Civil society: strong advocates for evidence-informed HIV/AIDS policies and action
As a member of 3ie’s HIV/AIDS programme team, I attended the annual International Conference on AIDS and STIs in Africa (ICASA), where I was struck by the strong and vital presence of countless civil society organisations (CSOs). From the displays in the main lobby calling for sex workers’ rights to the exhibits displayed by legal networks, human rights advocates and community organizations throughout the Cape Town International Convention Centre, I was reminded that participation of CSOs is crucial to moving forward the dialogue and action on improved HIV prevention and access to HIV/AIDS treatment, especially in hard-hit developing countries.
One highlight was how much recognition CSOs got for their important contributions to getting responsive and effective policies and practices at local, national, regional and global levels. They have been crucial in educating the public, providing services, and informing policymakers and stakeholders about what works well and what doesn’t and for maintaining demand for more and better responses to the epidemic. “Evidence shows programmes do better in terms of impact when civil society is involved,” proclaimed a panelist representing the CSO perspective in a session about the Global Fund’s new funding model.
Indeed, CSOs have been key actors in advocating for evidence-informed policies that address many of the critical issues in the HIV/AIDS sector. This is especially true for programmes and policies targeting key populations, such as persons with disabilities (PWDs), women and people infected with tuberculosis. In this context, CSOs have been increasingly effective in presenting evidence to policymakers that sheds light on the high risk of HIV/AIDS and other sexually transmitted infections (STIs) that PWDs face, given their higher vulnerability to sexual violence. The absence of discussion about this issue, and the limited resources for PWDs on sexual health education and sexuality, have been cited as factors contributing to the increased risk of PWDs acquiring HIV. USAID and other donors have responded with an increasing focus on policies addressing their needs. USAID requires that all of their projects integrate PWDs in their scope of work. Major international HIV/AIDS conferences are also taking the necessary steps to be a more inclusive forum, which was evident at ICASA conference sessions and accessible public spaces offering networking opportunities for PWDs.
Increased evidence about the social and structural drivers that contribute to women’s and girls’ increased risk of HIV, such as gender-based violence and inequality has helped make addressing these problems a key issue on the HIV/AIDS agenda. Here again, CSOs have made an important contribution forensuring the integration of gender into national HIV/AIDS strategic plans and health policies.
CSOs have been playing an important role in the Global Fund since its inception, thanks in part to having broad representation and rules for CSO representation in country coordinating mechanisms. Advocates for the integration of tuberculosis into HIV/AIDS programming have also made significant strides. The Global Fund is now accepting only one application for both HIV and tuberculosis programmes as their experience has demonstrated that having two separate parallel processes for programmes is not as effective as having them integrated. Their recently unveiled new funding model also requires that CSOs be involved in country-level dialogues. Organisations receiving Global Fund assistance also have to be transparent and document the process of CSO representation and participation.
HIV/AIDS CSOs bring passionate commitment and often some much needed tenacity and aggravation to their advocacy. That energy is part of what makes ICASA so worthwhile and inspiring for me. Translating research evidence effectively into policy and practice is a complex, difficult and often longer term endeavor. ICASA reminded me that CSOs are important policy actors and partners. Their involvement, and the communities they represent, is central to achieving an AIDS-free generation.