded by the Ministry of Health (MoH) with support from the Guyana MAP project. In Guyana, the Coordinator has: (i) led the development of a draft workplace policy (based on the ILO-UNESCO framework); (ii) provided training to teachers on the HFLE curriculum, which includes HIV&AIDS (with the support of the UNICEF); and (iii) piloted learning materials based on the AIDS Africa Series (with the 14 World Bank Working Paper support of UNESCO). The work plan is not funded by the HIV&AIDS Coordinator budget but by the corresponding budget item (curriculum development, etc.) of the Guyana MAP project. There is also a Ministerial Committee on HIV&AIDS composed of senior officials within the Ministry of Education, but the Committee does not include development partners. The Minister of Education showed clear leadership and ownership on the issue of HIV&AIDS, as was the case with the Ministers of Health and Youth, and the Ministry of Amerindian Affairs. The Minister stressed that the education sector response to the HIV&AIDS crisis is a priority, and more should be done in the larger context of life skills, lifestyles, and school health and nutrition. This response should tackle both the demand and the supply of education. The Minister of Health welcomed stronger partnerships with the education sector to improve HIV&AIDS prevention. There is general agreement in strengthening the current multi-sectoral approach. The alignment between the Ministries of Education and Health on the issue of HIV&AIDS is especially noteworthy, particularly in light of a World Bank assessment of external funds relevant to the education sector response to HIV&AIDS in the Caribbean that was presented to CARICOM Ministers of Education at the June 2006 special meeting of COHSOD (Bundy and others 2006), which states: There are two potential sources of external resources to support the sectoral response to HIV/AIDS: from multi-sectoral HIV/AIDS funds to the education sector; and from education sector funds to a specific sectoral subcomponent. Both sources are available in the Caribbean region but are underutilized. Current external funding for the education sector response to HIV/AIDS in the Caribbean region is estimated at $2.7 million. On the basis of funding experiences in other AIDS-affected regions, currently available external resources should be able to provide an additional $13 million from HIV/AIDS resources and an additional $30 million from education resources. This implies that only $2.7 million is currently being utilized to develop a sectoral response to HIV/AIDS out of a potential $47 million available. Recommended Actions Fruitful discussions in Guyana led to a clear plan of action to address some of the needs and challenges in the identified priority areas. Agreed next steps include: ■ The inclusion of the education response to HIV&AIDS in the forthcoming 2008–2011 Education Strategic Plan, to facilitate internal coordination. ■ The preparation of a comprehensive education sector policy and strategy on HIV&AIDS, including the collection and processing of data, and the development and delivery of culturally sensitive training and educational materials. ■ The strengthening of teacher education on HIV&AIDS at the pre-service level and the provision of in-service training through a modularized approach that would fit with the forthcoming Continuous Professional Development of Trained Teachers (CPD) initiative under EFA-FTI. The aim would be to improve teacher knowledge and mainstream HIV&AIDS education curriculum across the teaching force in a multi-dimensional way. This would be achieved by ensuring that both teachers’ and Strengthening the Education Sector Response to HIV&AIDS in the Caribbean 15 learners’ prevention, protection, care, support and confidentiality training is included in both pre- and in-service. Teacher’s Guides and student readers on HIV&AIDS adapted for the Caribbean context would supplement the curriculum. ■ The development of capacity to address stigma and discrimination from a human rights perspective, at the community, school and teacher levels, with particular regard for cultural differences within the vast territory of Guyana, and with the meaningful involvement of people living with HIV&AIDS. ■ The creation of a task force on HIV&AIDS within the Education Thematic Group to support the Government of Guyana’s (GoG) efforts on the above-mentioned activities, and to facilitate external coordination. It was also suggested that the MoE sits on the Presidential Commission for HIV&AIDS (PCHA) since this body provides policy guidance on the National AIDS Programme (NAP). Follow-up Two additional follow-up joint UNESCO/World Bank missions were sent to Guyana in August and November of 2007, resulting in an agreed work plan with the GoG that included the production of a situation analysis of HIV&AIDS in the education sector by PCD. This report was concluded and delivered to the MOE in December 2007. In addition, further support was provided with the hiring of international consultants by UNESCO