Communities first

Championing communities for effective action on HIV/AIDS

In 2004, the International HIV/AIDS Alliance (the Alliance) celebrated its tenth anniversary. The year’s key successes demonstrate that the work of the Alliance is more relevant than ever, says executive director Alvaro Bermejo.

From the very beginning, the central strategy for the Alliance has been to catalyse effective responses to the AIDS pandemic by building knowledge, skills and resources in affected countries. Our model is to develop and support national non-governmental organisations (NGOs), which can in turn provide technical and financial support to smaller non-governmental and community-based organisations.

In 1991 five donor agencies began discussions about ways to increase support for community responses to AIDS in developing countries. Following needs assessments, project design activities and two country-level pilot projects, the International HIV/AIDS Alliance was created in 1993, and up and running in early 1994.

A successful model

In our first eleven years, we worked with around 2,000 community-based organisations from over 40 countries. Through our support, 70% of these organisations became significantly involved in AIDS work for the first time. I came into the organisation as it celebrated its tenth anniversary, and my firsthand experience throughout 2004 has shown me that the Alliance model works and can help make a lasting impact on HIV/AIDS.

2004 proved that the Alliance can scale up programmes quickly and absorb significant resources. This was demonstrated in Ukraine, where we were asked in March 2004 to manage the grant of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). In the first nine months of the project we managed to disburse over US$12 million. In partnership with the Ministry of Health this was channelled to over 130 partner NGOs, and for the provision of anti-retroviral treatment to more than 1,000 people. Massive scaling up like this is a huge challenge for any organisation or government, and a very significant achievement.

2004 also proved that, through our support for organisational development training and skills building, we can create resilient, sustainable and long-lasting HIV/AIDS-focused organisations at country level. For example, in Ecuador, our linking organisation* Kimirina successfully went through a challenging process of restructuring, which has now ensured very effective delivery of our Frontiers Prevention Project work.

Expanding through experience

The confidence of donors in the Alliance model allowed us to reach more communities in more countries with more comprehensive responses than ever before. Expenditure in 2004 was US$37.4 million, up from US$20.5 million in 2003 – an increase of 82%. This rate of growth is impressive, as we try to support local responses facing an expanding epidemic.

As well as scaling up our work in Ukraine, this increased funding allowed us to start work in Myanmar, Zimbabwe and Côte d’Ivoire, and develop pilot projects in Haiti and Jamaica. It also allowed us to develop new work in Rwanda and Uganda through our participation in consortia such as Communities Responding to the HIV/AIDS Epidemic (CORE), Health Communications Partnership (HCP) and Horizons. In addition, it has also enabled exciting new work to test different models for engaging communities in HIV treatment and care.

Bridging the gap

The Alliance model has also proved to be an effective mechanism to help identify and resolve policy gaps in the HIV/AIDS response, and to create a better policy environment for effective community participation and evidence-based programmes. This is helping to break down the barriers that are preventing the huge increase in international funding for civil society AIDS responses from being fully effective. We help foster dialogue and strong links between those working at different levels, bringing international bodies, national governments and local communities closer together.

Our work with the Global Fund in 2004 is a great illustration of this. Alliance members provided technical support to non-Alliance Global Fund implementers and recipients at district level; implemented country programmes funded by the Global Fund (in Zambia and Ukraine, for example); and monitored Global Fund interventions through networks such as the Observatoire in Senegal.

We also worked closely with the Global Fund secretariat in Geneva – for example, in board meetings as part of the NGO delegation; on the monitoring, evaluation and financial audit committees and technical support working group; and developing a board briefing paper on a comprehensive framework for technical support. Finally, we have contributed to Global Fund governance, with an Alliance staff member, Anandi Yuvaraj, sitting as the Global Fund board of directors’ communities representative. Few organisations can bring together and build on such rich experience.

Throughout 2004 we also worked closely with the World Health Organization and the UN programme on AIDS (UNAIDS) to ensure that communities were a central part of the ‘3 x 5’ treatment initiative to get three million people onto anti-retroviral treatment by the end of 2005. As a UNAIDS Collaborating Centre, we also supported the UNAIDS to develop its new global strategy for HIV prevention. We facilitated consultation among civil society organisations (including national and international NGOs), and contributed our own policy statement, ‘What’s Preventing HIV Prevention?’, based on the Alliance’s lessons from more than a decade’s participatory, communitybased prevention work.

Working as an alliance

Last, but by no means least, in 2004 the Alliance really started to demonstrate the enormous potential of working as an alliance. In March 2004, Alliance members came from all over the world to celebrate our tenth anniversary. Meetings and workshops were held to discuss the experiences and knowledge gained over that time, and these were later published in a report, ‘Looking back to move forward’.

Our new Strategic Framework was also published, setting out our mission, strategy and new priorities for 2005–2007. For the Alliance, this is a landmark document, which will increase internal cohesion and provide a framework for communications with external stakeholders. The end of the year also saw work completed on a new Alliance website. This has received positive feedback from all constituencies and has proved since that it can play an important role in building a sense of ‘alliance’.

Furthermore, what has now been institutionalised as an annual national directors’ meeting confirmed the potential – and the desire – to build an even stronger alliance of national linking organisations* with a shared vision, mission, values and strategic framework. Our model is powerful, and dedicated staff and partners have made it work! This annual review presents some examples of our work and achievements in 2004.

In 2005, all of us will be measuring progress on targets set by UNGASS, the Millennium Development Goals, the World Health Organization and Global Fund performancebased renewals. I have no doubt that, as we do this (and the international community almost certainly falls short of where we should be), the model and values embraced by the Alliance’s supporters over the last decade will remain a reference for those who want to support effective community responses to HIV/AIDS.

Alvaro Bermejo - Executive director