Community mobilization

L to R: President of the Society for AIDS in Africa, Prof. Robert Soudré, UNAIDS Deputy Executive Director, Management and External Relations, Jan Beagle, Commissioner Bience Gawanas of the African Union Commission opening the community village.
Credit: UNAIDS/J.Ose

The dialogue space dedicated to community organizations was inaugurated today at the 2011 International Conference on AIDS and STIs in Africa (ICASA). The area, which is the heart of the Community Village at the conference, provides a space for grassroots and community based organizations to present innovative, local responses to the AIDS epidemic.

The community dialogue space of this year’s conference is organized by UNAIDS with support from UNDP, Irish Aid and the Global Fund to fight AIDS, TB and Malaria. It is an integral part of the Red Ribbon Award Initiative that recognizes outstanding community work on AIDS. The 10 African Red Ribbon Award winning community-based organizations from 2010 are running the community space.

Opening the Community Village, UNAIDS Deputy Executive Director for Management and External Relations, Jan Beagle stressed that most innovative and successful responses have often come from communities that are directly affected by the epidemic. “Communities have been central in developing the UNAIDS vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths,” said Ms Beagle. “Ending the epidemic is a shared responsibility and together we can do it.”

The dialogue space is a physical area designed to encourage discussions and provide a meeting place for policymakers and activists. “We need to work together,” said Innocent Laison, Director of Programmes at African Council of AIDS Service Organizations. “We need evidence from science but we also need the leadership and the heart of the communities,” he added.

All sessions within the community dialogue space are purposely unstructured and encourage direct dialogue with the audience. Discussions will focus on issues such as the realization of economic, political and social rights, access to HIV services as well as addressing stigma and discrimination that still prevails in many communities in the region. Particular emphasis will be placed on human rights and key populations at higher risk of HIV infection like sex workers, men who have sex with men and people who inject drugs.

The community dialogue space will also focus on community engagement in the recently launched Global Plan towards the Elimination of new HIV Infections among Children by 2015 and Keeping their Mothers Alive. Community representatives will also have the opportunity to discuss about their expectations on the community mobilization aspect of the UNAIDS investment framework.

The community dialogue space has been a regular feature at every ICASA conference since its inception in 2006.  UNAIDS Deputy Executive Director, Management and External Relations used the occasion to announce the launch of the 2012 round of the Red Ribbon Award, which will honor ten exceptional community organizations that have demonstrated outstanding leadership in the response to AIDS.

The Association Penitentiare Africaine (APA) is an NGO from Burkina Faso that ensures that the HIV prevention and care needs of prison inmates are addressed and is one of the 2010 Red Ribbon Award winners. “The Red Ribbbon Award programme has been instrumental in strengthening our credibility and increasing the impact of APA’s work,” said Julien Tougouri from APA.

Other Speakers at the opening of the dialogue space included Rosemary Nburu, KANKO; Béatrice Kogoyire, Rwandan Network of people living with HIV; and Joel Gustave Nana, from African Men for Sexual Health and Rights.

 

On this year’s World AIDS Day, UN and civil society partners jointly announce a global call for nominations for the 2012 Red Ribbon Award, intended to promote and support community organizations to respond to the AIDS epidemic.

The award, which will be presented at the XIX International AIDS Conference (AIDS 2012) in Washington DC in July 2012, will be given to ten organizations that have shown outstanding community leadership and action on AIDS. Additionally, each recipient of the award will receive a US$10 000 grant.

Awards will be given in the following five categories:

• Prevention of sexual transmission
• Prevention among people who use drugs
• Treatment, care and support
• Advocacy and human rights
• Stopping new HIV infections in children and keeping mothers alive; women's health.

Representatives of each winning body will present the work of their organization, their priorities, the challenges they faced and their approaches to community engagement in a dialogue space at the AIDS Conference in Washington.

Additional information regarding the Red Ribbon Award, the categories and criteria for selection, as well as the on-line nomination facility may be found online on the Red Ribbon Award website, www.redribbonaward.org.

From left: Jean-Louis lamboray, Director of The Constellation, one of the facilitators of the AIDS Competence project; Sveta Izambaeva, Niayaz Illiasovich Galiullin, Chief Doctor of the Kazan’s AIDS Center; Dr Denis Broun, Director of UNAIDS Regional Support Team for Europe

"You should not expect a solution to come from the outside. You need to look for it in the very communities and their people,” says the director of the international non-governmental organization The Constellation, Jean-Louis Lamboray during a recent presentation of the AIDS Competence project, in Kazan, Russia.

