Final Report and Recommendations from Southern-based NGOs

This final report incorporates feedback from the first two reports along with comments from additional southern-based NGOs. Thirty-three southern-based NGOs expressed interest in receiving the first two reports and nine of those contributed to this final report. The discussion was a reaction to the first two reports and provided an opportunity for southern-based NGOs to express concern and add insight as to what and how US-based NGOs can be most effectively involved in global AIDS efforts.

"The content and nature of current discussions, and how open the discourse has been between ASOs in the North and South are most encouraging, and if the process is sustained success would only come with time."

1. Involvement of American AIDS Groups

"Building global solidarity around HIV/AIDS is vital. An international movement around HIV/AIDS needs to be developed. Importantly, elements of this movement need to sit apart from governments and international organizations."

Involvement of US-based groups was viewed as beneficial not only to developing country NGOs but also US-based NGOs. "If you are linked to information networks, you can get communications that come directly from us and our experiences; This should help put a better picture on AIDS and help your government understand our issues better."

One participant expressed concern over what type of support, aside from funding, US-based ASOs can provide. "Because of the many significant differences between AIDS and all its implications in the affluent world and the developing world, information from the US for the developing world requires a strong filter. We need to know about activities, successes and failures, what has been learned, etc. from African colleagues rather than US-based advocates." Another participant from Zimbabwe expressed that most HIV/AIDS interventions can be developed and run in country and yet need additional funds to be carried out effectively.

In terms of what US-based organizations and donors can provide, one participant responded, "Money is the major resources need, along with some specific expectations of donors." Donors must provide clear, detailed and concise guidelines concerning funding requests and periodic reporting needs and acknowledge receipt of applications.

2. Global AIDS Advocacy

"I must observe that I am very excited about the intention of US AIDS service groups to expand their advocacy efforts to the international scene."

"Americans have a civic duty to educate the Congress, American public, and foreign governments about the current AIDS crisis and future pandemic."

five star hotel in BathInvolvement in global AIDS advocacy can provide a vehicle for US-based groups to raise public awareness of AIDS in developing countries and the US. One participant suggested, "You can raise public awareness through public demonstrations on our behalf, carrying our message as well as your own." It was also expressed that these campaigns can be more targeted to increasing access to treatment. "You can help us target particular individuals and organizations that are affecting our access to treatment." Several participants expressed a desire to connect with coalitions of organizations and individuals that serve underserved populations in the US.

Another participant cautioned against using advocacy to advance erroneous notions about HIV/AIDS in the developing world. "So often international ‘advocacy’ efforts, and media reporting emphasize the horror and the extremes of HIV/AIDS, with far less emphasis on the genuine social response. This paints an anecdotal picture that is far from correct, and leads to decisions being made and strategies being developed on the basis of assumptions rooted in a mediated reality. We must counter this at all costs." They suggested that, to avoid this phenomenon, advocacy efforts should be based on research that has been consolidated and analyzed to provide a clearer picture of the state of the epidemic.

Concern was expressed at the treatment of PLHWAs from Africa during most of the international AIDS conferences. "When Africans working with AIDS organizations want to take part in international conferences, they are often denied entry visas into the host country. Even when they attend, they are not always given what is useful to this AIDS devastated region–sub-Saharan Africa."

Again it was cautioned that activism must not be conducted in a vacuum and that US-based advocates must understand the context of whom and what they are advocating for and take responsibility for their partners in the south.

Some suggested advocacy issues include

• Elimination of the US travel ban on HIV-positive individuals
• Need to bypass governments to work directly with NGOs, more direct funding to in country NGOs
• Sustained debt relief
• Advocacy around the G8
• Greater involvement of people living with AIDS (GIPA)
• Access to care and support
• Intellectual property rights, restrictive trade agreements
• US-based multinational corporations labor and HIV practices overseas as compared to their US counterparts

3. Two-way Partnerships

"Our experience with the South African government response leaves much to be desired. There has been a tendency to attempt to deal with the epidemic at the political level rather than at the grassroots level, and yet northern governments and other organizations maintain funding and other linkages foremost with government (within the context of bilateral agreements, etc.), with little contribution or support to non-governmental and community based organizations. Emphasizing partnerships between non-governmental entities and US-based ASOs allows for the development of a social movement that is removed from the complex agendas of governmental entities."

All participants expressed that "day-tripping", "dabbling-in", or "dipping-into" HIV/AIDS struggles of other countries is time consuming and of little benefit. Developing long-term relationships can be costly and time consuming but are essential to developing effective and sustainable partnerships. Another participant expressed that dialogues and visits should at best be built around clear objectives and well defined outcomes. These relationships should place an emphasis on horizontal rather than vertical relationships, and should be mutually beneficial (in relation to organizational and HIV/AIDS objectives). Recognizing diversity and what each player can bring to the table is key. "There are many communities in so-called developing countries. Equally there is expertise and experience located amongst nationals of ‘developing countries’ that can be brought to bear on conceptualizing programmes in US communities."

Several participants expressed that there is already sufficient prevention activities and that the focus must be on care. One participant from South Africa stated, "The way forward is for US AIDS organizations and local NGOs to work together to collaborate around immediate areas of need such as voluntary counseling and testing, orphan care and development of PLWHAs groups." Another participant emphasized the need to fast track the response to HIV/AIDS. They stressed that this does not need to involve long studies but rather a critical review of the research and experience that have already been documented. They also suggested that partnerships could be utilized to consolidate and prioritize research. "Our challenge is to fast-track response, so that we guide individual, community and societal mobilization at a pace that is faster than the ‘natural’ pace of the epidemic."

One participant from Pretoria expressed that several organizations are lacking in planning, evaluation and monitoring techniques. It was suggested that US-based ASOs could facilitate trainings in these areas; however, they again emphasized these activities must be long term in scope. Another participant underscored the importance of infrastructure support, "My sense is that groups giving assistance, more often than not, offer once-off events that do not focus on developing effective infrastructure." Funds must be dedicated to improving infrastructure, for example human capacity, and creating processes whereby all projects are planned in detail, management structures are put in place and work is measured. This again implies a longer involvement of people doing development work and definitely not brief one-time trainings. Another participant supported this idea and stressed that institutional building (capacity building) of NGOs is certainly essential. However, discussants also stressed that NGOs must be asked what they need as opposed to US-based ASOs guessing their infrastructure needs. Also, US-based ASOs must conduct an honest analysis of their capacities and skills as organizations and not only "chase" potential funding opportunities.

One clear training need expressed by a participant from Swaziland was the distribution of simple guidelines on how to prepare proposals, seek funding and develop projects. Another suggestion for concrete actions was to send drugs (HAART and treatments for opportunistic infections, prophylactics, etc.) directly to NGOs or to develop a central point of co-ordination for collecting, purchasing and distributing drugs to developing country NGOs.

On the question of cultural competency, one participant expressed that "cultural competency is something that needs to be learned in both directions. It is a process, and we should actively and overtly recognize and build that process." Again, sensitivity to language and service delivery was stressed as important.