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					                              Annex 2



                    PRSPs of Countries of Focus:
            Sentences and Paragraphs Containing Key Words



1.   Burundi…………………………………………………………….. 2
2.   Chad……………………………………………………………....... 27
3.   Democratic Republic of the Congo……………………………........33
4.   Haiti……………………………………………………………........46
5.   Indonesia………………………………………………………........ 49
6.   Ivory Coast…………………………………………………………. 51
7.   Liberia…………………………………………………………........ 59
8.   Nepal………………………………………………………………...75
9.   Uganda………………………………………………………………77
                                                           1. BURUNDI




                                                                                                                                                          9. Mobile population
                                                                                                                                     8. Food insecurity
                                    1. Humanitarian




                                                                                                         6. Emergency
                                                                                          5. Displaced
                                                                    3. Refugee
                                                      2. Disaster




                                                                                                                        7.Conflict




                                                                                                                                                                                           11. AIDS
                                                                                                                                                                                 10. HIV
                                                                                 4. IDP
                        Date
Country    Document     issued
Burundi      PRSP        Sep 06          3            25            10             0      19             11             72                 2                    0                88        75


HUMANITARIAN

Page 20
The non-income dimension of poverty
136. Internal and external refugees: The different conflicts that have affected
Burundi created an unprecedented humanitarian disaster with a high number of internal and
external refugees. Many of them joined the ranks of the poor during the crisis because their
property was pillaged and destroyed. A great many of them also became physically and
psychologically disabled, malnourished and sick from endemic diseases.

Page 31
5.3.4. Growing numbers of disaster victims and vulnerable persons
197. All indications are that problems linked to disaster victims pose a major challenge for
Burundi. Although humanitarian assistance has facilitated repatriation and reintegration activities
targeting refugees and displaced persons and transitional subsistence allowances have been
provided to ex-combatants, major constraints are hobbling efforts to achieve the sustainable
socio-economic reintegration of all disaster victims.

Page 39
(vi) Promoting a new partnership with donors
239. The partnership between the government and the development partners of Burundi is a
continuation of their sustained support during ten years of war, in the form of humanitarian aid,
security assistance, and budgetary support. PRSP implementation requires that the capacities of
this cooperation be strengthened at all levels, in order to help the government establish an
environment of peace, resumed economic growth, and poverty reduction.


DISASTER

Page viii
Executive Summary
3. The government is now in peace talks with the last rebel movement through its two branches
within the framework of the democratic process in place. Nevertheless, during the same period, it
has become clear that poverty has worsened considerably. This pauperization is further
aggravated today because of the scant resources available to government and households and the
existence of a population of disaster victims resulting from the conflict, such as refugees, the
internally displaced, street children, and orphans.



                                                                                                                                                                                           2
Page x
Axis 3: Developing human capital
13. To this end, priority actions targeting the health and education sectors, water supply and
sanitation, urban planning and decent housing for all have been identified. In addition, actions
geared not only toward refugees and the displaced, but also toward other vulnerable groups, such
as street children, orphans, victims of natural disasters, and the disabled, have been emphasized.
Actions promoting community approaches to caring for and reinserting disaster victims were
decided upon, especially to help populations in dire circumstances to resume normal lives by
promoting national solidarity and the acquisition of skills enabling them to join the modern sector
of the economy.

Page 11
Chapter IV Overview of poverty in Burundi
95. Burundi is one of the world’s poorest countries, with per capita incomes at US$83 at end-
2004. The seriousness of poverty poses a major risk to the country’s economic and social
recovery.
96. While some progress has been made in just a few years, thanks to tangible progress in the
political arena and in the implementation of economic reforms, the social situation remains
difficult because of: (i) widespread poverty; (ii) the large number of disaster victims; (iii) the
shortfall in basic social services coverage, and (iv) the proportions of the HIV/AIDS problem.

Page 20
4.3 The non-income dimension of poverty
136. Internal and external refugees: The different conflicts that have affected Burundi created an
unprecedented humanitarian disaster with a high number of internal and external refugees.

Page 22
5.2.1 An unstable macroeconomic framework
(i) An expenditure structure largely unsuited to growth
149. The current public expenditure structure is not conducive to economic growth. A large
portion of current expenditure goes toward the payment of wages and unavoidable expenditures
arising from the rehabilitation needs of disaster victims and the need to reform the defense and
security forces.

Page 31
5.3.4. Growing numbers of disaster victims and vulnerable persons
195. As a result of the conflict, the number of disaster victims and vulnerable persons living in
conditions of utter deprivation increased. These persons owe their survival to national and
international assistance. Malnutrition, unhealthy conditions, and crowded conditions make them
even more vulnerable to all manner of diseases such as cholera, bacillary dysentery, exanthematic
typhus, cerebro-spinal meningitis, malaria, and HIV/AIDS.
196. The protracted nature of the crisis has also led to an increase in the number of indigent
persons, who are resorting to such undesirable activities as alcohol and drug use, crime, begging,
and prostitution. In most cases, these activities are the root cause of the higher incidence of
HIV/AIDS in camps housing refugees and displaced persons.

Page 31
197. All indications are that problems linked to disaster victims pose a major challenge for
Burundi. Although humanitarian assistance has facilitated repatriation and reintegration activities
targeting refugees and displaced persons and transitional subsistence allowances have been



                                                                                                     3
provided to ex-combatants, major constraints are hobbling efforts to achieve the sustainable
socio-economic reintegration of all disaster victims.

Page 33
5.5 Gender and equity constraints
209. … 21 percent of households are headed by women in rural areas; women figure prominently
among disaster victims (over 60 percent); chores are unevenly distributed within families; income
is unevenly distributed; the traditional mentality relegates women to a subservient role; and they
lack control over production resources.
210. The incidence of poverty in female-headed households is higher than in male-headed
households. Based on a study on the situation of female disaster victims conducted in 1995, the
percentage of women widowed by the war stands at 26.3 percent, and the percentage of female-
headed households is estimated at 22 percent of all households.

Page 42
(iii) Professionalizing the defense and security forces
257. The reforms under way within the defense and security forces have the dual objective of
stabilizing the size of the FDN and PNB at levels compatible with the country’s financial
capacities on one hand, and improving the performance of these components, on the other. The
sector’s contribution to national reconstruction could also extend to rehabilitation of the country’s
infrastructure (military engineering), management of natural disasters (FDN), firefighting (PNB),
environmental protection (reforestation), and assistance to the health sector (access to care
provided by military hospitals to the civilian population, support for public health programs such
as immunization campaigns).

Page 74
482. Budgetary expenditure will remain substantial owing to the reinstallation and reinsertion of
disaster victims, the rehabilitation and reconstruction of destroyed infrastructure, and the
financing of socio-economic infrastructure. Expenditure will amount to about 50 percent of GDP
annually owing to the sizable financial requirements for reducing poverty.

Page 101
Annex 1: Actions Matrix by Axis
Measures to be taken
Education in peace and reconciliation targeting disaster victims and ex-combatants

Page 103
Performance indicators
Preparation of plans for the reintegration of disaster victims
Disaster victims rehabilitated

Page 110
Measures to be taken
Establishment of an early warning and response system for natural disasters
Performance indicators:
Reduction in damages caused by natural disasters 2009

Page 118
3.2.3 Support for vulnerable groups
Measures to be taken



                                                                                                   4
Integration of disaster victims through trade apprenticeships, income-generating activities, and
access to microcredit
Performance indicators
Number of disaster victims having participated in trade training and education sessions
Number of disaster victims with access to microfinance institutions by commune

Page 119
3.2.3 Support for vulnerable groups
Measures to be taken
Improved coordination of the sector for assisting disaster victims
Policy developed and adopted
Platform for coordinating aid to disaster victims introduced at all levels

Page 120
4.1 Prevention of HIV transmission
Measures to be taken
Strengthened information, education and communication activities to change behaviors,
especially among at-risk groups (youths, disaster victims, women of childbearing age, prisoners,
men in uniform, women with multiple partners, unaccompanied travelers)


REFUGEE

Page viii
Executive summary
3. The government is now in peace talks with the last rebel movement through its two branches
within the framework of the democratic process in place. Nevertheless, during the same period, it
has become clear that poverty has worsened considerably. This pauperization is further
aggravated today because of the scant resources available to government and households and the
existence of a population of disaster victims resulting from the conflict, such as refugees, the
internally displaced, street children, and orphans.

Page x
Axis 3: Developing human capital
13. The government is convinced that sustainable development is predicated on qualified and
healthy human resources. Therefore, its objective is to re-establish quality social services in
partnership with the very communities that will be the beneficiaries. To this end, priority actions
targeting the health and education sectors, water supply and sanitation, urban planning and decent
housing for all have been identified. In addition, actions geared not only toward refugees and the
displaced, but also toward other vulnerable groups, such as street children, orphans, victims of
natural disasters, and the disabled, have been emphasized.

Page x
Axis 3: Developing human capital
136. Internal and external refugees: The different conflicts that have affected
Burundi created an unprecedented humanitarian disaster with a high number of internal and
external refugees. Many of them joined the ranks of the poor during the crisis because their
property was pillaged and destroyed. A great many of them also became physically and
psychologically disabled, malnourished and sick from endemic diseases. According to a study
conducted by UNICEF in 1997, 84 percent of displaced persons displayed symptoms of
conjunctivitis. The HIV rate is high among the internally displaced and they suffer from a high
prevalence of sexual violence.


                                                                                                   5
Page 21
5.1. Governance, security and conflict resolution constraints
144. In the security sphere, continuing insecurity is in part attributable to the delay in negotiations
to sign an agreement with the FNL. It is also linked to the need for vocational training of the
newly-minted defense and security forces, pervasive crime in urban and rural areas, and ongoing
gender-related violence. This situation is slowing the resettlement process of displaced persons
and refugees within and outside the country.

Page 31
5.3.4 Growing numbers of disaster victims and vulnerable persons
196. The protracted nature of the crisis has also led to an increase in the number of indigent
persons, who are resorting to such undesirable activities as alcohol and drug use, crime, begging,
and prostitution. In most cases, these activities are the root cause of the higher incidence of
HIV/AIDS in camps housing refugees and displaced persons.

197. All indications are that problems linked to disaster victims pose a major challenge for
Burundi. Although humanitarian assistance has facilitated repatriation and reintegration activities
targeting refugees and displaced persons and transitional subsistence allowances have been
provided to ex-combatants, major constraints are hobbling efforts to achieve the sustainable
socio-economic reintegration of all disaster victims.

Page 44
(ii) Settling land disputes
270. The multiple crises experienced by the country have forced Burundians to abandon their
property while taking refuge either outside or inside the country. As a result, social conflicts have
arisen here and there in the country as refugees and displaced persons have returned to their
property, often finding it occupied by other persons.

Page 68
6.2.3.2.2 Reintegrate victims in their communities
444. To ensure their voluntary reintegration in their communities with full dignity, the following
activities are planned: (i) identify and develop transit host sites; (ii) inform, mobilize, and monitor
returnees; (iii) facilitate the return of refugees and displaced persons by providing transportation
to their region of origin and assistance in fulfilling the administrative formalities, thus permitting
successful social rehabilitation; (iv) distribute a package of food and nonfood items to returnees
to ensure survival under decent conditions during a period of at least three months pending the
first harvest; (v) support the more vulnerable groups (unaccompanied children, the elderly, the
chronically ill, pregnant women, etc.).

Page 92
8.3.8. Partnership with NGOs
572. The national and international NGOs played a very important role in supporting the victims
of conflict, displaced persons, and refugees in the decade of crisis experienced by Burundi. They
are also behind many grassroots projects which have enabled the beneficiaries to combat poverty.




                                                                                                     6
DISPLACED

Page viii
Executive Summary
3. The government is now in peace talks with the last rebel movement through its two branches
within the framework of the democratic process in place. Nevertheless, during the same period, it
has become clear that poverty has worsened considerably. This pauperization is further
aggravated today because of the scant resources available to government and households and the
existence of a population of disaster victims resulting from the conflict, such as refugees, the
internally displaced, street children, and orphans.

Page x
Axis 3: Developing human capital
13. To this end, priority actions targeting the health and education sectors, water supply and
sanitation, urban planning and decent housing for all have been identified. In addition, actions
geared not only toward refugees and the displaced, but also toward other vulnerable groups, such
as street children, orphans, victims of natural disasters, and the disabled, have been emphasized.
Actions promoting community approaches to caring for and reinserting disaster victims were
decided upon, especially to help populations in dire circumstances to resume normal lives by
promoting national solidarity and the acquisition of skills enabling them to join the modern sector
of the economy.

Page 9
3.3 Social trends
79. Since the crisis began in 1993, some of the families who had escaped the massacres had to
flee and find refuge in army barracks. This situation was compounded by the subsequent
insecurity and their numbers continued to grow.
80. Typically, these families are living in abject poverty, which could worsen if they are not
offered better prospects. Thus far, some camps have become veritable centers for the displaced.
Moreover, this situation is jeopardizing the return to barracks that must take place as part of the
process of integration and normalization of the security situation.
81. This uncertainly is accompanied by a new phenomenon of sexual violence, especially rape,
which is gaining ground and claiming innocent victims. By way of illustration, 983 cases were
recorded in 2003 compared with 1,664 in 2004, and the situation is all the more dramatic
considering that 43 percent of the cases are minors, and 17 percent children under 10 years of
age. Sweeping reforms are being introduced in the penal code in order to stamp out this scourge.

Page 18
4.3 The non-income dimension of poverty
126. Immunization coverage fell from 82 percent in 1991 to 61 percent in 2001. In fact, it was
observed during the crisis that there was a renewed upsurge in infectious and parasite-borne
diseases, such as malaria, acute respiratory infections, skin diseases, and bacillary dysentery. The
current situation is also the result of substandard conditions and overcrowding, especially in the
camps for displaced persons, and of the inadequate access to medicines, especially in rural areas.

130. For housing, the situation is still precarious and fragile. The housing shortage grew more
severe with the crisis when thousands of housing units were destroyed in both rural and urban
areas. Notwithstanding concerted efforts by all the partners (government, donors and lenders, and
recipients) to reconstruct homes, the needs are still immense, given the large number of
households still displaced within the country and prospective returnees. Housing is generally still
of poor quality nationally.


                                                                                                      7
Page 20
4.3 The non-income dimension of poverty
136. Internal and external refugees: The different conflicts that have affected Burundi created an
unprecedented humanitarian disaster with a high number of internal and external refugees. Many
of them joined the ranks of the poor during the crisis because their property was pillaged and
destroyed. A great many of them also became physically and psychologically disabled,
malnourished and sick from endemic diseases. According to a study conducted by UNICEF in
1997, 84 percent of displaced persons displayed symptoms of conjunctivitis. The HIV rate is high
among the internally displaced and they suffer from a high prevalence of sexual violence.

138. Widowed heads of household: One of the consequences of the war and HIV/AIDS is the
appearance of a large number of widowed heads of household. For this reason, widows make up
31 percent of heads of household among the internally displaced households. This category is still
vulnerable because of gender-based discriminatory practices such as access to inheritance, land,
credit, and education.

Page 21
5.1 Governance, security and conflict resolution constraints
144. In the security sphere, continuing insecurity is in part attributable to the delay in negotiations
to sign an agreement with the FNL. It is also linked to the need for vocational training of the
newly-minted defense and security forces, pervasive crime in urban and rural areas, and ongoing
gender-related violence. This situation is slowing the resettlement process of displaced persons
and refugees within and outside the country. The demobilization of ex-combatants and
establishment of integrated army and police force are also prerequisites for maintaining security
over the long term.

Page 31
5.3.4 Growing numbers of disaster victims and vulnerable persons
196. The protracted nature of the crisis has also led to an increase in the number of indigent
persons, who are resorting to such undesirable activities as alcohol and drug use, crime, begging,
and prostitution. In most cases, these activities are the root cause of the higher incidence of
HIV/AIDS in camps housing refugees and displaced persons.

197. All indications are that problems linked to disaster victims pose a major challenge for
Burundi. Although humanitarian assistance has facilitated repatriation and reintegration activities
targeting refugees and displaced persons and transitional subsistence allowances have been
provided to ex-combatants, major constraints are hobbling efforts to achieve the sustainable
socio-economic reintegration of all disaster victims.

Page 44
(ii) Settling land disputes
270. The multiple crises experienced by the country have forced Burundians to abandon their
property while taking refuge either outside or inside the country. As a result, social conflicts have
arisen here and there in the country as refugees and displaced persons have returned to their
property, often finding it occupied by other persons.




                                                                                                     8
Page 66
6.2.3.3 Access to potable water, hygiene, sanitation and decent housing
…433. Such a policy will have the greatest chance of success because displaced and repatriated
populations are already accustomed to village life in host sites. Making villages viable,
specifically by developing water supply systems, electric hookups, and road access, will make
them more attractive, especially for youth to develop nonagricultural activities.

Page 68
6.2.3.2.2. Reintegrate victims in their communities
442. At the present time, more than 500,000 Burundians are living outside the country, and more
than 200,000 others are internally displaced. Ex-combatants should be added to these figures.

444. To ensure their voluntary reintegration in their communities with full dignity, the following
activities are planned: (i) identify and develop transit host sites; (ii) inform, mobilize, and monitor
returnees; (iii) facilitate the return of refugees and displaced persons by providing transportation
to their region of origin and assistance in fulfilling the administrative formalities, thus permitting
successful social rehabilitation; (iv) distribute a package of food and nonfood items to returnees
to ensure survival under decent conditions during a period of at least three months pending the
first harvest; (v) support the more vulnerable groups (unaccompanied children, the elderly, the
chronically ill, pregnant women, etc.).

Page 68
a. Support reintegration
445. The reconstruction and rehabilitation of social infrastructure are of critical importance to the
reintegration of those displaced by the conflict. This situation offers the opportunity to rethink
Burundi’s housing policy. While it is agreed that, for cultural reasons and issues of social
cohesion, it makes sense to encourage people to return to their native hillsides, it is also true that
land pressures and the goal of bringing social services closer to rural populations are sound
reasons for resettling victims in villages.

Page 69
c. Support the capacity to treat psychological trauma
452. The psychological consequences of the conflict and other traumas show up as after-effects in
the great majority of displaced populations. As a result, the rehabilitation of victims is not only of
a material nature - it also requires coverage for victims in terms of psychological and mental
health care. The government attaches a particular priority to this component of the program to
rehabilitate victims of the conflict. It will be planned in such a way as to ensure national coverage
with professional staffing and substantial resources.

Page 92
8.3.8 Partnership with NGOs
572. The national and international NGOs played a very important role in supporting the victims
of conflict, displaced persons, and refugees in the decade of crisis experienced by Burundi. They
are also behind many grassroots projects which have enabled the beneficiaries to combat poverty.

Page 118
Measures to be taken
Reconstruction and rehabilitation of housing for repatriated, displaced, and demobilized persons,
for war widows and orphans, and for other vulnerable




                                                                                                     9
EMERGENCY

Page 10
86. This new program, supported by an Economic Rehabilitation Credit (ERC) from the World
Bank and emergency post-conflict assistance from the IMF, sought the restoration of a sound
macroeconomic framework and the rehabilitation of community infrastructure.

Page 50
a. Develop and improve food production
309. While increased output, the restoration of food security, and nutritional improvements
remain medium-term objectives, it is still important in the shorter term to be in a position to
mobilize emergency assistance for a population beset by famine.

Page 81
524. The anticipated aid “lined up” for the 2006-2009 period is estimated at about FBu 669
billion. Implementation of the PRSP—apart from the 2006 Emergency Program (PU)—should
result in the additional mobilization of FBu 535 billion over three years.


FOOD INSECURITY

Page 18
127. The country currently suffers from food insecurity and is partially dependent on food aid to
meet its food needs.

Page 24
5.2.2 Structural obstacles to economic growth
c. Predominance of subsistence agriculture
165. In Burundi, the productive system is dominated by a traditional agricultural sector. In such a
context, land becomes a decisive factor. However, access to land is becoming increasingly
limited, owing to mounting demographic pressure which is gradually reducing the amount of land
available per household. This situation has already led to the overexploitation of land, land
degradation, and a decline in food production, which have spawned the food insecurity problem
seen in recent years, particularly in the northern provinces.


CONFLICT

Page i
Table of contents
Chapter V: Sustainable Development and Poverty Reduction Constraints................................ 20
5.1. Governance, security, and conflict resolution constraints............................................ 21

Page vii
Foreword
This PRSP is part of a two-pronged approach consisting of ongoing collaboration with population
groups on major issues and stronger partnership with donors and lenders. It is a valuable tool for
extricating the country from the crisis and is very timely in terms of helping the government that
was democratically elected in 2005 to take concrete steps toward national reconciliation and
reconstruction after so many years of conflict and economic decline.



                                                                                                            10
Page viii
Executive Summary
The government is now in peace talks with the last rebel movement through its two branches
within the framework of the democratic process in place. Nevertheless, during the same period, it
has become clear that poverty has worsened considerably. This pauperization is further
aggravated today because of the scant resources available to government and households and the
existence of a population of disaster victims resulting from the conflict, such as refugees, the
internally displaced, street children, and orphans.

Page viii
b. Post-conflict socio-economic context
4. This full PRSP comes at a time of post-conflict economic difficulty characterized by
insufficient production and incomes, low levels of international assistance and investment, as well
as persistently heavy pressure on the State’s cash flow.

Page ix
c. Content of the PRSP
(i) Main obstacles to poverty reduction and growth
6. The participatory community, sectoral, and thematic consultations carried out at the national
and community levels afforded an opportunity to analyze the characteristics of poverty and
identify the main constraints. They are:
(i) Governance, security, and conflict resolution constraints;
(ii) Structural rigidities impeding economic growth;
(iii) Instability of the macroeconomic framework;
(iv) Poor quality of, and insufficient access to, basic social services;
(v) An increase in vulnerable populations as a result of the conflict’s negative toll;
(vi) High prevalence of HIV/AIDS;
(vii) Gender and equity constraints.

Page ix
Axis 1: Improving governance and security
9. Improving Burundi’s security situation after over a decade of conflict is a sine qua non
condition for restoring an environment conducive to economic recovery and national
reconciliation.

Page 2
30. Burundi’s Poverty Reduction Strategy Paper is organized into nine chapters.
Chapter I discusses the post-conflict situation; …

Page 6
61. ….Some participants even held that one of the main obstacles to the peace process is the
apprehension that peace instills, because the conflict had been cited as one factor explaining the
dire poverty.

Page 7
3.2. Economic developments
64. Although the return to a peaceful situation re-establishes an environment conducive to
economic recovery, innovative policies and reforms must be initiated to salve the wounds left by
a conflict that lasted more than a decade.




                                                                                                   11
Page 8
3.3. Social trends
73. The social sector was gravely affected by the conflict that prevailed in Burundi in the past 12
years. The situation led to a considerable drop in production in virtually all sectors of the national
economy and consequently caused poverty to worsen. Life expectancy at birth fell from 51 years
in 1993 to less than 42 in 2005. Per capita incomes are below US$100, markedly lower than for
other African countries and lower than the Sub-Saharan average, estimated at over US$500.

Page 10
3.4. Economic and social recovery programs already under way
85. The poor performance recorded during execution delayed the completion of the post-conflict
program, which did not occur until October 2002.

86. This new program, supported by an Economic Rehabilitation Credit (ERC) from the World
Bank and emergency post-conflict assistance from the IMF, sought the restoration of a sound
macroeconomic framework and the rehabilitation of community infrastructure.

87. In November 2003, the Bretton Woods institutions’ positive assessment of the execution of
the post-conflict program led to the preparation of a three-year program of reforms (2004-2006)
supported by the Poverty Reduction and Growth Facility (PRGF).

Page 12
102. … For a third of participants in the survey, an end to the conflict is at the top of the list of
poverty reduction factors.

Page 14
114. From a spatial point of view, and according to the results of the 1998 priority survey, the
provinces most severely affected by the deleterious effects of the conflict were where poverty
rose most sharply. Such was the case in the provinces of Bujumbura rural, Bubanza, Cibitoke,
and Karuzi. Some provinces such as Ruyigi, where the percentage of poor was already quite high
before the crisis (over 50 percent), reached even more disturbing levels, with over 80 percent of
persons living below the poverty line.

Page 18
131. Generally, the combined effects of poverty and conflict are reflected in Burundi’s poor
social indicators compared with the Sub-Saharan African average. Per capita GDP for Burundi is
a mere fifth of the Sub-Saharan African average (Table 4). Life expectancy in Burundi is shorter
by four years than for the continent as a whole, while child mortality, like maternal mortality, is
higher.

Page 20
136. Internal and external refugees: The different conflicts that have affected Burundi created an
unprecedented humanitarian disaster with a high number of internal and external refugees. Many
of them joined the ranks of the poor during the crisis because their property was pillaged and
destroyed. A great many of them also became physically and psychologically disabled,
malnourished and sick from endemic diseases. According to a study conducted by UNICEF in
1997, 84 percent of displaced persons displayed symptoms of conjunctivitis. The HIV rate is high
among the internally displaced and they suffer from a high prevalence of sexual violence.




                                                                                                        12
Page 20
139. Children: Like the above-mentioned vulnerable groups, children make up a significant share
of victims of conflict and AIDS. They are the orphans and street children, abandoned children,
former child soldiers, HIV positive children, and children heads of household.

Page 20
140. The elderly and disabled: There are very little data on the disabled in Burundi, but the
conflict can be expected to be a key factor explaining the growing number of the physically and
emotionally disabled among the population.

Page 20-21
142. Poverty, as perceived and described during participatory consultations and confirmed by
empirical analyses, is manifested primarily in: (i) problems of governance and insecurity; (ii)
sluggish economic growth; (iii) an unstable macroeconomic framework; (iv) a growing and
widespread lack of access to basic social services; (v) an increase in the categories of
disadvantaged people and heightened vulnerability to poverty spawned by the conflict and
inadequate social safety nets; and (vi) a high prevalence of HIV/AIDS and other endemic
diseases.

Page 21
5.1. Governance, security, and conflict resolution constraints
145. … The country’s future is contingent on the effective management of conflicts rooted in the
past and the ability to better anticipate these conflicts in the future, in order to end the cycles of
violence that have marred the socioeconomic situation in the country in recent decades.

Page 21
146. With the advent of democratically-elected institutions, policies linked to good governance,
security, and conflict resolution are in a nascent stage and should be sustained.

Page 25
e. A low level of investment exacerbated by the conflict
169. The investment level dropped precipitously during the 1990s. This trend is attributable to the
conflict, which dampened the private sector’s interest in investment, and also, to some degree, to
the paucity of public sector resources.

170. The conflict has also adversely affected the country’s ability to attract foreign investors and
prompted the freezing of international assistance.

171. As with all post-conflict countries, net disinvestment had a significant and adverse effect on
the national economy during the crisis period.

Page 31
5.3.4. Growing numbers of disaster victims and vulnerable persons
195. As a result of the conflict, the number of disaster victims and vulnerable persons living in
conditions of utter deprivation increased. These persons owe their survival to national and
international assistance. Malnutrition, unhealthy conditions, and crowded conditions make them
even more vulnerable to all manner of diseases such as cholera, bacillary dysentery, exanthematic
typhus, cerebro-spinal meningitis, malaria, and HIV/AIDS.




                                                                                                    13
Page 32
5.5. Gender and equity constraints
208. In Burundi, as in other post-conflict countries, a host of factors impinge upon the integration
of gender into the country’s socio-economic development.

Page 34
6.1. Long-Term Development Vision
215. Emerging from a decade of conflict, Burundi seeks to move conclusively toward political,
economic, and social normalization and thereby put an end to the cyclical crises that have
weighed on the country, and to guarantee peace, security, and sustainable development for all.

Page 37
(i) Refocusing the role of government
222. A refocusing of government, after more than a decade of conflict, is critical in order to
rebuild a nation governed by the rule of law, energize government, and stimulate economic
growth.

Page 39
240. As it emerges from these ten years of armed conflict, the government is aware of its
financial, institutional, and operational limitations.

Page 40
Axis 4: Prevent and control HIV/AIDS
244. In a post-conflict country like Burundi, all national reconstruction actions are a priority.
Aware of this situation and of the stark necessity of setting in place the conditions and resources
needed for an economic takeoff likely to reduce poverty, the government has selected the
following programs as priorities:
- Good governance
- Economic recovery
- Social development
- HIV/AIDS prevention and control

Page 41
252. In addition, the government continues to participate actively in efforts to resolve the
conflicts in the sub region and ensure the security of the country’s borders.

Page 41
253. The end of the conflict has been marked by initial steps toward reforming the defense and
security forces, along with demobilization of some of the ex-combatants. With the support of its
development partners, the government has set in place a multisectoral program for the
demobilization, disarmament, and reintegration (DDR) of ex-combatants.

Page 41
256. In line with the Burundi Letter of Demobilization Policy, the government anticipates that,
over time, the PNDRR will help it conserve resources earmarked for defense and security during
the conflict and direct them instead toward other socioeconomic development sectors.

Page 42
262. The ongoing fight against impunity and the task of managing a society heavily prone to
conflict hinge on strengthening the rule of law and the judicial system, two fundamental and
necessary elements for consolidating sustainable peace in Burundi.


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Page 43
6.2.1.3. Manage disputes related to the past and anticipate the future
265. To establish truly pacific cohabitation, prevent new conflicts, and put an end to the cycle of
violence that impedes development and intensifies poverty, the government is firmly committed
to the following actions: (i) illuminate and establish the truth about the bloody events of the past
and determine the facts and responsibilities in order to bring Burundians to the point of
reconciliation; (ii) settle land disputes related to the crisis; (iii) promote equitable access to
resources.

Page 43
(i) Promoting reconciliation
266. As regards the serious violations of human rights committed over the course of forty years of
conflict in Burundi and their impunity, the parties to the peace negotiations recognized their
importance as a cause and aggravating factor of the conflict.