The objective of this initiative is to mobilize local responses to AIDS by promoting awareness within communities of their own strengths and capacities and facilitating the exchange of experiences within the communities. To accomplish this objective, the AIDS Competence project uses an approach called SALT— Stimulate, Acknowledge, Listen and Transfer—where trained facilitators visit communities to help them identify needs, formulate ideas and to form a leadership team from representatives of the community.

“People have enough wisdom and understanding of the risks. Our challenge is to encourage them to respond to the epidemic. Many communities and people are scattered and we have to help them form the right connections and networks,” added Mr Lamboray.

The meetings between communities and facilitators in Kazan show that when, a community openly acknowledges the risk of HIV, it can take action and mobilize support from within.

“I am a mother and grandmother,” said Irina, who took part in the meeting. “I worry about my family and want to know what I can do to protect them from HIV."

"If we want to get rid of stigma, we have to start from small groups, at home, at work,” said Natalia, whose husband Sergei uses drugs and is HIV positive. “Let’s have a discussion about it with the families in our neighborhood.”   

AIDS response in the Russian Federation

Eastern Europe remains the only region in the world where the epidemic is still on the rise. According to the Federal AIDS Centre in Russia, there are about 160 new registered cases of HIV infection daily in the country and more than 590,000 people are living with HIV. HIV transmission in the country is mainly driven by injecting drug use but heterosexual transmission is on the rise.

“The mobilization of the local response is critical for keeping the HIV epidemic under control in Russia as the lack of funding for HIV prevention programmes at the federal level may cause a serious setback in results achieved in the AIDS response,” said Dr Denis Broun, Director, UNAIDS Regional Support Team for Europe and Central Asia.

UNAIDS seeks to encourage community activism in the country and so it concentrates its advocacy work at decentralized levels for example by linking municipal authorities and civil society groups to help them share experiences and consolidate best practices around HIV prevention.

Functioning ARV dispensing site in Port-au-Prince after the devastating 12 of January earthquake. Credit: UNAIDS

Haitian civil society representatives visited Washington, D.C. on 6 April to mobilize political support for reconstructing the AIDS response in Haiti.

The civil society delegation, with support from UNAIDS, gave a testimony of their experiences with the earthquake and highlighted the importance of reconstructing the AIDS response with direct involvement of affected communities, especially people living with HIV. The briefing was held at Capitol Hill during a US Congressional briefing sponsored by US Senator Kirsten Gillibrand (D-NY) and attended by congressional staff, AIDS advocates and US civil society representatives.

Later that same day, the delegation from Haiti visited US Global AIDS Coordinator Ambassador Eric Goosby and his colleagues from USAID. The US government team pledged its support to encourage the Haitian government to include the involvement of people living with HIV in planning the reconstruction of the AIDS response in Haiti.

On 24 March, US President Obama asked the US Congress to approve $2.8 billion as an emergency requirement for relief and reconstruction support for Haiti following the devastating earthquake of 12 January 2010. The request is now pending before US lawmakers who will very soon vote on the proposal.

There were an estimated 120 000 people living with HIV in Haiti before the earthquake. Most of the structural damage happened in the three departments (Ouest, Sud-Est and les Nippes) that accounted for nearly 60% of the population of people living with HIV.

Following an initial rapid assessment of the situation with the Ministry of Public Health and Population, UNAIDS released a concept note Helping Haiti rebuild its AIDS response. The report explains the current situation in Haiti and what may be required to meet the immediate and intermediate AIDS response needs.

Civil society networks of people living with HIV as well as many of the organizations providing HIV services have been affected by the earthquake and are in need to be strengthened.

Credit: International HIV/AIDS Alliance

The Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) has developed a community systems strengthening (CSS) Framework in collaboration with other stakeholders including UNAIDS to clarify the range of community strengthening activities the Global Fund is mandated to support.

The International HIV/AIDS Alliance (Alliance) and the International Council of AIDS Services Organizations (ICASO) are conducting an online consultation for civil society to input into the draft framework that has been developed to outline community systems strengthening.

The Alliance and ICASO invite civil society views on this framework, which will play an important role for anyone working at a community level.

UNAIDS encourages civil society partners to participate in this consultation. “This is an important opportunity for community organizations to contribute to and strengthen the Framework,” said UNAIDS Head of Civil Society Partnerships, Kate Thomson.

Filling the gaps

The CSS framework has been developed in recognition that there are gaps in funding for many aspects of community action on HIV, TB, malaria, reproductive health and other health-related issues. It has been developed specifically to support the CSS component of Global Fund grants, but is applicable to all community based activities aimed at improving health though community based action.

