HIV/AIDS,Security and Conflict, released Tuesday at The Hague, recommends ways to makepeacekeeping, peace building and humanitarian efforts more in tune with therisks of the disease.
Alexde Waal is principle investigator for the AIDS, Security and Conflict Initiativeand program director at the Social Science Research Council in New York.
"Ten years ago when the Clinton administrationraised HIV/AIDS as a security issue, there were fears that the pandemic,particularly in the hardest hit countries in Africa, would bring about statecrisis, state collapse, the collapse of armies, simply because so manyindividuals were infected," he says.
Thoseconcerns, he says, were reinforced following the September 11terrorist attacks on the United States. He says the Bush administration thought there would be "more ungovernedspaces on the planet in which terrorism and anarchy could foster."
TheU.N. Security Council made HIV/AIDS a top priority in its first debate in the21 Century in January 2000 "at the instigation of the UnitedStates."
"Weknow a lot more about HIV/AIDS and security. The epidemic has evolved and there have also been some very majorresponses to it, not the least the President's Emergency Plan for AIDS Relief,PEPFAR," he says.
Someof the worst fears failed to materialize.
"Thealarmism of a decade ago has dissipated. States are not collapsing. Armiesare not imploding. But there is a hostof issues that we still need to be concerned about," he says.
Theseinclude violence against women in conflict situations, such as the manythousands of women who've been raped and sexually assaulted in the eastern DRC.
"Anywoman who is exposed to acts of sexual violence is at a greater risk ofreceiving HIV. The act of violenceitself is an increased risk factor. Andvery often the men who perpetrate these acts are themselves at high risk ofbeing infected with HIV," he says.
Eventhe transition from war to peace can be a risk factor for countries. Many people that had been isolated in arefugee camp may not have been exposed as much to HIV as those in the generalpopulation. But with the end of theconflict, refugees and displaced people return home.
"Youmay see a lot of investment going into certain town. They may become boom towns. They may attract sex workers. They may attract impoverished young women,who get drawn into sex work," he says.
Soldiersreturning home may bring HIV with them.
DeWaal also says in some cases, HIV/AIDS is being "driven underground."
"Inmost countries of the world, we see that the epidemic is concentrated amongstgroups that are on the margins of the law or beyond those margins -- peoplelike injecting drugs users, like sex workers, like gay men in countries wherehomosexuality is illegal."
Hesays these populations are often stigmatized, marginalized and evencriminalized.
"Theyrarely have interaction with the authorities that are straight forward andopen. And therefore, they are difficultto access, difficult to gain the confidence," he says.
So,it's more difficult to provide them with care and treatment.
"Oneof our recommendations is for a greater focus on sexual and gender-basedviolence across the board. Another?is todo with the uniform services?. The mosteffective methods for controlling HIV and AIDS in armies and uniform servicesis when responsibility is vested, not so much in the medical services, but inthe command of those institutions," he says.
Thisincludes not only national armies, but peacekeeping forces and police, as well.
Thereport calls for support for local governments in countries hard hit by theepidemic.
"Whilestates themselves may not be in crisis, very often?local government servicesare affected," he says.
The report is a joint project of theSocial Science Research Council and the Clingendael Institute for InternationalRelations at The Hague.