by Quentin Wodon
Today is World AIDS Day. Over the last three decades, the pandemic has taken the lives of 36 million people. According to the WHO, 35.3 million people live today with HIV (human immunodeficiency virus), but only about a third (11.7 million) receives antiretroviral therapy in low- and middle-income countries. The theme for the day this year is “Focus, Partner, Achieve: An AIDS-free generation”, calling for governments, NGOs, and individuals to contribute to AIDS prevention and treatment. This post is about the role of civil society and Rotary in fighting the AIDS epidemic.
Role of Civil Society
Governments and donors play a key role in the fight against AIDS, but civil society and individuals also play an important role and that role is being increasingly recognized and supported. Last year I published with World Bank colleagues a book entitled Funding Mechanisms for Civil Society: The Experience of the AIDS Response (the book is available online without charge here). We noted that in the past decade, international funding for the HIV and AIDS response provided by governments rose dramatically.
In addition donors have increasingly shifted their financial support toward funding community responses to the epidemic. Yet little is known about the global magnitude of these resource flows to civil society, especially at the local level, and how funding is allocated among HIV and AIDS activities and services by community organizations.
Part of the study focused on the mechanisms used to fund civil society and community-based organizations (CBOs) by four large AIDS donors: the U.S. President’s Emergency Plan for AIDS Relief, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank’s HIV/AIDS Program, and the UK Department for International Development. On average, these four donors provided at least US$690 million in funding per year for civil society organizations (CSOs) during the 2003–09 period.
Much of this funding went to large national CSOs. While part of the funding also went to smaller NGOs and CBOs, including through partnerships with the larger CSOs, in many cases only a small share of international resources trickles down to local communities. More needs to be done to support local-based organizations that are actively contributing on the ground to the fight against AIDS, often relying on volunteer work.
Role of Rotary
Rotary is active in the fight against AIDS in part through the Rotarians for Family Health & AIDS Prevention (RFHA) Rotarian Action Group. Rotarian Action Groups (RAGs) are groups are led by Rotarians in their field of expertise in order to help clubs implement projects and exchange ideas and experiences. There are close to 20 RAGs operating, and RFHA is one of them.
The signature program of RFHA is Rotary Family Health Days (the information provided here is from the RFHA website). The program promotes healthy living and disease prevention through annual campaigns in four African countries: Ghana, Nigeria, South Africa, and Uganda. Family Health Days provide comprehensive, free health care services to underprivileged communities. The services include lifelong immunizations to children, such as polio and measles vaccines, and comprehensive life-saving annual screens such as HIV, TB, Malaria, Diabetes, Hypertension and more, including information about HIV-AIDS.
The program was initiated in 2011 when Past District Governor (PDG) Stephen Mwanje from Uganda asked Marion Bunch, the founder of RFHA, for partnership support in obtaining funding and other resources for this program. PDG Mwanje’s vision was to have all Rotary clubs in his district work together towards a common cause, focusing on HIV/AIDS but also including other disease prevention measures.
Family Health Days is a Rotary-led program, but it leverages partnerships with others including the Coca-Cola Africa Foundation, the U.S. Mission – including the Centers for Disease Control, USAID and the health service delivery expertise of their Implementing Partners – as well as each of the four countries’ Ministries of Health that provide services and supplies at the sites.
Equally important in each country are the primary media partners that include the SABC and Caxton in South Africa, and other media centers in each of the other countries. The Family Health Days program has grown from serving 38,000 citizens in one day in 2011 to serving 343,622 citizens in 2014 in 402 sites with the help of more than 8,000 Rotary volunteers. RFHA hopes to expand the program in more African countries in 2015 and is planning a pilot in India. Importantly, it is also thinking about the measurement and evaluation of the impact and sustainability of the program.
In the fight against AIDS, community-based organizations play an important role because of their proximity to the population, their knowledge of the issues on the ground, and the trust that the population has in them. Rotary could be considered as a large NGO given the amounts of funding managed by The Rotary Foundation of Rotary International. But it can also be considered as a small local-based quasi-community group given that many Rotary clubs are indeed small and working at the local level collaboratively with other NGOs.
A key question for Rotary is how to leverage effectively the resources provided by its network of clubs and members around the world. The Family Health Days, the signature program of the RFHA Rotarian Action Group, is a very interesting case of a successful mechanism to leverage the energy of many local Rotary clubs into programs that reach at least some level of scale and make a difference in the fight against AIDS and the improvement of broader health indicators.