By feeding back on the draft framework, you will help further develop what will become a key document which can:

1. Help civil society actors articulate and scale up their activities, and access Global Fund funding
2. Equip governments to better understand the vital roles of community actors particularly when building stronger health systems
3. Enable the Global Fund to make informed decisions about awarding grants to proposals strong in CSS.

How to have your say

1. Read the Draft Community Strengthening Framework

Don’t have time to read the full version? We’ve read it for you – and condensed the vital information. Read the summary

2. Have your say on the eForum. Join the online focused discussion that will open a space for dialogue on the framework. Send an email NOW to: join-cssframeworkconsult@eforums.healthdev.org  

3. Take the online survey Available online in the coming weeks.

4. Get your friends to have their say. Use the ‘Share’ link above, to use the social networking icons to spread the word.

5. Watch out for more details on how to participate over the next few weeks.

It is in all our interests to make sure that the CSS framework is as strong as possible so please – participate!

For further information email Taline Haytayan at the International HIV/AIDS Alliance: thaytayan@aidsalliance.org 

Campaign materials with HIV prevention messages will be sent to 800 000 households in Brazil.
Credit: M. de Sousa Silva

For the first time in Brazil, post offices will join efforts to prevent new HIV infections. The local take on the global campaign “Post Offices Fighting Against AIDS”, was launched Tuesday 9 February in a post office in Brasilia, the capital of the country.

Brazil, with an estimated 730 000 people living with HIV, is one of seven pilot-countries participating in this global initiative launched in 2009 by UNAIDS, Universal Postal Union (UPU), International Labour Organization (ILO) and UNI Global Union. The objective is to mobilize the network of 660,000 post offices around the world in the AIDS response.

The campaign will span more than 12 000 Post Offices in Brazil. Materials includes leaflets, posters, post-cards and a special letter with HIV prevention messages – all adapted to the Brazilian context.

For example, the international slogan “Your post office cares” has been adapted to include an explicit prevention message: “The post offices are fighting against AIDS. What about you? Protect yourself: use condoms.”

The Minister of Health, Mr. José Gomes Temporão stressed the confidence and recognition of national post offices in Brazil and reinforced the commitment of the Brazilian government to the fight against prejudice, discrimination and to the consolidation of an inclusive and human rights based policy in the response to AIDS when speaking at the launch.

In the campaign’s first phase, materials will be distributed in the Federal District–where Brasilia is located–and in the priority regions of Amazonas and Bahia, states were UNAIDS and other UN agencies implement a joint programme to support the HIV response.

José Gomes Temporão, Minister of Health, and Carlos Henrique Custódio, the National Post Office President, at the launch of the post office HIV prevention campaign. Brasilia, 9 February, 2010.
Credit: M. de Sousa Silva

The Brazilian effort goes beyond the international initiative by delivering around 800 000 letters with HIV prevention messages to households in pilot regions. So for the first time ever in the country, families will receive HIV prevention information at home, through a special mail service delivery.

During the launch event, UNAIDS country coordinator for Brazil Mr Pedro Chequer said, “The post office, with its wide reaching distribution network, offers a strategic entry point to reach the general population and post office staff with HIV prevention messages. A multi-sectoral approache like this campaign will strengthen the AIDS response in the Brazil”.

For the campaign, a special web site has been launched containing information on AIDS and other sexually transmitted infections, details about the campaign with all campaign materials available for download and distribution. The web site includes a quiz for evaluation of personal HIV risk and a “contact us” section, coordinated by UNAIDS.

A special stamp has also been developed, containing the symbol of the campaign. The President of the National Post Offices in Brazil, Mr. Carlos Henrique Custódio highlighted the importance of such an initiative to be launched just before Carnival, when HIV prevention initiatives are reinforced by the government.

Pedro Chequer, UNAIDS country coordinator for Brazil spoke of the importance of a multi-sectoral approach in the AIDS response. Brasilia, 9 February, 2010. Credit: M. de Sousa Silva

In a second phase of the campaign, the International Labour Organization will support the development of a toolkit for postal employers to inform their staff about HIV in Brazil.

The “Post Offices Fighting Against AIDS” campaign is a partnership between the Brazilian Ministry of Communications, the National Post Offices, UNAIDS, the Ministry of Health, ILO, UPU, UNI Global Union and the National Federation of Employees from Post Offices, Telegraphs and related enterprises. The first phase of this global campaign will reach postal customers and post office staff in seven countries,Brazil, Burkina Faso, Cameroon, China, Estonia, Mali and Nigeria.