for the undergoing policy development and strategic planning process. At the moment of this writing the World Bank is engaged on the purchasing of learning materials on HIV&AIDS for students and teachers through EFA-FTI and UNESCO is considering undertaking an assessment of teacher education on HIV&AIDS in Guyana. Saint Lucia National Context and Diagnosis The St. Lucia Minister of Education expressed strong commitment to promoting the role of the education sector in the national response to HIV&AIDS. He highlighted the role of education in reducing stigma and discrimination, and the necessity for quality training and sensitization of teachers and principals, as well as other education personnel. One component of the planned education sector response is the mainstreaming of HIV&AIDS throughout the sector, with the establishment of a permanent HIV&AIDS Focal Point within the Ministry of Education and Culture (MoEC). Policy development to guide the education sector response is considered an immediate priority, but emphasis is placed on the development process being a joint effort between Ministry of Health and Labor (MoHL) and the MoEC. The Honorable Minister also highlighted the need for the MoEC to access new resource streams to support the education sector response and expressed concern for the sustainability of current programme initiatives. As is the case in other countries of the Caribbean, the MoEC has an HIV&AIDS Focal Point whose position is funded by the MoHL, with support from the Saint Lucia MAP project. The education sector is currently not accessing education-specific funds or GFATM resources for HIV&AIDS activities. 16 World Bank Working Paper In terms of the MoE’s curriculum response through HFLE, a syllabus has been devel- oped, the syllabus has been linked to the curriculum, and resources have been created or procured to enhance curriculum delivery. Additionally, a training manual on HIV&AIDS for teachers has been developed and was scheduled to be tested shortly after the mission. Discussions involving other senior education officials raised the issue of building aware- ness about HIV among education stakeholders. The HIV&AIDS Focal Point for the MoEC reiterated the need for a comprehensive sector response integrating components of policy and strategy development and implementation; care and support; and anti-stigma and dis- crimination education. Commitment from the MoHL is also strong and there appears to be a firm relation- ship with the MoEC in the area of HIV&AIDS, particularly in health promotion activities (including the development of the HFLE curriculum in collaboration with UNICEF), with the MoHL providing technical support to other line ministries. Voluntary Counseling and Testing (VCT) training is provided but uptake of VCT in St Lucia is still low due to stigma and discrimination issues. The MoHL also supports activities for orphans and vulnerable children through the financing of a social worker within the Ministry of Social Transformation, Human Services, Family Affairs, Youth and Sport (MoST) to work on this issue. The National AIDS Programme Secretariat (NAPS) is also committed to building the capacity of the education sector in the national response to HIV&AIDS. As with other institutions at the national level, NAPS is seeking better and clearer lines of authority and communication between themselves, relevant ministries and persons within the ministries. Coordination is considered especially important and the NAPS has emphasized the fact that efforts by the MoEC as part of the multi-sectoral response must fit into the larger context of the National AIDS Authority. The NAPS sees a MoEC policy and strategic plan as a key starting point for this. Members of the Sir Arthur Lewis Community College have expressed some interest in furthering their involvement in pre-service teacher training on HIV&AIDS (MoEC is responsible for in-service training). This does not appear to include training for teachers to protect themselves from infection. The St Lucia Teachers’ Union has been proactive in developing a response to HIV&AIDS and works closely with Education International and CUT. Accordingly, they have been pro- viding training in HIV&AIDS-related communication methods (at school and community levels) to members of their Executive. Recognizing the “internal” role of the education sector in the national response to HIV&AIDS, they also provide training on how teachers can protect themselves. Plans to expand training activities using funding from the NAPS have been approved. Recommended Actions Fruitful discussions in St. Lucia led to a clear plan of action to address some of the needs and challenges in the identified priority areas. Agreed next steps include: ■ The use of funds available through NAPS under the line item “sectoral policy” to develop a comprehensive HIV&AIDS sector-specific policy, including a workplace Strengthening the Education Sector Response to HIV&AIDS in the Caribbean 17 policy, and a strategic plan to be included in the national HIV&AIDS