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Local
responses to HIV/AIDS: the global agenda
Key
Note
The Local
Responses team at UNAIDS monitors and analyses instances of local
responses to HIV/AIDS from around the world, and extracts and
disseminates the principal lessons from these experiences. This
Key Note document -- updated by the team each year -- sets out
the current level of understanding regarding local responses and
how they may be best conducted under varying circumstances, given
that there is no single approach that can be universally prescribed.
What is a
"local response" to HIV/AIDS?
"People are
the subjects of the response to AIDS, not the objects of our interventions"
(Lesson from
Phayao province, Thailand)
A local response
to HIV/AIDS means the involvement of people where they live --
in their homes, their neighbourhoods and their work places.
Why encourage
a local response to HIV/AIDS?
What individuals
decide to do and how they behave are of prime importance in the
battle against the epidemic. It therefore makes abundant sense
that responses should, in the first instance, be local.
What are the
objectives of pursuing local responses to HIV/AIDS?
The ultimate
goal of pursuing local responses is to enable local communities
to acquire what may be termed "AIDS competence". This means that
people should become skilled in dealing with AIDS -- and, in particular,
they should:
• be
properly informed about the epidemic
• be
able to assess accurately the factors that may put them personally,
or their communities, at risk of infection
• act
so as to reduce those risks.
The end goal
of the process is to reduce HIV transmission, and enable those
living with HIV/AIDS, as well as those affected, to enjoy an improved
quality of life.
Local partnerships
on HIV/AIDS
Since there
are limits to what people can do on their own, local partnerships
can help improve the effectiveness of local responses. Such partnerships
bring together key social groups, service providers and facilitators.
Key social
groups are those whose members have a particularly important
role to play in HIV prevention and care activities. This may be
because they are especially at risk of infection, or have been
more strongly affected than others, or it may be for other reasons.
The experiences of these groups are critical to the working of
local partnerships. Individuals may be members of several overlapping
key social groups. Examples of such groups are: young people (particularly
those who are out of school or unemployed), women, men, people
living with HIV/AIDS, migrants, and members of specific occupational
groups, such as sex workers, soldiers, miners, and fishermen on
long-distance trawlers.
Service
providers may be government bodies (including those of local
government), nongovernmental organizations (NGOs), community-based
groups, or religious groups. They play a role by providing information,
resources and services.
Facilitators
enable and make easier the interaction between the various partners
in the local response, helping them become more competent and
command greater resources. They also help people better to articulate
their views. Some of the specific tasks of facilitators are:
• assisting
individuals and communities to mobilize resources, both technical
and financial
• helping
devise ways of carrying out projects to combat HIV/AIDS
• analysing
the processes and results of projects
• helping
people and communities document their experiences.
What type
of approach is appropriate for local responses to HIV/AIDS?
Typically,
a strategy for local responses to HIV/AIDS has four components:
• developing
human resources and systems for AIDS competence -- putting in
place inputs, structures and processes necessary for effective
local partnerships
• developing
policies, and creating an environment that enables AIDS competence
• mobilizing
local and external resources
• learning
from the process and from the interaction between the various
groups involved.
Learning:
the key element for scaling up
Complementary
actions and learning at all levels of a country are the key elements
for scaling up local responses.
Key social
groups engaged in local partnerships can create the self-confidence
necessary for progress to be achieved, sharing that confidence
and their experiences with other groups and communities.
District
bureaucracies -- the first level of sector management -- link
local with national activities. They assess the HIV situation
and help identify key social groups in the local response to AIDS,
providing support to such groups. The bureaucracies analyse, document
and disseminate what they learn from the local responses. They
can then press for and negotiate with the national authorities
the reforms needed in key sectors to sustain local responses.
Government
ministries, NGOs and the private sector should scale up local
responses to the national level by incorporating local lessons
into their strategic planning and reform processes. Governments,
for example, should scale up by adopting policy reforms that have
"passed the test" at the local level. Such reforms should enable
effective and sustained local responses throughout the country.
Country
facilitators act as intermediaries between local and global
learning. They help people document and exchange experiences.
Lessons learned are presented in Key Notes, Technical Notes and
case-studies.
International
organizations A UNAIDS cosponsor or a donor agency should
be responsible for enabling local response initiatives to take
place and be effective in a particular country. The organisation
takes the responsibility for the financial and administrative
support to implementation of the agenda.
The international
Technical Resource Network on local responses, consisting
of country-facilitators and other key actors in local responses
exchange experiences all over the world. Communication takes place
through an electronic platform (localresponse@unaids.org).
Members of the network meet face-to-face twice a year during technical
meetings where they seek concensus on global learning on local
responses.
The Geneva
based local response team has a specific task in facilitating
and stimulating learning on local responses. It incorporates the
local experiences in the global agenda and advocates policy and
strategy changes according to new lessons.
For more information,
please contact Dr Jean-Louis Lamboray, Senior Adviser to the Director
and Coordinator for Local Responses to HIV/AIDS, at:
Department
of Policy, Strategy and Research (PSR), UNAIDS, 20 Avenue Appia,
CH-1211 Geneva 27, Switzerland; tel: (41-22) 791 4756; fax: (41-22)
791 4741; e-mail: lamborayj@unaids.org
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