The big advantage of international NGOs (INGOs) I believe is their ability to facilitate, multiply and sustain positive change for communities who are marginalised in society. This includes for example, people who use drugs who face criminalisation and are unable to access basic healthcare services; sex workers who are abused by police and prosecuted, or people living with HIV who because of stigma and discrimination cannot access treatment or care.
Including the excluded
But many excluded communities can become agents of change and save lives when they are supported by INGOs. Community action when driven by the most marginalised is transformative and brings genuine development results. Governments and UN agencies until recently neglected some of the most marginalised communities and if not for INGO actions in the HIV and AIDS response for example these groups may still be neglected.
INGOs’ work delivers outcomes when action is embedded and driven by communities’ needs and actions and this requires a slightly different approach than is now practiced by many INGOs.
Shifting power to communities
The unique model of the International HIV/AIDS Alliance (Alliance) means that skills and experiences are shared across a global partnership of 38 independent civil society linking organisations in Africa, Asia, Eastern Europe, Latin America and the Caribbean who in turn work with over 2000 community based organisations (CBOs) many led by people living with or affected by HIV.
Learning exchanges are facilitated between linking organisations and CBO representatives who define areas of mutual learning and share experiences. For example, civil society and community representatives from Alliance Myanmar visited Alliance India to learn about best programming practice for orphans and vulnerable children and then implemented their own programming based on what they had seen and experienced in India, adapting it to their context.
The Alliance’s model also facilitates technical assistance and capacity building between linking organisations, civil society and community organisations to strengthen leadership, programming capacity and government interaction through Regional Technical Support Hubs. These are based in Alliance linking organisations and are able to respond to country needs and provide advice and guidance that develop local systems that work within the context.
Work focuses on strengthening community-based structures that will contribute to the longer-term sustainability of health and other priority issues at the community level so CBOs can proactively deliver health and social services in their community.
Nothing about us without us
Community action requires decentralised responses, but what matters is not whether the central office is located in the South or North. It is about who runs it. Linking organisations and CBOs are often run by people affected by HIV which makes it possible for communities to decide what needs to be done, how and when.
In Ukraine for example until recently stakeholders involved in the HIV response did not believe that people who use drugs would be able to run CBOs and deliver harm reduction services. With the support of Alliance Ukraine the CBOs have been trained how to assess the epidemiological situation, identify and define their communities needs, design interventions and provide effective services and information. By developing the confidence and leadership skills of members of the community people who use drugs are themselves conducting advocacy for their human rights and for the introduction of evidence-based interventions.
From 2007 the number of new HIV cases has been declining in Ukraine among people who use drugs thanks to the combined work of CBOs, national and international partners, including the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria.
Changing policy and impacting lives
The Alliance also facilitates opportunities to bring those voices that would otherwise remain excluded from international policy debates to the table and through national policy platforms at a country level organisations are working together to change legal and policy frameworks.
These platforms are often hosted by Alliance linking organisations and many have become key institutions influencing their national policy environments. In Ecuador, Kimirina’s successful advocacy contributed to the enactment of laws and procedures on care for sex workers. To achieve this, the sex workers of Ecuador, supported by Kimirina, spent four years approaching decision-makers, healthcare workers and other organisations in order to raise awareness of the problems and convince them of the need to bring about change.
Supporting community action
The HIV and AIDS response has helped to shape the approach to development. The Alliance’s model emerged when it was understood that we would not change the course of the epidemic unless community action was supported and central to the response. We have learned much over the last 20 years and are continuing to learn how to best adapt and refine our approach.
More widely, INGOs need to support how communities develop rather than determine how development is done. Those who are weakest need to become drivers of change to transform their own lives and strengthen their positions.
Independent functioning of CBOs should be the ultimate goal of any capacity building activities carried out by INGOs. I believe the future of development is that when communities need to, they are enabled by INGOs to bring about local, sustainable change.