HIV professionals working on the frontlines of the epidemic are the key to improving aid effectiveness and efficiency
April 29, 2011- To mark International Workers' Day 2011, the International AIDS Society (IAS) is calling on the global AIDS community to recognize the potential of the organization’s 16, 000 plus members, over a third of whom work as health care and social services providers on the frontlines of the HIV epidemic, to be included and consulted in the current efforts to improve aid effectiveness and efficiency in the HIV sector.
During the XVIII International AIDS Conference (AIDS 2010) held in Vienna in July 2010, we saw the emergence of two key messages. As high level speakers emphasized that current economic challenges and a flat-lining of resources are threatening progress made in the global response to HIV, the first message was plain and simple: more money is needed if we are to sustain and scale up the international response to the HIV epidemic.
The effect of the global recession on donor funding also raised questions as to whether the International AIDS community should continue to advocate for increased resources to fight HIV, or whether it should focus its efforts on working to do more with fewer resources. While the general consensus was that this should not be an either/or debate, and that the international health community should not be expected to do more with less, but to do more with more, the second key message to emerge was also clear: whatever the amount of aid in question, this aid must be more efficiently and effectively put to use.
As dialogue now turns to the practical ways in which we can seek efficiency gains, streamline complex processes, and maximize current prevention, treatment and care resources, I am surprised again and again that the debate focuses almost exclusively on two groups: the governments and donors who provide money and resources, and the people living with HIV and AIDS around the world who rely on this aid to keep them alive.
Very few are talking to and about the people who link the two groups: the physicians, the nurses, the community health workers, the social workers, the teachers and the scientific researchers who are implementing the programmes funded by governments and donors and who are working for and alongside people living with and at risk of HIV.
Here at the International AIDS Society, we are certain that it is these HIV professionals, especially those in the most affected countries, who can provide many of the creative solutions we need and who will help us understand how available resources for HIV treatment, care and prevention can be better used.
Over the next year, the International AIDS Society will put this theory into practice.
We will start by running a country pilot in Uganda and using our 300 Ugandan members – the HIV health professionals themselves - as resources for increased aid effectiveness. In the autumn of 2011, under the leadership of myself and IAS Governing Council member Alex Muganga Muganzi, Ugandan IAS members will be invited to participate in a consultation in Kampala, which will include dialogue with the Ugandan Health Authorities, community groups and donors involved in HIV treatment, prevention and care programmes in Uganda.
Uganda was chosen for several reasons, notably because while the country is often seen as a model for its scale-up of HIV/AIDS programmes, especially ARV therapy, it has simultaneously been criticized as poorly coordinating recent HIV funding, with suggestions that many donor-funded systems are operating side by side, and using different procurement mechanisms, different procedures and different products.
The outcomes of the pilot will be presented at the XIX International AIDS Conference (AIDS 2012), where the experiences of the Ugandan IAS members will help guide the IAS and the international AIDS community’s future country specific work.
We will also invite these members to a “summit” on the role of HIV professionals in aid effectiveness and efficiency programmes. Together with the US based Futures Group we will hold this summit in conjunction with the ICASA conference in Addis Ababa on 3 December 2011.
IAS members have first hand experience of what wastes money, resources and time, and what is efficient and effective. They know what works and what doesn’t because, although they may not be directly in charge of budgets, they see the day to day effects of efficient or wasteful use of aid. They witness the results of ARV shortages on their patients; they see how empowering nurses and community health workers to distribute essential medicines has boosted ARV treatment and adherence; and they can tell us in detail about the different procurement mechanisms and procedures which either obstruct or facilitate the roll out of emergency programmes.
We must look to the experiences of these HIV professionals, many of who have already been instrumental in implementing revolutionary process changes to health systems, and make sure that these experts can actively contribute and participate in the on-going and planned activities to increase aid effectiveness and efficiency at country level.
From IAS
By Elly Katabira, IAS President.