strategy plan. The first step is the development of a plan and timeframe for this activity. ■ The formalization of the post of HIV&AIDS Focal Point within the MoEC, and absorption of the cost of this by the education sector, once the project has been completed. ■ The clear identification of roles for all stakeholders and the formalization of commu- nication pathways to be achieved through the ratification of the education sector policy and strategic plan. ■ A clear system to be developed and included in the policy to coordinate non- governmental organization (NGO) activities with those of line ministries (particularly MoEC). ■ The carrying out of research, and collection and processing of data to better inform the development of the policy, prevention and advocacy activities. ■ The strengthening of teacher training on HIV&AIDS in the larger context of continuous professional development and in partnership with the St. Lucia Teacher Union. This training could focus on mobilizing both teachers’ and learners’ preven- tion, protection, care, support and confidentiality, thereby mainstreaming HIV&AIDS across the teaching force. ■ The development of capacity to address stigma and discrimination from a human rights perspective at the community, school and teacher levels, with particular consideration to the meaningful involvement of people living with HIV&AIDS (PLWHA). CHAPTE R 5 Next Steps at the Regional Level I n addition to these country-specific recommendations and resulting next steps, ongoing conversations with CARICOM focus on further developing and strengthening the education sector response to HIV&AIDS in the Caribbean Region through: ■ Knowledge-sharing: ● Challenging HIV & AIDS: A New Role for Caribbean Education. In follow-up to the COHSOD Meeting of Caribbean Ministers of Education on HIV&AIDS in Port-of-Spain, a joint UNESCO/World Bank/UWI publication has been produced with the support of CARICOM. Challenging HIV & AIDS: A New Role for Caribbean Education focuses on the education sector response to HIV&AIDS in the Caribbean and includes all the technical papers prepared for the Ministerial Meeting as well as other recently produced, related materials. The expected pub- lication date is early 2008. ■ Technical assistance at the Country Level: ● Following initial efforts in Guyana, Jamaica, and St. Lucia, technical assistance at the national level will be further developed throughout the Region. Requests for technical assistance have been received from Barbados, Belize, Grenada, and Saint Kitts and Nevis. ■ Capacity-building at the Regional Level: ● Exchange visits between the Caribbean and the African Networks of HIV&AIDS Education Sector Focal Points. In recent years, Africa has responded to the HIV&AIDS epidemic with the formation of three regional Networks for HIV&AIDS Educa- tion Focal Points including: Ministry of Education Network of HIV&AIDS Focal Points for the Economic Community of Western African States and Mauritania; 19 20 World Bank Working Paper Ministry of Education Network of HIV&AIDS Focal Points for Central Africa; and Education Sector HIV&AIDS Network for Eastern Africa. The groups meet and communicate regularly to discuss how best to work together to develop more effective regional, sub-regional, and national education sector responses to HIV&AIDS with the aims of building local capacity, and leading to stronger and better quality actions at the school level. The latest Africa HIV&AIDS Edu- cation Focal Point Meeting, bringing together representatives from each of these Networks, took place in Nairobi, Kenya, November 26–December 1, 2007. It was agreed that three Focal Points from the CARICOM Network of Education Sector Focal Points for HIV&AIDS would attend this Meeting, and that repre- sentatives from the Africa Focal Point Networks would be invited to attend the next Caribbean Education Sector HIV&AIDS Coordinator Meeting proposed for February 2008. This exchange was indeed carried out with the participation of Focal Points from Guyana, Jamaica, and St. Vincent and the Grenadines, sup- ported by representation from the UNESCO Kingston Cluster office for the Caribbean and EDC. The objective of the exchange is to promote consultation, exchange, and sharing of experiences and expertise among actors in the field of HIV&AIDS across Regions to build capacity, and benefit from global innovation and good practice in this area. ● Caribbean Education Sector HIV&AIDS Coordinator Network (EduCan). A Carib- bean meeting of Focal Points is planned for February 2008 and will focus on capacity building, including monitoring and evaluation (M&E) skills. In an effort to share expertise across regions, Africa Network Focal Points have been invited to participate in this meeting through a newly established Focal Point exchange program (see above). ● COHSOD Follow-up High Level Meeting of Ministers of Education and National AIDS Authorities. To progress dialogue begun at the last Ministerial Meeting of June 2006 in Trinidad and Tobago, a follow-up High Level Meeting of Ministers