a

GAO

United States General Accounting Office

Report to the Chairman, Committee on 

International Relations, House of 

Representatives

December 2001 U.N. PEACEKEEPING

United Nations Faces 

Challenges in 

Responding to the 

Impact of HIV/AIDS on 

Peacekeeping 

Operations

GAO-02-194
Page i GAO-02-194 HIV/AIDS and U.N. Peacekeeping

Contents

Letter 1

Results in Brief 2

Background 3

Department of Peacekeeping’s Policy Discourages but Does Not 

Preclude Deployment of HIV-Positive Peacekeepers 5

The United Nations Does Not Know How Many Peacekeepers Have 

HIV 6

U.N. Efforts to Address the Impact of HIV/AIDS on Peacekeepers 

Face Challenges 10

U.N.’s Effort to Provide HIV/AIDS Assistance to Civilians Affected by 

Conflict Faces Difficulties 15

Conclusions 17

Recommendations for Executive Action 17

Agency Comments 18

Appendixes

Appendix I: Objectives, Scope, and Methodology 20

Appendix II: U.N. Peacekeepers by Country, September 2001 22

Appendix III: Information Available on U.N. Peacekeeping Forces and HIV/

AIDS 24

Appendix IV: HIV/AIDS Activities of U.N. Agencies 25

Appendix V: Comments From the Department of State 28

Appendix VI: Comments From UNAIDS 30

Appendix VII: GAO Contact and Staff Acknowledgments 35

GAO Contact 35

Acknowledgments 35

Figures Figure 1: Ongoing U.N. Peacekeeping Missions 4

Figure 2: HIV/AIDS Awareness Card for U.N. Peacekeepers 12
Contents

Page ii GAO-02-194 HIV/AIDS and U.N. Peacekeeping

Tables Table 1: Contribution Levels to U.N. Peacekeeping Operations From

 Countries With HIV/AIDS Prevalence Greater Than 5 Percent 9

Abbreviations

AIDS Acquired Immunodeficiency Syndrome

DOD Department of Defense

DPKO Department of Peacekeeping Operations

FHI Family Health International

HIV Human Immunodeficiency Virus

OCHA Office of the Coordinator for Humanitarian Affairs

UNAIDS Joint United Nations Programme on HIV/AIDS

UNDP United Nations Development Programme

UNFPA United Nations Fund for Population Activities

UNHCR United Nations High Commissioner for Refugees

UNICEF United Nations Children’s Fund

UNIFEM United Nations Development Fund for Women

USAID U.S. Agency for International Development

WFP World Food Programme

WHO World Health Organiztion
Page 1 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

United States General Accounting Office

Washington, D.C. 20548

A

December 12, 2001 Letr

The Honorable Henry J. Hyde

Chairman, Committee on International Relations

House of Representatives

Dear Mr. Chairman: 

In July 2000, the United Nations Security Council passed a resolution 

expressing serious concern that the increased risk of Human 

Immunodeficiency Virus/Acquired Immunodeficiency Syndrome 

(HIV/AIDS) in conflict situations could adversely affect peacekeeping 

missions. The Security Council resolution noted that an environment of 

conflict and instability produces large movements of people and reduced 

access to medical care, which increases the risk of HIV transmission. The 

resolution expressly encouraged member states to provide HIV prevention 

training to peacekeeping personnel, including those troops who may be 

HIV positive. In January 2001, the U.S. Ambassador to the United Nations 

expressed concern that the United Nations had not yet initiated an 

adequate response to the Security Council’s concerns and, in particular, the 

risk of transmission between peacekeepers and civilian populations.

Given the importance of U.N. peacekeeping efforts to U.S. foreign policy 

goals and the approximately $700 million contributed to the United Nations 

by the United States for these efforts in fiscal year 2001, you expressed 

concern that HIV/AIDS infection could undermine the effectiveness of U.N. 

peacekeeping operations. This report responds to your request that we 

examine U.N. efforts to mitigate the potential impact of HIV/AIDS on its 

peacekeeping missions. In this report, we (1) analyze U.N. policies and 

guidance on the use and deployment of peacekeepers with HIV, (2) 

examine the data available on HIV/AIDS prevalence rates among 

peacekeepers, (3) assess actions the United Nations is taking to limit the 

spread of HIV/AIDS among peacekeepers, and (4) examine the actions the 

United Nations is taking to limit the impact of HIV/AIDS on civilians 

affected by armed conflict, including groups who may come into contact 

with peacekeepers.

As part of our review, we analyzed documents and interviewed key officials 

from the U.N. Department of Peacekeeping Operations, the Joint United 

Nations Programme on HIV/AIDS, the World Health Organization, the 

United Nations Children’s Fund, the U.N. Population Fund, and other U.N. 

agencies. We also obtained perspectives on U.N. policies and activities 
Page 2 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

from officials of the State Department and the Department of Defense. In 

addition, we researched and reviewed the limited data available on HIV 

prevalence rates for the uniformed services. Appendix I provides a more 

detailed description of our scope and methodology.

Results in Brief The U.N. Department of Peacekeeping Operations’ policies and guidance 

discourage, but do not preclude, countries from sending individuals who 

are HIV-positive on peacekeeping missions. The Department discourages 

the deployment of members of uniformed forces with HIV for a number of 

reasons, including the concern that peacekeepers could potentially become 

a source of HIV infection for local populations. This concern is consistent 

with the U.N. peacekeeper’s code of conduct to do no harm. The 

Department’s policy does not preclude deployment of individuals with HIV, 

which is consistent with U.N. policy that opposes discrimination against 

HIV-infected individuals. 

The number of HIV-positive peacekeepers is unknown because (1) the 

United Nations opposes mandatory HIV testing and therefore collects no 

information on prevalence rates, and (2) the countries that contribute 

peacekeepers either do not test or do not share test results with the United 

Nations. Without data on the HIV status of peacekeepers, the Department 

of Peacekeeping Operations is unable to determine if countries are 

following its recommendation that HIV-infected individuals should not 

become U.N. peacekeepers. Despite the absence of data, U.N. and U.S. 

government officials have expressed concern that peacekeepers may 

contract or transmit the virus during peacekeeping operations. According 

to U.N. officials, this concern is based on the belief that peacekeepers tend 

to be sexually active, engage in risky behaviors, and are likely to have 

contact with commercial sex workers, who are known to have high rates of 

HIV/AIDS. 

The United Nations has taken a number of actions to reduce the potential 

spread of HIV/AIDS during peacekeeping operations, but it faces 

immediate and long-term challenges to its initiatives. The Department of 

Peacekeeping Operations and the Joint United Nations Programme on 

HIV/AIDS developed an HIV/AIDS awareness card for peacekeepers to 

carry in their uniform pocket. The Department included HIV/AIDS 

awareness in its peacekeeping train-the-trainer program and has provided 

contingents with five condoms per peacekeeper per week. However, it is 

not clear whether all U.N. contingents will adopt the awareness card as a 

permanent part of their uniform or whether current HIV/AIDS awareness 
Page 3 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

and prevention training is adequately sensitive to the cultural differences of 

contingents under U.N. command. In addition, the United Nations will be 

unable to evaluate the effectiveness of its initiatives because it does not 

collect baseline data on peacekeeping troops’ knowledge and awareness of 

HIV/AIDS or their sexual behavior. 

