Integral sustainability theory is evident in the UN’s approach to tackling HIV/AIDS in various locations around the world. The approach focuses on a range of change activities that reference a multi-dimensional view of the issue.
HIV/AIDS is a global epidemic but is most acute in some of the poorest regions on earth. It is compounded by a range of issues including cultural and gender stereotypes, education levels and poor infrastructure. It is estimated that almost 60 million people have been infected with HIV globally and 25 million people have died of HIV-related causes. Sub-Sahara Africa is home to 67% of all people living with HIV worldwide.
Since early this century the UN has been using the ‘Leadership for Results’ programme to help combat the spread of HIV/AIDS around the globe. Critical to this has been the Leadership Development Programme (LDP) which, in the words of the programme’s director, helps to “build partnerships, overcome institutional inertia, generate innovations, and produce breakthrough results for halting the epidemic.”
The LDP recognises that HIV/AIDS has impacts at multiple levels – individual, community, institutional and societal; echoing the four quadrants of the integral model. It acknowledges the need to look at the internal quadrants, personal and collective attitudes, behaviours and norms that contribute to the spread of the disease. By doing so it raises issues of shame and guilt, of gender inequality and power relations, stigma and discrimination. All of these factors must be considered if results are to be effective.
Therefore, local context is also important, so the programme is designed to create a framework through which these issues can be more closely examined.
In support of the Millennium Development Goal to halt and reverse the spread of HIV/AIDS by 2015 it focuses on four main areas: preventing new infections; providing care and support for those impacted by the disease; reducing vulnerability amongst those at greatest risk of infection, often women; and mitigating the social and economic impacts of the disease. In essence, the individual responses to HIV/AIDS or I external.
This is achieved by focusing on three interrelated areas:
- Leadership and capacity development to address HIV/AIDS, including the promotion and representation of leaders within all areas of society (I internal )
- Development planning, implementation and HIV/AIDS responses, including systems at national, district and community levels. (We external )
- Advocacy and communication to address HIV/AIDS, to encourage a society that is more sensitive to and respectful of the rights of those living with HIV/AIDS (We and I external )
The framework also recognises the impact of the responses on other Millennium Development Goals and systems including the reduction of poverty and hunger, the empowerment of women, the reduction of maternal and infant mortality and the creation of a global partnership for development.
By focusing on leaders the programme facilitates new levels of thinking, societal values and behaviours creating transformational change within a range of institutions. It helps leaders take a wide view of the issue by engaging broadly with leaders from a range of stakeholders and allows them to identify structural weaknesses and co-create active solutions.
The programme is generating results in over 30 countries, but importantly these are owned and tailored to the needs of the local population acknowledging their own cultural, political and institutional environments. For instance, in Ethiopia the programme has resulted in the creation of a nationwide women’s collective; in Ukraine HIV/AIDS programmes have been run through the workplace and radio DJs addressed the issue of intravenous drug use; whilst in Cambodia Buddhist monks have addressed stigma and discrimination and mobilised community-based organisations.
The framework has yielded quite different but effective solutions based on an understanding of the local dynamics and effective application of the principles of integral theory.
- HIV/AIDS Leadership Capacity Development, UNDP website
- UNAIDS, joint United Nations programme on HIV/AIDS