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HIV/AIDS - Progress or Stalled? What Next?

15 comments

I can get a bit confused by the mood around HIV/AIDS progress. A few questions follow below (click "please review") for your consideration. In general the people and organisations who either monitor and report progress and/or develop and oversee the main strategies, talk in positive tones - good progress being made. But when stories are heard from countries about the ongoing struggle to make even a minor improvement in the HIV/AIDS situation in particular communities/provinces/states or across the whole country, it can be difficult to spot the good news.

Today the Lancet HIV/AIDS magasine published an article "Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015" that helps explain this dynamic but also poses a rather tricky problem on which I would welcome you sharing your analysis and thoughts. When AIDS is viewed related to mortality, all looks good - big decreases in people dying from AIDS related causes: HIV/AIDS mortality has been declining at a steady pace, from a peak of 1·8 million deaths … in 2005, to 1·2 million deaths … in 2015. But for the past 10 years, related to new infections, a much bleaker picture is painted: "Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5–2·8 million) since 2005". So, deaths down due to ARVs, but annual new infection levels have remained constant since 2005 - for 10 years!

Really!

Begs some big questions including

(a) How is that possible?

(b) What have we been doing wrong?

(c) What should we do much better?

Thanks for sharing your analysis and ideas in support of everyone's work on vitally important HIV/AIDS issues. 

Comments

Submitted by International … on Fri, 07/22/2016 - 11:14 Permalink

For organisation like ours dealing with training and awareness programs, about HIV/AIDS & TB co-infection on daily basis, we can only say the greed of the donors and even the government, their unreliable method of selection of grantees as well as projects to fund make the fight against HIV/AIDS & TB unbearable, and almost unachievable.

For the past 12 years, I have personally funded our NPO from my hard earned monies to achieve every bit of success I have achieved in the field of HIV/AIDS & TB Education, workshops. But because the funding do not come to small NPOs like ours, we are now forced to reduce our activities as we cannot even afford an office today.

We have been forced to vacate our offices in town and go to work from our homes. Making it almost impossible for us to continue working to empower people about it.

My suggestion is that the donors who really want to help should be more lenient with small NGOs as most of us cannot even afford the accountant fees. 

However, our organisation is even a public benefit thus tax deductible one. But still in spite of all our past achievements donot find funders.

Thank you for the opportunity.

Regards,

Christian Romeo NJIA

http://cr-njia-routes.strikingly.com/ 

Hello all,

when I perused Christian Romeo's post with respect to negligence of small/grass roots, I felt touched but relieved. I felt touched because someone out there is combating the same issue as with me. My organization is strictly for youth persons living with disabilities. The Funders had neglected our contributions here in the slums as they usually expect us to show big financial report for previous projects. Even when i tried partnering with bigger NGOs/CSOs; they end up hijacking your initiatives and kicking you out. This is why we had been demoraled.

I also felt relieved to see that am not the only comrade affected by this latchkey thus; my spirit is lifted to fight harder.

FREE ADVICE: whether they commend our actions and passion or not; we will still be the change with the little we can fetch as a day will come when the right IPO/grantor will see the light in our various initiatives. I know that......... SO i urge us to keep writing, keep sourcing; it is almost done.

Regards,

Sakar. 

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Submitted by nderitudavid (not verified) on Mon, 07/25/2016 - 01:35 Permalink

It is true even inthis part of the world.  Little effort is put in enabling communities through their grassroot organisations fight HIV/AIDS in the best way they know. Communities know factors that are precipatating new infections within their villages and also have the solutions on how bwest to address new infections. Much is happening in big hotels and flights across countries by international organisations and big national organisations. Infact there are some people who hardly sit in their office but are always in flights and hotels "fighting HIV/AIDS. Fat salaries, big offices, sleaky cars and exchange of documents online defines them. Very little happens on the ground and few considers funding and supporting young community organisations as an important avenue in fighting the scourge. In my view, much can happen if the real fight happens where communities live. Unfortunately, much of the HIV funding is going to paying hotel bills, salaries, buying sleaky cars and clearing airline fees for top notch "experts" flying across the globe. The answer to the crisi lies in the communities. I wish someday, this fact gets to the policy makers.