The U.N.’s effort to provide HIV/AIDS assistance to civilians affected by 

conflict also faces difficulties. Although the United Nations has begun to 

address the spread of HIV/AIDS among civilians affected by conflict, U.N. 

officials stated that it has not given adequate priority to this effort and has 

had difficulty obtaining funding for HIV prevention activities. Furthermore, 

the United Nations has taken little action to assist civilian populations 

specifically at risk of HIV transmission from U.N. peacekeepers.

This report makes recommendations to improve the U.N.’s ability (1) to 

measure the effectiveness of activities aimed at reducing risky behaviors 

among peacekeepers and (2) to identify which contingents are at highest 

risk of transmitting or contracting sexually transmitted infections, 

including HIV, at each mission. 

We received comments on a draft of this report from the U.S. Department 

of Defense (DOD), the U.S. Department of State, and the Joint United 

Nations Programme on HIV/AIDS (UNAIDS). DOD officials stated that the 

report accurately assesses the current situation with regard to HIV 

prevalence among U.N. peacekeepers and that they agreed with our 

recommendations. The Department of State summarized actions it is 

undertaking to respond to HIV/AIDS in conflict situations. UNAIDS agreed 

with our recommendations, however, they disagreed with our 

characterization of the U.N.’s overall effort to address HIV/AIDS in 

emergencies as inconsistent. Although UNAIDS considers meetings with 

its cosponsors that addressed vulnerable populations as demonstrating 

consistency in the U.N.’s approach, few concrete actions have been taken 

to date. 

Background The U.N. Department of Peacekeeping Operations (DPKO) serves as the 

operational arm of the U.N. Secretary General for all U.N. peacekeeping 

operations and is responsible for conducting, managing, directing, 

planning, and preparing those operations. DPKO is currently operating 15 

peacekeeping missions, as shown in figure 1, at a budgeted cost of 

approximately $2.7 billion for 2001. As of September 2001, 88 countries 

were contributing 46,957 military and civilian police personnel, and 
Page 4 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

countries are reimbursed about $1,000 per peacekeeper per month for 

contributing to these missions. (See app. II for a list of the countries 

contributing U.N. peacekeepers as of September 2001.) The United States 

currently contributes 732 peacekeepers and pays for 25 percent of the total 

cost of peacekeeping operations. Three U.N. peacekeeping missions are in 

sub-Saharan Africa, where more than 25.3 million people have HIV/AIDS.

Figure 1: Ongoing U.N. Peacekeeping Missions

Source: U.N. Department of Public Information, Aug. 2001.

Western

Sahara

1991-

Sierra 

Leone

1999-

Cyprus

1964-

Golan 

Heights

1974-

Middle East

1948-

Ethiopia &

Eritrea

2000-

Democratic

Republic of 

the Congo

1999-

Bosnia &

Herzegovina

1995-

Croatia

1996-

Lebanon

1978-

Georgia

1993-

Iraq/Kuwait

1991- East Timor

1999-

India & 

Pakistan

1949-

Kosovo

1999-
Page 5 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

We recently reported that several challenges hinder the ability of the 

international community to address the growing HIV/AIDS pandemic, 

including limited funding for programs, cultural impediments to program 

effectiveness, and weak national health care systems.1

 Conflicts 

exacerbate these challenges because the organizations that deliver 

HIV/AIDS prevention and awareness programs are unable to function 

normally. In these situations, vulnerable populations–including refugees, 

internally displaced persons, orphans, ex-combatants, commercial sex 

workers, and war-affected local civilians–face increased risk of exposure to 

HIV. 2 Refugees, internally displaced persons, and orphans are particularly 

vulnerable to HIV infection because they are at high risk of sexual violence 

and exploitation and because they may use sex as a commodity to survive. 

Peacekeeping missions bring peacekeepers in close proximity to these 

populations. 

In resolution 1308, passed in July 2000, the U.N. Security Council 

recognized that in conditions of conflict, violence, and instability there is 

increased risk of exposure to HIV. Resolution 1308 encouraged U.N. 

agencies to take action with member states to develop strategies to 

mitigate the spread of HIV/AIDS in peacekeeping missions. In addition, the 

resolution directed the Secretary General to take additional steps to 

develop and provide training to peacekeepers on HIV/AIDS awareness.

Department of 

Peacekeeping’s Policy 

Discourages but Does 

Not Preclude 

Deployment of HIVPositive Peacekeepers

DPKO recommends that countries contributing to U.N. peacekeeping 

operations should not send HIV-positive individuals on peacekeeping 

missions for three reasons. First, medical treatment available during the 

peacekeeping mission may not be adequate to meet the special 

requirements of peacekeepers with HIV. Second, peacekeepers may have 

to undergo predeployment vaccinations and may be exposed to diseases 

during deployment, both of which pose additional risks to their health. 

Third, the presence of HIV-positive peacekeepers poses the risk of 

1

See Global Health: U.S. Agency for International Development Fights AIDS in Africa, but 

Better Data Needed to Measure Impact (GAO-01-449, Mar. 23, 2001).

2

A refugee is a person who, owing to a well-founded fear of being persecuted for reasons of 

race, religion, nationality, membership in a particular social group, or political opinion, lives 

outside the country of his or her nationality. Internally displaced persons are those forced 

to flee their homes because of armed conflict and persecution but who remain in their own 

country.
Page 6 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

transmission to medical personnel, fellow peacekeepers, and the civilian 

population. 

DPKO officials point to the third factor as weighing heavily in their 

recommendation not to deploy HIV-positive individuals. The U.N. Code of 

Conduct for Peacekeepers, although it does not address specific sexual 

conduct, states that peacekeepers should do no physical, sexual, or 

psychological harm. To minimize the risk of spreading HIV to the local 

population in the peacekeeping zone, DPKO officials recommend that 

individuals with HIV not be sent on peacekeeping missions. 

While DPKO policy recommends against deploying individuals with HIV, its 

policy also states that those who do not show clinical manifestations of 

AIDS are not precluded from peacekeeping service. Therefore, DPKO 

policy is consistent with the overall policy of the United Nations, which has 

gone on record in several documents expressing its concern for the human 

rights of individuals with HIV/AIDS and taking a stand against 

discrimination against such individuals. Specifically, the General Assembly 

in a December 1991 resolution (Res. A/RES/46/203) urged U.N. member 

states to avoid taking discriminatory action against individuals with HIV in 

employment. In addition, the United Nations has stated that, in general, a 

public health exception to the principle of nondiscrimination, even in the 

case of HIV/AIDS, is seldom a legitimate basis for restrictions on human 

rights. U.N. guidelines state that mandatory testing or registration for HIV 

status is not justified on public health grounds.3

 Finally, the U.N.’s 

personnel policy states that (1) the only medical criterion for recruitment is 

fitness to work; (2) HIV infection does not, in itself, constitute a lack of 

fitness to work; (3) there will be no HIV screening of candidates for 

recruitment; and (4) there should be no obligation on the part of the 

employee to inform the employer about his or her HIV/AIDS status. 

