The challenges for civil society ahead
Despite some successes, and the greater level of global spending on HIV, there are still many challenges if we are to halt – and begin to reverse – the spread of HIV:
- The low levels of civil society participation in planning, coordinating and monitoring local, national and international responses will mean policies and programmes are less likely to be responsive, targeted and rapidly scaled up.
- Even with the expansion of globally sourced funding, the weakness of systems to disburse funds within most countries, and the low capacity of civil society organisations to access and use funds, will hinder the rapid uptake and effective utilisation of funding.
- Civil society itself is very nascent and weak in many regions and countries, where there may be few independent associations , a lack of infrastructure or networks to bring groups together, or an obstructive legal and policy environment.
- Many key population groups and communities remain at the margins of society, and working with them to build social capital through peers and participatory techniques is a slow and careful process.
- Even progressive policies have gaps and failings when implemented at the community level, and civil society must be a constant monitor to ensure that the current impetus and focus at a global level, is translated into real results for the people affected.
The expanded focus on the epidemic has led to an increased pressure for short term results, yet this may compromise some of the more fundamental and long-term developments needed. For example, the greater availability of anti-retroviral treatment will fail many people unless health services are made more affordable and accessible. Additionally, there is a danger that the increased funding available for HIV may not be put to effective and sustainable use by communities without their active and influential participation in the response. The nature of HIV as a chronic emergency increases the need for civil society to engage with and challenge the policies and programmes of other bodies, including government and health organisations, to ensure the urgency of the response is accompanied by real and meaningful action.