David Nderitu,

Imarisha CBO

Submitted by Nduka on Mon, 07/25/2016 - 06:48 Permalink

Dear Christian, I want to personally thank you for bringing up this issue for discussion. My organisation is also a victim of this policy against small NGOs. They will come and check what they call systems, personnels, structures and policies. Many of the CSO are so passionate about what they are doing in the communities. Our organisation is seated in a very remote place in the community without electricity, poor transport system, no hospital, yet the community have high disease burden. Unfortunately,we can not access funding to carry out our project because the major IPOs said we can not hold money, and we do not have qualified staff. This has been a major problem to our organisation and in fact smaller organisation that understands the problem of the community and knows how to handle themI strongly support this voice for the change. Regards - Nduka Ozor

Submitted by small world theatre on Tue, 07/26/2016 - 07:36 Permalink

Commenting on the post about a small NGO that does work in the communty promoting health /HIV awareness and it's dwindling access to funding. It seems that funding philosophy has shifted toward supporting government initiatives and more than likely hospitals and health services . I suppose this is seen as more effective if systemic institutional corruption is tackled at the same time.

However the grass roots role of of local NGO's that often are more linked to the current communities and harder to reach individuals has a special and very effective role in making a difference. We know from experience how this approach works well.

The mention of " funders greed" may need some explaination as the usual intrinsic generosity of funders is hard to characterise in this way. However funding decisions when they go against good proposals are often hard to fathom. In our post Brexit Britain funding will take an even harder and more competitive edge for us small NGO's as Europes social agenda is unlikey to be matched by national governments re balancing the funding overview.

Small NGO's have a great disadvantage in not having the profile that comes with consistent and full funding. The expertise and knowlegde of smaller organisations is a resource that should be recognised and audited so that we do not loose it in the push for monolithic solutions. Small is Still very beautiful

Bill

Small World Theatre

Submitted by Mamoletsane Khati on Tue, 07/26/2016 - 20:40 Permalink

There has been good progress when it comes to the mortality rates due to the lengthened lifes of those on ART. However, because most donors have concentrated on treatment, then it is still difficult to control the incidence rates as new infections still are on the rise  

There are a number of issues that lead to this increase in the new infection rates. dealing with this challenge has always been looked at from the biological side of HIV. With years, we have tried to encourage looking at the social, behavioral as well as the biological. HIV lives within people who have different attitudes, behaviour and perceptions. Therefore addressing the biological part of the problem which mostly is about understanding the virus and controlling it with treatment cannot be the only piece of the puzzle. 

We also have to make sure that people understand how their social and behaviour can affect progress. We know these include further, attitudes, perceptions, morals, religion, culture and many other aspects that describe who we are. 

There is therefore need to incorporate the social and behavioral communication  But looking at things as they are, funding for this has been dwindling and it's definitely going to fade away. 

Submitted by small world theatre on Wed, 07/27/2016 - 09:35 Permalink

I can not help by giving money to other small NGOs because we have no spare cash but we use theatre to help people tell the stories of the communities we work with. We bring policy makers and other officials to performances to experience the peoples lives and this helps determine the community's development. The policy makers now know whats needs to be done.

So why don't Small NGOs tell their story to policy makers at conferences , meetings  and other special low cost events to highlight the issues. Stories are compelling and direct and effective when they follow a truth and authenticity.

Maybe if we are respectful but honest, direct but wise we can show what it feels like to marginalised while helping the marginalised.  We can present our strengths and admit any weakness , Try not to blame others but let us fight for a place at the table . Our experience is worthwile and deserves a hearing. Speak out and and show our true worth. 

If we need our administration capacity built and our accounrting skills upgradeing we can show this clearly and ask for funds to develop our own organisations ability to join in the game and they may realise we are not trying to compete with the "BIG BOYS" but play our role with the unique set of skills and appropriate knowlwdge we possess.

If we are responsibe for the money we are given we know we can make every bit of it work well for benferficiaries 

Submitted by Lilian Mary Nabulime on Thu, 07/28/2016 - 13:09 Permalink

What is the Problem?

I think we fail because we are not confident. Small world theatre is a voice that educates others. I think u need to package your self better or find ways to let funders know that u are a powerful voice to the magnalised with less reading and writing skills.

Dr Lilian M Nabulime (Senior Lecturer)
Department of Fine Art, Margaret Trowell School of Industrial and Fine Arts, College of Engineering, Design, Art and Technology (CEDAT), Makerere University, Kampala, Uganda, East Africa

Submitted by Lilian Mary Nabulime on Fri, 07/29/2016 - 08:53 Permalink

Responds to: HIV/AIDS: Progress or Stalled? What Next?

(a) How is that possible?