The United Nations 

Does Not Know How 

Many Peacekeepers 

Have HIV 

The United Nations does not know how many peacekeepers have HIV/AIDS 

because it opposes mandatory HIV testing before, during, or after 

deployment to a peacekeeping mission and because contributing countries 

either do not test or do not share test results with the United Nations. 

Officials remain concerned that peacekeepers with the infection may be 

deployed on peacekeeping operations, especially the approximately 14 

3

See HIV/AIDS and Human Rights: International Guidelines (New York and Geneva: 

United Nations, 1998).
Page 7 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

percent of peacekeepers that come from countries with high HIV/AIDS 

prevalence rates, such as Nigeria and Kenya. Even if they are not infected 

before deployment, peacekeepers—like other military personnel—are 

likely to engage in behaviors such as unsafe sexual practices that increase 

the risk of contracting and spreading HIV. 

The United Nations Does 

Not Collect Data on the HIV 

Status of Peacekeepers

The United Nations opposes mandatory testing of peacekeepers for HIV 

before, during, or after deployment to a peacekeeping operation. It 

therefore does not know whether countries are sending HIV-positive 

individuals to peacekeeping operations or how many individuals with HIV 

or AIDS make up its peacekeeping forces. As a result, while the media have 

reported a handful of cases of peacekeepers spreading or contracting HIV, 

there is little direct information on the extent of HIV transmission in 

peacekeeping operations. (See app. III for a description of the information 

available.) Furthermore, because the United Nations opposes mandatory 

testing4

 and because contributing countries retain control over their own 

forces, DPKO cannot direct countries to test or keep data on HIV 

prevalence among their peacekeeping forces. 

HIV testing policies vary widely among contributing countries.5

 Some 

contributing countries do not test their personnel for HIV and have no data 

to share with the United Nations. For example, according to DPKO and the 

Department of Defense (DOD), the United Kingdom, the Netherlands, and 

Nigeria, among other countries, do not screen military personnel for HIV. 

Also, Zambia’s military, which at one time conducted testing and screening 

for HIV, is no longer financially able to do so. Together, these four countries 

account for about 11 percent of current peacekeeping forces. 

Some militaries test their troops intermittently and may test peacekeepers 

before, during, or after a peacekeeping operation. However, data from 

these tests are not always shared with the United Nations. For example, 

according to DOD, South Africa has conducted HIV testing of its rapid 

deployment force used for peacekeeping operations, although it is 

unknown if any of these individuals were precluded from peacekeeping 

4

The Executive Director of UNAIDS has requested an expert panel to revisit the issue of the 

U.N. policy on HIV testing in the context of peacekeeping operations, which will result in 

the publication of an updated policy and a report to the U.N. Secretary General. 

5

We were unable to determine the testing policies of all 88 contributing countries.
Page 8 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

service. According to a member of the UNAIDS Steering Committee on 

HIV/AIDS and Security, countries may consider this information vital to 

national security because it could be considered a strategic weakness. In 

addition, countries might not release this information because doing so 

may jeopardize both their standing as peacekeeping contributors and the 

revenue they receive in return for their participation. On the other hand, an 

HIV/AIDS expert at DOD, who works closely with militaries, stated that 

even those countries that test may not know the HIV/AIDS prevalence rates 

of their militaries because they do not capture, store, or analyze the data 

that result from the tests.

Some Peacekeepers Come 

From Countries With High 

HIV Prevalence Rates

Although the United Nations does not know how many peacekeepers have 

HIV, many come from countries with relatively high HIV prevalence among 

the general population, leading to expectations of high prevalence among 

the military, including peacekeepers. UNAIDS estimates that military 

personnel are two to five times more likely than civilians to contract a 

sexually transmitted infection, including HIV. In addition, according to the 

National Intelligence Council, HIV prevalence in African militaries is 

considerably higher than that of the general population. For example, the 

Council estimates that between 10 and 20 percent of Nigeria’s military is 

HIV-positive, compared to a 5-percent prevalence rate for the general 

population. Nigeria is the largest African contributor to U.N. peacekeeping 

operations. 

More than 14 percent of peacekeepers come from countries where the 

adult HIV prevalence rate is greater than 5 percent (see table 1). According 

to public health experts, prevalence levels this high make it significantly 

more likely that uninfected persons in the population will be exposed to the 

infection. The higher the prevalence rate in a population, the more rapidly 

the infection will spread. The situation is most pronounced in Sierra 

Leone, where 32 percent of peacekeepers originate from countries with 

HIV prevalence rates greater than 5 percent.
Page 9 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

Table 1: Contribution Levels to U.N. Peacekeeping Operations From Countries With 

HIV/AIDS Prevalence Greater Than 5 Percent

a

This total does not include the 12 peacekeepers remaining at the completed operation in Guatemala.

Sources: UNAIDS Report on the Global HIV/AIDS Epidemic, June 2000; DPKO's Monthly Summary 

of Military and Civilian Police Contribution to United Nations Operations for Sept. 30, 2001.

Conditions Are Conducive 

to the Spread of HIV/AIDS in 

Peacekeeping Operations

Peacekeepers operate in an environment where exposure to HIV is more 

likely. Because peacekeepers often have money to spend, commercial sex 

workers, known to have high rates of HIV infection, migrate to areas where 

peacekeepers are deployed. For example, in Ethiopia, where a U.N. 

peacekeeping operation is ongoing, sex workers were found to have HIV 

prevalence rates exceeding 70 percent. In addition to the presence of 

commercial sex workers, peacekeeping operations are surrounded by 

populations of orphans, internally displaced persons, and refugees. 

According to UNAIDS, these populations may have sold sex to survive and 

U.N. peacekeeping 

operation

Total number of

peacekeepers

as of Sept. 2001

Number of

peacekeepers

from countries

with prevalence

greater than 5

percent

Percentage of

peacekeepers from

countries with

prevalence greater

than 5 percent

Sierra Leone 16,630 5,267 32%

Ethiopia and Eritrea 3,920 674 17

East Timor 9,562 335 4

Kosovo 4,305 213 5

Democratic Republic of 

Congo

2,393 185 8

Western Sahara 258 16 6

Iraq/Kuwait 1,097 8 <1

Bosnia/Herzegovina 1,672 7 <1

Croatia 26 2 8

Lebanon 4,470 0 0

Cyprus 1,272 0 0

Golan Heights 1,036 0 0

Middle East 153 0 0

Georgia 106 0 0

India and Pakistan 45 0 0

Total 46,945a 6,707 14%
Page 10 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

may have been the victims of rape or sexual violence during the conflict 

preceding the peacekeeping operation. 

