Social Protection and HIV AIDS: an introduction Luisa Guimarães Manager, S ocial Protection Programme, International Training Centre of the ILO Turin, 21 November 2013
Structure of the presentation Part II: Part I: Part III : What is Social What is the global Social Protection and HIV AIDS? Protection? situation?
Structure of the presentation – Part I Part II: Part I: Part III : What is Social What is the Social Protection Protection global and HIV AIDS situation
Life events and contingencies Marriage Birth first Birth last Death first Death second child child parent parent EDUCATION, TRAINING, WORK RETIREMENT Birth Death CONTINGENCIES/RISKS VULNERABILITIES SOCIAL PROTECTION
What is S ocial Protection? “ S ocial protection” is used to mean protection provided by social security systems in the case of social risks and needs (World S ocial S ecurity Report, 2010- 2011) 5
What is social protection? Contingencies - Classification ILO European OECD United Nations Commission (1) Medical care (1) S ickness/ health care; (1) Old age (1) S ickness and disability (2) Cash sickness benefits (2) Disability (2) S urvivors (2) Old age (3) Disability (3) Old age (3) Incapacity related (3) S urvivors (4) Old age (4) S urvivors (4) Health (4) Family and children (5) S urvivors (5) Family/ children (5) Family (5) Unemployment (6) Maternity (6) Unemployment (6) Active labour (6) Housing market programmes (7) Family/ children (7) Housing (7) Unemployment (7) S ocial exclusion not elsewhere classified (8) Unemployment (8) S ocial exclusion not (8) Housing (8) Research and elsewhere classified development in social protection (9) Employment inj ury (9) Other social policy (9) S ocial protection not areas. elsewhere classified. (10) Protection against (10) Health poverty and social exclusion through social assistance
S ocial protection measures Those providing benefits, whether in cash or in kind, to secure protection, inter alia, from: 1. lack of work-related income (or insufficient income) caused by sickness, disability, maternity, employment inj ury, unemployment, old age, or death of a family member; 2. lack of access or unaffordable access to health care; 3. insufficient family support, particularly for children and adult dependants; 4. general poverty and social exclusion. S ocial protection schemes can be of a contributory (social insurance) or non-contributory nature.
Social Protection: types of schemes Social Protection Systems • Social Insurance • National Contributory Provident Funds schemes Non contributory • 1. S ocial security Universal schemes • Categorial • Means-tested Social assistance schemes 8
Social Protection: principal obj ectives Improving access Reducing to health services inequality and for all people inequity Reducing income Providing adequate insecurity and benefits as a legal Ensuring (1) poverty entitlement absence of discrimination and (2) fiscal affordability, efficiency and sustainability Decent work and living conditions 9
The right and the need for social protection Social security as a HUMAN RIGHT Economic, social and cultural rights indispensable for dignity and free development of personality International Universal Covenant on Declaration of Economic, Human rights Social and (Art. 22 and Cultural 25) Rights (Art. 9) 1948 1966 10
Why do we need social protection? ● S ocial protection is a social necessity (a) S ocial security transfers are a powerful tool to reduce poverty and inequality. It reduced poverty by at least 50% in almost all OECD countries (b) All socially and economically stable societies have extensive social security systems ● S ocial protection is an economic necessity (a) Economic growth does not automatically reduce poverty (b) Access to social health protection and education improves productivity levels an has a positive impact on growth (c) The famous trade-off between efficiency and equity is a myth. Cash transfers in developing countries have multiplier effects on local markets
Structure of the presentation – Part II Part II: Part I: Part III : What is social What is the Social Protection protection? global and HIV? situation?
