Country watch: The Philippines

This article describes the efforts of local Philippine HIV/AIDS programs to widen their reach and sustain their efforts. The model assumes that the engagement of an ever larger number of institutions that understand HIV/AIDS issues and are committed to prevention and care will help foster safer sexual behavior. The Philippines HIV/AIDS Nongovernmental Organization (NGO) Support Program (PHANSuP), with the support of the International HIV/AIDS Alliance, developed skills and strategies workshop sessions. This pilot training program builds and strengthens local NGO capacity and partnerships between sectors. The Alliance in 1993 raised funds for PHANSuP, and PHANSuP supported local NGOs, including the Olangapo City AIDS Foundation (OCAFI). OCAFI was forced to stretch the new funding over a longer period and agreed to be a resource for a wide variety of local institutions rather than a single AIDS project. In this way, resources were complementary and more broadly distributed. OCAFI built partnerships with a variety of institutions ranging from the local Rotary Club to the casino. The result was wider financial, political, and practical support in Olangapo City, and improved access to vulnerable groups. The pilot program proved that local NGOs could reduce their dependency on PHANSuP financial support. The links between NGOs and government health services have led to a wider reach of the education programs and the use of mass media. PHANSuP has developed several initiatives to promote the view that partnerships between different sectors are possible and that sustainability is possible. Programs must sell themselves to the local community, which in turn will support the programs.     

非政府组织(NGO)艾滋病防治工作在转型期的可持续发展

随着国际社会逐渐减少对中国的艾滋病防治工作提供经费支持,云南省防艾工作已逐步进入转型期。在转型期,非政府组织(NGO)防艾工作面临一系列挑战,如:如何继续获得参与的平台;如何促进NGO参与的管理方式、理念转化为政府的工作机制等。为使NGO防艾工作可持续发展,首先应开展一些独立的活动,如技术资料和人力资源及工作网络的整理与利用、经济资源投入促动行动、培训政府相关部门的艾滋病工作管理人员等,以推动目前NGO参与的产出进一步扩大、增值和继续发挥其作用;其次应创造条件,促进政府的认可,扩大NGO自己的生存空间;第三应从服务领域、服务层次、筹资渠道、志愿者发展、组织网络建设等方面努力提高自身专业能力的建构和财政的自主性,谋求长远发展。     

湖北省相关非政府组织参与艾滋病防治工作调查研究

目的了解和掌握湖北省相关非政府组织（NGO）参与艾滋病防治工作的基本情况、活动能力与目前的需求，探索湖北省NGO参与艾滋病防治工作的策略、方法与能力建设模式。方法发放统一调查表格，由各市、州预防医学会组织相关NGO填报，并个别访谈NGO负责人或艾滋病防治专家，对全省资料进行统计分析。结果①全省56个相关NGO主要分布在武汉、襄樊、宜昌、孝感、黄冈、咸宁、随州等地；活动经费来源依次为34％国内NGO、22％政府、16％企业、14％国际NGO、10％会费、4％个人资助。②主要活动领域依次为学术交流、健康教育、技术培训、行为干预、关爱护理等。③主要目标人群依次为大众人群、艾滋病病毒感染者／病人、性乱人群、男男性接触者（MSM）、青少年和孤儿、吸毒人群、妇女和流动人口等。④主要需求依次为活动经费、人力资源、场所设备、政策支持、信息提供、技术支持等。结论全省相关NGO参与艾滋病防治活动体系已初步形成，并在艾滋病防治工作中起到了重要作用。建议加强对NGO人力资源的管理和自身建设，加强对NGO的政策、资金和技术支持，建立参与艾滋病工作的NGO联盟，探索适合湖北省NGO参与艾滋病防治的策略、方法与能力提高模式。     

Retracted: Determinants of project success among HIV/AIDS nongovernmental organizations (NGOs) in Rakai,Uganda

The aim of the study was to identify the main determinants of grassroots project success among HIV/AIDS NGOs operating in Rakai, Uganda. It was a cross‐sectional study using face‐to‐face interviews in a mixed‐methods approach among community members and NGOs involved in providing HIV/AIDS and related health services. The study found that the success of grassroots projects of HIV/AIDS NGOs essentially relies on adequate financial resources, competent human resources, strong organizational leadership, and NGO networking. These data suggest that to increase grassroots project success, HIV and AIDS NGOs in Rakai need to improve not only the budget base and human capacities but as well decision‐making processes, organizational vision, mission and strategies, gender allocation in staffing, and beneficiary involvement. Copyright © 2010 John Wiley & Sons, Ltd.     