According to DPKO, there has been only one confirmed case of a member 

of a peacekeeping mission transmitting the HIV infection. At the same 

time, there have been a number of media reports of peacekeepers 

contracting HIV while on a peacekeeping mission. However, very few have 

been confirmed. According to DPKO, two Bangladeshi peacekeepers 

contracted the infection in Cambodia in 1993 and one in Mozambique in 

1994. In addition, a medical study in 1995 found that 10 Uruguayan 

peacekeepers had contracted HIV while on a U.N. peacekeeping mission in 

Cambodia.6

Despite the absence of data, U.N. and U.S. government officials have 

expressed concern that peacekeepers may be transmitting or contracting 

the virus during peacekeeping operations. Surveys of military personnel 

indicate that many do not practice safe sex. For example, according to the 

U.N. Population Fund, a study of the Ukrainian military showed that only 

10 percent of the officers surveyed practiced safe sexual behavior—that is, 

consistent condom use and one faithful partner—while 28 percent of the 

officers surveyed reported having multiple sexual partners. In addition, 

according to DOD, on a 2000 training operation in South America, about 30 

percent of U.S. sailors reported having sexual contact while in ports of call, 

with about 15 percent of this group saying they did not always use a 

condom. In addition, according to UNAIDS, 45 percent of Dutch 

peacekeepers in Cambodia had sexual relations with commercial sex 

workers or members of the local population over a 5-month period in 1993, 

with approximately 11 percent of that group saying they did not always use 

condoms. 

U.N. Efforts to Address 

the Impact of HIV/AIDS 

on Peacekeepers Face 

Challenges

The United Nations has initiated a number of activities to address the 

impact of HIV/AIDS on the health of peacekeepers. However, these 

prevention efforts face immediate obstacles that may impact their 

implementation. In addition, the long-term success of U.N. efforts will be 

difficult to ascertain due to the lack of baseline data on the knowledge and 

awareness of HIV/AIDS or on the sexual behavior of the contingents that 

make up its uniformed forces. 

6

“Multiple Introductions of HIV-1 subtype E into the Western Hemisphere,” The Lancet, Vol. 

346, No. 8984 (Nov. 11, 1995), pp. 1197-98.
Page 11 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

Implementation of U.N. 

Efforts Faces Immediate 

Obstacles

DPKO has focused its HIV/AIDS efforts on three interventions: (1) 

development and distribution of an HIV/AIDS awareness card, (2) training 

in HIV/AIDS prevention, and (3) the distribution of condoms. However, it is 

unclear if all contingents are implementing DPKO’s interventions, there are 

gaps in DPKO’s HIV/AIDS training curriculum, and not all contingents may 

make condoms readily available to peacekeepers under their command.

DPKO Begins Distribution of 

HIV/AIDS Awareness Card

Figure 2 displays the HIV/AIDS awareness card for peacekeepers. 

Developed jointly with UNAIDS, as of September 1, 2001, the card was 

available in English, French, and Russian. The awareness card includes 

facts about the disease and contains a pocket for a condom. The card 

states that AIDS is a deadly disease caused by the HIV virus and describes 

methods of protection against the disease. The back of the card provides a 

code of conduct calling for pride, respect, and consideration for law, 

customs, and traditions. The card also states that peacekeepers should 

limit alcohol use and avoid illegal drugs because they impair judgment and 

can lead people to take risks they may not otherwise take.

By September 2001, DPKO had distributed 15,000 HIV/AIDS awareness 

cards to peacekeeping contingents in Sierra Leone. According to DPKO, 

the official responsible for HIV/AIDS activities in Sierra Leone gave the 

contingents a lecture on HIV awareness when the cards were delivered to 

each contingent. DPKO leaves it up to contingents to include a condom 

with the card. DPKO plans to distribute the HIV/AIDS awareness card to 

U.N. peacekeeping operations in Ethiopia/Eritrea, Congo, East Timor, and 

Kosovo. In addition to being written in English, French, and Russian, the 

card is expected to be produced in Kiswahili, Arabic, Hindi, Bengali, Urdu, 

Spanish, and Portuguese. These represent the primary languages of 90 

percent of the nationalities serving in peacekeeping operations worldwide. 

Since the contributing countries are responsible for the conduct of their 

forces, DPKO officials stated they are not certain if all peacekeepers will 

carry the card.
Page 12 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

Figure 2: HIV/AIDS Awareness Card for U.N. Peacekeepers
Page 13 GAO-02-194 HIV/AIDS and U.N. Peacekeeping
Page 14 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

Gaps in Curriculum Challenge 

the Effectiveness of DPKO’s 

HIV/AIDS Prevention Training

As part of its train-the-trainer program, DPKO provides senior officers from 

contributing countries with an intensive 2- to 3-week peacekeeper training 

program.7

 The HIV/AIDS training is comprised of several modules on the 

impact of HIV on the military; the link between HIV, other sexually 

transmitted infections, and substance abuse; HIV risk assessment; 

prevention strategies; and behavior change. The contributing countries are 

responsible for ensuring that peacekeepers receive training before and 

after deployment. 

Effective implementation of DPKO’s HIV/AIDS training faces some 

immediate obstacles. First, the curriculum was developed in the United 

States and does not address issues specific to some cultures. For example, 

cultural practices in some parts of sub-Saharan Africa, such as social 

acceptance of multiple sex partners for males and females, increase the 

rates of sexually transmitted infections, including HIV/AIDS. Therefore, 

according to the U.S. Agency for International Development (USAID), 

training should be adopted to specifically address the risky behaviors 

unique to peacekeepers in question. Second, although gender issues are 

broadly addressed in the train-the-trainer program, according to the U.N. 

Development Fund for Women, the current HIV/AIDS training curriculum 

does not adequately address gender issues necessary to sensitize 

peacekeepers to respect girls and women rather than viewing them as 

sexual commodities. Third, according to UNAIDS, the training is too 

technical and requires trainers to have a medical background. In addition, 

HIV training competes with other training priorities, such as land mine 

awareness. Finally, because DPKO does not routinely monitor whether the 

contingents provide the training, it does not know whether peacekeepers 

received the training before and after being sent to the mission. 

Unclear Whether All Contingents 

Make Condoms Readily 

Available to Peacekeepers

DPKO provides contingents with five condoms per troop per week. DPKO 

procures condoms for peacekeepers primarily from the U.N. Population 

Fund, delivers them to the commanders of each contingent, and makes 

them available in bathrooms, nightclubs, and other venues frequented by 

peacekeepers. DPKO relies on the commanders of each contingent to 

distribute the condoms to their contingents. 

However, universal distribution of condoms to all peacekeepers faces 

religious and cultural obstacles. According to DPKO, commanders from 

7

The training also includes U.N. policies for peacekeeping, land mine awareness, 

demobilization, and the cultural dynamics of the country in which the mission will operate.
Page 15 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

south Asia and the Middle East object to making condoms readily available 

to their uniformed forces because sex with prostitutes outside of marriage 

is against their religious beliefs and would indicate tacit approval of such 

behavior. In addition, because DPKO does not routinely monitor condom 

distribution, it does not know whether peacekeepers have access to 

condoms. 

