Putting communities at the forefront for an AIDS free world

Roger Paul Kamugasha, CNS Correspondent, Uganda
The role of communities is essential in responding to the HIV/AIDS epidemic. Community advocacy, service delivery and participation in decision-making have shaped every aspect of the global AIDS response. While community responses, as well as community-based service delivery and advocacy, need to be reinforced, many community networks and civil society organizations (CSOs) are not receiving the support they need to engage fully.

They are struggling to fund their work and, too often, community voices are not meaningfully included in policy dialogue, especially the voices of key populations. In a recent UNAIDS survey of CSOs, 42% of respondents reported a decrease in their budgets since 2013, while another 26% said that their budgets had remained flat. Smaller organizations were reportedly suffering most from cuts, and those focused on advocacy were the worst affected.

Despite the wide recognition of the important role communities play in responding effectively to HIV, many community organizations are closing down due to severe financial crunch. A total of 40% of organizations responding to a recent Health Times Africa survey reported that their funding had decreased since 2013. Two thirds expected flat or reduced funding in the future. The decline in funding is resulting in a decline in community services—89% of those who reported a decrease in funding also reported they had to scale down their services as a result.

There is strong evidence that community responses produce results and we need to recognize the need for them to be scaled up and fully integrated into national responses. Funding policies, national regulatory frameworks and inhibiting legal environments need to be reviewed to remove barriers that prevent the flow of funding from national and international sources to CSOs.

Communities were the first responders to the HIV epidemic three decades ago, and they still remain essential in advocating for a robust response to the disease, delivering services that can reach everyone in need, and tackling HIV related stigma and discrimination. Working alongside public health and other systems, community responses are critical to the success and sustainability of the global efforts to fight HIV/AIDS.

The Strategic Investment Framework, published in 2011, identifies community responses as a “critical enabler” of service delivery. New opportunities for supporting community responses are emerging through the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other funders, but there remains a critical need for strategic investment in the community sector donors and implementing country governments. Investments in community mobilization and services must increase more than threefold in the next three years.

More investments in community systems strengthening (CSS) are also needed to establish stable and sustainable responses in the coming years. Whether they are advocates, providers, clients, participants in research or researchers themselves, community members remain the foundation of the HIV/ AIDS response.

The goal of ending the AIDS epidemic, as a public health threat, depends on transformed health systems that include scaled-up community responses and the funding and sustained support to make these responses possible. To end AIDS by 2030 (as envisaged in the sustainable development goals) , we need transformative action that scales up responses that are rights-based; of good quality and equitable; strengthen health and community systems to deliver a sustainable response to HIV and other health, social justice and development issues; and are evidence-informed, effective and appropriate to the communities they aim to reach.

Community responses to HIV have been the cornerstone of effective, equitable and sustainable programs. Moreover, communities act as barometers in their watchdog role, tracking what works and what does not work in their local context. Community efforts have proven critical in overcoming many of the major challenges in the AIDS response, including reaching people most affected by HIV with life-saving HIV services, providing support for adherence to treatment and other essential health services.

In order for community-led services to continue, it is essential that international organizations, development partners, governments, private funders and other partners increase investment in community advocacy and services. It is time to put the communities at the forefront as we continue to advocate for increased financing, leaving no one behind. Integration, innovation, and partnering between governments, the private sector and communities will shift the paradigm in consolidating our gains in the fight against HIV/AIDS.

Roger Paul Kamugasha, Citizen News Service - CNS
December 12, 2017

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