Page 44
270. The multiple crises experienced by the country have forced Burundians to abandon their
property while taking refuge either outside or inside the country. As a result, social conflicts have
arisen here and there in the country as refugees and displaced persons have returned to their
property, often finding it occupied by other persons.

Page 45
276. The mismanagement of power and public affairs over a period of several decades has been a
primary source of conflict.

Page 45
With respect to priority action aimed at averting bloody conflicts in perpetuity and reducing
poverty in real terms, promoting a culture of democracy is the key to success.

Page 66
431. With respect to housing, the destruction in the wake of the conflict has only worsened an
already difficult situation. In rural areas, where more than 90 percent of the population lives, there
is virtually no housing that meets standards of decency.

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6.2.3.2.1. Strengthen social welfare
435. The government’s strategy will be to strengthen existing structures in order to provide better
services to users and establish new structures for improved coverage of populations harmed by
the conflict.

440. The main challenges will be to develop peaceful conflict resolution capacities at the
community level, promote social mechanisms of mutual aid, and develop the habit of community
management of social infrastructure and micro projects with an eye to securing a sustainable
reconciliation.

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a. Support reintegration
445. The reconstruction and rehabilitation of social infrastructure are of critical importance to the
reintegration of those displaced by the conflict.



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Page 69
b. Upgrade the productive capacities of victims
448. The victims of the Burundian conflict face a steady decline in living conditions and extreme
poverty due to the pillaging of their means of production. This situation keeps them in a structural
and perpetual, structurally imposed state of requiring assistance.

Page 69
c. Strengthen the capacity to treat psychological trauma
452. The psychological consequences of the conflict and other traumas show up as after-effects in
the great majority of displaced populations. As a result, the rehabilitation of victims is not only of
a material nature -it also requires coverage for victims in terms of psychological and mental
health care. The government attaches a particular priority to this component of the program to
rehabilitate victims of the conflict. It will be planned in such a way as to ensure national coverage
with professional staffing and substantial resources.

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8.3.8. Partnership with NGOs
572. The national and international NGOs played a very important role in supporting the victims
of conflict, displaced persons, and refugees in the decade of crisis experienced by Burundi. They
are also behind many grassroots projects which have enabled the beneficiaries to combat poverty.

Page 101
ANNEX 1: ACTIONS MATRIX BY AXIS
Axis 1: Improved Governance and Security
1.1. Strengthening of peace, national reconciliation, and security
Measures to be taken
Alignment of national legal provisions with the optional protocol to the convention on children's
rights and the participation of children in armed conflicts
Outcome indicator
Ratification instruments received by the United Nations
Performance indicator
Lack of child participation in the conflict

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1.2 Promotion of the Rule of Law, Combating Impunity, and Justice For All
1.2.2 Strengthened credibility of the legal system
Performance indicator
Reduction in the number of succession-related conflicts associated with gender


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1.3. Reduce the risks of conflict associated with land tenure/sustainable management of land
tenure conflicts
1.3.1 Consideration of the land tenure dimension in conflict management

1.3.3 Strengthening of mechanisms for conflict prevention and resolution
Support for the establishment and operation of the Commission on Land and other property
Performance indicator
Number of conflicts settled




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Page 104
1.4 Promote Good Governance
1.4.1. Political governance
1.4.1.1. Build the capacity of elected institutions
Preparation and implementation of a training program for members of Parliament (on
Parliamentary work, budget questions, human rights, conflict resolution and reconciliation, the
factors behind conflict and poverty, and constituent relations)

Preparation and implementation of a training program for supervisory personnel in the
Parliamentary administration (on legal drafting techniques, on budget questions, and on topics
relating to conflict and poverty)

Training for members of the communal councils, communal administrators and supervisory
personnel in communal administration, and members of the c olline councils (on development
planning techniques, on the preparation, execution, and control of budgets, on conflict prevention
and management, and on human rights)

Training of civil society representatives (especially the bashingantahes ) in conflict prevention
and resolution (2 persons per c olline, or about 6,000 persons)

Training of media professionals on the role of the media (in strengthening the rule of law,
combating corruption, ensuring transparency in the monitoring and control of the management of
public affairs) in the consolidation of a democratic culture and in conflict resolution and
reconciliation

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1.4.2.3 Reduce labor conflicts in public administration
Performance indicator
Reduction in the number of conflicts and strikes in public administration

Page 109
Rural land registry
Reduced number of conflicts

Page 115
Primary education
(ii) Improve access to and quality of learning
Rehabilitation of schools destroyed by the conflict (865 schools)




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HIV/AIDS

Page i
CHAPTER V: SUSTAINABLE DEVELOPMENT AND POVERTY REDUCTION
CONSTRAINTS.................................................................................................................... 20
5.1. Governance, security, and conflict resolution constraints............................................ 21
5.2. Economic growth constraints ....................................................................................... 21
5.2.1. An unstable macroeconomic framework.................................................................. 22
5.2.2. Structural obstacles to economic growth ................................................................. 23
5.3. Undeveloped human capital .........................................................................................27
5.3.1. Educational improvement constraints ......................................................................28
5.3.2. Health sector development constraints..................................................................... 29
5.3.3. Low potable water coverage; hygiene and sanitation problems............................... 30
5.3.4. Growing numbers of disaster victims and vulnerable persons................................. 31
5.4. High prevalence of HIV/AIDS..................................................................................... 31
5.5. Gender and equity constraints ...................................................................................... 32

Page ii
CHAPTER VI: POVERTY REDUCTION AND GROWTH STRATEGY.................... 34
6.2.4. Prevent and Control HIV/AIDS.............................................................................. 69
6.2.4.1. Prevention of HIV transmission........................................................................... 70
6.2.4.2. Medical and psychosocial coverage of people living with HIV/AIDS................ 70
6.2.4.3. Socio-economic coverage ....................................................................................71
6.2.4.4. Institutional capacity building..............................................................................72
6.2.4.5. Management and coordination of the national response to HIV/AIDS ............... 72

Page ix
Executive Summary
c. Content of the PRSP
(i) Main obstacles to poverty reduction and growth
6. The participatory community, sectoral, and thematic consultations carried out at the national
and community levels afforded an opportunity to analyze the characteristics of poverty and
identify the main constraints. They are:
(i) Governance, security, and conflict resolution constraints;
(ii) Structural rigidities impeding economic growth;
(iii) Instability of the macroeconomic framework;
(iv) Poor quality of, and insufficient access to, basic social services;
(v) An increase in vulnerable populations as a result of the conflict’s negative toll;
(vi) High prevalence of HIV/AIDS;
(vii) Gender and equity constraints.

Page ix
(iii) Principal strategic axes
8. From the quantitative and qualitative analyses and the conclusions of the sectoral and thematic
poverty studies, it became clear that there was consensus on four main strategic axes:
(i) Improving governance and security;
(ii) Promoting sustainable and equitable economic growth;
(iii) Developing human capital;
(iv) Combating HIV/AIDS.




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Page x
Axis 4: Combating HIV/AIDS
14. The government’s key objective is to bring about a sharp reduction in the spread of the
pandemic by promoting prevention and treating the sick from families infected and affected by
HIV/AIDS. The actions selected are geared toward prevention, access to medicines, and support
for affected families to meet their basic needs. Acquiring skills for income-generating activities is
an important aspect of the policy advocated for tackling HIV/AIDS.

Page 9
76. HIV/AIDS is one of the main causes of mortality. The pressure on the healthcare
infrastructure has become a severe handicap to proper care of the sick in general, and of AIDS
patients in particular. The number of malaria victims has also risen, and for several years now
malaria has been a veritable national scourge.

Page 11
Chapter IV: Overview of Poverty In Burundi
96. While some progress has been made in just a few years, thanks to tangible progress in the
political arena and in the implementation of economic reforms, the social situation remains
difficult because of: (i) widespread poverty; (ii) the large number of disaster victims; (iii) the
shortfall in basic social services coverage, and (iv) the proportions of the HIV/AIDS problem.

Page 12
105. Combating HIV/AIDS is a relatively secondary priority for people. Only 13 percent of
respondents raised it, which places it in 13th position out of 15. This result denotes a gap between
the emphasis placed on this issue by the authorities and the perception of the public, who would
prefer to see spending redirected. This gap may well be a reflection of the difference between the
people and government authorities in their level of awareness of the scope of the pandemic.

Page 18
128. As regards HIV/AIDS, the AIDS prevalence rate is 9.5 percent in urban areas and 2.5
percent in rural areas. Women and children are the most affected by the virus
(56 percent of affected persons are women). The AIDS epidemic thus appears as a major
socioeconomic and health threat.

Page 19
132. Other indicators, such as the literacy rate and enrollment ratio, are also lower in Burundi
than Africa as a whole, whereas HIV prevalence is higher.

Page 19
Table 4: Social and Poverty Indicators, Burundi and Sub-Saharan Africa, Latest Data
(In percentage terms, unless otherwise indicated, and for the last year of each figure available)
Indicator -      Burundi -        Sub-Saharan Africa
Population (in millions; 2002) 7.3 702.6 Population growth (2003) 2.70 2.1
Per capita GDP (US$; (2004) 83 490 Life expectancy at birth (No. of years; 2002) 47.6 45.8
Infant mortality rate (every 1000, 2002) 127.1 103.1
Juvenile/child mortality rate (every 1000; 1998) 208 173.9
Maternal mortality rate (per 100,000 live births; 800 916.8
HIV/AIDS prevalence (% of sexually active population; 2001) 6 n.d.
Literacy rate (% of population; 2001) 55.4 64.9
Gross primary enrollment ratio (% of age group; 2004) 79.6 87
Population density (inhabitants/km²) 262.0 29.2


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Page 20
136. Internal and external refugees: The different conflicts that have affected
Burundi created an unprecedented humanitarian disaster with a high number of internal and
external refugees. Many of them joined the ranks of the poor during the crisis because their
property was pillaged and destroyed. A great many of them also became physically and
psychologically disabled, malnourished and sick from endemic diseases. According to a study
conducted by UNICEF in 1997, 84 percent of displaced persons displayed symptoms of
conjunctivitis. The HIV rate is high among the internally displaced and they suffer from a high
prevalence of sexual violence.

Page 20
137. Households suffering from HIV/AIDS: HIV/AIDS is a major risk for the Burundian
population, particularly individuals of working age. The consequences are also felt by the
members of families infected and affected by HIV/AIDS. They stem from failure to meet the
basic needs of those affected and failure to meet the cost of treatment and care of the children,
grandchildren, and parents who are victims of AIDS.

138. Widowed heads of household: One of the consequences of the war and HIV/AIDS is the
appearance of a large number of widowed heads of household. For this reason, widows make up
31 percent of heads of household among the internally displaced households. This category is still
vulnerable because of gender-based discriminatory practices such as access to inheritance, land,
credit, and education.

139. Children: Like the above-mentioned vulnerable groups, children make up a significant share
of victims of conflict and AIDS. They are the orphans and street children, abandoned children,
former child soldiers, HIV positive children, and children heads of household. The data appear to
indicate that while 24 percent and 27 percent of nonorphan boys and nonorphan girls,
respectively, work more than four hours per day, these proportions increase to 36 percent and 40
percent for orphan boys and orphan girls, respectively.

Page 21
Chapter V: Sustainable Development and Poverty Reduction Constraints
142. Poverty, as perceived and described during participatory consultations and confirmed by
empirical analyses, is manifested primarily in: (i) problems of governance and insecurity; (ii)
sluggish economic growth; (iii) an unstable macroeconomic framework; (iv) a growing and
widespread lack of access to basic social services; (v) an increase in the categories of
disadvantaged people and heightened vulnerability to poverty spawned by the conflict and
inadequate social safety nets; and (vi) a high prevalence of HIV/AIDS and other endemic
diseases.

Page 31
5.3.4. Growing numbers of disaster victims and vulnerable persons
195. As a result of the conflict, the number of disaster victims and vulnerable persons living in
conditions of utter deprivation increased. These persons owe their survival to national and
international assistance. Malnutrition, unhealthy conditions, and crowded conditions make them
even more vulnerable to all manner of diseases such as cholera, bacillary dysentery, exanthematic
typhus, cerebro-spinal meningitis, malaria, and HIV/AIDS.




                                                                                                    20
196. The protracted nature of the crisis has also led to an increase in the number of indigent
persons, who are resorting to such undesirable activities as alcohol and drug use, crime, begging,
and prostitution. In most cases, these activities are the root cause of the higher incidence of
HIV/AIDS in camps housing refugees and displaced persons.

Page 31
5.4. High prevalence of HIV/AIDS
199. In Burundi, the HIV/AIDS pandemic is exacerbating household poverty. A number of
deficiencies in the health sector are contributing to its spread and to the heightening of related
problems. These include insufficient preventive measures, a poorly functioning system to collect
HIV/AIDS/STI-related information, and a dearth of up-to date statistics on the pandemic at the
national and provincial levels. All these deficiencies are thwarting implementation of a
meaningful strategy to combat this scourge effectively.
200. AIDS was first detected in Burundi in 1983. In the past two decades, this disease has had a
major impact and taken a heavy financial toll in the social, economic, and health spheres. AIDS
has become the leading cause of death among adults and plays a significant role in child mortality
in Burundi. For this reason, it poses a major problem from a public health and developmental
standpoint.

Page 32
201. During the 1980s, the epidemic spread rapidly in urban areas while rural areas remained
relatively unscathed. During the 1990s, the prevalence of the epidemic stabilized somewhat in
urban areas; however, it made major inroads in rural areas.
202. The second national seroprevalence survey, conducted in 2002, pointed to a
seroprevalence rate among persons age 15 and over of 9.4 percent in urban areas,
10.5 percent in semi-urban areas, and 2.5 percent in rural areas. The latter rate more than tripled
between 1990 and 2002 (in the course of a decade).
203. In late 2004, the number of persons living with HIV/AIDS was estimated at 250,000, with
230,000 of this number corresponding to persons between the ages of 15 and 49. In 2001, the
UNAIDS estimated the number of children who had lost at least one parent to AIDS at 237,000.
204. HIV is exerting tremendous pressure on the health facilities of some services, largely the
internal medical, pediatric, and out-patient consultation services. AIDS patients account for more
than 70 percent of hospitalized persons in the internal medicine services of hospitals in
Bujumbura, while tuberculosis, the other major disease in Burundi, afflicts 56 percent of
hospitalized persons who are HIV-positive.
205. The cost of treating opportunistic diseases, the shrinkage of the labor force wrought by these
diseases, and the paucity of facilities to manage the situation and conduct awareness- building
activities are all impediments to economic poverty reduction and growth. HIV/AIDS has become
one of the factors stifling Burundi’s development.
206. Increased seroprevalence is attributable to: (i) the effects of war (population displacement
and regrouping and the increase in the number of widows and widowers); (ii) the rising incidence
of poverty among the population; and (iii) lack of access to means of communication.

Page 36
Table 6: MDG TARGETS AND CURRENT STATUS
7: By 2015, halt and then begin to reverse the current trend of HIV/AIDS transmission.
HIV prevalence rate between 9.5% and 10.5%
Rate rising in rural areas




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Page 40
6.2. Strategic Axes of the PRSP
Axis 1: Improve governance and security
Axis 2: Promote sustainable and equitable economic growth
Axis 3: Develop human capital
Axis 4: Prevent and control HIV/AIDS

244. In a post-conflict country like Burundi, all national reconstruction actions are a priority.
Aware of this situation and of the stark necessity of setting in place the conditions and resources
needed for an economic takeoff likely to reduce poverty, the government has selected the
following programs as priorities:
-Good governance
-Economic recovery
-Social development
-HIV/AIDS prevention and control

Page 63
6.2.3 Develop human capital
408. As with the economic growth sector, Burundi also faces a human capital development crisis
that spares no segment of society. The government’s social objective is to restore prewar
performance levels in the medium term and achieve the Millennium Development Goals (MDGs)
by 2015.
409. To meet this challenge, the government is committed to progressive budget increases in pro-
poor spending, principally in the areas of education, health, social welfare, and HIV/AIDS.

Page 69
6.2.4. Prevent and Control HIV/AIDS
455. The government is determined to provide a national response to the HIV/AIDS pandemic in
order to achieve two major objectives: (i) stem the spread of HIV; (ii) reduce its impact on
individuals, families, and communities. The goal is to prevent any expansion of HIV/AIDS and
provide social support and appropriate care to those already infected or affected by the pandemic.

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6.2.4.1. Prevention of HIV transmission
456. This is the fundamental basis of action in the fight against HIV/AIDS. Today, greater access
to anti-retroviral treatment is raising the hopes of thousands of people living with HIV/AIDS in
Burundi. It is essential that this improvement be accompanied by an expansion of prevention
programs, because if the incidence of HIV is not reduced, then access to treatment will become
more and more difficult.
457. The HIV prevention strategy will emphasize local awareness-raising activities, along with
other activities focusing on education for girls and gender equality, human rights, interventions
aimed at breaking the vicious circle of poverty, malnutrition, and HIV and opportunistic
infections, and will seek greater involvement of youth and of people living with HIV in the effort
to prevent the disease. These activities will follow the guidelines set forth in the national strategy
on communication for behavioral change, developed and validated in 2004.
458. The government will support implementation of the new national policy on condom use,
aimed at fine-tuning condom acquisition, storage, and distribution channels in order to make
condoms available throughout the country.
459. To step up voluntary screening of high-risk groups, the plan is to outfit at least




                                                                                                    22
300 voluntary HIV testing centers nationwide, with the dual objective of opening one voluntary
testing center for every 65,000 persons and establishing a certification system based on the results
of the testing center supervision activities.
460. Early diagnosis and treatment of sexually transmitted infections will be strengthened at
health care facilities.
461. Efforts to prevent the blood-borne transmission of HIV will be strengthened by providing
training to care providers, traditional healers, and traditional midwives and by making available
to health care facilities the resources needed for emergency prevention and treatment in the event
of rape or exposure to blood.
462. Implementation of the program to prevent mother-to-child transmission (MTCT) of HIV has
made significant progress which should be continued and consolidated. Burundi proposes to
accelerate the program by creating new treatment sites and incorporating MTCT prevention in
prenatal consultation services, while also ensuring adequate geographic coverage.

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6.2.4.2. Medical and psychosocial coverage of people living with HIV/AIDS
463. The government’s strategy is to pursue psychosocial treatment, by creating centers for
listening to concerns and dispensing advice, and to extend coverage to 25,000 people living with
HIV. Treatment will be provided for opportunistic infections, and drugs will be made available
for treating some 25,000 people living with HIV. Home care activities will also be strengthened
with the support of health care mediators.

Page 71
464. The opportunity provided by the availability of financial resources has resulted in adoption
of a more robust policy concerning access to health care for people living with HIV. This area
will remain the absolute priority in the coming years.
465. With respect to access to health care for people living with HIV, Burundi, in line with
WHO’s 3 by 5 Initiative, proposes to offer anti-retroviral treatment to all people living with HIV
within the next three years. To that end, emphasis will be placed on continued decentralization
and the creation of new treatment sites.
466. Intervention capacities in terms of human resources will be upgraded through training for
doctors and nurses, specifically by developing a training program that leads to a qualification for
comprehensive coverage as part of their respective courses of study.
467. Building the capacities of the human resources involved in implementing programs to
promote access to health care for people living with HIV will also entail pre-service and in-
service training for relevant actors. The training modules and the various monitoring and
evaluation tools will be standardized and widely distributed. The development of new treatment
sites to accelerate decentralization of access to health care is also planned.
468. Mechanisms will be set up for certifying facilities that are able to provide proper intake of
patients undergoing anti-retroviral treatment.
469. Special attention will be given to monitoring HIV resistance to anti-retroviral treatment.
Improved access to anti-retroviral treatment will be part of an overall plan of attack that also
includes psychosocial coverage starting from the moment of voluntary HIV screening, early and
proper treatment of opportunistic infections, and anti-retroviral treatment as soon as it is needed.

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6.2.4.3. Socio-economic coverage
470. The government’s priority in this area is to provide stronger protections for people living
with HIV by disseminating the law that protects people living with HIV, monitoring its
implementation, and taking steps to make the national watchdog agency for the rights of people
living with HIV fully operational.


                                                                                                  23
471. The government is also committed to supporting and assisting orphans and other vulnerable
children, with the objective of providing adequate coverage to 900,000 orphans and other
vulnerable children. At the present time, according to an identification survey performed by the
Permanent Executive Secretariat of the National AIDS Council (SEP/CNLS), orphans and other
vulnerable children under the age of 18 account for about 10 percent of the Burundian population.
In 2002, there were already 230,000 AIDS orphans, out of a total of 620,000 orphans and other
vulnerable children, according to UNAIDS estimates.
6.2.4.4. Institutional capacity building
472. The government will set in place appropriate mechanisms to mobilize resources and upgrade
skills in order to ensure that the resources arrive at the point where they are needed to support the
activities.
473. In addition, training will be provided to the relevant actors and equipment will be made
available to them so that they can be fully operational.

Page 72
6.2.4.5. Management and coordination of the national response to HIV/AIDS
474. In addition to the consultation and coordination frameworks already established by the
National Aids Council through its facilities, a priority will be placed on leadership development
at the municipal level as a way to improve national coordination. A review of the 2002-2006
Action Plan and the planning for 2007-2011 will be organized. Studies and research aimed at
improving the quality of overall coverage of program beneficiaries will also be carried out in
order to refine the basic guidelines for developing the 2007-2011 Action Plan. As part of the
evaluation of the 2002-2006 Action Plan, combined monitoring of seropositivity and behavior is
planned at the national level.

Page 75
487. Thus, for example, rather than increasing the government’s future commitments, the
generalized availability of health care, the maintenance of infrastructure, the fight against AIDS,
and demobilization costs will have a broadly positive impact on future reductions in state
obligations.

Page 84
Table 12: PRSP Costs and Financing
PROGRAM FINANCING - INCREASE PROPOSED BY PRSP - TOTAL
STRATEGIC AXES - 2006 2007 2008 2009 TOTAL - 2006 2007 2008 2009 TOTAL -2006
2007 2008 2009 TOTAL
4. FIGHT AGAINST HIV/AIDS 16.3 0.0 0.0 0.0 16.3 4.3 18.6 21.1 10.9 54.9 20.6 18.6 21.1
10.9 71.2
4.1. Prevention of HIV transmission 2.1 8.4 8.8 6.8 26.1 2.1 8.4 8.8 6.8 26.1
4.2. Assumption of care for patients infected by HIV 16.3 16.3 1.8 8.4 9.7 3.1 23.1 18.1 8.4 9.7
3.1 39.4
4.3. Reduction of impact on persons affected by HIV 0.3 1.6 2.0 0.8 4.7 0.3 1.6 2.0 0.8 4.7
4.4. Institutional capacity building 0.0 0.2 0.6 0.3 1.1 0.0 0.2 0.6 0.3 1.1




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Page 85
Table 13: PRSP Costs and Financing (in percent of annual expenditure)
PROGRAM FINANCING - INCREASE PROPOSED FOR PRSP - TOTAL
STRATEGIC AXES 2006 2007 2008 2009 TOTAL 2006 2007 2008 2009 TOTAL 2006
2007 2008 2009 TOTAL
4. FIGHT AGAINST HIV/AIDS 7.4 0.0 0.0 0.0 2.4 16.6 14.0 9.6 7.1 10.3 8.4 6.8 5.7 3.4
5.9
4.1. Prevention of HIV transmission 8.0 6.3 4.0 4.4 4.9 0.8 3.1 2.4 2.1 2.2
4.2. Assumption of care for patients infected by HIV 7.4 0.0 0.0 0.0 2.4 7.2 6.3 4.4 2.0 4.3 7.4
3.1 2.6 1.0 3.3
4.3. Reduction of impact on persons affected by HIV 1.3 1.2 0.9 0.5 0.9 0.1 0.6 0.5 0.2 0.4
4.4. Institutional capacity building 0.1 0.2 0.2 0.2 0.0 0.1 0.1 0.1 0.1

Page 85
534. It would appear that the priority actions identified during the participatory consultations have
made it possible to emphasize the sectors involving human capital, such as health and education,
water, etc., as well as the fight against AIDS (40.3 percent).

Page 90
555. The CTS (Technical Oversight Committee) prepares discussions on PRSP monitoring
around topics consistent with the four axes of the strategy:
• Topic 1. Security and Good Governance (axis 1)
• Topic 2. Growth and Macroeconomic Management (axis 2)
• Topic 3. The Social Sector: Education, Health, Vulnerable Groups (axis 3)
• Topic 4. HIV/AIDS (axis 4)

Page 120
ANNEX 1: ACTIONS MATRIX BY AXIS
AXIS 4: FIGHT AGAINST HIV/AIDS

4.1 Prevention of HIV transmission
Measures to be taken
- Condom availability
- Increase in number of voluntary screening centers for HIV and sexually transmitted infections
(STIs) within health structures
- Strengthened information, education, and communication activities to change behaviors,
especially among at-risk groups (youths, disaster victims, women of childbearing age, prisoners,
men in uniform, women with multiple partners, unaccompanied travelers)
- Strengthening of activities to prevent and combat HIV/AIDS in health structures
Outcome indicator
- Condom distributed or sold
- CDVs created
- Persons reached
- Health structures benefiting from support with capacity building (training, equipment)
Performance indicator
Prevalence of HIV/AIDS/STIs in at-risk groups
Persons screened
Percentage of persons in at-risk groups having ceased at-risk sexual behavior
Health structures with improved security practices for transfusions and injections/ total number of
health structures.



                                                                                                  25
4.2 Care for patients infected with HIV
Measures to be taken
- Availability of medicines to combat opportunistic diseases, antiretroviral (ARVs) and biological
monitoring of persons living with HIV.
- Training of health personnel in evidence-based practice (EBP)
- Training of healthcare providers in psychosocial care
- Extension of the Mother-Child HIV Transmission Prevention Program incorporating pediatric
EBP.
Outcome indicator
- PLHAs treated for opportunistic infections
- PLHAs receiving ARVs
- Number of persons trained
- Persons trained
- New mother-child transmission prevention sites created.
Performance indicator
% of PLHA 24 months after initial ARV treatment
Improved care
Persons trained and structures equipped
% of beneficiaries by comparison with total number of seropositive women

Page 121
4.3 Reduction of impact on persons affected by HIV
Measures to be taken
- Promotion of rights and protection of persons living with HIV/AIDS and other - vulnerable
groups
- Support for the care of orphans and vulnerable children (OVCs) and other vulnerable groups
(education, trade schooling, socioeconomic support, medical and psychological care, legal
assistance, and protection of rights of OVCs)
- Support for income-generating activities initiated by persons infected and/or affected by
HIV/AIDS and by OVCs (access to microcredit)
Outcome indicator
- Protection structures working to promote the rights of PLHAs and other vulnerable groups.
- Community support structures for OVCs established
- Microprojects financed
Performance indicator
- PLHAs and other vulnerable persons having received assistance with human rights
- Enrollment ratio of OVCs
- % of OVCs with trade schooling
- OVCs benefiting from medical and psychological care and economic and legal assistance
- Beneficiaries engaged in income-producing activities

4.4. Strengthening of institutional capacities
Measures to be taken
- Strengthened capacities of government structures and stakeholders in the fight against AIDS
Outcome indicator
- Persons trained and structures equipped
Performance indicator
- Effectiveness of interventions




                                                                                                26
                                                                 2. CHAD




                                                                                                                                                           9. Mobile population
                                                                                                                                      8. Food insecurity
                                     1. Humanitarian




                                                                                                          6. Emergency
                                                                                           5. Displaced
                                                                     3. Refugee
                                                       2. Disaster




                                                                                                                         7.Conflict




                                                                                                                                                                                             11. AIDS
                                                                                                                                                                                  10. HIV
                                                                                  4. IDP
                         Date
Country     Document     issued
 Chad         PRSP       June 03          0               3             0           0          1              2          10                 1                    0                18         23


DISASTER

Page 71
4.2.4.3 Social Protection
With respect to foreseeing risks, where informal mechanisms are more numerous and more
effective, the role of the public sector should consist of:
a) supporting existing and efficient informal mechanisms, such as mutual insurance of risks and
response mechanisms developed by communities to deal with disasters or chronic dangers;
b) adjusting social security and the retirement pensions system.

With respect to remedies, the aim is to:
a) mitigate the pernicious effects of informal mechanisms for responding to crises by
discouraging the worst forms of child labor;
b) guarantee government assistance in the event of a major disaster, and to do so by rethinking: (i)
the assignment of tasks among the different government departments; (ii) budgetary procedures
for allocating emergency funds in the event of a disaster; (iii) the criteria governing eligibility for
government aid and their enforcement; and (iv) the ways in which social assistance is provided.


DISPLACED

Page 58
4.2.1.2 Role of the state, the private sector, and civil society
Particularly in the case of the oil project, it will be necessary to develop legal, institutional, and
individual skills to manage the environmental impact of oil exploration and extraction activities.
There are several dimensions to the state’s responsibilities in developing mineral resources:

            monitoring and controlling the negative impact of mining exploration and production
             on the environment and on the population;
            monitoring and supervising the health and safety of persons exposed to the direct and
             indirect effects of mining projects;
            putting in place programs for relocating people displaced by mining exploration or
             extraction activities;
            maintaining, as far as possible, access to hunting, farming, and forestry areas;
            protecting the environment.




                                                                                                                                                                                            27
EMERGENCY

Page 26
2.1.2.2 Lessons drawn from participatory consultations
Kamen-Lac
The interviews with the people of this region show that poverty is perceived in terms of the lack
or shortage of resources to meet vital needs for food, housing, clothing, and health care, and
especially to ensure the safety of one’s property and person. People described the following
factors as causes of poverty in their region:
            ……and the lack of adequate birth centers and laboratories for medical analyses, the
             lack of ambulances for emergency evacuation of the sick, the shortage of competent
             medical personnel, and the lack of activities to heighten awareness regarding
             personal and environmental hygiene.