Success of U.N. Efforts Will 

Be Difficult to Determine

The long-term effectiveness of the awareness card, HIV prevention training, 

and condom distribution will be difficult to determine. UNAIDS and DPKO 

have not collected baseline data on troop knowledge and awareness of 

HIV/AIDS or sexual behavior. Baseline data are essential to evaluating the 

impact of interventions such as the HIV/AIDS awareness cards and training 

on peacekeeper knowledge and behavior. For example, U.N. officials 

recognized that the awareness card has not been tested or proven to be an 

effective HIV/AIDS intervention. In spite of this, U.N. officials agreed to get 

the cards to the field as soon as possible in Sierra Leone, recognizing that 

the time spent pretesting and gathering data would delay the rollout. 

According to USAID, surveys of sexual behavior are needed for measuring 

condom use, which is expected to increase as a result of successful HIV 

awareness and training and serves as a proxy for estimating HIV 

transmission. Officials at DPKO stated that they are in discussions with the 

U.S. Centers for Disease Control and DOD on the development of a data 

collection instrument to gather baseline data on HIV/AIDS knowledge and 

sexual behavior of peacekeepers. 

U.N.’s Effort to Provide 

HIV/AIDS Assistance to 

Civilians Affected by 

Conflict Faces 

Difficulties

The United Nations has begun to address the spread of HIV/AIDS among 

civilians affected by armed conflict8

; however, according to U.N. officials, it 

does not give adequate priority to this effort and faces challenges obtaining 

funding. Furthermore, the United Nations has taken little action to target 

populations specifically at risk of HIV transmission from peacekeepers. 

8

In June 2001, as part of the U.N. General Assembly Special Session on HIV/AIDS, the 

General Assembly adopted without reservation the Declaration of Commitment on 

HIV/AIDS, which included specific targets and deadlines for addressing HIV/AIDS in conflict 

situations.
Page 16 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

U.N.’s Effort to Address 

HIV/AIDS in Emergencies Is 

Inconsistent and Faces 

Funding Obstacles

Although U.N. agencies are implementing programs to provide HIV/AIDS 

education and care to populations affected by armed conflict, according to 

U.N. officials, the United Nations has not consistently given these programs 

priority and faces challenges in funding them. For example, the U.N. 

Children’s Fund’s (UNICEF) has trained young people in post-conflict 

situations to be peer educators on HIV/AIDS, and the U.N. Population Fund 

has provided condoms and reproductive health kits in emergency 

situations (see app. IV for other efforts). According to U.N. officials, U.N. 

agencies that supply emergency assistance have not traditionally focused 

on HIV/AIDS and have been reluctant to address HIV/AIDS because they 

have not always viewed it as part of their mandate. U.N. officials also 

report that U.N. agencies have not consistently included HIV/AIDS 

programs in their appeals for funding in complex emergencies. In addition, 

U.N. officials report that due to a lack of cooperation, different U.N. 

agencies work on small-scale, ad hoc projects that tend to cover similar 

areas while leaving program gaps in other areas. In regard to funding, 

participants at the 2001 Inter-Agency Task Team on HIV/AIDS and Children 

in Conflict9

 noted that HIV/AIDS programs have been underfunded because 

of a lack of response from U.N. member states.

The United Nations Has 

Taken Little Action to Assist 

Populations at Risk of 

Contracting HIV From 

Peacekeepers 

Efforts to assist civilian populations at risk of contracting HIV from 

peacekeepers are a subset of the U.N.’s overall effort to address 

populations affected by armed conflict. While the United Nations has 

recognized the importance of assisting groups that might be at risk of HIV 

transmission from peacekeepers, to date it has taken little action. At the 

Expert Strategy Meeting on HIV/AIDS and peacekeeping in December 

2000,10 delegates noted an urgent need to provide appropriate information 

and services to populations affected by peacekeeping operations. In 

response, DPKO now participates in some country-level HIV/AIDS theme 

groups11 even though there is no written policy requiring this participation. 

9

In August 2001, the Inter-Agency Task Team, composed of U.N. agencies and 

nongovernmental organizations, met to discuss how to best ensure that children in 

situations of conflict receive appropriate HIV/AIDS prevention, care, and support.

10In response to Resolution 1308, the UNAIDS Secretariat convened an Expert Strategy 

Meeting in Sweden in December 2000 to address the issue of HIV/AIDS and peacekeeping.

11UNAIDS’ 132 country-level theme groups are UNAIDS’ primary mechanism at the country 

level to coordinate the U.N. response to HIV/AIDS and support host countries’ efforts 

against HIV/AIDS (see GAO-01-625, p. 13).
Page 17 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

UNAIDS has agreed to help fund personnel to serve as HIV/AIDS policy 

officers in each of the five largest peacekeeping operations.12 However, 

DPKO has only appointed a focal point in Sierra Leone, and DPKO and 

UNAIDS are still discussing whether this focal point will become the HIV 

officer for that operation. 

Conclusions The United Nations recognizes that HIV/AIDS is a security issue that 

threatens the effectiveness of U.N. peacekeeping missions. DPKO policy, 

which discourages but does not preclude countries from sending 

individuals with HIV on peacekeeping missions, underscores the tension 

between the U.N.’s peacekeeping policy and increased concern about the 

threat of HIV/AIDS. Legitimate concerns have been raised regarding both 

the stigmatization of peacekeepers who may have HIV/AIDS and the 

potential risk that they could transmit the disease to local populations. 

Because of the U.N’s opposition to mandatory HIV-testing and contributing 

countries’ wide variance in testing potential peacekeepers for HIV, DPKO 

has no knowledge of the HIV/AIDS prevalence rates among its contingents. 

Without this information, DPKO will find it difficult to focus interventions 

on the peacekeepers at highest risk of transmitting HIV. In fact, without 

routine monitoring of how the contingents implement DPKO’s efforts, 

DPKO does not know if peacekeepers receive training or have access to 

condoms. 

Recommendations for 

Executive Action

To improve the United Nation’s ability to (1) measure the effectiveness of 

activities aimed at reducing risky behaviors among peacekeepers and (2) 

identify which contingents are at highest risk of transmitting or contracting 

sexually transmitted infections, including HIV, at each mission, we 

recommend to the Secretary of State and the U.S. Permanent 

Representative to the United Nations that they request the U.N. Secretary 

General and the Executive Director of UNAIDS to

• develop and conduct behavior surveys of U.N. peacekeeping 

contingents to gather baseline and follow-up data on peacekeepers’ 

knowledge and awareness of HIV/AIDS and their sexual behavior; and

12UNAIDS established terms of reference for the post of HIV/AIDS Policy Officer in 2001. 

The policy officers’ primary focus is to develop and implement a comprehensive mission 

strategy with DPKO to reduce the likelihood of HIV transmission to and by U.N. 

peacekeeping staff while deployed and upon repatriation. 
Page 18 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

• analyze information gathered from these surveys to measure the 

effectiveness of their efforts and to identify which contingents are at 

highest risk of transmitting or contracting sexually transmitted 

infections, including HIV, at each mission to better target resources.