Contact: UNAIDS Brazil – (55 61) 3038 9220 or imprensabrasil@unaids.org

A version of this story was first published at www.undp.org

Community conversations have proven to be an effective way to combat HIV in Namibia.
Credit: UNDP Namibia

What causes people to have more than one sexual partner at a time? “Sexual desire and satisfaction”; “It’s a cultural and social norm”; “Poverty and hunger; it’s a way to survive.” These are just some of the perspectives that emerged when communities under four traditional authorities came together to talk about what is known as ‘multiple and concurrent partnerships’ in the Caprivi region, in North East Namibia. This region is the most affected by the HIV epidemic in the country, where one in three pregnant women were found to be living with HIV in 2008.

The community conversations held late in 2009 is one of many taking place in throughout the country as part of a nationwide programme that engages communities in dialogue on the causes of HIV, boosting local responses to the epidemic.

The programme is known as ‘Community Capacity Enhancement through Community Conversations’. It is being implemented by the Namibian Ministry of Regional and Local Government, Housing and Rural development, with the support of the United Nations Development Programme (UNDP) in Namibia.

Multiple and concurrent partnerships have been identified as one of the main reasons why HIV has spread so rapidly in Namibia. “Long ago, marriages were respected. Nowadays, we have left this culture behind and both men and women have multiple sexual partners”, said one participant.

“By bringing together men, women and all those affected by HIV, this approach gives people the opportunity to make their voices heard, to identify their needs and to be counted when decisions about AIDS interventions are made,” says the Manager of UNDP’s Community Capacity Enhancement Programme, Immanuel Mwilima.

Community Capacity Enhancement through Community Conversations is a tried and tested methodology to boost the capacity of communities to identify concerns, deliberate on solutions and map out courses of action around AIDS.

Community members working with condoms during a community conversation on MCP in Katima Mulilo, Caprivi region.
Credit: UNDP Namibia

The approach opens up spaces for discussions based on relationships of trust and mutual respect.

According to Mr Henk Van Renterghem, UNAIDS Country Coordinator in Namibia, the community conversations offer a unique opportunity to strengthen the capacity of communities to engage with local government and development partners on the allocation of resources in the AIDS response.

“Too often communities are considered to be the passive recipients or beneficiaries interventions. They are inadequately consulted in top down processes for the identification of needs and priorities,” said Mr van Renterghem.

To date, communities in nine regions are conducting community conversations, with impressive results. In Caprivi, traditional leaders have led by example, going for voluntary counselling and testing and tackling the stigma associated with testing. In the words of one leader: “It is shocking that many of our relatives and loved ones have died because of AIDS....If this programme had come sooner, our relatives would have been alive today.”

Many challenges still remain in the AIDS response, however. For instance, 17.8% of pregnant women are HIV-positive in Namibia. “One of the biggest challenges facing rural communities in relation to accessing treatment, care and support services is stigma, discrimination, cultural norms and practices. Community Capacity Enhancement gives communities an opportunity to have an introspection of their cultural practices, norms and values,” says Lebogang Motlana, the Deputy Resident Representative of UNDP in Namibia. While the country is among the five most affected by HIV around the world, the epidemic is now on a downward trend, at just over 15%, after peaking at 22% in 2002.

Cultural structures and systems can facilitate or inhibit the success of HIV programs such as voluntary male circumcision, PMTCT and social protection. Thus science and culture must work in tandem to enable adoption of innovations. To promote voluntary male circumcision, the government programme has recognized the importance of working with social structures to catalyze behavioral transformation among non-circumcising communities.

Michel Sidibé, UNAIDS Executive Director, had an opportunity to visit the Luo Council of Elders in the western part of Kenya to discuss their role in social transformation. As guardians of traditions in the region, the Elders guide communities in many aspects of health and sexual practices.

Among their many achievements, the Elders have been instrumental in reinstatement of widows who had been disinherited following the death of their husbands from AIDS related illness. By speaking out against ingrained stigma, the Elders have facilitated community acceptance for more than 198 widows who would have been considered outcasts.

“I am very impressed with the work that the Luo Council of Elders has done to lead their communities. As agents of change, these leaders are paving the way on how communities can address challenges in the AIDS response while still retaining the positive cultural values and practices that hold communities together”, said Michel Sidibe.