Page 71.
4.2.4.4 Social Protection
With respect to remedies, the aim is to:
a) mitigate the pernicious effects of informal mechanisms for responding to crises by
discouraging the worst forms of child labor;
b) guarantee government assistance in the event of a major disaster, and to do so by rethinking:
(i) the assignment of tasks among the different government departments; (ii)budgetary procedures
for allocating emergency funds in the event of a disaster; (iii) the criteria governing eligibility for
government aid and their enforcement; and (iv) the ways in which social assistance is provided.


CONFLICT

Page 19
Chapter 2 Diagnostic assessment of poverty in Chad
At the same time, mention must be made of the adverse impact of the climate of insecurity and
impunity that has been fed for too long by the excessive frequency and scope of armed conflicts
in Chad. Undoubtedly, a conflict-ridden environment encourages hoarding in safe havens as
much as, if not more than, a peacetime culture encourages investment in productive activities.
That is why the PRSP covers not only production and living conditions, but also the institutional
environment in general.

Page 25
2.1.2.2 Lessons drawn from participatory consultations
Mayo-Kebbi/Tandjile
The second special issue is that of governance, especially as relates to the conflict between
farmers and stockbreeders. People want to have their say in political decisions; they see
themselves as constantly being victims of conflicts (farmers vs. stockbreeders) or of
discrimination by the political, administrative, and military authorities. Accordingly, they define
poverty in terms of a lack of freedom of action, security, and equity.




                                                                                                    28
Page 27
2.1.2.2 Lessons drawn from participatory consultations
Ouaddai-Biltine
…..The population also points out that "the lawlessness of bandit camel-drivers has struck fear
into the heart of the population living in the rural area of OuaddaY-Biltine. Besieged in their
communities by cruel roadblock bandits and living like prisoners, the inhabitants cannot venture
into the bush, even to collect gum arabic".

They also named the following as causes of poverty:
           war and the conflicts between farmers and stockbreeders;
           ….

Moyen-Chari and the two Logones
Poverty is perceived in this area as an inability to meet the basic needs of people for food,
health care and education for their children. The principal determinants of poverty identified by
the people are:
             ……
             injustice as a result of poor management of the numerous conflicts between farmers
              and stockbreeders;
             ……
Page 37
3. Determinants of poverty
3.1 Governance
…. Biased management of the farmer- stockbreeder conflict by local governments and political
authorities is a case in point. According to grass roots groups, the lack of tools provided for the
national mediator actually casts doubt on the authorities’ real intentions with regard to settlement
of conflicts.

Page 38
After several decades of armed conflict, the defense and security forces are disorganized and
constitute, rather, a threat to the security of persons and property. Discriminatory treatment of
these forces has led to a lack of discipline within the different units made up of both trained and
untrained soldiers. The difficulties of reintegrating demobilized military personnel and the
irregularity with which pensions are paid are a source of insecurity in the country.

Page 56
4.2.1.1 Consolidation of the rule of law
Concerning human rights, new initiatives are needed with respect to the status of women,
protection of children, national mediation and settlement of conflicts, security for people and
property, and the public and private media.


FOOD INSECURITY

Page 13
1.1.2 The National Context
A large portion of the population suffers from chronic food insecurity




                                                                                                  29
HIV and AIDS

N.B. HIV/AIDS is covered mainly in the following chapters:
Chapter 3
3.1 Determinants of poverty and Opportunities in Chad
3.1.3 Highly deficient human resources and living conditions
3.1.3.3 HIV/AIDS

Chapter 4
4.2.3 Improving Human Capital
4.2.3.3 HIV/AIDS

Page 13
The national context
Chad’s socio-economic indicators rank among the worst for countries in Sub-Saharan Africa.
When the process of preparing the PRSP began, 54 percent of the population lived below the
poverty line. Epidemics and endemic diseases are still rampant (including HIV/AIDS, to which
1704 [Tr. SIC] people would succumb in 2000, taking the total number of orphans to 55,000) and
child vaccination coverage ranges from 16 to 20 percent. A large portion of the population suffers
from chronic food insecurity.

Page 28
Certain socio-economic groups are at high risk. These are above all women and children
needing special protection, the disabled, demobilized military personnel, senior citizens, and
persons living with HIV.

Page 36
f) Victims of HIV/AIDS

The challenges to Chad’s health services, which were already difficult to tackle in the short term,
have been compounded by the worryingly rapid spread of HIV/AIDS. Indeed, the number of
confirmed cases of AIDS has risen from 10 in 1989 to 1,010 in 1993, to 1,343 in 1996, and to
over 12,000 cases in 2000. The percentage of people testing positive for HIV/AIDS in rural and
urban areas ranges between 4 and 10 percent. The speed with which this disease spreads and the
social and economic havoc it wreaks make it a development, as well as health, problem.
According to World Bank report No.16567-CD (1997), approximately 8,000 pregnant women per
year test positive for HIV, and 30 to 40 percent of them transmit the disease to their child.

This pandemic directly impairs economic growth because it mainly affects the economically
active population: 56 percent of detected cases are in the 15-49 year old population, in which
women of child-bearing age account for 31 percent and men in the same age group 32 percent.

According to the Population and Fight against AIDS Program (Programme Population et
Lutte contre le SIDA), the incidence of HIV/AIDS is approximately 4 percent. In some regions,
the figure is 6 percent, or even 10 percent. There are approximately 55,000 AIDS orphans (up
from 38,000 in 1997. However, the statistics are dubious, inasmuch as surveillance of the disease
is deficient due to the shortage of equipment, reagents, and qualified staff.




                                                                                                 30
AIDS leads to marginalization. Its victims become a burden on their families and those who die
of it leave children that society has to take care of. Actions so far taken by the government, with
assistance from external partners, aim to contain the spread of HIV/AIDS; community-based and
public care for AIDS victims and orphans is still rudimentary. The speed with which this disease
spreads and the social and economic havoc it wreaks make it a development, as well as health,
problem.

Page 44
3.1.3.3 HIV/AIDS
The real constraint with respect to HIV/AIDS is the lack of awareness campaigns/prevention and
hence of protection. Over 72 percent of the population continues to believe that they run no risk
of contracting the disease, so that only few people use condoms. Only three percent of women
and 13 percent of men say they have used them. Illiteracy, poverty, and certain beliefs are among
the principal factors helping to spread this disease.

Page 58
4.2.1.2 Role of the state, the private sector and civil society
Role of the state
There are several dimensions to the state’s responsibilities in developing mineral resources. …..
To meet these responsibilities, it will be necessary to:
….
(v)Monitor migration flows attracted by the revenue generated by the Doba (oil) project and put
in place a rapid response plan based on any need to expand social and economic infrastructure
(schools and health posts, centers to combat HIV/AIDS, sanitation and water supply systems,
procurement facilities, electricity) and to protect the environment of the area, which is already
subject to intense demographic pressure; ….

Page 67
4.2.3 Improving human capital
This strategy directly addresses the two priority sectors of health and education and training as
national objectives. It also covers national goals with respect to combating HIV/AIDS.

Page 69
4.2.3.3 HIV/AIDS
With regard to HIV/AIDS, actions to be taken will, in particular, address awareness campaigns
for high-risk groups but also children from primary school onwards. Arrangements will be made
for pregnant women to be systematically screened and for victims of HIV to be treated. In fact, in
addition to awareness campaigns, the government undertakes to take steps to care for patients and
victims of HIV/AIDS, including the provision of antiretroviral drugs.

Page 90
6.2 Monitoring
National statistical system
Particular emphasis should be placed on information on regional inequalities and cross-cutting
problems (AIDS, war, environment, etc.).




                                                                                                    31
Page 101
Annex 1
III Develop Human Capital
Focus: Fight Against HIV/AIDS
Action: Continue to broaden programs for early detection, prevention (particularly among those
aged 15 to 49, pregnant women, or seropositive women) and treatment.
Monitoring indicators:
- Rate of introduction of AIDS units in health facilities
- Annual number of condoms distributed, and
- Annual number of outreach campaigns

Page 117
Annex 3
Quantitative Poverty Reduction Objectives
Indicator: HIV/AIDS prevalence rate.
Frequency: Annual
Levels reached: 2001: 5-12%
Objective for 2006: 3-10%

Indicator: Number of children orphaned by AIDS
Frequency: Annual
Levels reached: 2002: 55,000
Objective for 2006: 44,000




                                                                                             32
                    3. DEMOCRATIC REPUBLIC OF THE CONGO




                                                                                                                                                             9. Mobile population
                                                                                                                                        8. Food insecurity
                                       1. Humanitarian




                                                                                                            6. Emergency
                                                                                             5. Displaced
                                                                       3. Refugee
                                                         2. Disaster




                                                                                                                           7.Conflict




                                                                                                                                                                                               11. AIDS
                                                                                                                                                                                    10. HIV
                                                                                    4. IDP
                           Date
Country       Document     issued
Democratic
 Republic      I-PRSP      Mar 02          4             18              3           0          8              3           55                0                    0                 25         21
 of Congo


HUMANITARIAN

Page 32
Pillar 1: Peace and good governance
Axis 2: Address the needs of the victims of the fighting
100. The ensuing humanitarian disasters have plunged much of the population into dire poverty
and destitution, requiring urgent remedies. The government has responded by taking two types of
demobilization and reintegration measures (Decree Law N° 0066 of June 9, 2000). To address
this poverty exacerbated by conflicts and the war of aggression, the government plans to launch a
post-conflict reconstruction and economic recovery program, as an essential accompaniment to
the peace process.

Page 45
4.4.8 Axis 8. Look after the victims of natural disasters
143. The following steps will be taken specifically to deal with erosion and landslides in urban
areas:
• Involvement of grassroots communities in an effort to combat erosion;
• Development of new settlements for poor persons threatened by erosion, land slides, and
flooding;
• Regular distribution of humanitarian aid to the victims of natural disasters;….

Page 74
Table AII.10. Indicators related to interventions by development partners in the DRC (US$
millions and percentages)
Management % Education % Health % Social % Humanitarian % Total %

Page 77
Annex III – Matrix of strategic actions
III.1 Introduction
... It is estimated that about 3.5 million Congolese have been killed in the conflicts, which has led
to mass displacement of the population and the most worrying humanitarian crisis of the
beginning of the new century.




                                                                                                                                                                                              33
DISASTER

Page 2
Table of contents
Chapter IV: Strategies and priority actions of the I-PRSP
4.4.8. Axis 8. Look after the victims of natural disasters ................................45

Page 6
7. Since the first quarter of 2001, the government has been firmly committed to restoring peace
and rebuilding a modern State, correcting macroeconomic imbalances, and relaunching growth,
while addressing the urgent needs generated by conflicts and natural disasters.

Page 28
4.1.2. The 2002-05 Period
92. This period bridges the gap between stabilization and the relaunching of pro-poor and
sustainable growth that benefits the poor. The intermediate objectives correspond with the
implementation of certain priority actions of the I-PRSP. These actions aim at mitigating the
effects of the crisis and the war on the standard of living of the poorer segments of the population
(especially vulnerable groups: children, women, victims of disasters, the unemployed- and under-
employed, the homeless, etc.) and of the victims of war.

Page 32
100. The ensuing humanitarian disasters have plunged much of the population into dire poverty
and destitution, requiring urgent remedies.

Page 32
101. The demobilization component comprises the following steps:
• Disarming the demobilized combatants;
• Storing and destruction of arms;
• Organizing focus group sessions, and individual interviews to offer guidance to vulnerable
people: demobilized soldiers, the aged, widows, and orphans;
• Purchasing clothes for the victims of disasters; and
• Relocating demobilized combatants, displaced persons, and refugees by transporting and
reintegrating them in settlements with social protection.

Page 45
4.4.8. Axis 8. Look after the victims of natural disasters
143. The following steps will be taken specifically to deal with erosion and landslides in urban
areas:
• Involvement of grassroots communities in an effort to combat erosion;
• Development of new settlements for poor persons threatened by erosion, land slides, and
flooding;
• Regular distribution of humanitarian aid to the victims of natural disasters;
• Rehabilitation of infrastructure, environmental sanitation, and water disposal; and
• Implementation of a national disaster prevention policy.

Page 51
4.5.4.5. Living environment
158. The widespread economic crisis in Congo, which has lasted over two decades, has taken a
heavy toll on the standard of living of the population. Grassroots communities have developed
survival mechanisms in all essential aspects of life, from safe water supplies to protection against
erosion and natural disasters.


                                                                                                   34
Page 77
III.2. The significance of the I-PRSP
The DRC is a disaster area. It suffers massive, abject poverty, at the limit of what human dignity
can bear. On more than one opportunity, the government has clearly stated its resolve to emerge
from the disaster. Without doubt, the way out of the disaster must pass through three fundamental
and decisive stages, namely: the restoration of peace throughout the territory and the reunification
of the national territory; the reconstruction of a modern State, which respects human rights and
freedom; and, finally, the initiation of a process of economic stabilization and recovery.

Page 78
The role the PRSP can play is to accompany the DRC as it emerges from disaster, serving as a
guide in respect of actions to stabilize the economy and reconstruct the conditions for a return to
growth. Pending preparation of the full PRSP (FPRSP), the I-PRSP proposes an approach with
three pillars, namely:
1) Restoration and consolidation of peace;
2) Macroeconomic stabilization and a return to growth targeting the poor; and
3) Community Dynamics

Page 90
Annex III
Axis 6. Rehabilitate Services, Infrastructure, and Living Conditions of the Poor
Without robust growth, it will be impossible to reduce the wide spread poverty in Congo. The
extent of the disaster is such that a considerable effort will be required and the road to recovery
will be very long.
Component - The situation of victims of natural disasters
Key Problems - The living conditions and standard of living of the victims of disasters are
particularly precarious
Priority Actions - Rehabilitate and reintegrate the victims of natural disasters
Progress Indicators - Victims of disasters are reintegrated and rehabilitated both psychologically
and socially


REFUGEE

Page 14
2.3.7. Environment
42. With their basic needs for food, energy, and other resources increasingly unmet, the
Congolese are putting their natural ecosystems under ever more intense and devastating pressure.
The situation is particularly dire in the eastern part of the country where the influx of 2 million
refugees from Rwanda and Burundi in 1994, in the wake of the crisis in those two countries, led
to deforestation and the destruction of fauna in the wildlife parks.

Page 32
101. (….) The demobilization component comprises the following steps:
• Disarming the demobilized combatants;
• Storing and destruction of arms;
• Organizing focus group sessions, and individual interviews to offer guidance to vulnerable
people: demobilized soldiers, the aged, widows, and orphans;
• Purchasing clothes for the victims of disasters; and
• Relocating demobilized combatants, displaced persons, and refugees by transporting and
reintegrating them in settlements with social protection.


                                                                                                  35
Page 81
ANNEX III. Matrix of Strategic Actions
Axes 2-3. Care for the victims of conflicts, guarantee stability on the borders, and promote good
neighborly relations
Priority actions: 2. - Reuniting of families and relocation of displaced communities and refugees


DISPLACED

Page 4
Chapter I: Context and Importance of the PRSP
1.1. Introduction
….At least 60 percent of the population inhabit rural areas and survive on traditional farming,
hunting, and fishing. Excluding large towns and regions where people displaced by the fighting
have congregated, the average population density is only 22 inhabitants per square kilometer,
making the DRC one of the most sparsely populated countries of the continent.

6. The economic, social, political, and environmental cost of this conflict has been huge. More
than three million human lives have been lost. Almost four million people are estimated to have
been displaced in the sub-region and some 10,000 to 15,000 children are being used as soldiers.

Page 5
Box 1.1. The Democratic Republic of the Congo: facts and indicators
7. Victims of conflicts
7.1. Displaced persons (millions) 3.0-4.0

Page 17
2.7. Conflict and poverty: the destitution of the victims
54. In the eastern part of the country, war has aggravated the poverty of both the displaced
population and the local host communities.

Page 30
Box 4.2. Some poverty reduction programs currently under way in the DRC (OLD)
1. Peace and governance
1.1 Reintegration of persons displaced by war

Page 31
4.3. Pillar I: Peace and good governance
98. To achieve lasting peace, the government has already committed itself to undertaking specific
steps between 2002 and 2005. These consist of:
(i) Organizing reconciliation days between warring communities and the signing of a National
Reconciliation Pact;
(ii) Reuniting families, above all by bringing back children and other people displaced by the
fighting;
…..




                                                                                                36
Page 32
101. …. The demobilization component comprises the following steps:
• Disarming the demobilized combatants;
• Storing and destruction of arms;
• Organizing focus group sessions, and individual interviews to offer guidance to vulnerable
people: demobilized soldiers, the aged, widows, and orphans;
• Purchasing clothes for the victims of disasters; and
• Relocating demobilized combatants, displaced persons, and refugees by transporting and
reintegrating them in settlements with social protection.

Page 81
Annex III. Matrix of Strategic Actions
Axes 2-3. Care for the victims of conflicts, guarantee stability on the borders, and promote good
neighborly relations
Component: 2. Care for the victims of ethnic and regional conflicts in the country.
Priority actions: - Demobilization and disarmament of combatants and child soldiers
- Recovery and destruction of weapons
- Preparation of a post-conflict program for the supervision and psychological and socioeconomic
and medical rehabilitation of the victims, education, health, housing
- Reuniting of families and relocation of displaced communities and refugees


EMERGENCY

Page 7
Box 1.2. Some of the economic reform measures adopted with the support of the international
community
18. Creation of a Consultative Group to coordinate the effort to raise the US$1.5 billion needed to
finance the government’s emergency program (World Bank and IMF);

Page 28
4.2 Some government programs
94. The government is committed to undertake, with the support of the international community,
a number of actions in each of the fields covered by the three pillars of this document, which will
be reinforced in the full PRSP. In the field, these actions are carried out either by government
bodies (ministerial departments), or by NGOs, or by staff of bilateral or multilateral cooperation
partners (Box. 4.2.). They are supplemented by activities under the Enhanced Interim Program
(EIP), monitored by the IMF, and the Emergency Multisector Rehabilitation and Reconstruction
Project agreed upon with World Bank staff.

Page 81
Axes 2-3. Care for the victims of conflicts, guarantee stability on the borders, and promote good
neighborly relations:
There is a basically reciprocal relation between conflicts and poverty. Poverty generates conflicts,
which, in turn, exacerbate the destitution of the victims of those conflicts: loss of human life,
mass displacements of the population, material destruction, deterioration of infrastructure, and
disruption of socio-economic circuits. This situation has plunged a sizeable percentage of the
population into poverty and destitution so severe that emergency measures are needed.




                                                                                                 37
CONFLICT

Page 1
Table of contents
Chapter II: Profile and determinants of poverty in the DRC
2.7. Conflict and poverty: the destitution of the victims..............................................17

Page 4
Chapter I: Context and Importance of the PRSP
6. The economic, social, political, and environmental cost of this conflict has been huge. More
than three million human lives have been lost. Almost four million people are estimated to have
been displaced in the sub-region and some 10,000 to 15,000 children are being used as soldiers.
The extent and complexity of the conflict have seriously undermined institutional stability and
eroded grassroots socio-economic infrastructure. It jeopardizes the territorial integrity of the DRC
and could spread violence and disruption throughout the Great Lakes sub-region.

Page 5
Box 1.1. The Democratic Republic of the Congo: facts and indicators
7. Victims of conflicts
7.1. Displaced persons (millions) 3.0-4.0
7.2. Number of people killed (millions) 1.5-3.0
7.3 Child soldiers (thousands) 10.0-15.0

Page 5
1.2. Rebuilding the DRC: window of opportunities and actions under way
7. Since the first quarter of 2001, the government has been firmly committed to restoring peace
and rebuilding a modern State, correcting macroeconomic imbalances, and relaunching growth,
while addressing the urgent needs generated by conflicts and natural disasters.

Page 6
8. On a subregional scale, the Multi-country Program for the Demobilization and Reintegration of
former combatants (MDRP) is an attempt to exploit the synergies generated by the disarmament
and reintegration programs of all the countries in the conflict.

Page 13
2.3.4 Employment
37. Unemployment has increased steeply as a result of the State’s inability to manage public
enterprises, and absence of a policy of joint-ventures and incentives to invest. In 2000, 2 percent
of the total population, 4 percent of the labor force, and 8 percent of the male work force were
employed, compared with 8, 18, and 35 percent, respectively, in 1958. The social and political
crisis of the 1990s and the conflicts have only exacerbated this downward spiral to a point at
which unemployment and the lack of vocational training have become one of the root causes of
grave social unrest. The result is a worsening of poverty, increased vulnerability of the
population, and the proliferation of urban unemployment.

Page 16
2.5 HIV/AIDS and other endemic diseases
48. Tuberculosis is the principal killer disease for adults, implying that it also impoverishes both
families and the country. The HIV/AIDS pandemic and the conflicts increase the incidence of the
disease.



                                                                                                            38
Page 17
2.7. Conflict and poverty: the destitution of the victims (sub-title)

57. Five mortality surveys conducted by the International Rescue Committee (IRC) in the eastern
part of the country discovered that the death rates were markedly higher than the reference rate
(1.5/1000/month). The average death rate (5.2/1000/month) is 246 percent higher than the
average prior to the conflict. In other words, an additional 1.6-1.8 million deaths are attributable
to war, either directly (murder, rape) or indirectly (from associated diseases, such as meningitis,
cholera, dysentery, measles, polio, and malnutrition).

Page 18
58. Young children have been particularly hard hit by the fighting. The mortality rate for children
under 1 year of age in the five locations surveyed is 23.2 percent. The highest rates were recorded
at Moba in Katanga (47 percent), Kisangani in Orientale province (23 percent), and Kalonge in
Kivu (21 percent). A little over 11 children per 1,000 of under 5 years of age die every month in
the areas of conflict (24.5 per thousand per month at Moba, 14.1 per thousand per month at
Kalonge, and 6.9 per thousand per month at Katana. See Box 2.2).

59. As a result of the conflict, the number of women unable to give birth with proper medical care
has increased steeply, and many have died in their homes. Maternal mortality rates range from
905/100,000 in Ituri (1999) to 3,000/100,000 in Kivu (2001).
The most frequently cited causes are, above all: hemorrhage and inability to afford transportation
and hospitalization. The high medical costs frequently force people to resort to self-medication
and traditional medicine.

Page 29
Box 4.1. Temporary time frame for the strategic axis to reduce poverty in the DRC
Pillar 1: Peace and governance
Axis 1.2 Victims of conflicts

Page 31
4.3 Pillar 1: Peace and good governance
96. The peace and good governance pillar comprises four priority axes, namely:
(i) restoration and consolidation of internal peace; (ii) care for the victims of the conflicts;
(iii) stability on Congo’s borders and promotion of good-neighbor relations; and
(iv) active participation of communities, through good governance, in the design, execution, and
auditing of decisions.

4.3.1. Axis 1. Restore and consolidate internal peace
97. No sustainable growth or development is possible without peace and respect for human rights
and fundamental freedoms. Restoring and consolidating peace is thus the core axis in that it
affects the medium- and long-term performance of the other I-PRSP axis. The government has
established ongoing peace and peacekeeping as prerequisites for the success of its poverty-
reduction strategy and the commencement of sustainable development. Within that perspective, it
has committed itself unwaveringly to the process of peacefully resolving the conflicts that have
sapped the country’s strength for nearly five years.

Axis 2. Address the needs of the victims of the fighting
99. The situation of conflict, which has been going on for four years, is having grave
repercussions: heavy loss of life, massive displacement of the population, widespread material
destruction, deteriorating infrastructure, and disruption of socio-economic circuits.


                                                                                                  39
Page 32
100. The ensuing humanitarian disasters have plunged much of the population into dire poverty
and destitution, requiring urgent remedies. The government has responded by taking two types of
demobilization and reintegration measures (Decree Law N° 0066 of June 9, 2000). To address
this poverty exacerbated by conflicts and the war of aggression, the government plans to launch a
post-conflict reconstruction and economic recovery program, as an essential accompaniment to
the peace process.

102. As regards reintegration, economic recovery, and post-conflict reconstruction, the following
actions have already been envisaged:
• Psychological rehabilitation;
• Vocational training in agriculture, livestock farming, and other trades;
• Training in running micro-enterprises;
• Integration in community dynamics;
• Rehabilitation of infrastructure;
• Strengthening of health district capacities;
• Housing rehabilitation and construction; and
• Resumption of economic growth through rehabilitation of basic infrastructure (transport,
communication, energy, rural and urban roads, rail and waterways network, etc.)

Page 33
4.3.3. Axis 3. Guarantee stability on the borders and promote neighborly relations
103. The actions envisaged for this area are:
(i) Getting the international community to convene intra-community dialogue in all bordering
countries involved in the conflict in the DRC. This would help prevent conflicts; and …

Page 37
4.4.4. Axis 4. Promote employment
120. Unemployment has become a pressing issue as the DRC has experienced economic crisis
and armed conflicts. To remedy this situation, the government has made job creation and
sustainable income generation a short- and medium-term objective.

Page 55
Chapter VI. Monitoring and Evaluation
6.1 Intermediary indicators
6.1.1. Peace and good governance
170. For this pillar of the PRSP, the selected principal indicators of follow-up/evaluation are the
following (Annex III, Axis 1):
• Holding of the inter-Congolese dialogue with agreement on a new democratic political order
(constitution) with a decentralized and reformed public administration and judicial system;
• Adoption of a national law against corruption;
• Assist the victims of the conflict;
• Organization of reconciliation days, drawing up of the national treaty of reconciliation and a
national framework for conflict resolution; and the holding of a sub-regional peace conference;
• Demobilization of soldiers and child soldiers, recovery of weapons, and formulation of a post-
conflict program;
• Capacity building at the local community level to prevent conflicts; and
• Involvement of the press and international community in the reestablishment of peace and good
political governance.



                                                                                                 40
Page 57
6.2 Result indicators
(vi) Gender and vulnerable groups: households managed by women (percent), women with
remunerated employment (percent), inequality of income and remuneration of men/women, result
indicators for victims of conflict and street children.

Page 60
Chapter VII. Constraints and risks
7.1 Endogenous risks and constraints
183. Sound political governance, especially the restoration of peace, is the base on which other
strategies can be crafted. Political negotiations between the parties in conflict, which began in
Lusaka in 1999 and concluded one year later in the form of the Lusaka Agreements, showed the
country the path to take (inter-Congolese dialogue).

Page 77
Annex III
III.1 Introduction
The crisis of transition following the fall of Mobotu’s dictatorial regime left the country with a
highly centralized and corrupt form of government, whose institutional structure was among the
most fragile in the world. Against this backdrop, the so-called war of liberation (1996) ensued,
followed some two years later by a sub-regional conflict (1998) so extensive that it not only
threatens to completely disintegrate the DRC but also to sow violence and disruption throughout
the Great Lakes region. It is estimated that about 3.5 million Congolese have been killed in the
conflicts, which has led to mass displacement of the population and the most worrying
humanitarian crisis of the beginning of the new century.

Page 79
Pillar I: Peace and good governance
During the participatory consultations, the communities identified .bad governance as the main
cause of poverty in the DRC, defining it as corrupt, influence-peddling public administration,
which ignores the fundamental aspirations of the population. It is also seen as the cause of wars
and inter-ethnic conflicts, which led to loss of human life, vulnerability to epidemics, increased
poverty, generalized insecurity, violations of human rights and fundamental freedoms, pillaging
of natural resources, and destruction of infrastructure. Without peace and good governance, the
strategies outlined in the I-PRSP run the risk of ending in failure. In the short term (2002-04),
restoring peace and caring for the victims of the conflicts (Axes 1 and 2) are two unavoidable
prerequisites for further action.

Page 80 (table)
Axis 1. Restore and Consolidate Peace
190. Without peace and respect for human rights and freedoms, no sustainable growth targeting
the poor will be possible in the DRC. The government has made the restoration and consolidation
of peace and conflict prevention pre-conditions for the success of its efforts to combat poverty
and initiate growth targeting the poor.
Component: 1. Peace and solution of internal conflicts
Key problems: For decades the political, social, and economic administration has been too
centralized, prone to influence peddling, and corrupt. It has ignored the aspirations and
fundamental rights of the population. This has led to frustration, ethnic and regional conflicts, and
poverty.
Objectives: Restore and consolidate internal peace



                                                                                                  41
Priority actions:
- Organization of reconciliation days for communities in conflict and signing of a National
Reconciliation Pact.
- Creation of a national framework for preventing and settling conflicts
Progress Indicators: National framework to prevent and settle conflicts put in place

Page 81
Axes 2-3. Care for the victims of conflicts, guarantee stability on the borders, and promote good
neighborly relations.
There is a basically reciprocal relation between conflicts and poverty. Poverty generates conflicts,
which, in turn, exacerbate the destitution of the victims of those conflicts: loss of human life,
mass displacements of the population, material destruction, deterioration of infrastructure, and
disruption of socio-economic circuits. This situation has plunged a sizeable percentage of the
population into poverty and destitution so severe that emergency measures are needed. The
government has taken two kinds of measures with respect to demobilization and reinsertion into
civilian life (Decree-Law No. 0066 of June 9, 2000). To combat poverty exacerbated by wars and
conflicts, the government is contemplating implementing a post-conflict program for
reconstruction and economic recovery, both of which are essential to the peace process.