Agency Comments We received oral comments from DOD and written comments from the 

Department of State and UNAIDS. The written comments from the 

Department of State and UNAIDS are reprinted in appendixes V and VI. In 

addition, the Department of State and UNAIDS provided technical 

comments to update or clarify key information. We incorporated these 

comments where appropriate.

DOD officials stated that the report was well written and that it accurately 

assessed the current situation with regard to HIV prevalence among U.N. 

peacekeepers. DOD agreed with our recommendations.

The Department of State stated that it will continue to consult with U.N. 

agencies involved in HIV/AIDS programs and peacekeeping operations to 

encourage programs to raise the level of HIV/AIDS awareness and reduce 

risky behaviors among U.N. peacekeepers, as well as efforts to measure the 

effectiveness of programs. The Department of State also said it would 

continue to encourage U.N. efforts to address the spread of HIV/AIDS 

among target populations in situations of violence and instability. The 

Department of State did not comment on our recommendations.

UNAIDS agreed with our recommendation that behavioral surveys should 

be carried out to gather baseline and follow-up data on U.N. peacekeepers’ 

knowledge and awareness of HIV/AIDS and their sexual behavior. UNAIDS 

disagreed with our characterization that the U.N.’s overall effort to address 

HIV/AIDS in emergencies is inconsistent. In their letter, UNAIDS lists a 

number of meetings in which concerns for vulnerable populations and 

peacekeeping are addressed. According to UNAIDS, these collaborative 

efforts demonstrate a consistency of approach that is contrary to our 

finding. While collaborative meetings are an important first step in efforts 

to assist vulnerable populations, U.N. agencies have undertaken few 

concrete actions to address this emerging problem. We found that that 

there has been a lack of consistency in U.N. actions to help vulnerable 

populations because emergency assistance agencies have tended not to 

include HIV/AIDS programs in their requests for funds and generally do not 

view HIV/AIDS prevention as part of their mandates.
Page 19 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

We are sending copies of this report to interested congressional 

committees, the Secretary of State, the Secretary of Defense, the Secretary 

General of the United Nations, the Executive Director of UNAIDS, and 

other interested parties. We will also make copies available to other parties 

upon request.

If you or your staff have any questions concerning this report, please call 

me at (202) 512-8979. Other GAO contacts and staff acknowledgments are 

listed in appendix VIII.

Sincerely Yours,

Joseph A. Christoff, Director

International Affairs and Trade
Page 20 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

Appendix I

Objectives, Scope, and Methodology ApApenednxidexiIs

At the request of the Chairman of the House Committee on International 

Relations, we (1) analyzed U.N. policies and guidance on the use and 

deployment of peacekeepers with HIV; (2) examined the data available on 

HIV prevalence rates among peacekeepers; (3) assessed actions the United 

Nations is taking to limit the spread of HIV/AIDS among peacekeepers; and 

(4) examined the actions the United Nations is taking to limit the impact of 

HIV/AIDS on civilians affected by armed conflict, including groups who 

may come in contact with peacekeepers. 

In analyzing U.N. policies and guidance on the use and deployment of 

peacekeepers with HIV, we interviewed officials from the U.N. Department 

of Peacekeeping Operations (DPKO), the Joint United Nations Programme 

on HIV/AIDS (UNAIDS), the Department of State, and the Department of 

Defense (DOD). We also questioned these officials concerning the context 

in which the policies were formulated and DPKO’s intent in issuing the 

policies. Additionally, we examined U.N. documents such as DPKO’s 

medical manual to determine the precise wording of the policies and 

guidance, as well as U.N. Security Council Resolutions and U.N. General 

Assembly Resolutions regarding the U.N.’s general policies on the rights of 

HIV-positive individuals in employment situations. 

In examining the data available on HIV prevalence among U.N. 

peacekeepers, we interviewed officials from DPKO, UNAIDS, USAID, DOD, 

and other officials to identify whether data collection is being conducted 

among peacekeepers. We also asked these officials to identify and discuss 

any other data sources, including medical research and academic studies. 

We conducted searches for reports of HIV transmission to and from 

peacekeepers, and we attempted to verify the validity of these reports 

through discussions with U.N. officials. To determine HIV/AIDS prevalence 

among populations that may be chosen for U.N. peacekeeping duty, we 

examined the data available on HIV/AIDS prevalence among uniformed 

forces and civilian adult populations for countries that contribute 

peacekeepers. This included collecting and analyzing information in the 

U.S. Census Bureau’s HIV/AIDS Surveillance Data Base, June 2000; 

UNAIDS’ report on the global HIV/AIDS epidemic, June 2000; and DPKO’s 

monthly summary of troop contributors. For our review of the risk factors 

that peacekeepers face during peacekeeping operations, we examined 

documents from UNAIDS, the Civil-Military Alliance to Combat HIV/AIDS, 

the International Crisis Group, and the National Intelligence Council. We 

also asked officials at DPKO, UNAIDS, DOD, Family Health International, 

and others to identify and discuss these risk factors. 
Appendix I

Objectives, Scope, and Methodology

Page 21 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

In assessing the actions the United Nations is taking to limit the spread of 

HIV/AIDS among peacekeepers, we reviewed DPKO program documents, 

including the HIV/AIDS Awareness Card. We also reviewed documentation 

from UNAIDS, including best practice studies. In addition, we spoke with 

senior officials at DPKO and UNAIDS about the development and 

implementation of the HIV/AIDS Awareness Card and other initiatives. In 

our review of DPKO’s HIV prevention training, we examined the DPKO 

training manual and held discussions with DPKO’s senior medical advisor 

and the Director of the Civil Military Alliance who developed the HIV/AIDS 

curriculum. We also discussed the current training with senior officials at 

the U.N. Population Fund, the U.N. Development Fund for Women, and the 

U.S. Naval Health Research Center responsible for HIV/AIDS prevention 

training of foreign military personnel. With USAID contractors from the 

Measure Demographic and Health Survey and Family Health International 

(FHI), we discussed the use of sexual behavior surveys for measuring the 

progress of HIV/AIDS prevention efforts to reduce risky behaviors and how 

information about condom use can be used as a proxy indicator for 

estimating risk of HIV transmission. 

In examining the actions the United Nations is taking to limit the impact of 

HIV/AIDS on civilians affected by armed conflict, we interviewed officials 

from DPKO, the U.N. Children’s Fund, the World Health Organization, the 

U.N. Population Fund, the U.N. Coordinator for Humanitarian Affairs, the 

World Food Programme, and several other U.N. agencies to assess the 

effectiveness of U.N. efforts to provide HIV/AIDS assistance in conflict and 

to determine the extent to which the United Nations has addressed groups 

at risk of contracting HIV/AIDS from peacekeepers. We also reviewed 

documents from U.N. interagency meetings that analyzed U.N. efforts to 

limit the impact of HIV/AIDS on civilians affected by conflict. To obtain 

information on U.N. agency programs and activities in combating 

HIV/AIDS, we examined the U.N. System Strategic Plan for HIV/AIDS, 2001-

2005, and various U.N. Consolidated Interagency Appeals. 