Great efforts have been achieved but: Yes, if people have become used to the epidemic more than 30 years. Good treatments make people feel that its like any disease.

(b) What have we been doing wrong?

I talk to women who are living with HIV/AIDS and they say warning messages are not strong enough or they are not there any more! This also depends in the countries we are coming from or based!

(c) What should we do much better?

More strong creative constant awareness messages  namely reminders in news papers , radios, TVs, mobile phones; the fine arts. music,  dance and Drama.................

 
Dr Lilian M Nabulime (Senior Lecturer)
Department of Fine Art, Margaret Trowell School of Industrial and Fine Arts,      College of Engineering, Design, Art and Technology (CEDAT), Makerere University, Kampala, Uganda, East Africa

Dear Dr. Lilian M. Nabulime,

Actually it is great information to be passed to all victims and
non-victims but mostly youths has to be used to address such
information to all community since they are the one used mostly in
different ways heading themselves into a disgraced issues like that.

their are plenty of youths groups and organization who felt unworthy
due they luck financial to address arts, drama even dances and so many
things.They should be given hand support to do that.

Submitted by small world theatre on Mon, 08/08/2016 - 04:12 Permalink

HIV / AIDS How do we seek the best way? Well there surely is a need to find the best WAYS. Large organisations NGOs and Agencies are probably the best conduit to deliver and supply the expensive drugs and treatmens for HIV. The bigger NGO's have the money and the reach to do this,I suppose there is always room for improvement. The crucial part of this multi piece puzzle is prevention and awarenes campaigns .

This is where a multi agency approch is needed, Posters, TV adds and news features dramas on TV, in theatres and on the streets. Social media is also important but there is a need for very grass roots organisations to be fully in the mix to help supply information and get to the very hard to reach people. They may know this demograhic well and crucially have gained their trust, even respect. These attributes are important for effective aid and awareness delivery. 

If the small organisations are ignored, underfunded and squeezed out of the picture the picture is incomplete.

Some funds should be put asisde to capacity build the smaller organisations. Competition for funds and a "market led" system is an inappropriate approach. As we all know when even a small piece is missing from an eco system the imbalance creates big gaps and unstable progress.

This is not an alien concept. Can we just remember to include all sections of the development family.

Bill

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Submitted by Wanjah (not verified) on Fri, 08/19/2016 - 12:57 Permalink

(a) How is that possible?

Very possible because, thanks to ARV's which have reversed a 'death sentence' to 'no sentence' at all, its become business as usual. Yet, in this business as usual, prevalence is not reducing and sadly, we are moving to another category of rise of infections - 15-24 age group that is careless about sex because there is prophiaxes to use etc. ABC has almost been thrown out of the window and its no longer mentioned as a prevention. In this age group, there is competition on who is 'hottest' around, 'most popular' etc. And this is where we need to focus now. The mature know the consequences and how to avoid them but this group needs special attention.

(b) What have we been doing wrong?

Not moving with the times. The risk of contracting HIV currently is in a critical group which is the generation of tomorrow - 15-24. At the rate the prevalence is rising in this group, we could see a reversal of everything that has been done towards Zero. There is fatigue in this group and we are not reaching out to them with what appeals to them - on social media, and messages that appeal to their category etc

(c) What should we do much better?

The fatigue mentioned above is not only in this young group but the media too. In data collection for a PhD study based on Stigma in Print Media Reporting on HIV & AIDS on two newspapers that I am doing, some of the sentiments from the editors in the interviews are: tell us - how do we tell the message differently so that people can read it? The editors say they need help from those working in the HIV & AIDS arena to create more creative messages that have not been seen before and will be more attractive from what has been there all these years. So, the honors is on us in this field to re-create our messages, our programs to reach a wider audience. Meanwhile, if researchers can speed up getting that cure - that will be another good enventuality. 

Submitted by JSAhmad on Sat, 08/20/2016 - 09:46 Permalink

Re: HIV/AIDS - Progress or Stalled? What Next?
 
HIV/AIDS is a disease emerging from a complex human behavior concerning sexual practices. I believe unless there is constant research of the population's values, sexual practices, and beliefs towards health and prevention, we cannot develop finely targeted communication. I also like to see behavior change communication institutionalized in such a way that research-based communication strategies are developed and implemented not only for HIV/AIDS but also towards other communicable diseases. Total focus on HIV is detrimental because purpose of remedial programs and communication should be to save lives and minimize illnesses no matter from what source.

Javed S. Ahmad