of Education and National AIDS Authorities is being planned for May 2008. Details of the content and specifics of the meeting are being jointly planned. ■ Policy development at the regional level ● In addition to initiatives targeting the Network, it was discussed and agreed that the forthcoming revision of the PANCAP Caribbean Regional Strategic Framework (CRSF) for the period 2008–13 would provide the opportunity to strengthen the component of the education sector response on HIV&AIDS for the Caribbean. In this regard UNESCO and EDC supported the participation of an EduCan representative at the 2007 Annual General Meeting of PANCAP and together continue to dialogue with PANCAP on the education sector’s contri- bution to the CRSF. Additionally, UNESCO will host a meeting of the Techni- cal Working Group for the revision of the CRSF in January 2008. CHAPTE R 6 Conclusions The Way Forward T he work to date has shown that there is strong regional leadership and support for an education sector response to HIV&AIDS. It has also demonstrated that, in gen- eral, there are resources available in-country to support the national HIV&AIDS response, provided from national budgets, from traditional sources of Official Develop- ment Assistance (ODA), and from specific HIV&AIDS sources, including the World Bank MAP and the Global Fund. One of the key purposes of the joint missions described here was to strengthen the capacity of Ministries of Education to advocate on its own behalf, with support from stakeholders, for an increased allocation of these resources to support implementation of HIV&AIDS activities as defined under the MoE’s sector- specific policy and plan. The evidence to date indicates that this is indeed a practical way forward, and that national AIDS authorities are increasing their support to the education sector. In the Port-of-Spain Declaration, the Ministers of Education pledged to facilitate continued access to resources from funds allocated for education sector development and HIV&AIDS response, and to advance the role of education in the accelerated approach to HIV&AIDS. The evidence to date is that current support to the education sector—from national budgets and from ODA—can indeed usefully support the strengthening of the HIV&AIDS response, without major restructuring of existing projects. The key here is that many of the main actions in the AIDS response by the sector—such as providing text books and teacher manuals, and training teachers—are already part of the existing resources plans. The CARICOM regional body in the Caribbean, as well as leadership at the national level, has demonstrated commitment to accelerating the education sector response to HIV&AIDS. To fully maximize efforts at the national and regional levels, common priority 21 22 World Bank Working Paper areas including (i) information and research; (ii) capacity building for planning, deci- sion-making and coordination; (iii) strengthening teacher education and learning mate- rials; and (iv) stigma, discrimination and human rights, including attention to cultural differences, will be addressed more systematically. Efforts will also be made to ensure that all donor-funded education projects in the Region include a component addressing HIV&AIDS. In addition, greater harmonization between all development partners in the Region will be encouraged through partnerships and coordinated work programs. To this end, UNESCO and the World Bank will continue to align efforts at accelerating the edu- cation sector response to HIV&AIDS throughout the Caribbean Region, and will continue to work with the countries to expand the partnership of stakeholders supporting these Sec- toral efforts. APPENDIX A Five Essential Components for a Comprehensive Education Sector Response1 1. Quality Education, Including Cross-Cutting Principles ■ Rights-based, proactive and inclusive ■ Gender responsive ■ Culturally sensitive ■ Age specific ■ Scientifically accurate 2. Content, Curriculum and Learning Materials ■ Specifically adapted and appropriate for various levels—primary/secondary/ tertiary, vocational, formal and non-formal ■ Focused and tailored to various groups including children/orphans and vulnerable children (OVC), young people out of school, people with HIV, minorities, refugees and internally displaced persons, men who have sex with men, sex workers, inject- ing drug users, prisoners ■ Prevention knowledge, attitudes, and behaviors covering sexual transmission, drug use including injecting, and other risk factors ■ Focused on stigma and discrimination as well as care, treatment and support 1. United Nations Educational, Scientific and Cultural Organization (2006). 