We conducted our fieldwork in Washington, D.C.; New York, N.Y.; and 

Geneva, Switzerland. We performed our work from April 2001 through 

November 2001 in accordance with generally accepted government 

auditing standards.
Page 22 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

Appendix II

U.N. Peacekeepers by Country, September 

2001 ApendxiI

Country

Total number of

peacekeepers Country

Total number of

peacekeepers

Bangladesh 6,048 China 111

Pakistan 5,552 South Africa 104

Nigeria 3,446 Brazil 101

India 2,852 Denmark 101

Jordan 2,728 Zimbabwe 84

Ghana 2,116 Gambia 74

Kenya 2,080 Netherlands 74

Australia 1,580 Norway 73

Ukraine 1,538 Benin 55

Portugal 1,134 Indonesia 54

Poland 1,035 Chile 51

Zambia 871 Czech Republic 47

Fiji Islands 849 Samoa 40

Guinea 795 Malawi 37

Thailand 789 Switzerland 35

Philippines 763 Sri Lanka 34

U.S.A. 732 Japan 30

United Kingdom 688 Niger 26

France 673 Tanzania 24

Ireland 670 Vanuatu 24

New Zealand 668 Bosnia/Herzegovina 22

Senegal 641 Cameroon 22

Morocco 617 Belgium 20

Slovak Republic 610 Algeria 19

Argentina 581 Greece 19

Austria 511 Slovenia 19

Uruguay 491 Croatia 15

Germany 473 Mozambique 15

Republic of Korea 471 Paraguay 13

Finland 356 Honduras 12

Russian Federation 334 Namibia 12

Nepal 329 Bolivia 11

Canada 317 Burkina Faso 11

Italy 308 Lithuania 9

Egypt 264 Mali 8

Tunisia 257 Peru 6
Appendix II

U.N. Peacekeepers by Country, September 

2001

Page 23 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

Source: DPKO's Monthly Summary of Military and Civilian Police Contribution to United Nations 

Operations for Sept. 30, 2001.

Malaysia 232 Iceland 5

Spain 191 Kyrgyzstan 4

Turkey 185 Venezuela 4

Singapore 173 El Salvador 3

Hungary 161 Cape Verde 2

Bulgaria 150 Estonia 2

Sweden 145 Albania 1

Romania 119 Côte d' Ivoire 1

Total 46,957

(Continued From Previous Page)

Country

Total number of

peacekeepers Country

Total number of

peacekeepers
Page 24 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

Appendix III

Information Available on U.N. Peacekeeping 

Forces and HIV/AIDS ApendxiI

Source: GAO analysis of U.S. Census Bureau's June 2000 HIV/AIDS Surveillance Data Base; 

interviews with DPKO, U.N., and U.S. officials; and U.N. documentation. 

Concern Confirmed cases Other evidence Estimates

Peacekeepers with 

HIV being deployed

Six HIV cases in East Timor and 

six in Kosovo were confirmed; it 

is unclear if peacekeepers were 

deployed with HIV or if they 

contracted the infection while on 

deployment. 

Data on HIV prevalence for samples 

of uniformed forces in three 

contributing countries show HIV 

prevalence above 5 percent. 

Defense Intelligence Agency 

estimates 10-20 percent prevalence 

for the Nigerian military, 15-30 

percent for the Tanzanian military, 

and 10-20 percent for the military in 

Côte d'Ivoire.

Contributing countries' HIV testing 

policies vary for uniformed forces 

being sent to peacekeeping 

operations. 

Sexually transmitted infection rates 

are estimated to be two to five times 

higher among military personnel than 

in civilian populations, suggesting 

higher HIV rates as well.

Fourteen percent of peacekeepers 

come from countries with high 

civilian prevalence. 

Peacekeepers 

spreading HIV while 

on deployment

DPKO confirmed that one 

civilian member of a 

peacekeeping mission spread 

the infection while on 

deployment.

The rapid spread of HIV/AIDS in 

Cambodia coincided with the U.N. 

peacekeeping mission.

None 

Increased rates of HIV infection in 

East Timor conincided with the 

presence of U.N. peacekeepers. 

Rates of sexually transmitted 

infections, which increase the risk of 

contracting HIV 5 to 20 times, are 

thought to be high among waraffected populations. 

Peacekeepers 

contracting HIV while 

on deployment

Ten Uruguayan peacekeepers in 

Cambodia tested negative prior 

to deployment and positive upon 

return to Uruguay.

Prevalence rates are high among 

samples of prostitutes in three 

countries where peacekeeping 

operations are ongoing: 27 percent 

in Sierra Leone; 29 percent in 

Congo; 73 percent in Ethiopia.

None 

DPKO confirmed that two 

Bangladeshi peacekeepers 

contracted HIV in Cambodia and 

one in Mozambique.

HIV/AIDS prevalence among a 

sample of war-affected local 

populations in Sierra Leone was 

found to be 16 percent in 1995, 

although rates in the sample prior to 

the conflict are not known.

Peacekeepers 

spreading HIV to their 

family or community 

upon return

None None None
Page 25 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

Appendix IV

HIV/AIDS Activities of U.N. Agencies ApendxiIV

Agency Mission Role in emergencies HIV/AIDS priorities

Funding for 

HIV/AIDS 

activities

Selected planned & 

ongoing 

emergency 

HIV/AIDS programs

U.N. High 

Commissioner 

for Refugees 

(UNHCR)

Leads and coordinates 

international action for the 

worldwide protection of 

refugees and the resolution of 

refugee problems.

Provides shelter, food, 

water, medicine, and 

other basic 

necessities to 

refugees and other 

displaced persons.

Supports programs 

to prevent and care 

for HIV/AIDS and 

sexually transmitted 

infections in refugee 

settings; provides 

technical assistance 

to partners.

UNHCR reports 

facing budgetary 

constraints that 

may limit its 

capacity to 

address HIV/AIDS 

among its 

beneficiaries. 

Disseminates 

information on 

HIV/AIDS. 

Implemented an 

HIV/AIDS education 

program for young 

refugees in southern 

Africa, in cooperation 

with other agencies.

United Nations 

Children’s 

Fund 

(UNICEF)

Advocates for children’s rights 

to help meet their basic needs 

and to expand their 

opportunities to reach their 

full potential.

Provides 

humanitarian 

assistance and 

protection to children 

in emergencies. 

Develops and 

supports actions to 

reduce the 

vulnerability of 

children at high risk 

of HIV/AIDS, 

including those 

affected by conflict. 

Ensures protection 

and support for 

orphans and children 

in families vulnerable 

due to HIV/AIDS.

$600 million 

projected for 

2001-2005.

Training adolescent 

refugees to be peer 

HIV/AIDS educators. 

Developing a training 

module for 

peacekeepers on 

gender and child 

protection.

United Nations 

Development 

Programme 

(UNDP)

Helps to eradicate poverty 

through sustainable human 

development activities.