Component 2. Care for the victims of ethnic and regional conflicts in the country
Key problems: The conflicts, in turn, have plunged the civil and military population into poverty
and destitution. They have brought loss of human life, mass displacements of the population,
enrolment of children in the army, material destruction, and damage to infrastructure
Objectives: Care for the victims of conflicts and expedite the process of demobilization of child
soldiers and reinsertion of the population into normal life
Priority actions - …- Preparation of a post-conflict program for the supervision and
psychological and socioeconomic and medical rehabilitation of the victims, education, health,
housing
Progress indicators … - Post-conflict program drawn up: victims of conflicts rehabilitated and
reinserted into normal life
Players: …. Victims of conflict

Page 82
Component 3 Stability on the borders and good relations with neighboring countries to
consolidate and perpetuate peace.
Key problems: The Congolese conflict involves almost all neighboring countries, some of which
have official or rebel troops fighting on Congolese territory. The entire sub-region is in danger of
collapse.
Objectives: To guarantee stability and good relations with neighboring countries in order to
prevent and settle conflicts in the sub-region of the Great Lakes
Priority actions: ….
- Creation of a regional framework for conflict prevention and settlement
- Participation of the international and the subregional community in conflict prevention and
settlement in the DRC
- Sub-regional and border community dialogue has taken place
- Peace conference held in the sub-region
- Sub-regional framework created
- Sub-regional and international community participating in the peace process




                                                                                                  42
Page 83
Axis 4. Ensure Sound Political, Administrative, and Judicial Governance
In the DRC, the lack of governance and the conflicts have destroyed the State, which now has to
be reconstructed, as well as good governance, which has now to be restored. For this to happen,
the following actions must be taken in the sphere of political, administrative, and judicial
governance.


HIV and AIDS

Page 1
Table of contents
Chapter II: Profile and determinants of poverty in the DRC
2.5. HIV/AIDS and other endemic diseases ................................................................15

Page 10
Box 2.1. Some poverty indicators in the DRC
5. HIV/AIDS
5.1. Incidence HIV/AIDS (percent, 2000) 5.07
5.2. Use of condoms (percent, 2000) 2.3

Page 12
2.3.2 Health
30. Most of the health districts are in a state of complete abandonment. Conservative estimates of
health facilities coverage show that at least 37 percent of the population or approximately 18.5
million people, have no access to any kind of health care.
31. The high mortality rate affects especially the poor and the vulnerable: people in rural and
suburban areas, women of child-bearing age, and children under five, and is associated with the
deterioration of the main health indicators (life expectancy at birth, all forms of malnutrition, and
the prevalence of HIV/AIDS).

34. The percentage of the population infected with the HIV virus also continues to rise for lack of
the resources needed for awareness a

Page 15
2.4 Gender
45. Women’s economic dependence on their husbands is at the root of the violence to which they
are subjected. Rape, mistreatment, verbal abuse, and conjugal sexual violence are widespread.
The five most prevalent forms of violence experienced and observed by women and girls are:
verbal abuse, prostitution, blows and wounds, dowries that are not paid, and discriminatory
traditional customs. Also worth underscoring is the sexual violence inflicted upon women by
armed combatants, especially the foreign armies coming from countries with a very high
incidence of HIV/AIDS.




                                                                                                              43
Page 15
2.5. HIV/AIDS and other endemic diseases
46. The prevalence rate at end-1999 was 5.07 percent, causing 300,000 deaths a year, of which 80
percent are persons of 15.45 years of age. In 1999, 8 percent of pregnant women were estimated
to have HIV/AIDS. This ratio has increased rapidly in the combat zones in the eastern part of the
country. Thus, Ministry of Health statistics showing a decline in life expectancy from 52.4 years
in 1994 to 50.8 percent in 1997 are quite credible. Surveillance centers report that the rates for
Matadi and Lubumbashi doubled between 1997 and 1999, from 5.1 percent to 10 percent and 4.8
percent to 8.6 percent, respectively. UNSIDA estimates that at least 90 percent of people who are
HIV positive are unaware of the fact. Some refuse to take a test because of its cost (US$10) and
the unaffordability of treatment, others because they prefer not to know.

Page 16
2.5. HIV/AIDS and other endemic diseases
48. Tuberculosis is the principal killer disease for adults, implying that it also impoverishes both
families and the country. The HIV/AIDS pandemic and the conflicts increase the incidence of the
disease. Indeed, 30 to 50 percent of those suffering from tuberculosis are also infected with HIV
and therefore constantly having relapses. Medical statistics show that 40 percent of deaths of
individuals with HIV/AIDS are attributed to tuberculosis.

Page 18
2.7
Conflict and poverty: the destitution of the victims
60. In the occupied zones, the prevalence of AIDS is estimated by the Ministry of Health at 10
percent (compared to the national average of 5.07 percent). Although no reliable survey has been
conducted in Kivu since 1998, Save the Children UK has estimated an HIV rate of 3.6 percent in
Goma and 6.9 percent in Kalemie.

Page 30
Box 4.2 Some poverty reduction programs currently underway in the DRC (OLD)
2. Health
2.1 National Program to combat AIDS

Page 42
4.4.7.3. Health
133. Regarding HIV/AIDS and other sexually transmitted diseases, the government expects to
take the following steps:
(i) Increase awareness of the population in general and high-risk groups in particular, regarding
HIV/AIDS and other STD epidemics;
(ii) Sensitize high-risk groups to the need for responsible sexual behavior;
(iii) Involve political decision-makers, leaders shaping public opinion, heads of companies,
traditional and religious leaders and local communities in mobilizing and administering local
resources capable of bringing about changes in behavior;
(iv) Promote social marketing of condoms;
(v) Strengthen national and international partnerships, as well as coordination of sector strategies
in the fight against HIV/AIDS and poverty;
(vi) Supply Health Centers and General Referral Hospitals with anti-retroviral medicines, HIV
tests, condoms, and other inputs needed to deal with the disease. Special attention will be paid to
the use of generic medicines and tri therapy;
(vii) Rehabilitate the National Medical-Social Fund (FONAMES) to assist those suffering from
endemic diseases and orphans resulting from them.


                                                                                                  44
Page 51
4.5.4.4. Health
157. Mortality rates are among the highest in Central Africa, because of a broad decline in living
standards and above all in health infrastructure and health care. The communities have developed
workable initiatives in the health sector, which the government intends to support with the
following activities:
• Reviving local development and health care committees;
• Mobilizing and training grassroots communities in maintenance and rehabilitation of health care
establishments and infrastructure;
• Rehabilitating traditional medicine and providing scientific and professional training for
practitioners of traditional medicine;
• Making the population more aware of techniques to prevent HIV/AIDS; and
• Bolstering mother-child health care service.

Page 57
6.2. Result indicators
174. The result indicators are those developed by the World Summit on Social Development.
They will be used and adapted to the context of the DRC and will take into account its capacity to
realize them in a specific timeframe compatible with the current situation. Particularly, we have
retained (subject to completion of the indicators in Annex A.II):
… (iii) Health and demography: global mortality rate, per age (neo-natal, infantile) by sex and the
maternal mortality rate at childbirth, malnutrition level and weight deficiency, level of access to
services and health services, level of prevalence for HIV (percent), malaria (percent), tuberculosis
(percent),

Page 92
Annex III
Pillar 2, Axis 6. Rehabilitate Services, Infrastructure, and Living Conditions of the Poor. Sphere
of the Poor: Education, Health, and HIV/AIDS
The deterioration of the educational and health systems and structures is evident all over the
DRC, and has resulted in the decline in the quality of education and health care. School
enrollment and dropout rates, the incidence of HIV/AIDS, and other endemic diseases have led to
extremely high mortality rates. Thus, consultations with the communities have shown that they
give priority to these two sectors in poverty reduction strategies. In addition to the support the
government will give to initiatives developed by the communities themselves in these two sectors
within the community dynamics framework, it is necessary to undertake the following urgent
reforms.

Table
Component: 6. Health HIV/AIDS and other endemic diseases
Key Problems: Very high death rate due to the combined effects of HIV/AIDS and other endemic
diseases.
Objectives: Improve access to quality health care for the population (37-45 percent) and lower the
incidence of the HIV/AIDS epidemic and other endemic diseases.
Priority actions: Improve the education and the mobilization of the communities in an effort to
prevent HIV/AIDS, malaria, and other endemic diseases.

Page 97
Pillar 3, Axis 4
Component 3: Health
Objectives - Reduce the incidence of HIV/AIDS in grassroots communities


                                                                                                 45
                                                                    4. HAITI




                                                                                                                                                             9. Mobile population
                                                                                                                                        8. Food insecurity
                                    1. Humanitarian




                                                                                                            6. Emergency
                                                                                             5. Displaced
                                                                       3. Refugee
                                                      2. Disaster




                                                                                                                           7.Conflict




                                                                                                                                                                                               11. AIDS
                                                                                                                                                                                    10. HIV
                                                                                    4. IDP
                        Date
Country    Document     issued
  Haiti      I-PRSP      Sept 06         2               5                0           0          0              0             0               0                    0                11         11


HUMANITARIAN

Page 8:
Introduction
5. Despite the foregoing, it must be acknowledged that humanitarian assistance—though not
always sufficient in times of acute crisis—continues to be provided in a variety of forms:
distribution of food, clothing, basic drugs to the destitute, and even in some instances farming
inputs such as seeds and pesticides. This sort of assistance, combined with funds sent home by
expatriates, has more often than might be imagined saved Haiti from a humanitarian catastrophe.


DISASTER

Page 7:
Introduction
2. The negative trend in production results from a variety of endogenous and exogenous factors:
political crises; poor governance combined with natural disasters; deterioration in the terms of
trade (lower coffee prices, rise in international oil prices, etc.); economic sanctions,2 rioting and
pillaging, etc. These and other misdeeds have eroded the investment climate, degraded social and
economic infrastructures, set off an exodus of qualified workers and provoked a brain drain,
caused chaotic urban growth, erosion of arable land, depleted the environment, and drained
capital from the private sector (formal and informal). Social solidarity has been negatively
impacted. To make up for the failures of the governing apparatus—i.e. the under-administration
or indeed the poor administration of the state—Haitian economic agents have had to obtain
essential services from private sources, in order to continue productive activities (e.g. security
services and electricity). Furthermore, some basic public services are only available to a minority,
who procure them at relatively high costs (drinking water, education, and health are striking
examples).

Page 28
81. Programs to establish tree nurseries in cities and municipalities will be funded in order to
provide interested citizens with appropriate species for reforesting. Management of the
environment at the municipal and communal levels will enable the public to participate actively
in natural resources management, the strengthening of risk and disaster management, and the
creation of a better environment.




                                                                                                                                                                                              46
Page 45
PART VII
Risks and Limitations
167. Emergencies or external shocks – such as natural disasters, social unrest, epidemics, or
significant changes in the prices of imported and exported products on international markets –
could disrupt planning.

Page 52
Environment:
Ensure informed risk and disaster management
Implement National Risk and Disaster Management.


HIV and AIDS

Page 8
Introduction
3. … The literacy rate among adults and youths varies from 50 percent to 66 per cent, and
HIV/AIDS prevalence in adults was estimated at 5.3 percent

Page 9
13. Part three presents the major sectoral priorities of intervention: first, growth favorable to the
productive sectors (agriculture, industry, trade, environment, craft industries, transportation,
electricity, communications, and tourism). Next comes governance and institutional reforms
(justice and rule of law, fiscal transparency, modernization of the management of public affairs,
deconcentration and decentralization), followed by development of the social sectors properly
speaking (health, HIV/AIDS, education, water, sanitation, and housing).

Page 11
Profile of poverty:
Table 1: Basic social indicators:
Prevalence of HIV/AIDS (% of persons aged 15-49, 2003): Haiti: 5.6 LAC: 0.7 LDC: 2

Page 32
HIV/AIDS
101. Because Haiti is the regional country with the highest incidence of HIV/AIDS, special
attention will be given to this pandemic, which exceeds the framework of the health sector by a
wide margin. Specific measures designed to control this illness and guarantee ongoing care will
be taken, in line with the MDGs. Action will be taken to reduce both risk and vulnerability
factors. These actions will be developed with both Haitian civil society and the international
community. The government will take the leading role in mobilizing political sectors (justice,
parliament, the executive), economic sectors (finance, business owners), and social sectors
(health, education, social affairs, culture, status of women, etc.). To that end, the government
undertakes to: (i) develop a national reference framework for the fight against HIV/AIDS that is
effective, integrated, and respectful of the principles of inclusiveness, universality and equity; (ii)
establish a high-level, multi-sectoral national body concerned with HIV/AIDS; (iii) draw up
integrated HIV/AIDS sectoral plans; and (iv) establish a national oversight and assessment
framework.




                                                                                                     47
102. There are sufficient resources available to fight the HIV/AIDS pandemic effectively in Haiti.
The problem needing a solution is that of distributing resources so that they reach the largest
possible number of beneficiaries. A dynamic public/private partnership based on the four points
listed above ought to yield more than satisfactory results.

Page 50
Sectoral Policy Matrix
Area: Health
Strategy: Strengthen the outreach/information program on STD/HIV/AIDS and the care taking of
persons living with HIV.

Page 13
Profile of poverty
22. According to the various assessments undertaken, Haiti stands no chance, with the public
policies adopted thus far, of reaching most of the Millennium Development Goals by 2015. Out
of the seven groups of indicators used internationally for measuring progress made, Haiti is likely
to meet only two of the Objectives, namely gender equity and the fight against AIDS and other
infectious diseases. More troubling is the fact that instead of poverty reduction in recent years,
some indicators—e.g. regarding forest coverage and infant malnutrition—have deteriorated.




                                                                                                48
                                                      5. INDONESIA




                                                                                                                                                           9. Mobile population
                                                                                                                                      8. Food insecurity
                                    1. Humanitarian




                                                                                                          6. Emergency
                                                                                           5. Displaced
                                                                     3. Refugee
                                                       2. Disaster




                                                                                                                         7.Conflict




                                                                                                                                                                                             11. AIDS
                                                                                                                                                                                  10. HIV
                                                                                  4. IDP
                        Date
Country     Document    issued
Indonesia    I-PRSP      Mar 03         0                 2             0          0          0              0              4              0                     0                 0             0


DISASTER

Page 3
1.1 Background
The endeavors to the poverty reduction that have been done in Indonesia for the last three decades
were quickly being reversed as millions of rural poor fell below the poverty threshold and
significant numbers of people increased their vulnerability and clustered around the poverty line
because of politic, economic, and social turmoil as well as natural disasters in some regions.
These factors indicated that there are some weaknesses in the efforts of poverty alleviation in the
past that need a major improvement. We might point this condition to: (i) the government put in
much of its focus to macro-economic growth (ii) centralized policies (iii) mainly consists of
charity purposes (iv) treat people as the objects (v) define poverty merely by economic-based (vi)
generalized poverty problem assumption and solution.

1.4 Progress in tThe Poverty Reduction Initiatives
As a matter of fact, the decrement of poverty degree is still very vulnerable to the changes of
macro economic situation, political conflict, social disturbances and conflict in some regions, and
natural disasters. In addition, there are many contradictory macro policies to increase people
welfare. Program implementation, for example, is still sector-based, lack of focus that is not
accommodative to the needs of the poor, and lack of public participation,


CONFLICT

Page 10
1.4 Progress in the Poverty Reduction Initiatives
As a matter of fact, the decrement of poverty degree is still very vulnerable to the changes of
macro economic situation, political conflict, social disturbances and conflict in some regions, and
natural disasters. In addition, there are many contradictory macro policies to increase people
welfare. Program implementation, for example, is still
sector-based, lack of focus that is not accommodative to the needs of the poor, and lack of public
participation.




                                                                                                                                                                                            49
Page 17
2.1 The Government Commitment in the Poverty Reduction
As a completion of the initiatives to accelerate poverty reduction in the next two years,
Government of Indonesia has also come to a decision to mainstream poverty reduction in
RAPBN, starting with the 2003 Annual Development Plan, which placed poverty reduction as
one of its top 11 priorities. Therefore, the government will also converge the policies and
programs of 2003 APBN in all sectors by: (1) creating opportunities related to macro economic
recovery as the main target, the construction of Good Governance, and the improvement of public
services, (2) community empowerment related to the provision of the poor with access to
economic resources and their involvement in decision-making process, (3) capacity building
regarding the improvement of education, health, food, and housing services for the people in
order to increase their productivity, and (4) social protection for people with physical defect,
poor, isolated, experiencing social conflict and job-loss whom prone to fall into poverty.

Page 26
Politics
Policy alternatives are:
(a) Increasing local government responsibility to alleviate poverty,
(b) Enhancing good governance principles in poverty alleviation,
(c) Promoting local organization and institutional capacity to establish democracy, participation,
and conflict resolutions in term of social resilience enhancement (d) Law enforcement.




                                                                                                 50
                                                      6. IVORY COAST




                                                                                                                                                            9. Mobile population
                                                                                                                                       8. Food insecurity
                                    1. Humanitarian




                                                                                                           6. Emergency
                                                                                            5. Displaced
                                                                      3. Refugee
                                                        2. Disaster




                                                                                                                          7.Conflict




                                                                                                                                                                                              11. AIDS
                                                                                                                                                                                   10. HIV
                                                                                   4. IDP
                        Date
Country    Document     issued
 Ivory
             I-PRSP      Jan 02          0                 0             1           0          0              0             8               0                    0                41         45
 Coast


REFUGEE

Page 98
Annex 2. Regional Characteristics
11.5.5. The workshop of July 23-24, 2001 in MAN brought together representatives of the
departments of BIANKOUMA, DANANE, BANGOLO, GUIGLO, TOULEPLEU, DUEKOUE,
and MAN.
….. Security has been of increasing concern in light of the massive presence of refugees for many
years, and the people strongly advocate the construction of corridors to border posts. They also
want facilities to be built for processing local products, so as to offer employment opportunities to
the area's youth. Implementation of the Rural Land Use Code is a priority concern in the region.


CONFLICT

Page 27
1.1.2 Causes of poverty
1.1.2.1. Economic, institutional, and governance-related causes
The economic causes of poverty are both domestic and external:
….. The destruction of plantations and persistence of conflicts between stockbreeders and
farmers;…

Page 45
1.6.2.7. The insufficiency of national entrepreneurship
For a long time, the myth of the diploma, the attractiveness of civil service, and its associated job
security have prompted the Ivoiriens to pursue their careers in administration, thereby neglecting
the opportunities offered by the private sector. in the framework of private sector promotion, it is
important to change the mentalities so that these opportunities are tapped, and that initiatives to
create jobs and wealth, beyond those offered by the public sector, are encouraged in order to curb
unemployment and the under-employment of the young. In this regard, the agricultural jobs need
to be also encouraged, but this implies higher land security and the settlement of land conflicts,
whose origins are the pressure on forest areas and land scarcity.




                                                                                                                                                                                             51
Page 45
1.6.2.8. Strong population growth
Strong population growth (3.3 percent) remains a major constraint that has an impact on the
supply of basic social services. The major investments made into basic infrastructure
(schools, health centers, housing, sanitation) are not sufficient to meet all of the population's
needs. This population growth puts some pressure on environment and exacerbates the land
conflicts between the natives and non-natives, hence the need to enforce the land law.

Page 46
1.6.2.12. Political stability and security
Political stability was long a major asset for Cote d'Ivoire's development. However, the socio-
political crisis that grew following the events of December 1999 and the year 2000 called into
question that stability and weakened it. On the security front, conflicts in some countries in the
sub-region (Liberia, Sierra Leone, and Guinea) led to an influx of weapons into the national
territory, resulting in a rise in organized crime. The return of calmer conditions should allow the
country to develop peacefully.

Page 60
Land tenure security with respect to acquired rights remains the main point of conflict to be
resolved, along with the role of the various parties involved in the demarcation and allocation of
plots of land (the state, supervisory entities, traditional authorities, etc.). The objective is to end
such conflicts by enforcing the Rural Land Use Code. Lessons will be drawn from the experience
of the PNGTER.

Page 98
Annex 2. Regional Characteristics
… Frequent conflicts between stockbreeders and farmers in the north of the country necessitate
government action to regulate the movement of animals, to prevent animal losses and losses of
farm production and human lives.
….The issue of land tenure security in this forest region was raised as a priority, in light of the
frequent conflicts that arise in this regard.


HIV and AIDS

Page 3
Table of contents
Part 1. The poverty situation and macroeconomic framework
1.6.2.10 The expansion of HIV/AIDS ........................................................ 44

Page 4
Table of contents
2.4.2.4. HIV/AIDS ................................................................ 67

Page 7
1.2 Population - poverty situation and profile
-overall mortality is on the rise with a rate of 15 percent linked to HIV/AIDS and the resurgence
of certain epidemics. The infant mortality rate was 11.2 percent in 1999 and maternal mortality
was 597 deaths per 100,000 live births;




                                                                                                      52
Page 9
1.3 Results of poverty reduction programs (1997-2000)
Partial conclusions
The assessment leads to the conclusion that some progress has been made vis-a-vis the
population's access to basic social services (improvement in the school attendance ratio, the
medical coverage, job offers, housing, rural electrification, and access to safe water) between
1994 and 1998, as illustrated by the above-mentioned indicators and the decline in poverty
incidence to 33.6 percent in 1998 from 36.8 percent in 1995. Nevertheless, the situation
stagnated, and even further deteriorated in 1999 and 2000. Indeed, the income per capita fell, the
HIV/AIDS incidence rose, the quality of social services did not improve, the absorption capacity
remains weak with some deficits in terms of basic infrastructure (classrooms which are not built
are unfinished, existing health centers which are not operational) and the persistence of
governance issues which disrupt the management of numerous programs.

Page 9
HIV/AIDS seriously and perniciously undermines the foundation of the economy and weakens
the educational, defense, and security systems. In rural areas, the percentage of households with
access to drinking water and electrification remains low.

Page 12
1.6. Strengths and Weaknesses of Poverty-Reduction and Growth Policies
Constraints and weaknesses:
-the expansion of HIV/AIDS;

Page 15
Rural development
Strategies:
…These objectives will be achieved through the following strategic approaches:
(i) modernization, implementation of agricultural services, and revitalization of applied scientific
research; (ii) diversification and development of production (food crop sector,
particularly rice, fishing, and livestock farming, export crops including coffee and cocoa, cotton,
and others); (iii) improvement of marketing systems and product storage techniques; (iv) further
government divestiture, and liberalization of agricultural activities and product marketing; (v)
development of agricultural statistics; (vi) implementation of financing for the agricultural sector;
and (vii) provision of land tenure security (application of the new Rural Land Use Code adopted
in December 1998, and the new forest policy), preservation of environment and implementation
of the new forest policy; and (viii) access of rural population to basic social services, including
women, the poorest, and reduction in the HIV/AIDS incidence in rural areas.

In view of the limits and weaknesses of programs to combat poverty, the government aims to
achieve the following objectives: namely, to (i) ensure universal education and to guarantee free
primary education; (ii) ensure that the general public has access to health care and guarantee
universal health insurance; (iii) improve and modernize basic infrastructure, housing, and living
conditions, and to protect and preserve the environment; (iv) ensure the advancement and
participation of women and youth; (v) lessen the incidence of HIV/AIDS; and (vi) reduce
regional and local inequalities and disparities and promote the population's large access to land
property. These objectives are consistent with the objectives of the millennium approved by the
United Nations.




                                                                                                  53
Page 17
Strengthening of security of property and people
-at the level of the personnel: (i) implementation of a training program (800 staff to be recruited
per year) and rational relocation; (ii) strengthening of the units, including the crack units fighting
against crime; (iii) motivation of agents (salaries; housing; coverage of accident risks; health
services, notably fight against HIV/AIDS; application of the new police personnel status).

Page 22
IV.2.2 Future institutional framework for implementation
A technical committee comprising includes: ……..
…..ministry responsible for advancement of women, family and childhood, ministry responsible
for fighting HIV/AIDS.

Page 28
I.1.2.2. Demographic and socio-cultural causes
Demographic causes
Poverty is also rooted in the demographic situation:
-High morbidity and mortality contributed to the deterioration of the population's health status,
with the return of illnesses such as yellow fever, typhoid, and cholera in addition to HIV/AIDS.
Life expectancy fell from 56 years in 1988 to 51 years in 1998; and

Page 29
Social and cultural causes
The population feels that in many cases certain traditions is a contributing factor to
impoverishment, such as:
-The influence of the extended family and pressure from the kinship unit, village, or even the
region, act as a curb upon individual development;
-The dependency ratio is high, leading to social parasitism;
-Traditions that militate against the education of girls (early marriage and fertility, housework);
-The exclusion of women from inheritance rights;
-The spread of the HIV/AIDS pandemic;
-Superstition, which stymies initiative; and
-Conspicuous expenditures (funerals, marriages, etc.).

Page 30
1.2. Population Poverty Situation and Profile
-Overall mortality is on the rise with a rate of 15 percent linked to HIV/AIDS and the resurgence
of certain epidemics. The infant mortality rate was 11.2 percent in 1999 and maternal mortality
was 597 deaths per 100,000 live births; and

Page 32
Results of poverty reduction programs (1997-2000)
…Specifically, this is aimed at the following issues: social welfare, human resources
development, and controlling population growth, through the following areas: education-literacy;
health and HIV/AIDS; employment and income-generating activities; women and the family;
youth and children; housing and the physical environment (housing conditions, water resources,
rural electrification, roads, sanitation, environment); and agriculture and food.




                                                                                                      54
Page 34
1.3.2 Results of the national anti-poverty program
1.3.2.2. Health and HIV/AIDS
The health program was implemented through the 1996-2005 National Health Development
Program (PNDS) with the following objectives: (i) to improve coverage, quality, and use of
health services; (ii) to raise the child immunization rate from 60 percent in 1996 to 80 percent in
2000; (iii) to fight AIDS; (iv) to lower the total fertility rate from 5.7 in 1994 to 4.5 in 2015; and
(v) to increase the prevalence of modem contraception methods from 4 percent in 1994 to 10
percent in 2000. Fulfillment of these objectives as of end-December 2000 was as follows:

Page 35
1.3.2 Results of the national anti-poverty program
1.3.2.2. Health and HIV/AIDS
o Stepping up the fight against AIDS
The fight against AIDS incorporates three strategies: awareness raising (prevention), protecting
the blood supply, and therapeutic case management. Regarding prevention, nationwide 20 million
condoms were sold in 2000, down from 23 million in 1999. Prevention among prostitutes consists
of activities to promote condom use, awareness rising, and STD case management. Following
implementation in Abidjan, these activities are currently under way in Bouake and Aboisso. For
now, activities to prevent the transmission of HIV from mother to child are under way only in
Abidjan. Counseling and voluntary screening activities are in effect in Abidjan, Bouake, and
Korhogo.

As of December 31, 2000, the blood supply was fully protected throughout the territory with four
blood transfusion centers on which hospital blood centers depend. Training sessions on
HIV/AIDS case management were organized for medical and paramedical personnel. Three (3)
hospitals specialize in case management for AIDS patients: Abidjan, Bouake, and Bondoukou.
Since 1998, CMte d'Ivoire has been committed to the UNAIDS initiative on therapeutic case
management for HIV/AIDS patients. Antiretroviral (ARV) are available through the PSP in
centers accredited for that purpose. The government established a national solidarity fund to
subsidize ARV treatment. In this context, 1,013 patients currently receive support; monthly ARV
treatment costs CFAF 300,000 per person, 75 to 95 percent of which is subsidized by the
government.

Page 38
1.3.2.8. Partial conclusions
The assessment leads to the conclusion that some progress has been made vis-a-vis the
population's access to basic social services (improvement in the school attendance ratio, the
medical coverage, job offers, housing, rural electrification, and access to safe water) between
1994 and 1998, as illustrated by the above-mentioned indicators and the decline in poverty
incidence to 33.6 percent in 1998 from 36.8 percent in 1995. Nevertheless, the situation
stagnated, and even further deteriorated in 1999 and 2000. Indeed, the income
per capita fell, the HIV/AIDS incidence rose, the quality of social services did not improve, the
absorption capacity remains weak with some deficits in terms of basic infrastructure (classrooms
which are not built are unfinished, existing health centers which are not operational) and the
persistence of governance issues which disrupt the management of numerous programs.

Page 39
HIV/AIDS seriously and perniciously undermines the foundation of the economy and weakens
the educational, defense, and security systems. In rural areas, the percentage of households with
access to drinking water and electrification remains low.


                                                                                                    55
Page 46
1.6.2.10.
The expansion of HIV/AIDS
The HIV/AIDS pandemic, which affects nearly 12 percent of the population, continues to hamper
the availability and effectiveness of the human capital needed to sustain growth.

Page 50
11.2.1.2. Rural development
Strategies….
(viii) access of rural population to basic social services, including women, the poorest, and
reduction in the HIV/AIDS incidence in rural areas.

Page 50
II.2.2 Improving equitable access to and quality of basic social services
In view of the limits and weaknesses of programs to combat poverty, the government aims to
achieve the following objectives: namely, to (i) ensure universal education and to guarantee free
primary education; (ii) ensure that the general public has access to health care and guarantee
universal health insurance; (iii) improve and modernize basic infrastructure, housing, and living
conditions, and to protect and preserve the environment; (iv) ensure the advancement and
participation of women and youth; (v) lessen the incidence of HIV/AIDS; and (vi) reduce
regional and local inequalities and disparities and promote the population's large access to land
property.

Page 53
II.2.6 Strengthening of security of property and people
The objectives of the security system aim at: (i) guaranteeing the security of property and
individuals; (ii) creating an environment propitious to investment; (iii) bringing security forces
closer to the population and modernizing the resources of the services and for intervention.
Strategies
-At the personnel level
(i) implementation of a training program (800 staff to be recruited per year) and rational
relocation; (ii) strengthening of the units, including the crack units fighting against crime; (iii)
motivation of agents (salaries; housing; coverage of accident risks; health services, notably fight
against HIV/AIDS; application of the new police personnel status).

Page 66
11.4.2. Social sectors and basic infrastructure
Development of the social sectors and basic infrastructure relates to the specific objective of
ensuring equitable access to basic social services and to decent living conditions, with a view to
reducing regional and local inequalities and disparities.
In this context, emphasis will be placed on the following areas: (i) population and development;
(ii) education/training; (iii) health/HIV/AIDS; (iv) social protection and coverage of vulnerable
groups (women, children, handicapped people, elderly), notably the poorest; (iv) jobs; (v)
housing; (vi) transportation and communications infrastructure; and (vii) electricity,
water/sanitation, environment.