23 24 World Bank Working Paper 3. Educator Training and Support ■ Teacher education, pre-and in-service, including modern and interactive methods ■ Non-formal educators, including youth leaders, religious leaders, traditional healers ■ Support groups—mentoring, supervision positive teachers, etc. ■ School and community linkages ■ Educational support materials 4. Policy, Management and Systems ■ Workplace policies ■ Situation analysis/needs assessment ■ Planning for human capacity, assessment and projection models ■ Strategic partnerships, including coordination, advocacy and resource mobilization ■ Monitoring, evaluating and assessing outcomes 5. Approaches and Illustrative Entry Points ■ School health ■ Life skills ■ Peer education ■ Counseling and referral ■ Communications and media ■ Community-based learning and outreach ■ School feeding ■ Adult education and literacy ■ Greater involvement of people living with HIV and AIDS (GIPA) APPENDIX B The HIV&AIDS Response by the Education Sector A Framework Endorsed at the COHSOD meeting on HIV & AIDS and Education, Trinidad & Tobago, June 2006. Sector Policy Framework Check Item Comments National HIV&AIDS Strategy Demonstrates the government’s commitment to ⅙ has been adopted by the government responding to HIV&AIDS. The inclusion of the ⅙ includes education in a multi-sectoral education sector shows the recognition of the approach role of the sector in the response. National Education Sector HIV&AIDS Strategy Shows how the sector plans contribute to the ⅙ has been adopted by the Ministry response to HIV&AIDS nationally. Inclusion in of Education the education plan (and EFA) indicates how ⅙ has been incorporated in the national this strategy will be implemented. sector plan Education Sector Policy for HIV&AIDS Addresses sector specific HIV&AIDS issues. The ⅙ has been adopted by Ministry of policy will only be effective if it is owned by the Education relevant stakeholders, especially the teaching ⅙ has been shared with all stakeholders, unions, and if it is widely known and under- Greater Involvement of People with stood. Addressing curriculum at this stage can HIV&AIDS (GIPA), and disseminated facilitate dialogue and agreement with the ⅙ addresses gender, curriculum content, community on sensitive issues that can planning issues, and education needs otherwise slow progress in implementation. of orphans and vulnerable children Establishing policy is the essential first step ⅙ includes workplace policy in an effective response. Input from GIPA will ensure that the policy reflects the needs of people living with HIV&AIDS within the sector. (Continued) 25 26 World Bank Working Paper Sector Policy Framework (Continued) Check Item Comments Workplace Policy Addresses HIV&AIDS presents major new issues in the ⅙ stigma and discrimination in workplace (the school, the office): recruitment recruitment and career advancement and career progression are constrained by ⅙ sick leave and absenteeism stigma and discrimination; sick leave policies ⅙ dissemination and enforcement of rarely cope with long-term disease, and codes of practice, especially with encourage undisclosed absenteeism; codes of respect to the role of teachers in practice that forbid sexual abuse of pupils are protecting children rarely enforced; easy access to VCT, treatment ⅙ care, support and treatment of staff and psychosocial support. The Public Sector ⅙ access to voluntary counselling and can often learn from the private sector in testing (VCT) developing a workplace response. Planning and Management Framework Check Item Comments Management of the sector response requires: Mainstreaming the HIV&AIDS response requires, ⅙ an interdepartmental committee at least initially, mechanisms for involving all ⅙ department focal points who have departments (the committee) and for imple- HIV&AIDS activities as a specific part mentation (the unit). Keys to success are: the of their job description focal points have space in their work program to ⅙ a secretariat or unit that supports allocate time to HIV&AIDS; the unit reports to the mainstreaming of the response, the highest level; the unit is led at the depart- and has clear political support ment director level. The sector can now access ⅙ understanding of new sources of financial resources (e.g., MAP, GFATM) often financial support thought to be exclusive to the health sector. For short to medium term planning, use the Even where an effective EMIS is unavailable, Education Management Information System school survey data can be used to assess the (EMIS) or school survey data to assess: impact of HIV&AIDS on the education system. ⅙ HIV&AIDS-specific indicators This should relate district level education data to ⅙ teacher mortality and attrition data the geographical pattern of the epidemic, using ⅙ teacher absenteeism data epidemiological data from the health service. ⅙ district level data For long term planning: The effects of the epidemic have a time scale ⅙ computer model projection of the of decades and impacts, only slowly become impact of HIV&AIDS on education apparent. Long term planning similarly requires supply and demand projection of impact over decades, which is best ⅙ assessment of the implications of achieved using computer projection models, changes in supply for teacher such as EdSIDA, which combine epidemiological recruitment and training and education data. Projection allows for the ⅙ assessment of the implications of planning of future teacher supply needs and, changes in the size of the school where necessary, the reform of teacher training age population and the proportion schedules. of orphans and vulnerable children for education demand Strengthening the Education Sector Response to HIV&AIDS in the Caribbean 27 Prevention Framework Check Item Comments Achieve Education for All Completion of education is a social vaccine vs. HIV&AIDS. Prevention curriculum requirements: The aim is to develop knowledge and protective ⅙ formal and non-formal, within the behaviors: start before risky behaviors have national curriculum become established; match content to the ⅙ begin early, before the onset of sexual development stage of the child; use teaching activity methods which establish skills, values and prac- ⅙ use grade- and age- specific content tices to help children protect themselves. Use of ⅙ develop participatory teaching methods a single carrier subject (e.g., social studies) is ⅙ include a life skills approach often more realistic than more complex ⅙ use a carrier subject approaches (e.g., spiral, diffusion). Failure to ⅙ teach in the context of school health involve the community in this potentially sensi- (e.g., FRESH) tive area is one of the major causes of delay in ⅙ ensure community ownership and implementation. support Teacher training in HIV&AIDS prevention Preventive education is more frequently taught requires development of: as part of in-service training than pre-service. ⅙ pre-service training and materials While it is necessary for both, new teachers may ⅙ in-service training and materials be more readily trained in the participatory ⅙ messages and approaches that help methods that are required to teach the subject. teachers to protect themselves Teacher training institutions frequently over- look the benefits of helping teachers to protect themselves. Complementary approaches: An holistic approach is essential for effective ⅙ peer education prevention. Peer education is particularly ⅙ Ministry of Education has input to important for reinforcing active learning by community IEC strategies youth. IEC strategies ensure consistent messages ⅙ Ministry of Education coordinates with in the school, home and community. Building NGO prevention programs and GIPA on existing NGO programmes speeds up the to provide consistent messages response. Early and effective treatment of STIs ⅙ Ministry of Education assists Ministry is effective in reducing HIV transmission; youth of Health in promoting youth-friendly need access to condoms to translate learned clinics for the treatment of sexually behaviours into practice. transmitted infections (STIs) and condom distribution 28 World Bank Working Paper Orphans and Vulnerable Children (OVC) Framework Check Item Comments Barriers to education are removed: Achieving EFA enhances access, including for ⅙ achieve Education for All OVC. School fees, in particular, may prevent OVC ⅙ abolish school fees from accessing education. Abolition provides ⅙ develop a mitigation strategy to avoid partial relief, but fees are often substituted by informal and illegal levies levies (e.g., for textbooks, PTA, uniforms). Social ⅙ subsidize payment of informal levies funds offering subsidies through schools, PTAs or the community can help overcome these barriers. The Education System helps maintain Ensuring that OVC are able to attend school is attendance: only the beginning: they also require support ⅙ offer conditional cash (or food) to remain in school. One effective method is transfers to offer caregivers cash (or food) transfers that ⅙ provide school health programmes, are conditional upon attendance. OVC have including psychosocial counselling typically suffered severe shock, and benefit from school health programmes based on the FRESH framework. The Education Sector works with other agencies Long term care, support and protection of OVC providing care, support and protection: are typically the mandate of social programmes ⅙ MoE coordinates with NGOs under Ministries of Welfare or Social Affairs. In ⅙ MoE coordinates with Ministry of practice, NGOs are often most directly involved Welfare/Social Affairs in these programmes and offer an immediate point of entry. In both cases, it is important that the Ministry of Education Department ensures that education system programmes are complementary to these activities. Source: These frameworks are based on experiences from 33 countries in sub-Saharan Africa and 10 countries in Asia. It was developed by Don Bundy, Andy Tembon, Alexandria Valerio and Stella Manda (World Bank), Amaya Gillespie (UNICEF), David Clarke (DfID), Christine Panchaud (UNESCO –IBE), Seung Hee Lee (Save the Children, USA) and Lesley Drake, Matthew Jukes (Partnership for Child Development) It is a product of the UNAIDS Inter- agency Task Team for Education Working Group to Accelerate the Education Sector response to HIV&AIDS, 2003. It is a work in progress and further contributions are welcomed. Please contact www.schoolsandhealth.org. References Browne, Diane, Gisela Winkler and Maren Bodenstein. 