Provides logistic, 

communications, and 

other support for 

international relief 

agencies and focuses 

on the relief- todevelopment 

transition.

Supports the U.N. 

response to 

HIV/AIDS through 

advocacy, capacity 

building, and 

training.

$600 million 

projected for 

2001-2005.

World Food 

Programme 

(WFP)

Leads the fight against global 

hunger through food 

distribution in emergencies 

and helps support social and 

economic development.

Meets the food needs 

of vulnerable 

populations. 

Attempts to mitigate 

HIV/AIDS’ impact on 

food security by 

improving the longerterm food security of 

families and groups 

affected by 

HIV/AIDS.

No information 

available.

Makes its logistics 

services and food 

distribution sites 

available for 

HIV/AIDS prevention 

activities by other 

U.N. agencies. 

Requires its truck 

drivers in Ethiopia to 

take 2-month HIVprevention course.
Appendix IV

HIV/AIDS Activities of U.N. Agencies

Page 26 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

World Health 

Organization 

(WHO)

Attempts to ensure that all 

people obtain the highest 

attainable level of health.

Mobilizes expertise 

and resources for 

rapid response. Gives 

high priority to 

assisting vulnerable 

groups, such as 

commercial sex 

workers and persons 

in emergency 

situations.

Aims to strengthen 

the health sector’s 

response to 

HIV/AIDS and to 

provide technical 

assistance to 

countries to improve 

their HIV/AIDS 

prevention and care 

interventions.

$146 million 

projected for 

2002-2003.

Developing a project 

for HIV/AIDS 

assistance to 

refugees, internally 

displaced persons, 

and returnees from 

Angola, Democratic 

Republic of Congo, 

and Sierra Leone. 

Producing a basic 

supply package for 

HIV/AIDS assistance 

in emergencies.

U.N. Fund for 

Population 

Activities 

(UNFPA)

Aims to ensure universal 

access to high-quality 

reproductive health services 

to all couples and individuals 

by 2015.

Provides reproductive 

health kits, trains 

service providers to 

diagnose and treat 

sexually transmitted 

infections, and 

conducts information 

activities. 

Advocates for HIV 

prevention and the 

integration of HIV 

prevention into 

national reproductive 

health programs. 

Aims to strengthen 

its emergency 

HIV/AIDS activities.

$254 million 

projected for 

2001-2005.

Provided health kits 

and technical 

support in Bosnia, 

East Timor, Eritrea, 

Ethiopia, Kosovo. 

Provided training on 

HIV/AIDS prevention 

and care for health 

providers working 

with Eritrean 

refugees in Sudan.

Office of the 

Coordinator for 

Humanitarian 

Affairs (OCHA)

Coordinates the international 

humanitarian response in 

complex emergencies, 

supports the humanitarian 

community in policy 

development, and advocates 

on humanitarian issues. 

Monitoring/early 

warning, contingency 

planning, interagency 

needs assessment, 

field coordination, and 

development of 

interagency funding 

appeals.

Advocates for the 

inclusion of 

HIV/AIDS programs 

into U.N. emergency 

appeals for funding.

No information 

available.

Provided training for 

other U.N. agencies 

on incorporating 

HIV/AIDS and other 

factors into U.N. 

emergency appeals.

(Continued From Previous Page)

Agency Mission Role in emergencies HIV/AIDS priorities

Funding for 

HIV/AIDS 

activities

Selected planned & 

ongoing 

emergency 

HIV/AIDS programs
Appendix IV

HIV/AIDS Activities of U.N. Agencies

Page 27 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

Source: GAO analysis of U.N. documents.

Joint United 

Nations 

Programme on 

HIV/AIDS 

(UNAIDS)

Supports HIV/AIDS 

prevention and care, helps 

reduce the vulnerability of 

individuals and communities, 

and assists in alleviating the 

pandemic’s impact.

Provides strategic 

guidance to the U.N. 

system on HIV/AIDS, 

mobilizes partners 

and resources, and 

assists partners in 

information activities. 

UNAIDS’ 132 

country-level “theme 

groups” on HIV/AIDS 

coordinate the U.N. 

response to 

HIV/AIDS at the 

country level.

$305 million 

projected for 

2001-2005.

Created a 

humanitarian unit to 

address HIV/AIDS 

and security issues, 

including 

peacekeeping. 

Funded a study to be 

conducted by the 

U.N. Children’s Fund 

to improve HIV/AIDS 

interventions for 

children in conflict.

Together with DPKO, 

plans to deploy five 

high-level HIV/AIDS 

officers to five 

peacekeeping 

operations.

United Nations 

Development 

Fund for 

Women 

(UNIFEM)

Promotes women’s human 

rights, economic security, and 

political participation; 

promotes U.N. efforts to 

support women’s 

empowerment and to 

incorporate gender into U.N. 

policies and programs.

Advocates for 

increased gender 

sensitivity in U.N. 

programs operating in 

complex 

emergencies. 

Attempts to increase 

understanding of the 

links between human 

rights, gender, and 

HIV/AIDS. 

Advocates for a 

revised code of 

conduct for 

peacekeepers and 

for greater gender 

awareness in 

peacekeeper 

HIV/AIDS training.

$8 million 

projected for 

2001-2005. Fifty 

percent of 

UNIFEM’s 

HIV/AIDS 

resources are 

assigned to 

programs in 

Africa.

Produced a joint 

manual on gender, 

human rights, and 

HIV/AIDS. 

Plans to deploy a 

gender adviser in 

Sierra Leone, in 

conjunction with 

UNAIDS.

Developing a guide 

for women on 

negotiating safer 

sex.

(Continued From Previous Page)

Agency Mission Role in emergencies HIV/AIDS priorities

Funding for 

HIV/AIDS 

activities

Selected planned & 

ongoing 

emergency 

HIV/AIDS programs
Page 28 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

Appendix V

Comments From the Department of State ApendxiV
Appendix V

Comments From the Department of State

Page 29 GAO-02-194 HIV/AIDS and U.N. Peacekeeping
Page 30 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

Appendix VI

Comments From UNAIDS ApendxiVI
Appendix VI

Comments From UNAIDS

Page 31 GAO-02-194 HIV/AIDS and U.N. Peacekeeping
Appendix VI

Comments From UNAIDS

Page 32 GAO-02-194 HIV/AIDS and U.N. Peacekeeping
Appendix VI

Comments From UNAIDS

Page 33 GAO-02-194 HIV/AIDS and U.N. Peacekeeping
Appendix VI

Comments From UNAIDS

Page 34 GAO-02-194 HIV/AIDS and U.N. Peacekeeping
Page 35 GAO-02-194 HIV/AIDS and U.N. Peacekeeping

Appendix VII

GAO Contact and Staff Acknowledgments ApendxiVI

GAO Contact Thomas Melito (202) 512-9601

Acknowledgments In addition to the person named above, key contributors to this report were 

Richard Boudreau, Lynn Cothern, Andrew Von Ah, Eve Weisberg, and Tom 

Zingale.

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