Manuel Carballo, Ph.D., M.P.H. is Professor of Clinical Population & Family Health at Columbia University Mailman School of Public Health. He is also the Executive Director of the International Centre for Migration and Health, an international research and training NGO that has been designated a World Health Organization Collaborating Centre for health-related aspects of people displaced by disaster. His areas of specialization include: psychosocial health, maternal and child health, HIV/AIDS, and public health in complex emergencies and forced migration.

Pam DeLargy is the Chief of the United Nations Population Fund (UNFPA) Humanitarian Response Group and Senior Coordinator of the Fund's response to the Afghanistan crisis. Prior to her New York position with UNFPA, Pam DeLargy served as UNFPA's Representative in Eritrea for five years, from 1994 to 1999. Pam also worked in Eritrea for USAID from 1991 to 1994. In addition, Pam worked in Sudan, the Horn of Africa, and throughout the Middle East. She has extensive experience in the area of humanitarian relief. Pam grew up in Georgia, and received her M.A. in Public Health from the University of North Carolina.

• HIV prevalence data from refugee and displaced populations is increasingly available, especially in Africa, alongside data relating to host populations and various population groups in countries affected by, or emerging from, conflict. These data are still of uneven quality. They demonstrate an extremely complex and varied picture, which in turn entails a complicated set of responses.
• Cluster two will focus its research activities on countries for which there are already some baseline data (hopefully good enough for comparative purposes), working in partnership with those organizations that are already collecting relevant data. Examples may include Burundi, Cambodia, Cote d’Ivoire, DR Congo, Liberia, Papua New Guinea, Rwanda, Sierra Leone, Southern Sudan and northern Uganda. Building upon the frameworks of the drivers of HIV prevalence and the determinants of effective policy, it is possible to construct testable hypotheses that relate humanitarian crisis and post- conflict transitions to HIV/AIDS.
• The aim of the research will be to extract clear and immediate policy and programme recommendations for how HIV/AIDS initiatives should be designed for humanitarian crisis and post-conflict transitions. To date, post-conflict and reconstruction programmes have not taken HIV/AIDS sufficiently into account. A careful specification of the drivers of the epidemic in specific situations will allow these interventions to be better designed, 8 sequenced and implemented, and will lead to a new perspective and set of actionable recommendations on the design and implementation of post conflict transition and reconstruction efforts. Similarly, the framework for examining effective HIV/AIDS policies should enable interventions to be assessed and improved.
• For example, if population mobility (especially short-term circulation) is a major driver of prevalence, it follows that the specific social and economic environment of a displaced or refugee camp is the critical determinant of the risk of HIV among the camp population. If camp residents are free to move in and out of the camp, for example spending some days trading in a local town before returning to the camp, it is likely that their HIV will be higher than a population that is confined to a camp. Similarly, the opening of trade routes and the reconnection of former garrison towns and their rural hinterlands following the end of a conflict will be a time of increased risk of HIV transmission. Hypotheses such as this can readily be tested by working with organizations present in refugee, conflict and post-conflict settings and encouraging and facilitating HIV surveys. While it will not be possible to conduct large-sample panel surveys to achieve the highest level of scientific proof, a comparative method, piggy- backing on recent and ongoing survey work in different locations, can examine and refine a range of important hypotheses derived from the “drivers of HIV” framework.
• A second example is the importance of sexual violence in HIV transmission. Evidence suggests several ways in which rape and sexual exploitation increase vulnerability to HIV among women, including increased physiological risk of contracting HIV during forced sex, and subsequent social ostracism and economic vulnerability for the rape survivor that may lead her into high-risk sexual encounters. Levels of sexual violence are largely unmeasured though there are ongoing efforts to establish mechanisms for monitoring.
• The research method will be a combination of breadth and depth. Existing data sets will be examined using the “drivers” framework and, where possible, additional data will be generated. Detailed analysis of specific cases will be undertaken.

Research Projects

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