Page 68
11.4.2.2. Education and Training
….To that end, the following strategies will be implemented: (i) introduction and progressive
general implementation of free and mandatory education from nursery school through the fourth


                                                                                                   56
year of secondary school, with particular emphasis on the most underprivileged areas; (ii)
increase school capacity by government construction of 800 primary classrooms per year,
reducing the lack of teachers at all levels, and updating the teacher status; (iii) transfer of
responsibility for literacy to local groups; (iv) reinforcement of the management capacity of the
education system at the central and decentralized levels and taking account of the HIV/AIDS
incidence in the school environment; (v) reduction in the dropout rate in schools and universities;
(vi)strengthening of the articulation between the general education and vocational
education;……….

Page 69
11.4.2.4. HIV/AIDS
HIV/AIDS is the leading cause of death of the adult and young population; 12 percent of the
population is HIV positive. HIV/AIDS affects youth and all social and occupational categories in
rural and urban settings.

Objectives
The main objective is to reduce HIV seroprevalence rates to less than 10 percent by 2005.
Specific objectives are: (i) to reduce the prevalence and incidence of sexually transmitted
infections; (ii) to increase the rate of condom use; (iii) to reduce by 50 percent the proportion of
the target population that engages in risky sexual behaviors; (iv) to reduce the vulnerability of
women to the HIV/AIDS epidemic; (vi) to improve screening conditions; and (vii) to improve the
living conditions of individuals with HIV/AIDS.

Strategies
The strategy for the fight against HIV/AIDS was defined in the context of the national plan
adopted in 2001. The main approaches are: (i) to appeal to leaders and decision-makers to
intensify the multi-sector and decentralized fight against HIV/AIDS; (ii) to raise awareness and
disseminate information about HIV/AIDS; (iii) to promote condom use and to make condoms
more widely available; (iv) to promote national support for infected persons; (v) to strengthen the
involvement of NGOs and the private sector in caring for persons living with HIV/AIDS; (vi) to
create a legal environment favorable to infected and affected persons; and (vii) to broaden the
organizational and institutional bases of the fight against AIDS.
The issue of HIV/AIDS is a cross-sector concern, which will be dealt with as such in the final
PRSP.

Page 81
111.4.4. Thematic discussions
The thematic discussions within the uniform groups on the framework for poverty reduction
(CSRP) will be organized in February-March 2002. Their objectives are: (i) to deepen the study
of the diagnosis and poverty reduction strategies, especially at the sectoral level in a medium and
long term prospect; (ii) to lead to measures supplementary to those included in the I-PRSP; (iii)
strengthen the participatory approach in the strategy formulation. The participants are the
members of the uniform groups (including the international partners) and the sectoral ministries.
The themes are:
> macroeconomic framework, public finance, debt and poverty;
> financial sector, credit system, savings policy and poverty;
> reform of the agricultural sector and poverty;
> water, energy, and poverty;
> transportation, infrastructure, and poverty;
> housing, cleaning up, environment and poverty;
> new information and telecommunication technologies and poverty;


                                                                                                 57
> social security and poverty;
> employment, income and poverty;
> education, training and poverty;
> health and poverty;
> HIV/AIDS and poverty;
> women, young, handicapped people and poverty;
> administrative reform, decentralization and poverty;
> governance, capacity building and poverty;
> justice, security and poverty.

Page 87
IV.2.2 Future institutional framework for implementation
A technical committee comprising includes:
-Representatives of government (Cabinet of the Prime Minister, Ministry of Planning and
Development-Directorate-General of Planning), Ministry of Economy and Finance (Directorate-
General of Economy, Directorate-General of Budget, Directorate- General of Treasury), ministry
responsible for interior and decentralization (Directorate-General of Decentralization), Ministry
of Justice, Ministry of Agriculture and Animal Resources, Ministry of Industry and Private Sector
Promotion, Ministry of Commerce, Ministry of Economic Infrastructures, Ministry of
transportation, Ministry of Public Service, Employment, and the Administrative Reform, National
Education Ministry, Ministry of the Young, Employment and Professional Training, Ministry of
Health, Ministry of Social Affairs and the Living Environment; ministry responsible for
advancement of women, family and childhood, ministry responsible for fighting HIV/AIDS).

Page 95
Annex 1 Statement of the Prime Minister at the start of work on the PRSP, May 28, 2001.
In carrying out this national strategy to tackle poverty, there will clearly be obstacles to address,
particularly the growth in the HIV/AIDS epidemic associated with the deterioration of the social
and family environment.

Page 99
Annex 2. Regional characteristics
11.5.7. The workshop of July 26-27, 2001 in ABENGOUROU brought together representatives
of the departments of AGNIBILEKRO and ABENGOUROU.
Rural drift has deeply affected this area, which supplies a large number of housekeepers in homes
in large cities. Consequently, the people are requesting a vigorous functional literacy program, a
broad-based campaign to raise awareness concerning HIV/AIDS, and a strengthening of efforts
by rural supervisory projects to offer farmers new farming techniques and agricultural
management systems. The people also want irrigation systems to be developed so that lowlands
may be placed into production to reduce the deleterious effects of inadequate food production,
and they are calling for the construction of processing and canning facilities for manioc,
tomatoes, soy, and corn. They recommend that the Abengourou-Bettie-Aboisso route be paved,
and that a firefighting brigade be established.




                                                                                                   58
                                                      7. LIBERIA




                                                                                                                                                         9. Mobile population
                                                                                                                                    8. Food insecurity
                                   1. Humanitarian




                                                                                                        6. Emergency
                                                                                         5. Displaced
                                                                   3. Refugee
                                                     2. Disaster




                                                                                                                       7.Conflict




                                                                                                                                                                                           11. AIDS
                                                                                                                                                                                10. HIV
                                                                                4. IDP
                       Date
Country    Document    issued
Liberia     I-PRSP      Jan 07          2               0          10             6          8              4          102                7                    0                33         34

HUMANITARIAN

Page 28
Figure 3.3: National Development Planning Process
Humanitarian services

Page 88
Liberian NGOs and charitable organizations have always played a significant role in meeting
the needs of the poor. For example, during the war years and under very difficult
circumstances, civil society organizations provided the needed humanitarian and basic services
when the government was essentially not functioning.

Page A2-2
The non-governmental organization (NGO) sector lacks coordination and adequate oversight,
though it has done a credible humanitarian job in often difficult circumstances over the years.


DISASTER


REFUGEE

Page x
The destruction and long-term negative consequences of the conflict were enormous. An
estimated 270,000 people died, hundreds of thousands became refugees and internally
displaced and thousands of lives were shattered. National and civil institutions were
completely destroyed: systems of checks and balances were dismantled; the rule of law
virtually ignored; the media severely weakened; and corruption in all its forms and
manifestations pervasive.

Page xiii
Pillar 1: Enhancing National Security
These programs will be combined with efforts to provide jobs for youth and ex-combatants
and programs to reintegrate and resettle former internally displaced persons and returned
refugees.




                                                                                                                                                                                          59
Page 2
The decimation of the economy has led to very high levels of unemployment and ex-
combatants, returning refugees and internally displaced persons (IDPs) are struggling to find
work.

Page 13
The government has resolved to avoid recreating pre-war Liberia, in either its governance
or economic structures, and do business differently in order to move the country from conflict
to peace and on to development. It is determined to build a new economy with opportunities
for all and not simply for the elite or a select few Liberians. Key efforts in this regard will
include addressing the needs for national healing; reintegration and resettlement of refugees
and internally displaced persons (IDPs); rebuilding social capital; reintegration of ex-
combatants; and expanding employment and livelihoods for all (Box 2.2).

Page 13
Returnees and Resettlement: The return and reintegration of the estimated 250,000 refugees
and 350,000 internally displaced persons presents great challenges, as most communities are
yet to be revitalized after years of destruction. Land and property disputes will escalate as
those that fled find new settlers where they once lived and the absence of basic sustainable
livelihoods will create challenges and tensions.

Page 19
Box 2.5: 150-Day Action Plan: Key Achievements as of 30 June 2006
Peace and Security
….Repatriated 21,000 refugees and 314,000 IDPs.

Page 31
Another major challenge is completing the process of reintegrating refugees and internally
displaced persons (IDPs), ensuring they are back in their communities with productive
livelihoods.

Page 32
Pillar 1: Enhancing National Security
Initial response:
….Facilitating the return of refugees and IDPs to their homes

Page A1-1
Annex 1. Concerns from the counties on poverty in Liberia
Pillar 1: Security
Maryland: Refugees/ Returnees: Facilitate return and resettlement

Page A1-2
Annex 1. Concerns from the counties on poverty in Liberia
Pillar 1: Security
Refugees/ Returnees: Improve health and education services




                                                                                                60
IDP

Page 2
The decimation of the economy has led to very high levels of unemployment and ex-
combatants, returning refugees and internally displaced persons (IDPs) are struggling to find
work

Housing and shelter: Liberia is experiencing substantial housing and shelter shortages. The war
sparked massive internal displacements and rural-to-urban movements, with Monrovia hosting
the majority of IDPs. There is a huge mismatch between the number of urban dwellers and
available social services, leading to overcrowding, deteriorating living conditions and the
growth of slums and illegal home occupation. Shortage of suitable housing is a major
constraint to getting professionals such as doctors, nurses and teachers into rural areas.

Page 13
The government has resolved to avoid recreating pre-war Liberia, in either its governance
or economic structures, and do business differently in order to move the country from conflict
to peace and on to development. It is determined to build a new economy with opportunities
for all and not simply for the elite or a select few Liberians. Key efforts in this regard will
include addressing the needs for national healing; reintegration and resettlement of refugees
and internally displaced persons (IDPs); rebuilding social capital; reintegration of ex-
combatants; and expanding employment and livelihoods for all (Box 2.2).

Page 19
Box 2.5: 150-Day Action Plan: Key Achievements as of 30 June 2006
Peace and Security
….Repatriated 21,000 refugees and 314,000 IDPs.

Page 31
Another major challenge is completing the process of reintegrating refugees and internally
displaced persons (IDPs), ensuring they are back in their communities with productive
livelihoods.

Page 32
Pillar 1: Enhancing National Security
Initial response:
…Facilitating the return of refugees and IDPs to their homes


DISPLACED

Page x
The destruction and long-term negative consequences of the conflict were enormous.
An estimated 270,000 people died, hundreds of thousands became refugees and
internally displaced and thousands of lives were shattered. National and civil institutions
were completely destroyed: systems of checks and balances were dismantled; the rule
of law virtually ignored; the media severely weakened; and corruption in all its forms and
manifestations pervasive.




                                                                                                61
Page xiii
Pillar 1: Enhancing National Security
These programs will be combined with efforts to provide jobs for youth and ex-combatants
and programs to reintegrate and resettle former internally displaced persons and returned
refugees.

Page 2
The decimation of the economy has led to very high levels of unemployment and ex-
combatants, returning refugees and internally displaced persons (IDPs) are struggling to find
work

Page 4
Urban Poverty: In towns that used to be prosperous from mining and rubber concessions of the
past, 85 per cent of households are poor and 60 per cent are living in severe poverty today. In
county headquarters, which received the bulk of internally displaced people during the war, 75
per cent of households are poor, while 40 per cent live in extreme poverty. In Monrovia, about
50 per cent still fall below the poverty line while 22 per cent live in severe poverty.

Page 13
Key efforts in this regard will include addressing the needs for national healing; reintegration
and resettlement of refugees and internally displaced persons (IDPs); rebuilding social capital;
reintegration of ex-combatants; and expanding employment and livelihoods for all (Box 2.2).

Page 13
Returnees and Resettlement: The return and reintegration of the estimated 250,000 refugees
and 350,000 internally displaced persons presents great challenges, as most communities are
yet to be revitalized after years of destruction. Land and property disputes will escalate as
those that fled find new settlers where they once lived and the absence of basic sustainable
livelihoods will create challenges and tensions.

Page 31
Another major challenge is completing the process of reintegrating refugees and internally
displaced persons (IDPs), ensuring they are back in their communities with productive
livelihoods.

Page 94
The aim is to build consensus and a longer-term vision for the nation, not only on the poverty
reduction strategy but other aspects of national development, which will take the nation
beyond managing poverty to rapid growth and development. Focus group discussions will
target stakeholders, beneficiaries, community and opinion leaders, civil society
representatives, displaced communities, government workers, professional organizations,
university, religious bodies, parliamentarians, youth and women organizations, county officials
and non-governmental organizations (NGOs). Targeted focus group discussions will be held
regularly.




                                                                                                62
EMERGENCY

Page 5
All 15 counties have high to extremely high chronic malnutrition rates. Of children below five
years old, 39 per cent are stunted, about 27 per cent are underweight and 7 per cent are wasted,
though in some areas this is over 10 per cent or what is considered to be 'emergency' level.

Box 1.1: Food Insecurity: A Recommended Approach
In transitioning from emergency to recovery and finally to development, the following
interventions are recommended to achieve food security in Liberia: …

Page 28
Moving beyond short-term emergency planning, the government has embarked on its poverty
reduction strategy as a tool towards achieving the Millennium Development Goals (MDGs)
and the iPRS represents the beginning of a systematic and strategic approach for development
management, which promises to transform the economy and society of Liberia.

Page A1-3
Annex 1. Concerns from the counties on poverty in Liberia
Pillar 2: Governance and the rule of law
Sinoe: - The ‘emergency' state of mind of international NGOs sidelines communities, national
NGOs and the line ministries

Page A1-8
Annex 1. Concerns from the counties on poverty in Liberia
Pillar 4: Infrastructure and basic services
Grand Gedeh: Continue emergency feeding buildings


CONFLICT

Title Page:
Breaking with the Past: From Conflict to Development

Content
Chapter 1: From Conflict to Development

Page ix
Introduction
This Interim Poverty Reduction Strategy (iPRS), the first to be prepared for Liberia, sets out
the emerging process and framework for recovery and reconstruction in the context of post-
conflict Liberia.

Page ix
The iPRSP is structured into three parts:
Part 1 (chapters 1, 2 and 3) provides historical background to the conflict and the prevailing
socio-economic context within which the nation's poverty-reducing strategy is being
developed.




                                                                                                 63
Page ix
From Conflict to Development
The origins of the Liberian conflict can, inter alia, be traced to the exclusion and
marginalization of significant portions of society from institutions of political governance
and access to key economic assets, such as land. An over-concentration of power,
closed political system that bred corruption and restricted access to decision making
processes limited the space for civil society participation in governance and instead,
fueled ethnic and class animosities and rivalries over time. This was compounded by a
collapsing economy brought on by bad policies as well as declining commodity prices,
which created ideal conditions for the crisis. The conflict itself quickened the pace of
economic decline and today, the economy is estimated at about one eighth of what it
was before the war.

Page x
The destruction and long-term negative consequences of the conflict were enormous.
An estimated 270,000 people died, hundreds of thousands became refugees and
internally displaced and thousands of lives were shattered.

Page x
After many years of conflict, the Accra Comprehensive Peace Agreement of 18 August 2003
ushered in peace and the creation of a National Transitional Government. ….

….But the challenges of significantly reducing poverty and achieving people-centered
development in post-conflict Liberia remains daunting and will require continued and
significant efforts going forward.

Page xi
Furthermore, to make the new vision a reality and avoid a recurrence of conflict, steps must be
taken to create institutions that will address civil war-related legacies and enhance effective
governance in a post-conflict setting.

Page xiii
Pillar 1: Enhancing National Security
Extensive training already under way will be continued for the sector and an early warning
system will also be established to prevent conflicts.

Page xiv
More specifically the government, in collaboration with civil society, will focus on: reforming
and rebuilding the public sector; decentralizing political governance and social responsibilities;
strengthening the rule of law and respecting human rights; conflict-sensitive policy
making and conflict management mechanisms; affirmatively addressing gender inequalities;
strengthening environmental rules and regulations; rebuilding civil society and the media;
involving broader participation in the governance process; and reducing corruption.

Page xv
Thus far, visible progress has been made, but given the nature of the challenge there is still
much to do. Without adequate infrastructure, the ability of Liberia to reduce poverty in any
significant way will be severely hindered, thereby increasing the likelihood of a return to
conflict.




                                                                                                 64
Page xvii
Managing potential risks: Ensuring implementation risks are identified and measures
taken to minimize them are fundamental considerations. Possible risks include shortfalls
in financing, re-emergence of conflict and limited leadership and administrative
capacity.

Page xvii
Even though a strong cabinet and national leadership team is currently in place, capacity at
levels below Deputy Minister and Assistant Minister are extremely low (even by normal post-
conflict country standards).

Page 1
Chapter One
From Conflict to Development
“Failure to do the nation's business differently will slip the country and its people back into
conflict and deeper poverty”.

Page 1
1.1 Introduction
This chapter presents the overall policy context of the Liberia Interim Poverty Reduction
Strategy (iPRS). The case for a conflict-sensitive, anti-poverty strategy is made, beginning
with the root causes of the Liberian conflict and the relationship between conflict, poverty and
human rights.

Page 1
1.2 Origins of the Conflict
The origins of the Liberian conflict can be traced to two broad factors.

Page 2
The economic hardship created an active setting to enlist young people in rebel groups and, as
conflict took hold, commercial and productive activities ceased as various warlords looted and
vandalized the country's resources. All of this contributed to a precipitous economic decline
and with it, the spread and deepening of national poverty.

Page 8
Despite the years of conflict and repression, the main association of media professionals in
Liberia, the Press Union of Liberia, has managed to retain a relatively coherent and unified
approach to addressing the challenges.

Page 10
Box 1.3: Peacekeeping in Post-Conflict Liberia: The Role of the United Nations Mission in
Liberia

Page 12
2.3.1 Developing a Conflict-Sensitive Poverty Reduction Strategy
In Liberia, it is essential for the government and society to respond appropriately to post-
conflict challenges to avoid a recurrence of future conflict. Bearing this in mind, Liberia needs
a conflict-sensitive development strategy so it can better anticipate the potential for events to
exacerbate or create conflict and design development institutions that address the root
structural causes of the conflict and contribute to peace-building. (Box 2.1).



                                                                                                  65
Box 2.1: The Links Between Conflict, Poverty and Human Rights
Conflict, poverty and human rights violations are closely interconnected through negative
cyclicality. Poor countries are much more likely to experience conflict and human rights
violations. A country with a per capita income of 500 United States Dollars (USD) is about
twice as likely to have a major conflict within five years as compared to a country with a per
capita income of 4,000 USD. Once conflict begins, it inevitably deepens and exacerbates
poverty. A country affected by civil war typically has one third the per capita income of a
peaceful country with similar characteristics.

Liberia's civil war not only took the country significantly backwards, its legacies will continue
to present challenges for years to come. For example, research on the gender impact of
armed conflict suggests that women and children suffer disproportionately through
exposure to sexual violence, limited access to essential services, deprivation, absence of any
social protection measures and widowhood, among other factors. It will take years to fully
reintegrate the population, reconstruct basic infrastructure and rebuild institutions of
governance. The Liberian war essentially ended human capital formation and resulted in the
mass exodus of skilled workers, thus depriving the country of its development resource.
Current estimates show that about 400,000 Liberians are in the diaspora, mainly in the United
States, Canada and the United Kingdom. More importantly, constant conflict and poverty
provide fertile grounds for the abuse of human rights.
Liberia's conflict makes achieving the Millennium Development Goals (MDGs) a daunting
challenge. As a result of the interrelationships, it is highly unlikely that Liberia will attain any
of the MDG targets within the specified time frame of 2015.

Page 13
The government has resolved to avoid recreating pre-war Liberia, in either its governance
or economic structures, and do business differently in order to move the country from conflict
to peace and on to development

Box 2.2: Why Liberia Needs a Conflict-Sensitive Anti-Poverty Strategy

Where the root causes of conflict are not addressed, a return to war is common. Liberia's
conflict history exemplifies this reality and several factors must guide the development of
conflict-sensitive policies and programs to guard against a return to the past. These include:
…
Social Capital: The Liberian conflict traumatized people and eroded social capital, including
trust, traditional norms and customs, social cohesion and networks within communities.
Without healing and strong social capital, implementation of national programs and policies in
rural Liberia is likely to be thwarted as communities fail to rise to the challenge of
exercising collective ownership, initiative and cooperation.
…
Regional Dimensions: The causes and effects of the conflicts in Côte d'Ivoire, Liberia and
Sierra Leone are intimately linked. Restoration of a durable peace in the sub-region requires
that a number of key issues be addressed at the national and sub-regional levels.
…
Natural Resources: Mismanagement of natural resources has fueled and sustained civil
conflicts in Liberia. Proper administration of natural resources is essential




                                                                                                  66
Page 14
Additionally, the government will be working with countries in the region to deal with the
regional dimensions of conflict.

Page 14
2.3.2 Enhancing Effective Governance in a Post-Conflict Setting
Working alongside its partners, the Government of Liberia has already taken several key steps
to create institutions that will address conflict-related legacies of the civil war. These steps are
bolstered with associated policies and programs that are conflict-sensitive and that continue to
address the underlying factors perpetuating both income and non-income poverty in Liberia.
Amongst those efforts are:

Page 16
Empowering Local Governance: The government is clear on its commitment to decentralize
decision making and resource allocation to county and municipal governments. A key element
of this is empowering and engaging communities, especially the poor and vulnerable within
those, in the reconstruction process, in local governance and in addressing the root causes
of conflict.

Page 16
Given the challenges facing Liberia, policy choices for the government are quite clear: prevent
the nation from sliding back into conflict, build on the current peace to create an enabling
environment for prosperity and forge strategic and constructive partnerships internally and
with external partners to build a desirable future for the people of Liberia.

Page 21
A performance review of the 150-Day Action Plan suggests that good progress overall was
achieved on most of the targets _ about 70 percent of deliverables were completed, while
about 28 per cent were initiated and are still ongoing, to be dovetailed into the Interim Poverty
Reduction Strategy (iPRS). This is a very strong record for a new government in a difficult
post-conflict setting.

Page 24
The pillar working committees were responsible for galvanizing inputs from sectors and cross-
cutting groups and for conducting technical consultations. Each pillar working committee had
to describe the existing post-conflict situation, reform problems and inherent structural
weaknesses.

Page 29
In a post-conflict environment of extreme and widespread poverty with a very weak economy,
absence of employment opportunities, little or no socio-economic infrastructure and high
household dependency rates, everything is important and at worst, urgent. Yet financial
resources and capacities are very limited.

Page 31
The past has shown how vicious and symbiotic the cycle of poverty driving conflict and
conflict driving poverty really is. Considering this, the approach of the government in
addressing key sources of conflict, including poverty, will be holistic, taking into account the
multidimensional nature of peace and security.
Page 33



                                                                                                  67
Other key priority areas are: ensuring a smooth transfer from international peacekeeping to
national security institutions in assuming the role of maintaining peace and security in Liberia;
strengthening the judiciary and completing ongoing reform measures to enhance peace, human
rights and justice, deepen democratic values in Liberian culture and substantially reduce
gender-based violence; and building and implementing a conflict early warning system to
monitor and respond to threats of uprisings/insurgencies, as mandated by the Economic
Community of West African States for all national governments in the sub-region are the focus
of the Government.

Page 34
Table 4.1
Policy objective: To ensure that cross-border conflict is avoided and peace is maintained
within the region.

Page 37
Proper natural resource management is also critical in reducing corruption and
exploitation of resources to sustain conflict.

Page 40
While such a pattern of spending is understandable in a country emerging from prolonged
conflict, the government is committed to containing personnel-related spending in order to
facilitate the financing of programs with visible, on-the-ground impact.

Page 44
Given the severity of the post-conflict unemployment situation currently confronting Liberia,
rapid job creation is central to maintaining security (especially jobs aimed at ex-combatants
and youth), jump-starting the economy, rebuilding infrastructure, generating income and
fighting poverty.

Page 62
The government, along with its international partners, has also established institutions to
address conflict related legacies of the civil war and that will make the Liberian context more
responsive to development interventions.
….The University of Liberia established a Center for Conflict Transformation
which aims to undertake research, offer courses and give policy advice. The capacity of
Liberia's civil society in this area has noticeably increased; there are at least 20 national non-
governmental organizations (NGOs) that focus on peacebuilding initiatives and conflict
sensitive development issues across the country, as well as many faith-based organizations and
community-based organizations that undertake peacebuilding and conflict resolution in a
variety of forms.

Page 63
However, owing to the effect of conflict, there are serious institutional and technical capacity
gaps to adequately addressing gender equality issues.

The key objective of the government is to strengthen governance and the rule of law to
ensure Liberia does not witness conflict and gross violations of human rights again.


Page 65


                                                                                               68
Another key priority will be developing strategic responses to promote national, regional and
local inter-group reconciliation, as well as to resolve key conflicts that undermine national
security and poverty reduction. While a particular ministry or government institution might
take the lead on training, capacity-building or even the identification of strategic responses to
conflict, innovative inter-ministerial responses are likely required in order to properly address
protracted, multi-faceted conflict factors.

Page 65
Conflict-sensitive policymaking and conflict management
Though significant efforts to address the conflict legacy of Liberia are already being made, the
need for policymaking and planning to be conflict sensitive and for conflict management
capacity to be enhanced at all levels of government is critical to poverty reduction. To achieve
this, training and capacity-building focused on analytical and evaluative skills for conflict-
sensitive development will be given to representatives in all ministries and local government
institutions. Training in conflict management and resolution will also be conducted and
mechanisms put in place within ministries and local government institutions to resolve
conflict.

Page 66
Due to lack of good governance and rule of law, natural resources were used by various
warring factions to fuel civil conflicts.

Page 77
In the short term, the aim is to restore basic services to facilitate economic activities and
combat poverty. Without adequate infrastructure, the ability to reduce poverty is severely
hindered and increases the likelihood of a return to conflict.

Page 79
High rates of illiteracy among women owing to social, cultural, economic and conflict factors
severely undermines the prospects for poverty reduction and therefore, must be addressed.

Page 87
Although the poverty crisis and many of the other development problems predate the war, the
realities of Liberia as a post-conflict nation pose tremendous challenges for the formulation
and implementation of anti-poverty measures.

Page 89
The government appreciates this concerted support and would like to continue harnessing it for
the recovery, reconstruction and development process of post-conflict Liberia. The
government will continue to place emphasis on improving donor support, coordination and
harmonization.

Page 90
The monitoring and evaluation process will be linked with a program to enhance the capacity
for statistical data collection and analysis. The details of the monitoring and evaluation
architecture will be further developed during the iPRS period, building on best practices from
other countries, bearing in mind the post-conflict institutional challenges of Liberia.




                                                                                                69
Page 91
The Government of Liberia is committed to doing everything within its power to combat
poverty. There are, however, a number of risks that could frustrate this level of commitment
and derail strategy execution. Possible significant risks include shortfalls in financing, re-
emergence of conflict, limited leadership and administrative and technical capacities.

Page 91
Large numbers of unemployed youth increase the risk of them being used to refuel conflict.
The government is also aware of the risk associated with a lack of commitment and
engagement of stakeholders. The faster the strategy is implemented, the greater the chances for
minimizing the risk of slipping back into conflict.

The government intends to continue to be fully open, transparent and accountable.
Objectives are to ensure public support for government programs, build trust and minimize
the threat of a return to conflict.

Page 92
The history of conflict and turmoil over the past two decades is well established in the West
African sub-region. Yet today, Liberia enjoys extraordinary goodwill, regionally and in the
international community, and the fervent desire of the Liberian people for sustained peace is
proven. Regional institutional structures are likely to mitigate the risks of a relapse into
conflict over the medium term, however the goodwill that exists must be consolidated.

Page A2-1
The weak capacity endowments of Liberia have manifested themselves in many ways over the
years. This frailty has undoubtedly been exacerbated by violent conflict and associated adverse
effects. Capacity has been consistently weak in the public, private and civil society sectors.


FOOD INSECURITY

1.5.1 Food Insecurity
Food insecurity is a challenge in the current post-war Liberia with critical implications for
peace and security, economic revitalization and poverty reduction. Estimates indicate that
Liberia loses at least 1.2 per cent of GDP annually due to vitamin micronutrient deficiencies. A
joint Food and Agriculture Organization (FAO)/World Food program (WFP) Crop and Food
Security Assessment carried out in January/February 2006 found four major causes of food
insecurity in Liberia: agricultural production constraints; poor infrastructure and limited access
to markets; poor biological utilization of food due to lack of access to health services, safe
water and sanitation facilities; and lack of household labor and social support caused by a
general disruption of traditional social networks during the war.

In March/April 2006, the Government of Liberia carried out a countrywide Comprehensive
Food Security and Nutrition Survey (CFSNS), which found that:
-       11 per cent of the rural/semi-urban population are completely food insecure with a
maximum of 28 per cent in the area that was mostly affected by the war and
-       40 per cent are highly vulnerable and 41 per cent are moderately vulnerable to food
insecurity. Only 9 per cent are completely food secure dropping to almost 0 per cent in five
counties;




                                                                                                 70
Page 5
Box 1.1: Food Insecurity: A Recommended Approach
In transitioning from emergency to recovery and finally to development, the following
interventions are recommended to achieve food security in Liberia:
- Distribute free seeds, tools and food resettlement packages to farmers; food-for-work and
training activities should focus on population groups that are highly vulnerable to food
insecurity.
- Intensify interventions and capacity-building in animal pest control, crop diversification,
horticulture, improved preservation and storage techniques and improved processing and
marketing systems.
- Restock livestock and promote small-scale businesses and post-harvest industries and
services.
- Strengthen education programs, provide food-for-education programs and improve access to
basic health care services and to clean water and sanitation. Nutrition and health programs
should be implemented with a focus on child feeding practices, food reparation, dietary
diversity, immunization, micronutrients and HIV/AIDS.
- Enhance institutional capacity to manage interventions and resources devoted to improving
the food security and nutrition situation, including the development of an institutional policy
framework and a food security monitoring system.
- Implement sustainable land management practices.

Page 2
Foreword
Food insecurity prevails, which only exacerbates poverty.