HIV / AIDS control programme: lessons from the VHAI-EC joint initiative

The Voluntary Health Association of India (VHAI), with financial support and technical advice from the European Commission, developed the HIV/AIDS Control Programme. The program began in January 1995. Its overall goal was to strengthen the capacities of nongovernmental organizations (NGOs) in initiating and developing HIV/AIDS interventions at the grass-roots level. Program strategies include capacity building within NGOs for effective HIV/AIDS efforts, primary prevention of HIV/sexually transmitted disease (STD) transmission through information and education and promotion of safer sex, promotion of condom use, improvement of STD control in primary health care, and advocacy and social mobilization in support of persons affected by HIV/AIDS. VHAI first invited project proposals from NGOS in Manipur, Assam, West Bengal, Bihar, Kerala, and Andhra Pradesh. Then it held a workshop for interested NGOs on policy and funding criteria. 24 NGOs were selected in the first round from all the above states, except Andhra Pradesh. The intended audiences included youth, women, migrant workers, intravenous drug users, commercial sex workers, tribals, and students. The selected projects consisted of awareness generation, needle exchange, blood safety, condom promotion, and counseling. Training programs addressed project management, counseling, and training of health personnel (medical practitioners, health workers, peer educators, and paramedical workers). State-specific communication strategies involved traditional and folk media, a condom key chain, workshops for journalists, and meetings with members of the Legislative Assembly. VHAI is developing a comprehensive communication package for lobbying and advocacy activities. The May-June 1996 mid-term evaluation found that the program helped state VHAs to work more closely with member NGOS and non-member groups and that NGOs did become familiar with HIV/STD prevention and control. NGOS had inadequate experience in project management. NGOs were able to mobilize communities, to take on innovative interventions, and to network effectively.     

Country watch. Zimbabwe

The Zimbabwe AIDS Network (ZAN) was formed when nongovernmental organizations (NGOs) engaged in HIV/AIDS activities realized they could support each other by sharing scarce human and material resources and experiences. Among the activities initiated by ZAN are courses in practical and project management to improve skills needed to manage organizations. Another ZAN activity is the Small Project Fund, which was established because many good projects could not get started because of lack of funding. Most NGOs find it difficult to approach distant donors for the often relatively small amounts of money needed. ZAN approaches major donors on behalf of small organizations, who can apply to ZAN for funding. ZAN's national coordinator provides them with information on the funding criteria, which were drawn up together with donor agencies. Though the criteria are regularly revised, two on-going stipulations are that the projects must be HIV/ AIDS-related and no funds will be paid to individuals. Organizations not registered with the Department of Social Welfare receive funds through a welfare organization that is a ZAN member. ZAN's Executive Committee has appointed a Small Project Committee to assess all applications. Organizations receiving funds are requested to regularly submit reports to ZAN about the activities carried out; ZAN then accounts for the monies received to the major donors.     

Intervention planning. Guiding principles for coordinating HIV / AIDS programmes

What follows are recommendations by the World Health Organization's Global Programme on AIDS 1993 task force on HIV/AIDS coordination, which produced a document entitled Framework of Guiding Principles of HIV/AIDS Coordination at Country Level. Coordination of HIV/AIDS activities and decision making is a process that promotes information exchange and facilitates the cooperation between different organizations. The principal purpose of coordination is to enhance the collective capacity of a country, region, or community to respond to the HIV/AIDS epidemic. The parties concerned must cooperate in policy development, strategy planning, and working together during these activities. A partnership approach is necessary for an effective response to the HIV/AIDS epidemic. Governments are responsible for implementing a multisectoral response, and they must protect the human rights of PHIV. Parties engaged in these activities have both rights and responsibilities: PHIV/NGOs, private sector organizations, UN agencies, and donors. The coordination process entails the recognition of the equality of all the parties, open contributions, flexibility for discussing different views, choosing respected people for coordination, maintaining the trust of involved communities, and using methodologies to evaluate and modify the process. Access to technical expertise must be ensured for coordinating structures, and information exchange must also be guaranteed by adequate financing for the management of national regional HIV/AIDS plans. A country's specific circumstances will determine the appropriate coordinating structures.     

