Authors: Jacques du Guerny and Lee-Nah Hsu

Foreword

One of the greatest challenges for workers in HIV prevention is the establishment of programmes that result in primary prevention of the spread of HIV. Such programmes must target the temporal and spatial factors that create environments that are fertile for transmission, rather than simply reacting postfacro to local trends in HIV prevalence and incidence.
Recently, the role of development in affecting the vulnerability leading to possible HIV infection in communities has become increasingly clear. Development efforts can sometimes de-stabilize a community by moving people in or out of it. or by affecting people's economic or cultural environment. For example, the construction of a dam can at once force people to leave their homes near the construction and find work elsewhere, and recruit new people into the area to work on the dam. Such social and cultural flux changes the way people behave and the populations with whom they are in contact.
To be effective. HIV preventive efforts must be closely synchronized with exactly those development factors that acutely increase a population's vulnerability. The proposed Early Warning Rapid Response System (EWRRS) has been conceived to establish this synchronization.
By linking information about development activities with information about effective prevention for the populations affected, an EWRRS would have a critical role in HIV prevention. Knowing which development activities can trigger population movements, which populations are moving, where they will be. and what languages they speak can foster public- and private-sectoral coordination of immediate actions to educate and support these populations to reduce their vulnerability. Such knowledge can also lead to retooling development activities in order to achieve both the development objectives and HIV prevention.
In May of 2000. representatives from the Greater Mekong Sub-region and international HIV specialists met in Bangkok for a Think Tank Consultation on the EWRRS. The work of that meeting is summarized here. While the EWRRS is an unconventional idea, the efficacy of which may be difficult to show at this point in its conception, its potential to promote well-informed and coordinated actions to significantly reduce HIV spread is compelling. Mr. Philip Guest, rapporteur, deserves a special thanks for his excellent synthesis of the complex debate of the Think Tank.

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July 2000