MOBILE POPULATION



HIV and AIDS

Page xv
Pillar 4: Rehabilitating Infrastructure and Delivering Basic Services
The government has launched various programs to facilitate infrastructure rehabilitation and
the delivery of basic services. These include the rehabilitation of several hundred kilometers of
roads and a few bridges, rehabilitating schools, clinics and community health facilities,
financing community projects, beginning to rebuild the electricity grid, revitalizing the
national strategy to fight HIV/AIDS and the fight against malaria and tuberculosis,
rehabilitating water pipelines in certain parts of Monrovia, initiating the process of school
curriculum review, drafting a new national youth policy, launching a new girl's education
policy and increasing budgetary allocation for health and education. Over the short to medium
term, the government will continue to focus strongly on fundamental national infrastructure to
ensure telecommunications, transport, electricity, water and sanitation, education and health
and nutrition for all.




                                                                                              71
Page 5
Box 1.1: Food Insecurity: A Recommended Approach
In transitioning from emergency to recovery and finally to development, the following
interventions are recommended to achieve food security in Liberia:
- Strengthen education programs, provide food-for-education programs and improve access to
basic health care services and to clean water and sanitation. Nutrition and health programs
should be implemented with a focus on child feeding practices, food reparation, dietary
diversity, immunization, micronutrients and HIV/AIDS.

Page 6
1.5.3 Poor State of Basic Social Services
Health: …. Maternal mortality rate was estimated at 578 per 100,000 live births (LDHS 2000)
and the HIV/AIDS prevalence rate has risen to an estimated 5.2 per cent.

Page 27
Box 3.1 Key messages from the consultation process
- Establish and promote outreach programs for cholera, diarrhoea, malaria and HIV/AIDS
preventions.

Page 32
Strong health programs for security forces with prevention and awareness campaigns for
communicable diseases including HIV/AIDS will be undertaken, as well as programs to
prevent environmental degradation by security agencies.

Page 66
Enhancing youth development and involvement in the development process
The new national youth policy highlights the need for youth to be institutionally included in
decision making. Next steps will begin with the institutionalization of the national youth policy
through enactment into law by the legislature, committing the government to policy
formulation and budgetary allocation to positively impact youth in a number of key areas,
especially education and life skills, economic governance and HIV/AIDS, among others.

Page 77
Health activities must concentrate on malaria, HIV/AIDS, diarrhoea and other major diseases
that kill many Liberians.

The 150-Day Action Plan of the government set out a number of short-term objectives that
were pursued, including
…
- Rehabilitating about 36 high schools, 39 clinics and four community health facilities around
the country;
…..
- Revitalizing the national strategy to fight HIV/AIDS, providing 5,000 bed nets in malaria
endemic communities and medicine for 300 new cases of tuberculosis;

Page 79
The government will also strengthen financial management and
procurement systems to international standards by November 2007 and reconstitute
and implement the National AIDS Commission (NAC) by June 2007. Other major priority
areas include:
- Building the human capacities of health workers and health managers;


                                                                                              72
- Ensuring a financially sustainable primary health care system;
- Re-establishing an efficient health referral system;
- Reducing maternal, infant and under-five mortality rates;
- Reducing malnutrition among infants, children and pregnant/lactating mothers;
- Sustaining immunization rates at 80 per cent;
- Implementing strong programs to fight malaria, tuberculosis and HIV/AIDS (see box);
- Establishing early warning systems for epidemic response and disease control;
- Develop national social welfare policy and plan.

Page 80
Box 7.1:         Fighting HIV/AIDS
Since the first case of HIV/AIDS in Liberia was reported in 1986, it is estimated that the
HIV/AIDS prevalence rate had risen to 5.2 per cent. The advent of the war led to the spread of
the virus and the destruction of health infrastructure undermined the provision of treatment and
care for people living with HIV/AIDS, voluntary counselling and testing, safe blood and
prevention of mother to child transmission. Several factors add to the spread of the disease:
Liberia's high rates of poverty, cross-border movement of people and cultural risk factors such
as female genital mutilation. Less than 5 per cent of people living with HIV/AIDS are
currently on antiretroviral drugs and less than 5 per cent of the population has access to
voluntary counselling and testing.

The initial response of the government to the HIV/AIDS epidemic was the creation of the
National HIV/AIDS and STD Control Program in 1987 to facilitate inter-sectoral coordination
and the scaling-up of responses nationwide. Unfortunately, the civil war undermined these
efforts. The first real post-war initiative came in 2000 when the National AIDS Commission
(NAC) was established and a national HIV/AIDS strategic plan was developed. Despite this,
the NAC has not been very active. Even though the national HIV/AIDS strategic plan was
updated in 2004 and fully endorsed by stakeholders, it is not the basis for all funding
contributions.

Major efforts in recent years have come through an 8.7 million USD grant form the Global
Fund to Fight AIDS, tuberculosis and malaria, beginning in late 2004 and administered by the
United Nations Development program (UNDP). Public sector response to the HIV/AIDS crisis
has been mainly through the Ministry of Health and Social Welfare (MoH&SW), but other
ministries including the Ministry of Gender and Development (MoG&D), Ministry of Defense
(MoD), Ministry of Education (MoE) and Ministry of Labor (MoL) are gradually
mainstreaming HIV/AIDS awareness and responses into their work and programs. Community
and civil society commitment is still low, but action by some community-based organizations
focusing on awareness raising and condom promotion is visible in the field, especially
targeting youth. An assessment of the situation of orphans and vulnerable children to
HIV/AIDS has been completed. In addition, awareness raising, condom distribution and
voluntary counselling and testing activities are ongoing among international peacekeepers.

Noting the low knowledge levels of the population as well as among HIV/AIDS service
providers, the government will embark on a nationwide HIV/AIDS awareness campaign. In
addition, health service providers will undergo training in HIV/AIDS knowledge, universal
precautions against HIV, voluntary counselling and testing (VCT), prevention of mother to
child transmission, antiretroviral therapy management and home-based care. A legal
framework to address stigma and discrimination against people living with HIV/AIDS as well
as punishing those that deliberately infect others with HIV is vital. programs aimed at
HIV/AIDS prevention and care will be introduced in the workplace and in schools.


                                                                                             73
Efforts will be exerted to capacitate NAC to formulate and implement an HIV/AIDS policy
which takes into account gender-based vulnerabilities and risk factors for both men and
women, direct and coordinate multi-national sectoral activities in the fight against AIDS, as
well as mobilize and allocate resources. Additional efforts will be exerted to curtail the spread
of the epidemic through strengthening safe blood supply, waste management and preventing
mother to child transmission. Longer-term strategies will be needed to ensure that the fight
against HIV/AIDS is approached in an integrated manner, with HIV/AIDS prevention
programs operating in communities and all work places, institutions of learning, places of
worship and the informal sector. Attention will also need to be given to the care and welfare of
the increasing numbers of orphaned children.

Page 84
Table 7.1 Policy objectives and expected results for rehabilitating infrastructure and basic
social services for the period July 2006 – June 2008
Results/ Indicator: National AIDS Commission reconstituted and functional
Policy objective: To provide required guidance and leadership support in the fight against
HIV/AIDS.

Page 93
Since January 2006, the Liberian Institute for Statistics and Geo-Information Systems
(LISGIS) has been conducting the 2006-2007 LDHS. When completed in June 2007,
the LDHS will provide key indicators on child labor, maternal and infant mortality,
fertility rates and, for the first time, information on HIV/AIDS by sex.




                                                                                               74
                                                            8. NEPAL




                                                                                                                                                          9. Mobile population
                                                                                                                                     8. Food insecurity
                                    1. Humanitarian




                                                                                                         6. Emergency
                                                                                          5. Displaced
                                                                    3. Refugee
                                                      2. Disaster




                                                                                                                        7.Conflict




                                                                                                                                                                                            11. AIDS
                                                                                                                                                                                 10. HIV
                                                                                 4. IDP
                        Date
Country    Document     issued
 Nepal       PRSP       May 03           0               0             0           0          0              1             4               2                    0                 6             6


EMERGENCY:

Page 41
99. Fourth, the Plan will need to be interpreted as a strategic and flexible document.
While the overall strategy provides a broad framework and strategic interventions for poverty
reduction, and the key priorities themselves will need to be protected in terms of budget
allocations and funding, such interventions and policies will need to be reassessed from time to
time, and revised if necessary, in order to achieve the poverty reduction goals. A number of such
initiatives have already been taken in the first year of the Plan, such as the MTEF, education
sector reform package and, the emergency relief program, among others.


CONFLICT

Page 7
18. … extensive public discussions have been held at national and regional levels. These have
helped to evolve a broad consensus and wide support for the poverty reduction strategy and
structural reforms incorporated in the PRSP/Tenth Plan. While the conflict may have constrained
the consultation process in some parts of the western and far-western regions at that time, HMG
intends to expand the future consultation process to include all key stakeholders in these areas as
an ongoing process.

Page 70
187. Accordingly, under the Normal Case, an early resolution of the conflict, together with
efforts to “right size” the administration and reduced administrative costs, would help to bring
down the regular expenditure/GDP ratio from 12.7% this year (and 11.7% in 2001/02) to the pre-
conflict level of around 10% by 2006/07.

Page 75
196. ..a continuation of the domestic conflict, associated high security spending and constraints
on mobilizing adequate domestic revenue for financing development activities would be even
more of a concern. The recent pause in hostilities and the initiation of peace negotiations however
hold considerable promise in this regard; and over the past two months, there is evidence of some
pick up in economic activity, tourism and revenue collections, as well as considerable optimism
for a recovery in economic growth and development implementation.




                                                                                                                                                                                           75
FOOD INSECURITY

Page 45
115. The major outcomes which are expected from the effective implementation of programs in
the agriculture sector are that the production systems will be more diversified and agricultural
growth will increase by 4.1 percent p.a., and livestock by 4.9 percent p.a. Food insecurity and
malnutrition will also be reduced. Market access for agricultural products, as well as farmers'
incomes and consumption levels, will increase.

Page 92
Table 18
Outcome: Reduced food insecurity and significant contribution to income increases and reduction
in malnutrition and poverty in rural areas.


HIV and AIDS

Page 54
146. To address the health sector needs, the government formulated a Health Sector Strategy in
August 2002, which provides a coherent strategic framework to involve all the stakeholders. The
key sector objectives are: (i) Extending essential health care services to all, with special emphasis
on the poorer population living in rural areas; (ii) Management of the growing population by
enhancing the accessibility of rural population to family planning services and expanding
maternal and child health services; and (iii) Ensuring effective control of communicable diseases,
such as Malaria, and Tuberculosis, as well as HIV/AIDS.

Page 55
148. Focus programs particularly for immunization, safer motherhood and control and prevention
of communicable diseases such as HIV/AIDS, as well as a Health Insurance Scheme will be
initiated. Family planning and nutrition programs will be expanded and made more effective.

Page 57
154. (In relation to gender) In the health sector, the major thrusts of the program—emphasis on
MCH programs, family planning services, HIV/AIDS control,—should all help women. Mobile
clinics will also be used for this purpose.

Page 85
Table 18 (Human Development and Infrastructure Indicators). Diseases Incidence (TB, malaria,
HIV/AIDS). Levels of analysis/disagregation: NERUGS. Frequency of collection: 5-6 years.
Sources: HH Survey. Responsible agency: DoHS/CBS

Page 107
Table 18
Health: Objective: Increase essential health care services to all with special emphasis to
rural/remote/poor population.
Strategy: Expand accessibility/ facilities
Activities: Focus of the program in immunization, safer motherhood, control and prevention of
communicable diseases, malaria control, JE, TB and leprosy, HIV/AIDS and CDP programmes.
Immediate indicators: Proportion of TB/malaria/JE/leprosy/ HIV/AIDS etc. cases detected and
prevention and treatment measures. Condom use by 14-35 years old men increased to 35 percent.
Responsible agency: MOH, DOH.


                                                                                                  76
                                                      9. UGANDA




                                                                                                                                                          9. Mobile population
                                                                                                                                     8. Food insecurity
                                    1. Humanitarian




                                                                                                         6. Emergency
                                                                                          5. Displaced
                                                                    3. Refugee
                                                      2. Disaster




                                                                                                                        7.Conflict




                                                                                                                                                                                            11. AIDS
                                                                                                                                                                                 10. HIV
                                                                                 4. IDP
                        Date
Country    Document     issued
Uganda       PRSP       April 05    15                57            49           44       27             15             95                 1                    0                84         92

HUMANITARIAN

Page xxi
Pillar 3: Security, conflict-resolution and disaster management
The most severe disaster requiring response is internal displacement. While humanitarian aid is
treated off-budget, Government will continue to coordinate the response. Government will
consider allocating funds more flexibly to distressed districts and will involve IDPs actively in
planning and monitoring conditions in the camps, ensuring adequate attention to sanitation in
particular.

Page 100
5.2 Security and Defence
Since 2002, insecurity and violence against civilians and humanitarian organisations has
heightened, especially after the termination of the ceasefire in April 2003. This has made
humanitarian access to the Internally Displaced Persons (IDPs) very difficult, leading to a further
worsening of the humanitarian situation in Northern Uganda. Some relief agencies have been
forced to suspend their activities as a result of repeated attacks on their convoys resulting in loss
of lives and tonnes of relief aid. Civilians also suffer; about 20,000 children have to walk long
distances every evening in search of safety from abduction, and women and girls suffer from
sexual abuse. This explains in part why Northern Uganda has the highest infection rates of HIV in
the country.

Civilians often get caught in the crossfire. The humanitarian agency AVSI has recently reported
that 75 percent of the amputations in the Acholi area are due to war traumas, such as landmines
and other weaponry.

Page 107
5.4 Disaster Preparedness and Management
All the actions discussed below aim to ensure that when people are affected by disasters, they can
continue to meet their minimum needs through their own efforts, supported where necessary
through assistance that is appropriate in terms of type, timing, location, duration and method of
provision. Addressing these challenges will require a multisectoral approach involving various
government ministries, local governments, NGOs, humanitarian agencies, private sector and the
communities with the Office of the Prime Minister taking the lead.




                                                                                                                                                                                           77
Page 108
Disaster response
Internal displacement
Humanitarian assistance to IDPs is mainly provided by international agencies such as World
Food Programme, UNICEF and Red Cross Society to meet the needs of IDPs.

Page 109
Government treats humanitarian aid as off-budget because of its unpredictable nature and little
macroeconomic impact. However, its delivery needs to be better coordinated with security
operations and the delivery of other services.

Page 109
Priority Actions
Government will:
• Aim for better integration of humanitarian needs and existing resources into the national plans.
 Implement the policy of self-reliance in cooperation with other partners.
• Encourage donors supporting refugees to cooperate with local authorities in avoiding
duplication and cooperating in service delivery.

Page 114
Conflict-resolution and disaster management
Government will continue to treat humanitarian assistance off-budget, but improve its integration
into planning. The current insecurity has a number of implications for public expenditure,
namely:
• Increased cost of service delivery during conflict
• The cost of implementing the amnesty process and small arms control.
• The cost of the long run recovery of Northern Uganda
• Dealing with the immediate consequences of conflict. While humanitarian relief is critical,
Government has an obligation to act if humanitarian contributions are not available to meet the
needs. Moreover, some responses such as water supply and sanitation have long-run implications
and require integrated planning (in some cases water sources in camps have become polluted
because of the lack of sanitation).

The amounts needed in this sub sector are hard to quantify. Some insecure districts have had
difficulty spending their mainstream service delivery conditional grants. The priority is therefore
to allow adequate flexibility to these districts to spend money on immediate needs, subject to
reasonable accounting requirements. Government will therefore make provision for insecure
districts to spend their resources in a more flexible manner to meet immediate humanitarian
needs, with a particular focus on environmental health and sanitation in camps.
Incentives are also needed to attract staff to these areas; this is discussed in Chapter 6.

Page 231
PEAP Results and Policy Matrix
Pillar 3: Security, conflict resolution, and disaster management
PEAP Policy Actions: - Integrate humanitarian need and existing resources into the national plans

Page 260
Endnotes, Chapter 8
13 These aid projections do not include emergency humanitarian aid for refugees, internally
displaced persons, etc.



                                                                                                  78
DISASTER

Page v
Contents
5 Security, Conflict Resolution and Disaster Management ...................... 99
5.4 Disaster Preparedness and Management ........................................ 105
5.5 Planning for the aftermath of disaster and insecurity .................... 111

Page viii
List of tables
Table A 5.1: Major disasters in Uganda and their impact during 1966-2003 ....... 247

Page xv
Executive summary
The PEAP is grouped under five ‘pillars’: (1) Economic management, (2) Production,
competitiveness and incomes (3) Security, conflict-resolution and disaster-management (4) Good
governance and (5) Human development.

Page xx
Pillar 3: Security, conflict-resolution and disaster management
Uganda has suffered from insecurity of various kinds including rebel insurgency and, cattle
rustling. The country suffers from various forms of natural disaster in addition to the large
number of internally displaced persons.

Page xxi
Government will strengthen disaster preparedness, using the successful experience of the El Nino
rains in 2002, where the population was effectively protected. Central Government will promote
awareness of the risks and recommend actions to local governments.

Page xxi
The most severe disaster requiring response is internal displacement. While humanitarian aid is
treated off-budget, Government will continue to coordinate the response. Government will
consider allocating funds more flexibly to distressed districts and will involve IDPs actively in
planning and monitoring conditions in the camps, ensuring adequate attention to sanitation in
particular.

Page xxi
There are a number of initiatives that are intended to assist areas recovering from disaster and
insecurity, Government will streamline these initiatives. Regional plans will be mainstreamed
within sector strategies. The Northern Uganda Social Action Fund will provide funds for
communities to dedicate to projects they identify.

Page 5
1.3 Pillars and priorities
Security, conflict-resolution and disaster-management

Page 7
Chapter 2 discusses the phenomenon of regional inequality, and Chapter 5, on security, conflict-
resolution, and disaster-management, is centrally concerned with the North and parts of the East.




                                                                                                    79
Page 11
1.7 Structure of the PEAP
Chapter 2 sets out the existing state of knowledge about poverty in Uganda, and the implications
for poverty eradication strategy. Chapters 3 to 7 set out the actions planned under five pillars:
• Economic management
• Enhancing production, competitiveness and incomes
• Security, conflict resolution and disaster management
• Good governance
• Human development

Page 99
5 Security, Conflict Resolution and Disaster Management
5.1 Overview
Uganda continues to be severely affected by natural and man-made disasters and conflicts. The
prevalence of security in the country has long been recognised as a precondition for improved
human welfare and one of the key factors necessary for achieving all the other goals of the PEAP
and aspirations of Government.

Page 99
Disaster preparedness and management is an area that requires strengthened interventions to
reduce poverty among the most disadvantaged and vulnerable populations. The persistent
phenomenon of displacement in Uganda implies that Uganda’s disaster management policy must
be closely linked to issues of security and conflict resolution. For this reason, these issues are
handled together in this part of the PEAP.

It should be appreciated that not all security concerns may be resolved through the PEAP process
alone. Other processes, particularly in the political arena need to complement all efforts geared
towards conflict resolution in the affected areas. Communities should not only be seen as passive
recipients of agreed policy actions but rather should be facilitated to become active participants in
peace and disaster preparedness.

Page 105
5.4 Disaster Preparedness and Management
Disaster risk management
Disaster is defined as an event or series of events that give rise to casualties or damage/loss of
property, infrastructure, essential services or means of livelihood on a scale that is beyond the
normal capacity of the affected communities to cope unaided. In the short run, the main challenge
is the living conditions of people in the IDP camps. Several other disasters relate to the presence
of refugees in the country and environmental challenges.

Page 106
Refugees
Uganda has hosted refugees since the 1940s. Most of these refugees flee from neighbouring
countries, particularly Sudan, the Democratic Republic of Congo and Rwanda, due to armed
conflicts and abuse of human rights in their respective countries. Based on records from the
Department of Disaster Management and Refugees, as of August 2003, Uganda hosts over
200,000 refugees, 75 percent of whom originate from Sudan.




                                                                                                  80
Page 107
Other disasters
Between 1980 and 2003, one in thirty people in Uganda were affected by a natural or man-made
disaster. The death toll resulting from disasters in the country is estimated to exceed 50,000
persons annually (Security, Conflict Resolution and Disaster Management SPRP, 2003). The
major disasters that have occurred in Uganda since the 1960s are shown in Annex Table 5.1.
Section 5.4 discusses Government’s responses to these challenges.
Government has implemented a number of programmes since 1986 to address disaster related
problems. These have included: ….
- Emergency Relief and Rehabilitation Programme (ERRP) that began in 1986 resettling the
displaced populations from past civil wars by availing essential communities and provision of
essential infrastructure and social services;
- Programme for the Alleviation of Poverty and Social Costs of Adjustment (PAPSCA)
implemented during 1989-1995
- Current programmes under the Office of the Prime Minister – Disaster Preparedness and
Refugees; Luwero Triangle Rehabilitation; and Pacification and Development of Northern
Uganda and Karamoja.

The main challenge with all these programmes is that responses to disaster have been mainly
reactive rather than anticipatory and they have tended to focus on only two stages of the disaster
cycle – response and rehabilitation. Hence the framework set out here starts with prevention and
preparedness.

All the actions discussed below aim to ensure that when people are affected by disasters, they can
continue to meet their minimum needs through their own efforts, supported where necessary
through assistance that is appropriate in terms of type, timing, location, duration and method of
provision.

Disaster prevention and preparedness
Improving preparedness is the key to reducing disasters. Disaster preparedness aims to minimize
the adverse effects of a hazard through effective precautionary measures as well as ensuring
timely, appropriate and efficient organisation and delivery. This goes hand in hand with disaster
management, which deals with the consequences of the disaster when it occurs.

Page 108
Many disaster preparedness actions need to be mainstreamed into sectoral programmes. For
example, classrooms in earthquake prone areas can be designed to withstand earthquakes, while
classrooms in windstorm prone areas such as Bubulo County should be designed to withstand
windstorms. More generally, local investments that are needed to avoid disaster, such as
strengthening river embankments, can be considered under the district’s capital budget under a
scheme such as LGDP. Central Government’s role will be mainly to promote awareness about the
risks and recommend actions to local Governments and to build up a Contingencies Fund, as
mandated by the Public Finance and accountability Act. Access to this Fund will be conditional
on strict criteria in terms of emergency needs responding to a disaster. Geographical Information
Systems will be used to identify the areas of greatest risk.

The national Disaster Preparedness and Management Act and Policy is due for consideration by
Parliament and implementation during 2004-5.




                                                                                                 81
Priority actions
Government will:
• Mainstream disaster preparation considerations into sectoral programmes
• Consider funding disaster preparation measures under the LGDP programme.
• Promote awareness of the need for disaster preparedness measures through provision of public
information at all levels.
• Establish an Emergency Contingencies Fund in accordance with the Public Finance and
Accountability Act.
Disaster response
The form of disaster response that is most needed in the immediate future is that of addressing the
problems confronted by internally displaced people as well as refugees. The special needs of
conflicts affected districts and areas in delivering public services need to be recognized

Page 111
5.5 Planning for the aftermath of disaster and insecurity
Page 114
Conflict-resolution and disaster management

Page 114
Disaster prevention
Disaster prevention should mainly be addressed under the local Government investment budget.

Page 157
Improving access
Government will use the following methods of improving access:
• Provision of basic education in emergency situations e.g. psychosocial support, construction of
temporary infrastructure in cases of disaster among others.

Page 194
Pillar 3: Security, conflict-resolution and disaster management

Page 231
PEAP Results and Policy Matrix
Pillar 3: Security, conflict resolution, and disaster management
Strategic Objectives 3. Protection of persons and their property through elimination of conflicts
and cattle rustling, resettlement of IDPs, and strengthened disaster management

Page 235
PEAP Results and Policy Matrix
Pillar 5: Human development
PEAP Policy Actions: - Provision of basic education in emergency situations e.g. psychosocial
support, construction of temporary infrastructure in cases of disaster among others.

Page 247
Table A 5.1: Major disasters in Uganda and their impact during 1966-2003




                                                                                                    82
REFUGEE

Page xxi
Pillar 3: Security, conflict-resolution and disaster management
Refugees numbered over 200,000 in mid-2003. The management of the issue will be
mainstreamed into district planning. Government will continue to implement the policy on self-
reliance of refugees.

Page 29
2.6 Empowerment
The steps taken by Government through various social policies and programmes for
disadvantaged groups like, women, widows, the youth, the elderly, neglected children and
orphans, people with disabilities, the displaced and refugees are central to poverty reduction
initiatives over the PEAP period.

Page 105
5.4 Disaster Preparedness and Management
Disaster risk management
Disaster is defined as an event or series of events that give rise to casualties or damage/ loss of
property, infrastructure, essential services or means of livelihood on a scale that is beyond the
normal capacity of the affected communities to cope unaided. In the short run, the main challenge
is the living conditions of people in the IDP camps. Several other disasters relate to the presence
of refugees in the country and environmental challenges.

Page 106
Refugees
Uganda has hosted refugees since the 1940s. Most of these refugees flee from neighbouring
countries, particularly Sudan, the Democratic Republic of Congo and Rwanda, due to armed
conflicts and abuse of human rights in their respective countries. Based on records from the
Department of Disaster Management and Refugees, as of August 2003, Uganda hosts over
200,000 refugees, 75 percent of whom originate from Sudan. About 80 percent of all the refugees
in Uganda live in Northern Uganda, particularly in the districts of Adjumani, Moyo, Arua and
more recently Yumbe. The rest of the refugees are settled in the West and South Western parts of
Uganda.

Page 107
The majority of refugees hosted in Uganda were poor in their countries of origin and come when
they have lost all their property. They are usually hosted in remote rural areas where the host
communities are also impoverished. The majority of refugees are women, children, physically
and mentally handicapped and the aged, which increases their vulnerability to poverty.

Government has implemented a number of programmes since 1986 to address disaster related
problems. These have included:
• Emergency Relief and Rehabilitation Programme (ERRP) that began in 1986 resettling the
displaced populations from past civil wars by availing essential communities and provision of
essential infrastructure and social services;
• Programme for the Alleviation of Poverty and Social Costs of Adjustment (PAPSCA)
implemented during 1989-1995
• Current programmes under the Office of the Prime Minister – Disaster Preparedness and
Refugees; Luwero Triangle Rehabilitation; and Pacification and Development of Northern
Uganda and Karamoja.


                                                                                                 83
Page 108
Disaster response
The form of disaster response that is most needed in the immediate future is that of addressing the
problems confronted by internally displaced people as well as refugees. The special needs of
conflicts affected districts and areas in delivering public services need to be recognized.

Page 110-111
Refugee Management
The national policy on refugees has the twin objectives of protecting refugees in such a way as to
protect national interests while meeting international standards. By promoting self-reliance,
refugees hosted by Uganda are enabled to become an asset to the country. To this end, arable land
has been allocated to enable the refugees become self-sufficient. In total, Government has
allocated well over 3300km2 of arable land for refugees. The settlement of refugees in rural areas
has social and economic implications on the host community which have to be given due
consideration. Key challenges include:
• Large numbers of refugees in the allocated areas have put pressure on the environment through
deforestation and poor sanitation.
• There is strain on social amenities including health and education services, and land in the
districts hosting refugees.
• HIV/AIDS prevalence is relatively high in refugee-affected regions. Displacement and
migrations from other countries increases the host communities’ exposure to STDs. Redundancy,
trauma, poverty and ignorance also contribute to the spread of diseases.
• Refugees also continue to suffer from insecurity like all the other nationals.
• There is need to improve the living conditions in the refugee-hosting communities.

Generally, funding for refugee programmes from Government is limited. Refugees are mainly
assisted under the UNHCR country programme. However, the annual budget for the country
programme has fallen from US$14 million in 2000 to US$10 million in 2003. This funding is
used to deliver multisectoral activities for refugees in health, education, community services,
environment, agriculture and the running costs of UNHCR and NGOs involved in the refugee
programme.

Being an emergency issue, expenditure on refugees is not treated as part of the MTEF. However,
costs can be saved if the planning of refugees’ needs can be integrated into the districts’ normal
planning. This would imply that the districts received resources adequate to cope with the flow of
refugees and included refugees in the services they deliver. Districts and development partners
are encouraged to cooperate in merging activities as far as possible to avoid duplication.
Successful implementation of this approach can minimise damage to host communities, create
infrastructure and promote amicable relations.
A policy on self-reliance of refugees has been implemented since 1999. Its focus is on
enhancement of household incomes and well-being of refugees and host communities and
development of an appropriate legal and institutional framework to foster productive activities
and the relevant civil, social and economic rights.

Priority Actions
Government will:
• Aim for better integration of humanitarian needs and existing resources into the national plans.
• Implement the policy of self-reliance in cooperation with other partners.
• Encourage donors supporting refugees to cooperate with local authorities in avoiding
duplication and cooperating in service delivery.


                                                                                                  84
Page 123
6.2 Justice, Law and Order
Particular social groups face specific obstacles in gaining access to justice. For example, ethnic
minorities can suffer from lack of literacy and awareness of the justice system. There are an
estimated 1.4 million IDPs and 230,000 refugees, mainly in Northern Uganda. With limited JLOS
presence in the Northern region, the ability to provide the required levels of service delivery is
severely constrained. As a result of the conflict in the northern region JLOS activities have been
badly affected, and the police anticipate increased crime in the aftermath of conflict because of
youth unemployment and possible acts of revenge.

Page 151
AIDS in Uganda
HIV/AIDS also affects development at the micro level. Particular social groups like children,
OVC, women, refugees and internally displaced people have been specially hit by the epidemic
due to their disadvantaged position and low incomes. It is estimated that Uganda has over 2
million orphan children, around 50% of whom are due to AIDS. This number is expected to
increase over the next decade, increasing the risk of children becoming street children, or a target
for abuse and exploitation.