Estimating resource needs for HIV/AIDS health care services in low-income and middle-income countries

As funding mechanisms like the Global Fund for HIV/AIDS, Tuberculosis and Malaria increasingly make funding decisions on the basis of burden of disease estimates and financial need calculations, the importance of reliable and comparable estimating methods is growing. This paper presents a model for estimating HIV/AIDS health care resource needs in low- and middle-income countries. The model presented was the basis for the United Nations' call for US dollars 9.2 billion to address HIV/AIDS in developing countries by 2005 with US dollars 4.4 billion to address HIV/AIDS health care and the rest to deal with HIV/AIDS prevention. The model has since been updated and extended to produce estimates for 2007. This paper details the methods and assumptions used to estimate HIV/AIDS health care financial needs and it discusses the limitations and data needs for this model.     

An ecological framing of HIV preventive intervention: a case study of non-government organizational work in the developing world

The work that non-governmental organizations (NGOs) perform in terms of HIV and AIDS is wide-ranging. Financial resources are available from government and other agencies if NGOs can frame their work in alignment with their interests. We take the particular case of Disha Foundation, an NGO working in Nasik, in the state of Maharashtra in India, whose clients are migrant workers. Drawing upon a broad notion of frame, we focus on the way in which activities such as 'intervention', 'prevention', 'empowerment' and 'community' in the HIV field can differ radically from articulation (at a government level) to practice (of NGOs). Disha's interventions can be described as ecological, in so far as they map and change root causes. Thus, Disha can be seen as doing HIV prevention. Further, we argue that framing HIV funding calls primarily in terms of 'quality of life' would facilitate the work of NGOs, especially of ecological interventions.     

Providing support to caregivers and self-care

The evolution of HIV/AIDS care has resulted in a wide range of caregivers who work out of public and private hospital facilities, nongovernmental organizations (NGOs) and community-based facilities. Others are volunteers and community health and social workers based at facilities or community sites. Many caregivers are family members or part of a client's close social network. Additionally, people living with HIV/AIDS (PHA) themselves engage in self-care and provide support to other PHA through support groups. In the best-case scenario the services of these caregivers are sometimes provided free of charge at one site by a specialized NGO. In many cases, however, a person wishing to gain access to care and social services may need an understanding how the systems and procedures of various institutions operate. Many PHA are unprepared for the administrative, financial, and legal barriers that they may encounter. To cope with this need, a new type of support service called the "buddy" system has emerged. Buddies are individuals who are less directly involved with, but who know about HIV/AIDS, the services available and the rights of PHA. A buddy is close enough for the PHA to approach, has sufficient time to devote to him/her and can be asked almost everything. The article on the Rio de Janeiro Buddy Project provides an example of a project for gay men in Brazil. In other parts of the world where the buddy system is non-existent, the PHA must often rely on support provided by family and friends.     

Sustainability of NGO capacity building in southern Africa: successes and opportunities

Despite an increase in organizational capacity building efforts by external organizations in low and middle income countries, the documentation of these efforts and their effects on health programs and systems remains limited. This paper reviews key frameworks for considering sustainability of capacity building and applies these frameworks to an evaluation of the sustainability of an AIDS non‐governmental organization (NGO) capacity building initiative. From 2004–2007 Bristol‐Myers Squibb Foundation's Secure the Future^TM initiative in southern Africa funded a five country program, the NGO Training Institute (NGOTI), to build capacity of NGOs working to address HIV/AIDS. Lessons learned from this project include issues of ownership, the importance of integrating planning for sustainability within capacity‐building projects, and the value of identifying primary capacity‐building objectives in order to select sustainability strategies that are focused on maintaining program benefits. Sustainability for capacity building projects can be developed by discussing key issues early in the planning process with all primary stakeholders. Copyright © 2010 John Wiley & Sons, Ltd.     

Are reproductive health NGOs in Uganda able to engage in the health SWAp?

