In the fight against HIV/AIDS, children “represent our window of hope to the future.”
Once resistant, Sub-Saharan ministries of education now embrace prevention programs.
Programs reach 90 million schoolchildren in 26 countries.
November 27, 2007— Two decades as a prestigious professor-his last stop was as at Oxford University-didn't leave Don Bundy snug in an ivory tower. Since 1998, he has been helping Sub-Saharan Africa and other developing regions develop education programs to save African children from becoming a new generation of HIV/AIDS statistics.
His job takes him from the ministries of educations in country capitals to teacher workshops and primary and secondary classrooms in AIDS-devastated communities.
For Bundy, the World Bank's Lead Specialist for School Health HIV/AIDS & Education, the battle against infection must be waged not only with treatment, but also prevention. The best place to teach prevention, he says, is in the schools. While up to 30 percent of all Sub-Saharan adults have AIDS in the worst affected countries, nearly all school-age children are free of infection and have the lowest prevalence rate of any group.
“With prevention, we can save a whole generation,” Bundy says. “Children between 5 and 14 years of age represent our window of hope to the future."
But opening that window wasn't easy.
'Treatment Cannot Keep Up With Demand'
Treatment, including recent advances in drug therapy that can help those infected lead long and useful lives, gets most of the attention and money, Bundy says, but it has no medical effect on transmission of the disease, and is much more costly than prevention. “For every case you bring into treatment, there are many new cases,” he says. “Treatment cannot keep up with demand unless we bring in prevention.”
In 2002, when the Bank, the UN, and other partners first took that message to African countries, not all ministries of education were ready to listen and act. They were burdened with the challenge of trying to put build and staff enough schools to enroll 100 percent of their youth by the year 2015 - a Millennium Development Goal.
But five years later, attitudes have changed - not only in the education ministries but on down to the community level. Today, 26 Bank-supported HIV/AIDS education programs reach 90 million schoolchildren in 26 Sub-Saharan countries. “We're aiming for 118 million schoolchildren in 41 countries,” Bundy says.
Countries Will Share Practices at Nairobi Meeting
On Nov. 29 representatives of ministries of education from 34 Sub-Saharan countries - out of 48 region-wide - are gathering in Nairobi to share their school- and community-based prevention practices. “We're moving from promoting from the outside to promoting on the inside,” says Bundy, who will join the meeting. “We want them [the host countries and their ministries of education] to put the Bank out of a job.”
Bundy's Washington, D.C., office in the Bank's Human Development Network is a “lean and mean operation” consisting of three people. He said the small team is able to leverage results through its partnership in the Accelerate Initiative Working Group, established in 2002 by the Joint UN Programme on HIV & AIDS, as well as by working with Bank staff in regional and country offices. The working group also includes other development organizations, civil society, teachers' unions and the media.
The framework for the prevention initiative is the joint UNESCO, UNICEF, WHO, World Bank- developed Focusing Resources on Effective School Health (FRESH), which uses a skills-based approach to show schoolchildren how prevention - including sexual abstinence, avoiding multiple sexual partnerships, and using condoms - can prevent HIV/AIDS infection.
The initiative has been expanded to five countries in the Mekong subregion of East Asia and eight in the Caribbean.
Bundy and Alexandria Valerio of the Latin America and Caribbean Region's Human Development Education Sector produced a 30-minute “A Window of Hope” video about Accelerate and FRESH that has won five international awards.
Thomas Abokyi, teacher in Accra, Ghana
'Teachers Are Considered Role Models'
A major component of FRESH is working closely with the teachers. They are key, Bundy says, because of their dual role in the classroom and the overall community. Hilda Eghan, coordinator for Ghana's Ministry of Education - and one of the officials with whom Bundy and the Accelerate group work - says, in the video, “In many urban and rural areas our teachers are considered role models.
Thomas Abokyi, a teacher in training who is responsible for a classroom of 8- to 11-year-olds at Teacher Mota Primary School in Accra, Ghana, says in the video: “As a teacher in the community, people look up to me. Whatever I do, they try to emulate.” Accelerate has received strong cooperation from Sub-Saharan teachers' unions, whose members have attended 21 of the 24 instructional workshops over the past five years.
While Accelerate prevention programs are reaching many millions of schoolchildren, Bundy acknowledges that results have yet to be quantified on any scale. “We don't have enough evaluation of programs,” he says. “Treatment gets more attention because it's more measurable. There's a barrier between the medical/business fraternity and the softer, more nebulous area of prevention.”
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