Page 231
PEAP Results and Policy Matrix
Pillar 3: Security, conflict resolution, and disaster management
Strategic Objectives 3 Protection of persons and their property through elimination of conflicts
and cattle rustling, resettlement of IDPs, and strengthened disaster management
Challenges/ Constraints: Uganda hosts over 200,000 refugees, which add pressure on the use of
local resources
PEAP Outcomes/indicators: 3.1 Enhanced refugees self reliance. % of MTEF budgetary
resources allocated to Refugee programs in targeted districts
PEAP Policy Actions: - Integrate humanitarian need and existing resources into the national plans
- Implement the policy of self-reliance in cooperation with other partners
- Encourage Donors supporting refugees to cooperate with local authorities in refugees service
delivery

Page 247
Table A 5.1: Major disasters in Uganda and their impact during 1966-2003
1986-2003 - Northern conflict in Acholi, Lango and Teso regions - Over 1m people displaced,
over 200,000 refugees; an average US$ 100 million is lost each year.

Page 260
Endnotes, Chapter 8
13 These aid projections do not include emergency humanitarian aid for refugees, internally
displaced persons, etc.




                                                                                                  85
IDP

Page vii
List of Tables
Table 5.2: Total number of IDPs by district by 10th October 2003 ........................... 106

Page xxi
Pillar 3: Security, conflict-resolution and disaster management
The most severe disaster requiring response is internal displacement. While humanitarian aid is
treated off-budget, Government will continue to coordinate the response. Government will
consider allocating funds more flexibly to distressed districts and will involve IDPs actively in
planning and monitoring conditions in the camps, ensuring adequate attention to sanitation in
particular.

Page 16
Insecurity
Some areas, such as the East, have experienced an increase in insecurity-related poverty, partly
because there has been distress migration into the East from disturbed parts of the North,
including the relocation of some camps for IDPs. However, the proportion of households in the
sample in the East who report that they migrated to escape insecurity is low, so the observed
deterioration in the East may mainly reflect other factors.

Page 52
4 Enhancing production, competitiveness and incomes
… The situation in northern Uganda requires special attention. Ending the war, resettling IDPs
and enabling them to become productive citizens and rebuild their livelihoods is critical.

Page 76
Housing
The national housing stock is estimated at 4.2 million units of which less than 20% are of
permanent construction materials. About 50% are semi permanent and the remaining 30% are
grass-thatched huts. In urban areas, over 60% of residents in urban areas stay in slums,
characterised by poor sanitation, high disease incidence and frequent epidemics. The increase in
the number of IDPs further aggravates the housing problem.

Page 100
5.2 Security and Defence
…Since 2002, insecurity and violence against civilians and humanitarian organisations has
heightened, especially after the termination of the ceasefire in April 2003. This has made
humanitarian access to the Internally Displaced Persons (IDPs) very difficult, leading to a further
worsening of the humanitarian situation in Northern Uganda. Some relief agencies have been
forced to suspend their activities as a result of repeated attacks on their convoys resulting in loss
of lives and tonnes of relief aid. Civilians also suffer; about 20,000 children have to walk long
distances every evening in search of safety from abduction, and women and girls suffer from
sexual abuse. This explains in part why Northern Uganda has the highest infection rates of HIV in
the country.




                                                                                                    86
Page 105
5.4 Disaster Preparedness and Management
Disaster risk management
Disaster is defined as an event or series of events that give rise to casualties or damage/loss of
property, infrastructure, essential services or means of livelihood on a scale that is beyond the
normal capacity of the affected communities to cope unaided. In the short run, the main challenge
is the living conditions of people in the IDP camps. Several other disasters relate to the presence
of refugees in the country and environmental challenges.

Page 105
Internal Displacement
As a result of insecurity, Uganda was estimated in October 2003 to be hosting slightly over 1.4
million internally displaced persons (IDPs) living in camps and other places such as school and
church premises (see Table 5.2). About 80% of the IDPs are women and children. The majority
of the IDPs reside in camps in Northern Uganda. By virtue of the large IDP numbers, the camps
where they live generally lack the basic amenities such as proper shelter, safe water, clothing and
sanitation. Many of the children have dropped out of school due to lack of educational necessities
and school facilities. IDPs’ access to farmland and work opportunities is severely hampered by
the prevailing insecurity. The IDPs in Northern Uganda are able to access between 35 percent and
50 percent of their own minimum basic food needs through own production, market purchase and
casual labour for food. Hence many households are dependent on food aid and some studies have
found a high incidence of malnutrition. Together with a relatively high risk of prostitution and
low level of awareness, HIV infection is also a major concern for IDPs.

Page 106
Table 5.2: Total number of IDPs by district by 10th October 2003
Total IDP population 1,405,976 (46.9% of total population)

Page 106
There are also displaced people on the streets of Gulu, Kitgum and Pader, and in towns in
neighbouring districts like Soroti, Masindi and Lira. In general these people are not registered as
IDPs and therefore are unable to benefit from relief distribution or other assistance. They may
therefore be highly insecure. The population of the northern towns grew sharply over the 1990s,
reflecting displacement.

Page 108-109
Internal Displacement
Government is finalizing the IDP policy. The policy commits Government to ensure freedom of
movement for internally displaced persons, as well as the delivery of basic services, and specifies
entitlements to such items as food, shelter and clothing. Government aims at ensuring that people
return to their previous places of residence or migrate permanently, and that they are secure
whichever they choose to do. Humanitarian assistance to IDPs is mainly provided by international
agencies such as World Food Programme, UNICEF and Red Cross Society to meet the needs of
IDPs. For example, the WFP in 2003 distributed over 75,000 metric tones of relief food
commodities valued at US$ 40.7 million to 1,397,899 IDPs in Gulu, Kitgum, Pader, Lira, Soroti,
Kaberamaido, Katakwi and Kumi. However, poor road conditions and insecurity have caused
irregularities in food distributions. WFP also supports 95,000 school children in displaced camps
and over 17,000 persons affected by HIV/AIDS.




                                                                                                 87
Government treats humanitarian aid as off-budget because of its unpredictable nature and little
macroeconomic impact. However, its delivery needs to be better coordinated with security
operations and the delivery of other services. This essential coordination role of Government is
undertaken at the local level by district authorities and at national level by the Prime Minister’s
Office. Government appreciates the cooperation of local authorities with donors in promoting
block farming in the immediate neighbourhood of some IDP camps.

Concern has been raised by Civil Society on inadequacy of sanitation facilities.
Government will address this and seek the active involvement of IDPs in planning and
monitoring the sanitation conditions in the camps regularly. A post-conflict plan that respects IDP
rights to security, livelihood, services and participation in decision making will be put in place,
including measures to facilitate resettlement and rehabilitation of the IDPs. While many IDPs will
leave the camps, it is possible that some camps will evolve into permanent urban centres. In such
cases, the normal structures of local government will be established and services provided as with
other urban centres.
Priority actions
• Government will develop concrete plans to implement the IDP policy, in cooperation with key
stakeholders including donors and civil society.
• Where appropriate, increased flexibility may be given to distressed districts to divert money
from activities that are currently impractical to meeting the immediate needs of the IDPs.
• Better monitoring and improvement of conditions in the IDP camps is a key priority, with a
particular focus on health and sanitation.
• Through stakeholder consultations, Government will implement appropriate long term measures
to deal with the challenge of IDPs in the country.

Page 111
5.5 Planning for the aftermath of disaster and insecurity
Existing and proposed programmes
A major issue will be the role of transitional support as communities recover. For instance,
packages of productive assets might be provided to IDPs who wish to return home and take up
productive activities. Given the exceptional circumstances, such ‘start-up’ help would not
necessarily contravene Government’s general focus on the provision of public goods rather than
productive assets to households.

Page 123
Particular social groups face specific obstacles in gaining access to justice. For example, ethnic
minorities can suffer from lack of literacy and awareness of the justice system. There are an
estimated 1.4 million IDPs and 230,000 refugees, mainly in Northern Uganda. With limited JLOS
presence in the Northern region, the ability to provide the required levels of service delivery is
severely constrained. As a result of the conflict in the northern region JLOS activities have been
badly affected, and the police anticipate increased crime in the aftermath of conflict because of
youth unemployment and possible acts of revenge.

Page 150
Sanitation
…Sanitation in IDP camps is a particularly urgent issue, because major inadequacies in sanitation
are causing outbreaks of disease such as cholera.




                                                                                                      88
Page 172
The rapid increase in primary school classrooms and enrolment in response to Universal Primary
Education (UPE) increased pressure on the limited sanitation facilities available. In 2000 only 8%
of primary schools had sufficient latrines for the number of students attending, and only one third
of the schools had separate latrines for girls. According to the Ministry of Health (2000) 2.7% of
all students’ time is lost to sickness from sanitation related illnesses. Sanitation is a particularly
important issue in the crowded circumstances of IDP camps.

Page 194
Pillar 3: Security, conflict-resolution and disaster management
Ending the insecurity and coping with its aftermath imply a number of specific public expenditure
requirements, including:
• Support to districts where service delivery costs are increased by insecurity (e.g. armed escorts).
• Flexible funding to allow special service delivery measures for areas where conventional service
delivery is impractical (e.g. learning centres for children in IDP camps). This may not require
funding which is additional to existing allocations, because such districts often have problems
spending the existing conditional grants.
• Assistance to people in camps, especially for sanitation. Food and shelter receive significant
donor support, but it is reported that sanitation is a problem.
• Psycho-social support to people traumatised by conflict, especially abducted children.
• Post-conflict security: it will be necessary to review policing needs as the conflict ends.
• Amnesty; it is important for Government to provide support to rebels who have asked for
amnesty, although the support should not be so generous that people falsely claim rebel status.
• Support to IDPs who wish to return to their previous residence, and/or support to the long-term
evolution of some IDP camps into urban settlements.
• Small arms control in the region (especially for Karamoja).
• Hardship allowances or other facilitation for recruitment of frontline staff in insecure districts.
(This should be mainstreamed into the relevant sectoral strategies).

Page 216
Gaps in Information and Underused Information
Effective M&E also requires a reasonably comprehensive information base, but some gaps exist
in the Uganda data base, which weaken M&E. For example, household surveys are incomplete in
areas of insecurity. Surveys of users of services (beneficiaries) have been less systematic than the
surveys on expenditures and activities on the one hand and poverty impact on the other hand (the
“missing middle” problem). Over time, these weaknesses should diminish in importance as the
security situation improves, the quality of the National Service Delivery Surveys improve, and
the concept of “client score cards’ catches on.
One area where better monitoring is particularly badly needed is in the conditions of IDPs in the
camps. Government’s ability to respond quickly enough to problems in the camps depends on
timely and accurate information.




                                                                                                   89
Page 231
PEAP Results and Policy Matrix
Pillar 3: Security, conflict resolution, and disaster management
Strategic Objectives 3. Protection of persons and their property through elimination of conflicts
and cattle rustling, resettlement of IDPs, and strengthened disaster management
Challenges/ Constraints: Over 1.6 million people are internally displaced with poor condition of
life.
PEAP Outcomes/indicators: 3.3. Reduced number of people internally displaced
- Number of people internally displaced (million)

PEAP Policy Actions: - Develop concrete plans to implement the IDP policy, in cooperation with
key stakeholders including donors and civil society
- Better monitoring and improvement of conditions in the IDP camps is a key priority, with a
particular focus on health and sanitation.


DISPLACED

Page xx
Pillar 3: Security, conflict-resolution and disaster management
Uganda has suffered from insecurity of various kinds including rebel insurgency and, cattle
rustling. The country suffers from various forms of natural disaster in addition to the large
number of internally displaced persons.

Page xxiv
Health
The health sector is slowly recovering from the decline in social services experienced during the
1970s and 1980s. The Health Sector Strategic Plan is being implemented in a phased manner,
reflecting resource constraints. Priorities include hygiene and sanitation; immunisation; malaria
control; information, education and communication; reproductive health and HIV/AIDS. Under
the HSSP Government has upgraded infrastructure, abolished user fees in public facilities,
provided subsidies to the not-for-profit sector, and upgraded training and enhanced drug
availability. As a result, the usage of the public health system has expanded dramatically, though
the impact on health outcomes is not yet known. Government will continue to implement these
reforms and will prioritise preventive care under the new (HSSP II) Cross-Cutting Cluster: Health
Promotion, Prevention and Community Health Initiatives. Elements of this CCC include health
education and promotion, environmental health, control of diarrhoeal diseases, school health and
community health, internally displaced populations and extension work from other sectors. In
addition, insecticide treated nets, vaccination, family planning messages, and IEC messages.

Page 2
Core Challenges and Priority Action for the PEAP
• Restoring security, dealing with the consequences of conflict, and improving regional equity
Over the PEAP period, Government will endeavour to end armed conflict in all parts of the
country, to enable Internally Displaced Persons (including formerly abducted children) to return
home or to find new livelihoods (according to their preference), and to start to repair the damage
done by the war to the economies of the North and North-East.




                                                                                                90
Page 14
2.1 Income, poverty and inequality
The results in Table 2.1 have a number of implications for poverty in the period 2000-2003:
The regional shares of population changed markedly, with an increase in the share of the East and
a reduction in the share of the North. This partly reflects the movement of some displaced persons
to the East because of insecurity.

Page 21
The displaced
One of the most serious forms of poverty in Uganda is the living conditions of people in camps.
While rigorous data are scarce, some studies have shown alarmingly high rates of malnutrition in
the camps. This group is not always easy to identify within the household surveys, although a
pointer is that poverty was high in the 2003 survey among people now resident in the East who
had recently moved from other districts. Improved monitoring of the living conditions of people
in camps is a high priority research need.

Page 29
2.6 Empowerment
The steps taken by Government through various social policies and programmes for
disadvantaged groups like, women, widows, the youth, the elderly, neglected children and
orphans, people with disabilities, the displaced and refugees are central to poverty reduction
initiatives over the PEAP period.

Page 30
Ending these forms of inequality represents a major challenge. Displaced people also represent an
important, relatively disempowered group.

Page 99
5 Security, Conflict Resolution and Disaster Management
5.1 Overview
Nationally, over 5% of the population has been displaced and the effects on poverty spread
beyond the distress suffered by the displaced.

Current circumstances present four major challenges in this part of the PEAP:
• First, the country needs to end the rebel insurgency.
• Secondly, the destructive pattern of cattle-rustling needs to cease.
• Thirdly, the conditions of life of internally displaced people need to be addressed both in the
short run (while they are still displaced) and in the long run (by successful reintegration into
normal life, including psychological recovery).
• Fourthly, the country needs to develop capacity to anticipate crises including conflicts.

Page 100
Since 2002, insecurity and violence against civilians and humanitarian organisations has
heightened, especially after the termination of the ceasefire in April 2003. This has made
humanitarian access to the Internally Displaced Persons (IDPs) very difficult, leading to a further
worsening of the humanitarian situation in Northern Uganda.




                                                                                                    91
Page 105
5.4 Disaster Preparedness and Management
..Internal Displacement
As a result of insecurity, Uganda was estimated in October 2003 to be hosting slightly over 1.4
million internally displaced persons (IDPs) living in camps and other places such as school and
church premises (see Table 5.2). About 80% of the IDPs are women and children. The majority
of the IDPs reside in camps in Northern Uganda. By virtue of the large IDP numbers, the camps
where they live generally lack the basic amenities such as proper shelter, safe water, clothing and
sanitation. Many of the children have dropped out of school due to lack of educational necessities
and school facilities.

Page 106
There are also displaced people on the streets of Gulu, Kitgum and Pader, and in towns in
neighbouring districts like Soroti, Masindi and Lira. In general these people are not registered as
IDPs and therefore are unable to benefit from relief distribution or other assistance. They may
therefore be highly insecure. The population of the northern towns grew sharply over the 1990s,
reflecting displacement.

Page 107
Government has implemented a number of programmes since 1986 to address disaster related
problems. These have included:
• Emergency Relief and Rehabilitation Programme (ERRP) that began in 1986 resettling the
displaced populations from past civil wars by availing essential communities and provision of
essential infrastructure and social services;

Page 108
Disaster response
The form of disaster response that is most needed in the immediate future is that of addressing the
problems confronted by internally displaced people as well as refugees. The special needs of
conflicts affected districts and areas in delivering public services need to be recognized.

Internal Displacement
Government is finalizing the IDP policy. The policy commits Government to ensure freedom of
movement for internally displaced persons, as well as the delivery of basic services, and specifies
entitlements to such items as food, shelter and clothing. Government aims at ensuring that people
return to their previous places of residence or migrate permanently, and that they are secure
whichever they choose to do.

Page 109
WFP also supports 95,000 school children in displaced camps and over 17,000 persons affected
by HIV/AIDS.

Page 110
Service delivery in conflict-affected areas
In addition to emergency-related activities, local authorities have to support normal service
delivery in the context of insecurity. Even where the population served is not displaced, insecurity
imposes extra costs.




                                                                                                 92
Page 151
HIV/AIDS also affects development at the micro level. Particular social groups like children,
OVC, women, refugees and internally displaced people have been specially hit by the epidemic
due to their disadvantaged position and low incomes. It is estimated that Uganda has over 2
million orphan children, around 50% of whom are due to AIDS. This number is expected to
increase over the next decade, increasing the risk of children becoming street children, or a target
for abuse and exploitation.

Page 231
PEAP Results and Policy Matrix
Pillar 3: Security, conflict resolution, and disaster management
Strategic Objectives 3. Protection of persons and their property through elimination of conflicts
and cattle rustling, resettlement of IDPs, and strengthened disaster management
Challenges/ Constraints: Over 1.6 million people are internally displaced with poor condition of
life.
PEAP Outcomes/indicators: 3.3. Reduced number of people internally displaced
- Number of people internally displaced (million)
PEAP Policy Actions: - Develop concrete plans to implement the IDP policy, in cooperation with
key stakeholders including donors and civil society
- Better monitoring and improvement of conditions in the IDP camps is a key priority, with a
particular focus on health and sanitation.

Page 247
Table A 5.1: Major disasters in Uganda and their impact during 1966-2003
1981-1986 Civil strife – 500,000 displaced
1986-2003 - Northern conflict in Acholi, Lango and Teso regions - Over 1m people displaced,
over 200,000 refugees; an average US$ 100 million is lost each year.

Page 260
Endnotes, Chapter 8
13 These aid projections do not include emergency humanitarian aid for refugees, internally
displaced persons, etc.


EMERGENCY

Page xxiii
Government will take measures to improve the efficiency of primary education, including multi-
grade teaching, double-shift teaching, and incentives for teachers in hard-to reach areas. Quality
will be improved by teacher training, implementing the use of mother tongue in lower grades, and
increasing the relevance of the curriculum. Access will be improved by the continued provision
of schools and classroom facilities, training teachers in special needs education, and provision of
basic education in emergency situations.

Page 107
Other disasters
Government has implemented a number of programmes since 1986 to address disaster related
problems. These have included:
• Emergency Relief and Rehabilitation Programme (ERRP) that began in 1986 resettling the
displaced populations from past civil wars by availing essential communities and provision of
essential infrastructure and social services;


                                                                                                  93
Page 108
Central Government’s role will be mainly to promote awareness about the risks and recommend
actions to local Governments and to build up a Contingencies Fund, as mandated by the Public
Finance and accountability Act. Access to this Fund will be conditional on strict criteria in terms
of emergency needs responding to a disaster. Geographical Information Systems will be used to
identify the areas of greatest risk.

Priority actions
Government will:
• …...
• Establish an Emergency Contingencies Fund in accordance with the Public Finance and
Accountability Act.

Page 110
Service delivery in conflict-affected areas
In addition to emergency-related activities, local authorities have to support normal service
delivery in the context of insecurity.

Page 110
Being an emergency issue, expenditure on refugees is not treated as part of the MTEF. However,
costs can be saved if the planning of refugees’ needs can be integrated into the districts’ normal
planning.

Page 111
5.5 Planning for the aftermath of disaster and insecurity
The challenge is to integrate these various initiatives into a coherent programme that addresses
the needs of conflict-afflicted areas. Since these expenditures are for development rather than
emergency, they form part of the MTEF, and in the long run the actions proposed in them cannot
be funded unless they are integrated into the strategies of the various sectors.

Page 157
Priority actions in primary education
Improving access
Government will use the following methods of improving access:
• Provision of basic education in emergency situations e.g. psychosocial support, construction of
temporary infrastructure in cases of disaster among others.

Page 231
PEAP Results and Policy Matrix
Pillar 5: Human development
Strategic Objectives 3: 5.1 Better Educated Ugandans
Challenges/ Constraints: Not all primary school age are attending school
PEAP Outcomes/indicators: 5.1.1 Increased primary enrolment. - Net primary enrolment rate
(Disaggregated by gender)
PEAP Policy Actions: Government will use the following methods of improving access:
- Provision of basic education in emergency situations e.g. psychosocial support, construction of
temporary infrastructure in cases of disaster among others.




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CONFLICT

Page iii
Foreword
In the current revision, Government has taken stock of the achievements so far attained and the
remaining challenges. The challenges include the following: (a) to consolidate national security,
deal with the consequences of conflict, and improve regional equity; (b) to restore sustainable
growth in the incomes of the poor; (c) to build strong social and economic infrastructure; (d) to
enhance human development; and (e) to use public resources more efficiently. Over the next three
years, Government will focus its attention on addressing these challenges.

Page v
Contents
Security, Conflict Resolution and Disaster Management ...................... 99
5.3 Conflict-resolution .......................................................................... 102
5.6 Public expenditure implications for security, conflict-resolution and defence ........ 114

Page viii
Table A 4.5: Forms of land conflicts in registered and unregistered land ............ 245

Page xv
Executive Summary
Four core challenges for the PEAP are (a) the restoration of security, dealing with the
consequences of conflict and improving regional equity (b) restoring sustainable growth in the
incomes of the poor (c) human development (d) using public resources transparently and
efficiently to eradicate poverty. The PEAP is grouped under five pillars’: (1) Economic
management, (2) Production, competitiveness and incomes (3) Security, conflict-resolution and
disaster-management (4) Good governance and (5) Human development.

Page xx
Pillar 3: Security, conflict-resolution and disaster management

… The search for peaceful methods of conflict-resolution will continue; Government will
cooperate with CSOs, faith-based groups and traditional leaders. Diplomatic ties with countries
will be strengthened to assist with conflict-resolution.

Page 2
This set of circumstances implies the following core priorities for action in this PEAP.
• Restoring security, dealing with the consequences of conflict, and improving regional equity.
Over the PEAP period, Government will endeavour to end armed conflict in all parts of the
country, to enable Internally Displaced Persons (including formerly abducted children) to return
home or to find new livelihoods (according to their preference), and to start to repair the damage
done by the war to the economies of the North and North-East.

Page 4
What is new in the PEAP
e) Prioritizing Ending Insecurity: A new pillar on security and conflict resolution has been
introduced as a direct recognition that security of all Ugandans needs to be treated as a national
priority and in a holistic manner so that we can cater for interventions both in conflict areas and
also post conflict areas.



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Page 5
1.3 Pillars and priorities
Security, conflict-resolution and disaster-management
The key priorities in this area are:
• Ending rebel insurgency, by peaceful means if possible
• Ending cattle-rustling
• Dealing with internal displacement and abduction, which are major sources of distress in
contemporary Uganda

Page 7
Regional equity: One particularly dramatic source of inequality in Uganda is the poor economic
performance of the North, caused largely by the insecurity suffered by its population. Chapter 2
discusses the phenomenon of regional inequality, and Chapter 5, on security, conflict-resolution,
and disaster-management, is centrally concerned with the North and parts of the East. It is
intended that the problems of the North should mainly be addressed by mainstreaming this
concern throughout the sectors’ actions, but there are a number of outstanding policy issues in
this area discussed particularly in Chapters 5,6 and 8.

Page 8
In the last three years, there has been a marked increase in poverty in Eastern Uganda.
One reason for this is distress migration from the conflict-affected areas of the North.

Page 9
Civil Society
It is essential to the concept of civil society that its actions are not planned or dictated by
Government. However, Government enjoys productive partnerships with civil society in a
number of areas and there are four general roles that civil society organisations play:
• Advocacy, particularly for the interests of groups who might otherwise be neglected;
• Voluntarily financed service delivery in sectors not covered by Government programmes;
• Publicly financed service delivery, subcontracted by Government;
• Support to conflict resolution; and
• Independent research on key policy issues.

Page 11
1.7 Structure of the PEAP
Chapter 2 sets out the existing state of knowledge about poverty in Uganda, and the implications
for poverty eradication strategy. Chapters 3 to 7 set out the actions planned under five pillars:
• Economic management
• Enhancing production, competitiveness and incomes
• Security, conflict resolution and disaster management
• Good governance
• Human development
These are different from the 4 pillars of the previous PEAP. The restructuring of the pillars is
intended to emphasise the importance of the conflict-related issues and to group actions in a way
that mirrors the institutional structure of Government, as well as being more logical.




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Page 18
• Social and cultural factors
Recent research indicates that high alcohol consumption is perceived by women as a serious and
increasing problem15. The reasons for this problem include the availability of a wider range of
drinks and the effects of past conflict and trauma on some of the population. A high share of
alcoholic drinks in expenditure and in consumption is associated with poverty16 and domestic
violence.

Page 20
Other disadvantaged groups
There are a number of specifically disadvantaged groups who need attention.
Orphans and other vulnerable children
About 14% of children below 18 have lost at least one parent, and 3% have lost both. For children
aged 6-17, as many as 20% have lost at least one parent mostly as a result of HIV and conflict.

Page 30
Insecurity has been a major contributor to poverty and inequality over the last fifteen years and
the most afflicted areas have not been able to share in the benefits of economic growth. Hence
achieving an end to conflict and the rue of law and order is critical for poverty-reduction.

Page 99
Security, Conflict Resolution and Disaster Management
5.1 Overview
Uganda continues to be severely affected by natural and man-made disasters and conflicts. The
prevalence of security in the country has long been recognised as a precondition for improved
human welfare and one of the key factors necessary for achieving all the other goals of the PEAP
and aspirations of Government.

….The persistent phenomenon of displacement in Uganda implies that Uganda’s disaster
management policy must be closely linked to issues of security and conflict resolution.
For this reason, these issues are handled together in this part of the PEAP.

Current circumstances present four major challenges in this part of the PEAP:
• First, the country needs to end the rebel insurgency.
• Secondly, the destructive pattern of cattle-rustling needs to cease.
• Thirdly, the conditions of life of internally displaced people need to be addressed both in the
short run (while they are still displaced) and in the long run (by successful reintegration into
normal life, including psychological recovery).
• Fourthly, the country needs to develop capacity to anticipate crises including conflicts.

It should be appreciated that not all security concerns may be resolved through the PEAP process
alone. Other processes, particularly in the political arena need to complement all efforts geared
towards conflict resolution in the affected areas.

Page 99
5.2 Security and Defence
Rebel insurgency
Northern Uganda has since the mid-1990s experienced conflicts and insurgency due to rebel
activity particularly in the sub-regions of Acholi (Kitgum, Gulu, Pader), Madi (Moyo and



                                                                                                    97
Adjumani) and West Nile (Arua, Yumbe and Nebbi). Concerted efforts by Government to end
insurgency have restored peace in most districts.
Page 100
The reasons why conflict persists are complex and cannot be attributed to a single cause or failure
of any particular dialogue process. Several studies1 suggest that conflict has been fuelled by a
combination of factors, including external support to rebel groups, the proliferation of guns in the
region, poverty and imbalances in access to economic opportunities. The impact of conflict has
been to generate regional disparities that may themselves fuel future conflicts.

…. As a result, Northern Uganda has become the poorest region in the country. Poor people in the
sampled Northern districts ranked insecurity as the most important cause of poverty (UPPAP,
2002). Insecurity is not only reducing the quality of life of these communities but also repeated
child abuse and traumatisation are sowing seeds of hatred and revenge, which makes the potential
for further conflict considerable.

Page 101
A combination of strategies will be pursued by Government in collaboration with civil society to
restore peace in the conflict afflicted areas.

One critical question is the relative role of police and military forces in dealing with problems
such as conflict and organized terrorism.

Future security threats and defence transformation
Security in Uganda is threatened by conflict in the Great Lakes region.

While Government is planning for the long-term, the transformation programme must also take
into account Uganda’s immediate security needs such as ending the conflict in the north.

Page 102
5.3 Conflict-resolution
Priority actions
Government will:
• Work with CSOs, faith based groups and traditional leaders in conflict resolution and the peace
building process.
• Assign responsibility within Government to respond to peace initiatives.
• Strengthen diplomatic ties with neighbouring countries, including participation in regional
initiatives for conflict resolution.
• Consider the development of a regular forum for national discussion on conflict resolution.

Page 103
The easy availability and use of small arms and light weapons is a major contributory factor in
the escalating conflicts in northern Uganda and particularly in Karamoja.

Page 104
Peace building initiatives in Karamoja
A number of civil society initiatives have focused on restoring better relations between different
groups in Karamoja and between the Karamojong and neighbouring groups. Actors have included
the Acholi Religious Leaders, World Vision, the Centre for Conflict Resolution and the OAU,
among many others.




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Page 106
Refugees
Uganda has hosted refugees since the 1940s. Most of these refugees flee from neighbouring
countries, particularly Sudan, the Democratic Republic of Congo and Rwanda, due to armed
conflicts and abuse of human rights in their respective countries.

Page 107
Other disasters
Between 1980 and 2003, one in thirty people in Uganda were affected by a natural or man-made
disaster. The death toll resulting from disasters in the country is estimated to exceed 50,000
persons annually (Security, Conflict Resolution and Disaster Management SPRP, 2003).

Page 108
Disaster response
The form of disaster response that is most needed in the immediate future is that of addressing the
problems confronted by internally displaced people as well as refugees. The special needs of
conflicts affected districts and areas in delivering public services need to be recognized.

Page 109
Concern has been raised by Civil Society on inadequacy of sanitation facilities. Government will
address this and seek the active involvement of IDPs in planning and monitoring the sanitation
conditions in the camps regularly. A post-conflict plan that respects IDP rights to security,
livelihood, services and participation in decision making will be put in place, including measures
to facilitate resettlement and rehabilitation of the
IDPs.

