The Home and Community Care Conference in Chiang Mai, Thailand, continued on Thursday 18 December, its last day, with a session on partnerships in responding to AIDS.
Stuart Flavell spoke for GNP+, the global network of people living with HIV and AIDS, and on the value of partnerships as evidenced in his own life and in GNP+ experience in the past year through the UN General Assembly Special Session on HIV/AIDS and in the setting up of the Global Fund to fight AIDS, TB and Malaria.
Bill Black, a hotel manager in Singapore and a founder of the Thai Business Coalition on AIDS, outlined the history of that initiative and current efforts, backed by the Ford Foundation, to mobilise businesses in the region through the Asian Business Coalition on AIDS.
However, as befits an event partly organised by the Thai Red Cross Society, this report will focus on the presentation from its parent body.
A new level of commitment?
Dr Alvaro Bermejo, the Head of Health and Care for the International Federation of Red Cross and Red Crescent Societies (IFRC) reviewed the organisation’s struggles to come to terms with HIV and AIDS and what appears to be a new level of commitment to respond to the pandemic.
The IFRC works in 178 countries and has supported a number of HIV/AIDS projects since the mid-1980s but, said Bermejo, these have lacked the consistency and the scale needed to make a significant impact on the epidemic. Over the last two years, however, it has developed a commitment to scaling up its response, which was confirmed most recently in its General Assembly held in Geneva in November 2001.
He defined scaling-up as “a process of engaging a wider community … in order to have impact on the epidemic”.
The strengths of the IFRC included its respected emblem, its global network of volunteers, its involvement in first aid training and responding to disasters, its access to at least some populations other agencies couldn’t reach, and a strong policy base, shared across cultures.
An early example of the usefulness of the emblem had been in 1983 in Norway, when a gay community group had produced a leaflet but couldn’t get funding or support to distribute it. They couldn’t even get to see the health minister. Yet when the Red Cross adopted the leaflet and put their emblem on it, there was suddenly funding and access.
The current policy on responding to AIDS is built on a vision in which prevevention, fighting stigma and discrimination, care and support all need to go together, “even in low prevalence countries”, with people living with HIV/AIDS placed at the centre of the response.
Partnership with positive people
He freely acknowledged past failures of the organisation to address these issues, especially stigma and denial. The first task IFRC had set itself was to deal with this by asking how AIDS was affecting “us” – its own volunteers and staff. It was now working in partnership with GNP+ to develop the contribution of people living with HIV and AIDS to the IFRC response. It had produced a “Living with…” video featuring Red Cross people living with HIV/AIDS.
The second task was to link AIDS with the IFRC’s mainstream concerns and work. He pointed out that AIDS is set to kill more people this decade than all wars and disasters in the last 50 years, and that there are twice as many people living with HIV as there are refugees. In the hardest-hit countries, as many as 25 per cent of Red Cross staff and volunteers could be HIV positive: in these countries, “our organisational survival is at stake”.
Thirdly, they were building institutional competence, to understand how their work could make an impact on the epidemic. They are adapting existing programmes to include HIV and AIDS components. For example, their first aid training programmes and their programmes for the military, which train armed forces personnel in international law. They were also creating specific AIDS programmes and working to raise public awareness that AIDS is an issue that concerns Red Cross and Red Crescent societies across the world. Finally, they sought to ensure that the organisation learned from its experience and could improve its ability to make a difference to the epidemic.
The IFRC’s partnership with GNP+ was not a case of seeking to work with like-minded people. The two organisations could hardly be more different. But the point was that each had much to offer to the other. GNP+ - and also UNAIDS – had helped the IFRC to break internal stigma and denial, making “quick progress” to the point where openly HIV positive delegates were now attending the IFRC’s Global Assembly as members of their national delegations. AIDS programmes in Eastern Europe, Central Asia and Latin America were now being planned with the help of GNP+ regional networks. Conversely, GNP+ had been able to gain from access to Red Cross support with training and to reach many people it could not have reached alone. Both organisations had been able to gain credibility through the partnership.
Finally, he paid tribute to the leadership shown by the Thai Red Cross Society (a co-organiser of the conference) in addressing HIV and AIDS within its own country and internationally, through the IFRC.