This paper explores the ability for reproductive health (RH) non-governmental organizations (NGO) in Uganda to survive in the context of SWAp and decentralization. The authors argue that, contrary to the perceptions that this context may increase NGO's financial vulnerability, a SWAp and a decentralized system may provide an opportunity that should be embraced by NGOs to enhance their sustainability and effectiveness by reducing their current dependency on donor funding. The paper discusses the systemic weaknesses of many NGOs that currently make them vulnerable, and observes that unless these weaknesses are addressed, such NGOs will lose their space in the SWAp and decentralization arena. The authors suggest that NGOs need to recognize the opportunities that participating in public-private partnerships through a SWAp can offer them for long-term and significant funding. They need also to develop their capacity to pro-actively participate in a SWAp and decentralized context by becoming more entrepreneurial in nature, through re-orienting their organizational philosophies and strategic planning and budgeting so as to be able to partner effectively with the public sector in accessing funds made available through health sector reform.     

HIV prevention programs of nongovernmental organizations in Latin America and the Caribbean: the Global AIDS Intervention Network project.

OBJECTIVE: The objective of this paper is to describe HIV prevention programs conducted by nongovernmental organizations (NGO) that are meeting this challenge. METHODS: One NGO undertaking HIV prevention programs was evaluated in each of the 23 countries participating in the Global AIDS Intervention Network (GAIN) Project throughout Latin America and the Caribbean. A two-stage selection process was used: (1) a search in databases and other information sources; (2) identification of NGOs that were best established and most actively engaged in HIV prevention activity. Executive directors were questioned about staffing, budget issues, populations served and barriers faced by these entities. RESULTS: The 23 NGOs conducted 58 direct-service programs and had been conducting HIV prevention activities for a mean of 8 years (SD=4.45; range 1-18 years). Average annual program budget was US $205,393 (range: US $10,000 to US $1,440,000). The NGOs reported a mean of 4.5 full-time employees (range 0-15, SD=4.7). Many relied on volunteers (median=10, mean=51, range 0-700, SD=150) to conduct HIV prevention activities. The NGOs provided prevention services for the general community (82.6%), children and adolescents (34.8%) and men who have sex with men (30.4%). Activities conducted by NGOs included train-the-trainer activities (43.5%) and face-to-face prevention activities (34.8%). Obstacles cited included lack of funding (60.9%) and HIV-related stigma and discrimination (56.5%). CONCLUSION: The strategies used by NGOs to overcome barriers to prevention are a testament to their ingenuity and commitment, and serve as examples for NGOs in other world regions.     

Memisa and home care for AIDS patients in Zambia

Health care in Zambia has since long been receiving support from non-governmental organizations (NGOs) like Memisa. Church organizations bear responsibility for a considerable part of the national health services. During the last 15 years, growing attention has been given to improvement of basic services in the villages and to recruitment and organization of groups in the community active in the field of health care. The combat against AIDS is a major focus. Many NGOs give health education on HIV and AIDS, are coaching HIV-positive individuals and are trying to organize support for AIDS patients and their relatives and relief for women and children after the death of husband or father. The community home care projects established in the urban areas of Copperbelt province in Zambia provide a decent terminal phase for AIDS patients and assist the surviving families in maintaining a certain socioeconomic level of existence.     

男男同性性行为者草根非政府组织参与艾滋病防治能力的现状

目的了解目前男男性行为（men who have sex with men,MSM）人群草根非政府组织艾滋病防治能力现状及存在的问题。方法对全国7个省（市）的较大的11个MSM小组的16名组织负责人进行问卷调查、个人深入访谈和专题小组讨论。结果各组织之间都存在注册困难、经费不足、志愿者管理制度缺失、人力资源缺乏及媒体倡导不足等方面的问题。结论进一步改善政策,加大对MSM草根非政府组织的支持,加强各组织经验交流,完善管理制度是提高各组织能力的重要途径。     

HIV Prevention in Africa: Programs and Populations Served by Non-Governmental Organizations

The AIDS epidemic in Africa remains an urgent health crisis. Non-governmental organizations (NGOs) in Africa play a critical role in the delivery of HIV prevention services and assistance to persons living with AIDS. African NGOs are conducting numerous HIV prevention programs with several at-risk populations, yet their efforts have only rarely been systematically documented. To address this gap in the literature, the authors surveyed one NGO in each of 29 African countries regarding their HIV prevention activities and populations served. This report provides details concerning HIV prevention activities across the continent and describes in detail innovative programs from Togo and South Africa. NGOs in the present sample operate with modest budgets and small staff sizes, yet conduct programs that reach large segments of their communities. NGOs were most likely to report community-level interventions such as peer-education or community outreach. Faced with an epidemic where the main transmission occurs via heterosexual activity, African NGOs were most likely to direct their attention to the general public and to youth. NGOs in Africa are struggling to implement sustainable, cost-effective programs with few resources. Strengthening the infrastructure and capacity of these key agencies is crucial to fighting the AIDS epidemic in Africa.     