Page 110
Service delivery in conflict-affected areas
In addition to emergency-related activities, local authorities have to support normal service
delivery in the context of insecurity. Even where the population served is not displaced, insecurity
imposes extra costs. For instance, officials travelling in the area need protection, or because it is
difficult to recruit staff. Hence there may be a need for extra funding in some cases and tailoring
the implementation mechanisms to the conflict situations.

Psycho-social support
One service that is clearly needed in the context of conflict is psycho-social support for the
traumatised, particularly the abducted children. A number of CSOs have played an important role
in this area, which Government will support.

Page 111
5.5 Planning for the aftermath of disaster and insecurity
Existing and proposed programmes
During and after the conflicts are resolved, there is a clear need to plan for the recovery and
development of the affected areas in the northern and eastern parts of the country. There has been
a plethora of initiatives designed to address post-conflict needs. The majority of these
programmes are currently implemented within the second phase of the Northern Uganda
Reconstruction Programme (NURPII). Under NURPII, selective investments are being made in
public infrastructure and services and the participation of community based organizations, NGOs,
private sector and other stakeholders in development is being promoted through a bottom-up
approach.


                                                                                                  99
The challenge is to integrate these various initiatives into a coherent programme that addresses
the needs of conflict-afflicted areas.

Page 112
Northern Uganda Social Action Fund (NUSAF)
The total financing is sub-divided across the four programme areas as follows:
• Community Development Initiatives (72.8% of total financing)
• Vulnerable Groups Support (16.7%)
• Community Reconciliation and Conflict Management (2.1%)
• Institutional Development (8.4%)

Page 113
5.6 Public expenditure implications for security, conflict-resolution and defence
It is important to note that Government’s criteria for public expenditure include both rates of
return and distributional impact. There is therefore a case for accepting somewhat lower
economic rates of return on expenditures in areas that are disproportionately poor and
disadvantaged. There is also some international evidence that expenditures in post-conflict
countries have unusually high rates of return, and this may also apply to expenditures in post-
conflict regions within a country. Sectors are urged to bear these considerations in mind while
prioritising expenditures.

Page 113
Security and defence
The public sector role in defence is clear. The returns are also high in the event that defence
expenditure is effective in ending conflicts or preventing new ones. For instance, the approximate
cost of the conflict in the North has been estimated at 3% of GDP, and simulations confirm that
the loss of consumption in the North could be of the same order. The returns in terms of human
suffering are enormous. It is essential that any increases in expenditure are associated with greater
efficiency and effectiveness.

Page 113
The achievement of peace would allow reductions in current defence expenditures.
However, the extent of the reduction will depend on the long-run view taken of the necessary size
of the army. In particular, it is to be hoped that a reduction in conflict in the region as a whole
will reduce the likelihood of external invasion or armed insurgency; this would allow a more
modest view to be taken of the country’s long-run military needs.

Page 114
Conflict-resolution and disaster management
Government will continue to treat humanitarian assistance off-budget, but improve its integration
into planning. The current insecurity has a number of implications for public expenditure,
namely:
• Increased cost of service delivery during conflict
• The cost of implementing the amnesty process and small arms control.
• The cost of the long run recovery of Northern Uganda
• Dealing with the immediate consequences of conflict. While humanitarian relief is critical,
Government has an obligation to act if humanitarian contributions are not available to meet the
needs. Moreover, some responses such as water supply and sanitation have long-run implications
and require integrated planning (in some cases water sources in camps have become polluted
because of the lack of sanitation).


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Page 114
Post-conflict reconstruction
Costs of post-conflict reconstruction are being addressed through NUSAF at a community level.

… There are also specific human development needs after conflict, such as support for abducted
children and other traumatised people. The strengthened CDW function should have
responsibility for coordinating efforts in this area, and some extra expenditure may be needed
(though important work of this kind is already done by NGOs and donors).

…In common with other areas of support, planning for post-conflict areas needs to be integrated
into sectoral strategies rather than treated in isolation. As discussed in the chapter on public
expenditure, the best way of reprioritising public expenditure is to integrate projects into the
MTEF and progressively reduce the share of the project modality in public expenditure.
Government will therefore ensure that the actions identified in regional plans are discussed with
the various sectors, so that the needs of post-conflict areas can be effectively addressed within
sectoral strategies.

Page 119
Human Rights in Uganda
Uganda has also adopted the World Fit for Children declaration and programme of action and
ratified the optional protocol on use of children in armed conflict and commercial sexual
exploitation of children; it has also ratified the ILO convention 182 on the elimination of the
worst forms of child labour.

Page 122
Juvenile crime (especially economic crime) is on the increase, particularly among females. Two
categories are of particular importance: defilement and economic crime. Defilement cases
reported have risen by 87.9% over the period of 5 years, contributing to a 95% increase in youth
charged with capital crimes Defilement is related to poverty, armed conflict, orphan hood and
‘street children’.

Page 123
As a result of the conflict in the northern region JLOS activities have been badly affected, and the
police anticipate increased crime in the aftermath of conflict because of youth unemployment and
possible acts of revenge.

Page 124
Oversight of the courts falls within the local Government sector. The LC courts deal with civil
matters including land disputes and marital disputes, and some criminal matters including
children in conflict with the law.

Page 160
Priority actions for secondary education
Government will consider affirmative action for children from districts affected by conflict to
access post primary education and training through targeted bursaries and more generous entrance
requirements.

Page 185
Inter-sectoral budget allocations be shifted in favour of those sectors which can make the
strongest contributions to tackling the core challenges of the PEAP: accelerating pro-poor growth,
human development and restoring security and support for regions afflicted by conflict.


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Page 194
Pillar 3: Security, conflict-resolution and disaster management
Ending the insecurity and coping with its aftermath imply a number of specific public expenditure
requirements, including:
• Support to districts where service delivery costs are increased by insecurity (e.g. armed escorts).
• Flexible funding to allow special service delivery measures for areas where conventional service
delivery is impractical (e.g. learning centres for children in IDP camps). This may not require
funding which is additional to existing allocations, because such districts often have problems
spending the existing conditional grants.
• Assistance to people in camps, especially for sanitation. Food and shelter receive significant
donor support, but it is reported that sanitation is a problem.
• Psycho-social support to people traumatised by conflict, especially abducted children.
• Post-conflict security: it will be necessary to review policing needs as the conflict ends.
• Amnesty; it is important for Government to provide support to rebels who have asked for
amnesty, although the support should not be so generous that people falsely claim rebel status.
• Support to IDPs who wish to return to their previous residence, and/or support to the long-term
evolution of some IDP camps into urban settlements.
• Small arms control in the region (especially for Karamoja).
• Hardship allowances or other facilitation for recruitment of frontline staff in insecure districts.
(This should be mainstreamed into the relevant sectoral strategies).

Page 212
The three core challenges of the PEAP are accelerating pro-poor economic growth, human
development and conflict resolution and support for recovery in conflict afflicted areas.

Page 226
PEAP Results and Policy Matrix
Pillar 2: Enhancing Production, Competitiveness and Incomes
Strategic Objectives: 2.2 Increased and more efficient agricultural production
PEAP Policy Actions: Operationalize Land Tribunal in order to strengthen conflict resolutions
mechanisms

Page 231
PEAP Results and Policy Matrix
Pillar 3: Security, conflict resolution, and disaster management
Strategic Objectives 3. Protection of persons and their property through elimination of conflicts
and cattle rustling, resettlement of IDPs, and strengthened disaster management
PEAP Outcomes/Indicators: 3.1 Reduced insurgency conflict
- No civilian casualties from conflict (disaggregated by killed, wounded, abducted)
- % returnees/reportees that are resettled
PEAP Policy Actions - Work to end the rebel insurgency
- Work with faith based groups and traditional leaders through a regular forum of national
discussion on conflict-resolution
- Implementation of defence review recommendations, which include removing Ghost workers
from defence pay.

Page 245
Table A 4.5: Forms of land conflicts in registered and unregistered land
Type of conflicts occurring on land where rights are defined and registered vs. unregistered
interests in Land.



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Page 246
Table A 4.6: Household perceptions of benefits of systematic demarcation in pilot areas
   - Reduced land conflicts

Page 247
Table A 5.1: Major disasters in Uganda and their impact during 1966-2003
1986-2003 - Northern conflict in Acholi, Lango and Teso regions


HIV and AIDS

Page xv
Executive Summary
Poverty in Uganda: trends and patterns
During the 1990s, income poverty fell dramatically. However, since 2000, income poverty has
risen, with the proportion of people below the poverty line rising from 34 % in 2000 to 38% in
2003. This has been accompanied by a marked increase in inequality, which has been rising since
1997. The Gini coefficient, which measures inequality, rose from 0.35 in 1997/8 to 0.43 in 2003.
The reasons for the recent patterns include a slowdown in agricultural growth during the last three
years, declines in farmers’ prices reflecting world market conditions, insecurity, high population
growth rate and morbidity related to HIV/AIDS.

In regard to human development, recent years have seen major improvements in education and
literacy. Child health outcomes, however, did not improve in the 1990s, and HIV/AIDS remains
the leading cause of death within the most productive age ranges of 15- 49. Child nutrition,
together with infant and maternal mortality indicators deteriorated between 1995 and 2000, and
HIV/AIDS prevalence rates stagnated between 6% and 7%.
Notably, even if prevalence continued to fall, morbidity is unlikely to drop for at least another 5
years. Co-ordinated multi-sectoral action is required to reverse these trends, and mitigate the
impact of HIV/AIDS. The health reforms of the last few years have shown encouraging signs of
improvements, but data is not yet available to confirm this.
Access to public services has improved, but the poor are less well served than other groups.
Government therefore needs to target its services more effectively to ensure that they reach the
poorest households.

Page xvi
Pillar 1: Economic management
Government aims to boost growth from 6.5% to 7% over the medium term by the following
measures:
• Removal of bureaucratic barriers to investment
• Improvement in transport infrastructure and utility services
• Modernisation/commercialisation of agriculture, with emphasis on valueaddition
• Actions to improve rural access to finance and to strengthen SME development.
• Actions to enhance environmental sustainability
• Security in Northern Uganda
• Continued focus on HIV prevalence reduction and impact mitigation




                                                                                                103
Page xviii
Pillar 2: Enhancing production, competitiveness and incomes
To address the recent increases in inequality, Government’s strategy will focus on agriculture,
promote better security in the North, and take actions to empower women and strengthen
women’s land rights, and promote the involvement of men in HIV prevention and care.

Page xxii
Pillar 4: Good Governance
Managing the public sector
There are major challenges to human resource management in the public sector, including the gap
in pay between public and private sectors and between the public sector and autonomous
agencies; excessive use of consultancy in some sectors; inadequate supervision; staff
absenteeism; inadequate projection of the impact of the HIV/AIDS epidemics on human
resources requirements; weak management of the payroll and of training; and arrears in pension
and terminal gratuities.

Page xxiv
Health
The health sector is slowly recovering from the decline in social services experienced during the
1970s and 1980s. The Health Sector Strategic Plan is being implemented in a phased manner,
reflecting resource constraints. Priorities include hygiene and sanitation; immunisation; malaria
control; information, education and communication; reproductive health and HIV/AIDS.

Page 3
1.2 Government’s strategy for poverty eradication
Government will endeavour to improve the quality of primary education and reduce dropout, to
expand post-primary education, and reduce infant and child mortality. Government will ensure
that family planning services are accessible to all those who need them and that all households are
aware of their responsibility of protecting themselves from HIV/AIDS and to make sure that they
can support their children.

Page 3
The Process of Revising the PEAP:
A working group on cross cutting issues integrated issues of gender, HIV/AIDS and environment
into the whole PEAP revision process.

Page 4
What is New in the PEAP
Cross cutting Issues: The PEAP 2004 has also paid attention to several cross cutting issues that
affect people’s livelihoods and have an impact on the PEAP. The environment sector working
group, HIV/AIDS sector working group and gender sector working group organized their own
consultations and contributed evidence that has been used in the PEAP revision process. It is now
clear that removing constraints caused by HIV/AIDS, Environment and above all gender
inequalities is key to achieving Uganda’s poverty eradication goals.

Page 6
1.4 Cross-cutting issues
As part of the PEAP process, a working group was formed: to focus on cross-cutting issues, in
particular gender, environment and HIV/AIDS. Other cross-cutting issues include: employment,
population, social protection, income distribution and regional equity.



                                                                                              104
With HIV/AIDS prevalence apparently plateauing at 6% of the adult population, more needs to
be done to reduce it and to treat victims of the disease. Actions for prevention and treatment are
mainly covered in Chapter 7. Implications for human resource management are covered in the
various sectors, although not all sectors have human resources management systems of enough
sophistication to take HIV/AIDS fully into account.

Page 19
Gender inequalities
If the delayed age at first intercourse for both has certainly added to the decrease in HIV
prevalence, women remain more affected by HIV/AIDS than men. In addition to biological
susceptibility, there is the problem of unequal power relationships, when women cannot control
their sexuality. The impact of the HIV/AIDS epidemics is also more heavy for women who often
have to care for the sick and the dependant.

Page 20
Orphans and other vulnerable children
About 14% of children below 18 have lost at least one parent, and 3% have lost both. For children
aged 6-17, as many as 20% have lost at least one parent mostly as a result of HIV and conflict.

Page 28
In the case of HIV/AIDS, the last three years have seen some fall in the prevalence rate from
6.8% to 6.2%, though the number of people getting sick as a result of infection over the last 5
years or more will remain high for some time to come and will need to be factored in to all
strategies described in this PEAP. The continuing insecurity and consequent population
movements in parts of the country expose some groups to higher risk, and make a continued
vigorous prevention and impact mitigation efforts particularly important.

Page 79
The fisheries sub sector also faces some social problems; for instance, the circumstances of
fishermen often expose them to a high risk of HIV infection, with devastating consequences for
some fishing communities, and the theft of fish nets represents a constraint on investment.

Page 80
Priority actions for fisheries
Government will focus on the following priorities:
• Implementation of the FSSP
• Establishment and capacity-building of community institutions to manage beaches and lakes
• Monitoring and control of illegal practices
• Development of quality guarantees for fish exports
• Development of a central information system
• Stock enhancement for dams and small lakes
• Evaluation of options for fish technologies.
• Protection of children by BMUs against exploitation and abuse
• Management and control of HIV/AIDS among fishing communities




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Page 100
Since 2002, insecurity and violence against civilians and humanitarian organisations has
heightened, especially after the termination of the ceasefire in April 2003. This has made
humanitarian access to the Internally Displaced Persons (IDPs) very difficult, leading to a further
worsening of the humanitarian situation in Northern Uganda. Some relief agencies have been
forced to suspend their activities as a result of repeated attacks on their convoys resulting in loss
of lives and tonnes of relief aid. Civilians also suffer; about 20,000 children have to walk long
distances every evening in search of safety from abduction, and women and girls suffer from
sexual abuse. This explains in part why Northern Uganda has the highest infection rates of HIV in
the country.

Page 105
5.4 Disaster Preparedness and Management
Internal displacement:
IDPs’ access to farmland and work opportunities is severely hampered by the prevailing
insecurity. The IDPs in Northern Uganda are able to access between 35 percent and 50 percent of
their own minimum basic food needs through own production, market purchase and casual labour
for food. Hence many households are dependent on food aid and some studies have found a high
incidence of malnutrition. Together with a relatively high risk of prostitution and low level of
awareness, HIV infection is also a major concern for IDPs.

Page 106
Box 5.1: ‘Night Commuters’
A unique form of displacement is known to exist in the town centres and municipalities of war-
affected districts; the phenomenon of night commuters. When evening falls scores of children are
seen making their way into town centres to seek shelter and security from rebel attacks. These
children have come to be known as night commuters. Prior to the establishment of reception
centres that now accommodate most night commuters, these children were found sleeping on
verandas and under street lamps. Fears of sickness, sexual abuse and spread of HIV/AIDS
spreading amongst these children were and continue to be rife.

Page 109
WFP also supports 95,000 school children in displaced camps and over 17,000 persons affected
by HIV/AIDS.

Page 110
Refugee management
The settlement of refugees in rural areas has social and economic implications on the host
community which have to be given due consideration. Key challenges include:
• Large numbers of refugees in the allocated areas have put pressure on the environment through
deforestation and poor sanitation.
• There is strain on social amenities including health and education services, and land in the
districts hosting refugees.
• HIV/AIDS prevalence is relatively high in refugee-affected regions. Displacement and
migrations from other countries increases the host communities’ exposure to STDs. Redundancy,
trauma, poverty and ignorance also contribute to the spread of diseases.
• Refugees also continue to suffer from insecurity like all the other nationals.
• There is need to improve the living conditions in the refugee-hosting communities




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Page 140
Managing human resources in the public sector
However, several challenges remain:
- Human resource planning has mostly not been systematic. Most sectors do not have a systematic
way of accounting for the effects of HIV/AIDS on their staffing or of predicting future
requirements of staff as a result of HIV.
- The effect of HIV /AIDS on productivity in the public service.

Page 147
The remainder of this chapter focuses on progress and challenges in human development,
followed by intersectoral issues in human development (i.e. nutrition, sanitation, HIV/AIDS, and
fertility), before a detailed discussion of individual sectors.

Page 149
As the capacity for projecting human resource needs is strengthened, sectors will need to give
consideration to the effects of HIV and other causes of adult illness and death on the availability
of human resources.

Page 150
AIDS in Uganda
Uganda has been one of the countries hardest hit by the AIDS epidemic. However, significant
progress has been made in reducing prevalence, which now stands at about 6% nationally.
Despite doubts over the accuracy of the current estimate of the prevalence rate, as a result of
constraints on HIV/AIDS reporting and uneven coverage of sentinel sites (UAC, 2003), there is
no doubt that Uganda has succeeded in providing a significant decrease in HIV prevalence rates
over the last decade. This partly reflects the deaths of many people infected by HIV/AIDS, but
also a marked reduction in new transmissions.

This has been achieved by a mixture of methods, including abstention, fidelity and condom use.
Although this compares favourably to most countries similarly afflicted, many people are still
affected by the epidemic in Uganda with devastating health, psychosocial and economic
consequences. It is now estimated that over one million people (of which 100,000 are children
under the age of 15) are currently infected and probably over a million have already died from
HIV disease. The risk of mother to child transmission (MTCT) remains at 15-25% (UAC, 2004).

Page 151
Consistent commitment at national and decentralised level to combating HIV and
AIDS remains critical. There is need to commit locally generated funds at both national and
district levels to HIV and AIDS interventions. A crucial part in dealing with the consequences is
also being played by civil society and households themselves.

Prevention
Continued emphasis on public information is needed. Education is key to the fight against AIDS.
It can help eliminate prejudice and myths about how the disease is spread and avoid the social
stigma associated with it. Studies have shown that educated women are more likely to know how
to prevent HIV infection, to delay sexual activity and to take measures to protect themselves
when they do become sexually active than non educated women. A recent analysis suggests that
if all children received a primary education, the economic impact of AIDS could be greatly
reduced. If universal primary education was fully implemented, around 700,000 cases of HIV in
young people would be prevented every year (UNHSII, 2002-2003).



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Impact Mitigation
In addition to prevention, HIV/AIDS policies have increasingly emphasised the mitigation of
impact and the universal provision of ART. Indeed, AIDS is a development issue: there is an
interaction between HIV and poverty, and reflects inequalities between different population
groups.

At national level, HIV/AIDS robs sectors of both skilled and unskilled workforce, and diverts
meagre resources. It increases absenteeism from work due to frequent illness of staff or/and
nursing of sick family members leading to decreased productivity. The impact of HIV on labour
supply has clearly affected agricultural growth in some regions, and this has had some impact on
overall growth and on inequality. This translates to reduced acreage and thus food insecurity. The
sharp increase in the proportion of investors reporting that AIDS is a constraint reported in
Chapter 3 indicates that the effects on growth in industry and services may be becoming more
severe.

The epidemic also affects public sector service delivery, household savings and the
intergenerational transmission of knowledge, and imposes a greater burden on the elderly while
reducing their economic security. By killing primarily young adults, AIDS does more than
destroy the human capital; it also deprives their children of the requirements (parents’ care,
knowledge, and capacity to finance education) to become economically productive adults. This
weakening of the mechanism through which human capital is transmitted across generations
becomes apparent only after a long time lag, and it is progressively cumulative in its effects.

HIV/AIDS also affects development at the micro level. Particular social groups like children,
OVC, women, refugees and internally displaced people have been specially hit by the epidemic
due to their disadvantaged position and low incomes. It is estimated that Uganda has over 2
million orphan children, around 50% of whom are due to AIDS. This number is expected to
increase over the next decade, increasing the risk of children becoming street children, or a target
for abuse and exploitation.

Page 152-153
ARV diffusion
Government has decided to provide free treatment for HIV/AIDS. The treatment will be
accompanied by close monitoring, because if patients do not adhere to treatment protocols
resistance to drugs will emerge. Experience shows that patient adherence to treatment regime is
more achievable in urban than rural settings. However, this requires very close follow up. Recent
data suggest that close to 30,000 clients are receiving antiretroviral treatment (UAC, MoH 2003).
While this is evidence of clear progress, only 6.30% of those urgently in need of HAART in
Uganda are actually receiving it (UAC, 2004). In Uganda to date, close to 150 000 require ARV
treatment. The national target is to have 50% of them on treatment by the end of 2005 (UAC,
2004). This requires enormous commitment to capacity building with additional training of health
care workers and development of a stable health care infrastructure.

Currently despite the national policy to provide free ARV to all those in need, at household level
the cost of AIDS treatment (when paid out-of-pocket) competes with other crucial expenditures,
such as food, shelter, and educational expenses. The burden of AIDS care falls heavily on the
most vulnerable members of the household, such as orphan children. Even if treatment is
subsidized, there are other costs associated with treatment such as cost of transport to the
distributing center for treatment, costs of other medications, potential loss of income during times
of illness, and diversion of funds toward healthcare.



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This is a dynamic and a critical time in Uganda as HIV treatment is expanding. Questions remain
as to how to ensure sustainability and equality in distribution throughout the country as treatment
is rolled out. With the vast majority of Ugandans living in rural settings it is critical that they too
have equal opportunity to access these life prolonging medications. Thus, the existing health care
infrastructure must be strengthened in this landscape, to ensure sustainable and favorable
treatment outcomes. Multi-district wide programs represent potential targets for embracing the
expanded response for antiretroviral treatment in Uganda. Indeed, the majority of antiretroviral
treatment has been limited to urban settings and private, self-paying patients. This illustrates the
fact that the distribution of ARV requires government planning as market forces left alone fail to
take into account the social costs of the epidemics.

Mainstreaming and coordination of AIDS policies
Actions to prevent HIV and the treatment of AIDS are the responsibility of all sectors particularly
education and social development and health, while treatment issues are clearly the domain of the
health sector. Women’s vulnerability both socially and physically to HIV compounds existing
gender inequality and demands greater commitment and involvement of men in prevention and
care initiatives. Actions to deal with the consequences of AIDS affect all sectors, and need to be
factored into human resource planning in each of them. The particular problems of orphans are
discussed under the social development sector.

The National Strategic Framework (NSF) guides the implementation of all the policies on
HIV/AIDS and its mainstreaming into the development of sector policies. Most sector line
ministries and districts have designed integrated HIV/AIDS strategies and developed appropriate
budget lines. In addition, resources have been mobilised by both government and civil society to
help run HIV/AIDS programmes at district level, and help the poor access such services. The
coordination of the effort to fight the epidemic, both in the public and private sector, is guided by
the “Three Ones” principle: One national coordinating authority with a broad based mandate in
this case Uganda AIDS Commission, One national framework for AIDS action that forms the
alignment of all stakeholders, and One national monitoring and evaluation system.

Key Priorities
• To reduce HIV prevalence by 25% by 2006
• To mitigate the impact of HIV/AIDS: to improve the quality of life of people living with AIDS
(PHA); to mitigate the psychosocial and economic effects of HIV/AIDS; to mitigate the impact of
the epidemics on the development of Uganda
• To strengthen the national capacity to coordinate and manage the multisectoral response to
HIV/AIDS.

Page 162
HIV/AIDS and education
Over the past decade, HIV/AIDS has had an effect on the demand for education services. Over
the last three years, 7% of total enrolments were estimated to be double orphans. Ensuring that
they receive education is vital; to this end, more evidence is needed of their relative enrolment
rates compared to other children of the same age. Buffering the loss of teachers and teacher time
and effective HIV education is also needed. The education sector will work with other
stakeholders to address the impact of HIV/AIDS on the sector.

Page 164
Health sector reforms in Uganda
The major priorities identified during the biannual joint sector reviews under HSSP, include:
immunization, malaria control, health education, reproductive health, sanitation and HIV/AIDS.


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Page 164
A multidisciplinary approach to treatment of HIV/AIDS has to be developed. Health care workers
have to be trained to undertake the delivery of antiretroviral therapy and the treatment of their
side effects as well as potentially high rates of immune reconstitution that may be seen. There is a
need to integrate counsellors adapting already learned techniques and incorporate arising issues,
as treatment becomes more available, nutritionists, etc.

Page 165
Table 7.4: Health sector PEAP performance indicators
Urban/rural specific HIV seroprevalence (national average)
B a s e l i n e value (99/00): 6.8%
2000/01: 6.1%
2001/02: 6.5%
2002/03: 6.2%

Page 166
Government has continued to implement active HIV prevention strategies that have effectively
sustained the declining trend of HIV sero-prevalence. This has now stabilized at around 6.2% at
the Antenatal Clinic surveillance sites. These prevention strategies must be further strengthened
to ensure that HIV infected patients in this era of treatment in Uganda do not revert to risky
behaviours that may perpetuate the epidemic. It is hoped that the increasing trend in condom use
and the rise in age at first intercourse will sustain this positive trend.

Page 176
Social Protection for Vulnerable Groups
Orphans and Other Vulnerable Children
Orphans and other vulnerable children constitute a large and growing share of Uganda’s
population largely as a result of HIV/AIDS and war related deaths of parents over the past decade
or so. As of the year 2002/0332, 3.2 % of children aged less than 18 years had lost both parents
while 8.4% and 2.2% had lost the father and mother respectively.

About 2 million Ugandan children have been orphaned by AIDS. There are a growing number of
child-headed households as a result of AIDS-related orphanhood, which are particularly
vulnerable. Indeed, orphans may be vulnerable to sexual abuse, thereby increasing their risk of
contracting HIV.

Transition to adulthood is characterised by reproductive health concerns including HIV and other
STDs, early marriages, unwanted pregnancies, unsafe abortions and low contraceptive use.

Page 177
Support to the Elderly
Recent work on social protection has identified the elderly as a potential target group for social
protection. The elderly increasingly have to care for people living with HIV/AIDS and orphans,
giving them an important role in economic growth.

Page 179
On the demand side, the communities have inadequate information on their civic and human
rights. As a result, the poor and vulnerable remain subject to abuse as exemplified by the
continued instances of gender-based violence and child abuse among others. In addition, women
are physically more vulnerable in terms of maternal health and HIV.


                                                                                                110
Page 181
The top priority for the health sector must be that the most basic preventive and curative measures
are available to the population as a whole. Ugandan’s health outcome improved very little over
the period from the mid-1960s to 2000, with a major deterioration due to HIV/AIDS and very
little improvement in child and infant mortality.

Page 190
To this end, budget mechanisms for sanitation need to be strengthened at all levels. This is
complicated by the fact that, like HIV/AIDS, this will require a cross-cutting, inter-sectoral
response.

Page 195
In the health sector, Government aims to enhance preventive and basic curative care, including
the introduction of free treatment for HIV patients.

Page 196
The costs for curative health are inevitably highly approximate. One major area of uncertainty is
the treatment of drugs. A major new challenge is presented by the fact that anti-retroviral drugs
(ARVs) for the treatment of HIV/AIDS, which were previously unaffordable, have become much
cheaper in the past few years. The cost-effectiveness of spending on ARVs remains lower than
those of some other medical interventions that are not yet afforded by Government. However, the
scale of the HIV epidemic presents Government with a significant policy issue.

While Government is committed to free provision of AIDS drugs, the financial implications have
not yet been factored into the health sector’s envelope and could be very large. Initially, there are
perhaps 100,000 people who need the drugs, and if the costs of treatment (including counselling)
are conservatively estimated at 700,000 per month the annual cost would be about 84 billion
shillings. However, as the numbers of people qualifying for treatment rise, the costs are likely to
increase overtime. There are between 500,000 and 1 million people infected with HIV in Uganda
(according to different estimates), so the ultimate costs could be very large if the price of drugs
does not come down further. Government will therefore aim to identify funding modalities that
allow these drugs to be supplied sustainably to the accumulating number of patients who are
likely to need them. Possible financing options include donor subsidy of drugs, so that the cost of
drugs is included in the budget but at less than full cost. The use of generic drugs, wherever
feasible, will also be necessary in order to keep the overall costs realistic.

Page 205
There are also a number of cross-cutting issues that influence actions in various sectors.
Examples include gender, HIV/AIDS, vulnerable groups and child mortality. In a number of
cases, strategies have been developed to address these cross-cutting issues. For the purposes of
expenditure allocation, these strategies are not additional to the budget; they make
recommendations which sectors can integrate into their priorities.




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Page 231
PEAP Results and Policy Matrix
Pillar 5: Human development
Strategic Objectives 3: 5.2 Healthier Ugandans
Challenges/ Constraints:
PEAP Outcomes/indicators: 5.2.0 Improved Key Strategic Health objectives
- Infant mortality rate
- Maternal mortality rate
- % population undernourished
- HIV/AIDS Prevalence rate
PEAP Policy Actions: - Promote better health care seeking behaviour. Improve and expand
delivery of quality health care services. - Promote multi-sectoral response to health targeting
nutrition, population and reproductive health, sanitation and community participation.




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