Another example on how the Elders are forwarding the response to HIV is in the process of rolling out male circumcision. Male circumcision is now recognized as an important HIV prevention strategy, and the government began offering the service in December 2007. HIV prevalence among uncircumcised men in 2007 was found to be three times higher (13.2%) than among men who were circumcised (3.9%).

Male circumcision is not traditionally practiced in some parts of western Kenya, but with recent efforts there has been an upsurge of demand. Over 20,000 men have undergone voluntary medical male circumcision over the past few months. The Elders have been instrumental in promoting and generating this demand.

Participants at the regional consultation organized by the UNAIDS Regional Support Team, in collaboration with three regional civil society networks (AfriCASO, International HIV/AIDS Alliance, ENDA Santé) in Dakar from 11 to 14 August 2009. Credit: UNAIDS

Thirty civil society organizations involved in the HIV response in West and Central Africa (WCA) identified six priority areas for action to accelerate the movement towards universal access to HIV prevention, treatment, care and support in the region. This decision was the outcome of a regional consultation organized by the UNAIDS Regional Support Team, in collaboration with three regional civil society networks (AfriCASO, International HIV/AIDS Alliance, ENDA Santé) in Dakar from 11 to 14 August 2009.

The consultation was an opportunity to define concrete actions to be taken in the West and Central African region to achieve universal access targets and Millennium Development Goals considering the central role played by civil society organizations in the response to AIDS.

Over four days, the consultation brought together representatives of regional and national networks of people living with HIV, women, youth, religious leaders, parliamentarians, media, traditional practitioners, human rights associations, people with disabilities, trade unions, men who have sex with men, international NGOs involved in the HIV response as well UN system representatives.

Despite significant efforts in recent years made by countries to improve the response to the epidemic, participants underscored that many challenges remain to be addressed by all stakeholders to accelerate the movement towards universal access in West and Central Africa. Participants committed to coordinate their efforts towards the following six priority areas: Sustainable funding of the AIDS response; integration of HIV, tuberculosis and sexual and reproductive health services; improving the legal and societal framework; access to treatment and accelerating prevention; access to prevention of mother-to-child HIV transmission services; and innovation, communication and partnership.

For example, only 11% of pregnant women requiring services to prevent mother-to-child HIV transmission have access to them and only 25% of people living with HIV in need of antiretroviral drugs have access to treatment. The participants underlined that the quality and coverage of services and interventions targeting most-at-risk populations need to improve in most of the region. They noted the urgency to support countries in adopting laws protecting human rights that guarantee access to HIV services for all and provide effective protection for the most-at-risk populations. Participants also highlighted the urgent need to integrate HIV services into the tuberculosis programmes.

A new shared blog for the development community

The burning issues in the world today demand discussions among the whole UN family and the development community. This is why the UNFPA, the United Nations Population Fund, is launching a series called Conversations for a Better World. It is based on the idea that if the AIDS epidemic and other key development issues are to be dealt with effectively, greater attention has to be paid to population dynamics and reproductive health. The idea is to activate informed discussion and debate.

Conversations for a Better World is a shared blog, where people can express and exchange ideas and opinions on development issues. Each month the blog will have an editorial focus on one major topic.

“Poverty and AIDS: What really drives the epidemic?” is the conversation topic that launches 6 August and includes various opinion pieces and blog-posts related to the complicated relationship between lack of access to resources and HIV. The previous conversation topic was “Women and the Economic Crisis.”

Conversations for a Better World is based on ‘the power of we’: the idea that when it comes to addressing complex challenges, collective wisdom is called for. Anyone can contribute by uploading personal stories, relevant photos or videos and comments or opinion pieces.

“We’re hoping to engage discussion from experts as well as people who are directly impacted by these issues,” said Neil Ford, chief of the Media and Communications Branch of UNFPA. “We know that many visitors to the UNAIDS website are very knowledgeable about AIDS and poverty, and we encourage them to register and share their opinions and insights. That’s what ‘Conversations’ is all about.”

Not afraid to be provocative, subsequent Conversation topics will pose a number of questions over the coming year. These will include:
1. September 2009: Young People and Times of Change: Talking about life, love and sexuality
2. October 2009: Motherhood and Human Rights: Do all pregnant women have the right to live?
3. November 2009: Population Dynamics and Climate Change: Who’s at the centre of the storm?
4. December 2009: Sexual Violence and Progress: What are the real costs?
5. January 2010: Women and Hunger: Who feeds the family, and how?
6. February 2010: Migration and Prosperity: What’s fair?

You are invited to share your opinion. Start by going to www.conversationsforabetterworld.com Then, feel free to register and join the conversation!