2006. Teaching about HIV and AIDS in the Caribbean. Oxford: UNESCO/Macmillan Education. Bundy, Donald, Tara O’Connell, Alexandria Valerio, and Mary Mulusa. 2006. “External funds relevant to the education sector response to school health and HIV/AIDS in the Caribbean region.” World Bank paper presented at the CARICOM Special meeting of the Council on Human and Social Development, Washington, D.C. Department for International Development, World Health Organization/Pan-American Health Organization, Global Fund to Fight AIDS, TB and Malaria, Joint United Nations Programme on HIV/AIDS, and the World Bank. 2005. “HIV/AIDS in the Caribbean Region: A Multi-Organization Review.” Washington, D.C. High Level Forum. 2005. “Paris Declaration on Aid Effectiveness. Ownership, Harmoni- sation, Alignment, Results and Mutual Accountability.” Paris. International Bank for Reconstruction and Development. 1944, 1989. Articles of Agreement. Washington, D.C.: The World Bank. International Labor Organization and United Nations Educational, Scientific and Cultural Organization. 2006. An HIV/AIDS Workplace Policy for the Education Sector in the Caribbean. Port-of-Spain. Kelly, Michael J., and Brendan Bain. 2005. Education and HIV/AIDS in the Caribbean. Kingston: Ian Randle Publishers, UNESCO Office for the Caribbean and the Inter- national Institute for Educational Planning. Morrisey, Michael, with Myrna Bernard, Donald Bundy, and David Plummer, editors. Forthcoming. Challenging HIV & AIDS: New Role for Caribbean Education. Kingston: Ian Randle Publishers, UNESCO Office for the Caribbean and CARICOM. 29 30 World Bank Working Paper United Nations Educational, Scientific and Cultural Organization. 1947. Constitution of the UNESCO. Paris. ———. 2006. EDUCAIDS. Towards A comprehensive education sector Response: A Frame- work for Action. Paris. ———. 2007. UNESCO’s Strategy for Responding to HIV and AIDS. Paris. United Nations Organization. 1946. “Resolution 50 (I) of the General Assembly: Agreements with Specialized Agencies.” New York. ———. 1947. “Resolution 124 (III) of the General Assembly: Agreements with Specialized Agencies.” New York. Eco-Audit Environmental Benefits Statement The World Bank is committed to preserving Endangered Forests and natural resources. We print World Bank Working Papers and Country Studies on 100 percent postconsumer recy- cled paper, processed chlorine free. The World Bank has formally agreed to follow the rec- ommended standards for paper usage set by Green Press Initiative—a nonprofit program supporting publishers in using fiber that is not sourced from Endangered Forests. For more information, visit www.greenpressinitiative.org. In 2006, the printing of these books on recycled paper saved the following: Trees* Solid Waste Water Net Greenhouse Gases Total Energy 203 9,544 73,944 17,498 141 mil. * 40” in height and 6-8” in diameter Pounds Gallons Pounds CO2 Equivalent BTUs Strengthening the Education Sector Response to HIV&AIDS in the Caribbean is part of the World Bank Working Paper series. These papers are published to communicate the results of the Bank’s ongoing research and to stimulate public discussion. The Caribbean Region is second only to Africa in the impact of HIV&AIDS. The Caribbean Community (CARICOM) has responded to this challenge by promoting a multisectoral response to the epi- demic. UNESCO has provided regional leadership in strengthening the education sector component of this response. In 2005, UNESCO launched, with CARICOM and the World Bank, a regional dialogue involving representatives of Ministries of Education, national HIV&AIDS coordinating councils, development partners, and regional institutions providing leadership in the HIV response, which led to the development and endorsement of a regional Proposal for Action: Accelerating the Education Sector Response to HIV&AIDS in the Caribbean Region. In June 2006, Ministers of Education and representatives of National AIDS Authorities met in Port-of-Spain, Trinidad and Tobago, under the auspices of the CARICOM Council on Human and Social Development, and agreed to promote education sector leadership in addressing HIV&AIDS and to create a supportive pol- icy and financial environment at national and regional levels. This report describes the development of these regional processes and how they have led to a stronger education sector response at the regional level. It also focuses on developments in three countries (Guyana, Jamaica, and St. Lucia) as examples of how this regional effort translates into action at the national level. World Bank Working Papers are available individually or on stand- ing order. Also available online through the World Bank e-Library (www.worldbank.org/elibrary). UNESCO/WB PARTNERSHIP IN SUPPORT OF CARICOM STRATEGY IN EDUCATION AND HIV&AIDS ISBN 978-0-8213-7476-4 THE WORLD BANK 1818 H Street, NW Washington, DC 20433 USA Telephone: 202 473-1000 Internet: www.worldbank.org E-mail: feedback@worldbank.org SKU 17476