The need for social security ...% of the world National social security strategies, population do based on social dialogue not have access to comprehensive coverage ...% of the population do S trengthening social not have health protection access to S ocial essential health care security coverage gap … % of the elderly do not S ocial pension programmes receive a pension ...% of children are living in poverty, many Child and family benefits lack access to health and education 13
Social protection coverage: Statutory and effective coverage Branches of social security: Number covered by a statutory social security programme, 2008–09
Health protection: Proportion of the population covered by law 15
S ocial security expenditure Total public social protection in percentage of GDP - regional estimates Weighted by population Total 5.7 2.7 8.4 Public social security expenditure Sub-Saharan Africa 2.8 2.5 5.3 (excluding health) 5.3 Asia and the Pacific 3.6 1.7 Public health expenditure Middle East 7.6 2.2 9.8 Latin America and the … 7.1 3.1 10.2 CIS 9.9 3.6 13.5 North Africa 11.0 2.5 13.6 North America 9.0 7.0 16.0 18.9 Central and Eastern Europe 14.1 4.8 Western Europe 18.0 7.1 25.1 0 5 10 15 20 25 30 Percentage of GDP 16
Options to extend coverage to vulnerable groups 1. Extending formal statutory schemes 2. Introducing community based social protection schemes 3. Extending tax financed social protection schemes (conditional & unconditional social transfers, universal)
Structure of the presentation – Part III Part II: Part I: Part III : What is social What is the Social Protection protection global situation and HIV
HIV/ V/Ai Aids I ds Impact act o on So Social Pr l Protect ection ion syst ystems • It affec ects t the he mo most e econ onomically a active age ge gr group (15-49) who who are i e in n emp mploym oymen ent an and d pot otent ntially c contributors • It therefore may may r red educe t the he nu numb mber of of cont ntributors t to SS scheme mes • It affec ects t the he po poor or disproportionat ately an and d exac acerbates inc ncome ineq equal ality a and nd ab absolute po poverty • Already f fragi gile h hea ealth s systems a are b being r g robbe bed o of skilled s d staff • HIV/Aids ids o over ertax axes es t the s socia ial p l protec ectio ion s n system ems Amo moun unt of Hea Health Car Care c e costs Numb Nu mber er o of ol old d Sickness b ben enef efits age ge pe pens nsions Inv nval alidi dity c claims ms/pension ons Sur urvivors c claims ms/pen ensions Fune Fu neral gr grant nts
HI HIV/ V/Ai Aids ds Impact mpact on on Soci Social al Pr Prot otec ection on sys systems Whe When a n a breadwi dwinn nner falls i ill: – Los oss o of lab abou our a and nd con onsequ quen ently i income ome – Ri Rising g me medi dical c costs – Ul Ultima mately f fune neral ex expenses Poo oorest hou households are are mos most l likely t to o resor ort t to coping s ping strat ategi egies es : : sale o le of land nd or lives estoc ock o or withd hdrawa awal o l of child ildren f en from school hool rty Chro ronic p c pove vert Nex ext gen generation’s c cap apacity to c o climb out out of of pov poverty i is signif gnific icant ntly ly r reduc duced ed
Why is social protection relevant to HIV? S ocial Protection can significantly reduce HIV- related vulnerability and is a critical enabler for successful HIV prevention and treatment outcomes • Reduces disavantadges and inequalities • Helps overcome barriers to access to treatment • Mitigates the impact of HIV on household poverty and social exclusion 21
Recognition by the international community of the importance of social protection measures in the fight against HIV / Aids • The ILO Code of Practice on HIV/AIDS and the World of Work - 2001 • Calls on governments to ensure that social security programmes take into account the progressive and intermittent nature of the disease and tailor schemes accordingly, for example by making benefits available as and when needed and by the expeditious treatment of claims. • The Recommendation no 200 includes social protection as an essential element in addressing HIV/AIDS (article 3, 20, 30 and 37) • Draft WHO HIV strategy 2011– 2015 • Under the strategic direction 3: Build strong and sustainable systems: • “ ...Mobilize f inancing f or healt h and st rengt hen social prot ect ion syst ems.” • UNAIDS Outcome Framework 2009– 2011 One of the nine priority areas: HIV and S ocial Protection Guidance Note
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