Faith-based orphan care: Addressing child-oriented goals and child rights in HIV/AIDS-affected communities

Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) has had a profound effect on children and families in sub-Saharan Africa, increasing the need for effective support. Because the large number of children affected by AIDS (CABA) often exceeds the capacity of local families to care for them, state agencies, non-governmental organizations (NGOs) and a wide variety of community-based organizations (CBOs) have become essential partners in caring for HIV/AIDS affected children. Faith-based organizations (FBOs) are a primary source of care for many children, yet relatively little is known about FBOs’ specific approaches and services. National governments are also relying increasingly on FBOs to help them meet the Millennium Development Goals (MDGs) and fulfill their responsibilities under the Convention on the Rights of the Child (CRC). This article looks at two FBOs in South Africa providing care to HIV-affected families and children and explores the extent to which each addresses the objectives of the MDGs and CRC. Both organizations provide important services with regard to the MDGs and Article 6 of the CRC, which relates to life, survival and development. However, the extent to which the two organizations respected Article 3 of the CRC, which relates to prioritizing the nuclear family and preserving the identity of the child, differed.     

Circus monkeys or change agents? Civil society advocacy for HIV/AIDS in adverse policy environments

This paper explores the factors enabling and undermining civil society efforts to advocate for policy reforms relating to HIV/AIDS and illicit drugs in three countries in Eastern Europe and Central Asia: Georgia, Kyrgyzstan and Ukraine. It examines how political contexts and civil society actors’ strengths and weaknesses inhibit or enable advocacy for policy change – issues that are not well understood in relation to specific policy areas such as HIV/AIDS, or particular regions of the world where national policies are believed to be major drivers of the HIV/AIDS epidemic. The study is based on in-depth interviews with representatives of civil society organizations (CSOs) (n = 49) and national level informants including government and development partners (n = 22). Our policy analysis identified a culture of fear derived from concerns for personal safety but also risk of losing donor largesse. Relations between CSOs and government were often acrimonious rather than synergistic, and while we found some evidence of CSO collective action, competition for external funding – in particular for HIV/AIDS grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria was often divisive. Development partners and government tend to construct CSOs as service providers rather than advocates. While some advocacy was tolerated by governments, CSO participation in the policy process was, ultimately, perceived to be tokenistic. This was because there are financial interests in maintaining prohibitionist legislation: efforts to change punitive laws directed at the behaviors of minority groups such as injecting drug users have had limited impact.     

Circus monkeys or change agents? Civil society advocacy for HIV/AIDS in adverse policy environments

This paper explores the factors enabling and undermining civil society efforts to advocate for policy reforms relating to HIV/AIDS and illicit drugs in three countries in Eastern Europe and Central Asia: Georgia, Kyrgyzstan and Ukraine. It examines how political contexts and civil society actors’ strengths and weaknesses inhibit or enable advocacy for policy change – issues that are not well understood in relation to specific policy areas such as HIV/AIDS, or particular regions of the world where national policies are believed to be major drivers of the HIV/AIDS epidemic. The study is based on in-depth interviews with representatives of civil society organizations (CSOs) (n = 49) and national level informants including government and development partners (n = 22). Our policy analysis identified a culture of fear derived from concerns for personal safety but also risk of losing donor largesse. Relations between CSOs and government were often acrimonious rather than synergistic, and while we found some evidence of CSO collective action, competition for external funding – in particular for HIV/AIDS grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria was often divisive. Development partners and government tend to construct CSOs as service providers rather than advocates. While some advocacy was tolerated by governments, CSO participation in the policy process was, ultimately, perceived to be tokenistic. This was because there are financial interests in maintaining prohibitionist legislation: efforts to change punitive laws directed at the behaviors of minority groups such as injecting drug users have had limited impact.