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Good health is fundamental for development. This post, the third in a series on open access World Bank publications, provides easy access to a selection of more than 50 books and reports published since 2010 by the World Bank on health, nutrition, and population. The publications were compiled as a resource for participants at the 2016 Rotary Presidential Conference on Disease Prevention and Treatment in Cannes, France. The list of publications is available here.
Rotary International has long recognized the importance of health. PolioPlus, the first global campaign aiming to eradicate polio through mass vaccination of children, was launched in 1985 by Rotary. In 1988 Rotary became a spearheading partner in the Global Polio Eradication Initiative (GPEI), a public-private partnership in which the Bill and Melinda Gates Foundation, UNICEF, the U.S. Centers for Disease Control and Prevention, the World Health Organization, and a number of national governments are also engaged and contributing.
In addition, disease prevention and treatment, and saving the lives of mothers and children, are two of the six areas of focus of the Rotary Foundation with large funding commitments, and many Rotary clubs and districts around the world implementing projects.
How can clubs and districts contribute to efforts to improve health, nutrition, and population outcomes worldwide? These are some of the questions that will be discussed at the Cannes conference, one of five flagship conferences organized by Rotary International in 2015-16. The other conferences are on peace and conflict resolution in California, economic development in Cape Town, literacy and WASH (water, sanitation, hygiene) in schools in Kolkata, and WASH in schools in Manila.
The compilation of recent World Bank publications on health, nutrition, and population made available here is provided as a service to Rotarians and others working on those areas without any endorsement of the World Bank as to which publications should be featured. Access is provided through the World Bank’s Open Knowledge Repository. In order to keep the list manageable, the focus is on books and reports published since 2010 as opposed to other publications. Only publications from the World Bank are listed simply because covering (many) other organizations would be a rather complex task. At the same time, focusing on World Bank has the advantage of being able to go global with a single organization.
The hope is that the publications listed, and more generally the World Bank’s open access knowledge resources, will be useful to conference participants and others working on health, nutrition, and population.
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.
“The first trip changed my life, seeing how happy these young children were despite how little they have inspired me to be more involved.”
Mary Nagel from the Carroll Creek Rotary Club has gone twice to South Africa to visit and help out with the Hope in South Africa (HISA) project that her Rotary club is supporting. HISA is a community development partnership that aims to address critical needs in the Karoo region. Efforts focus on key areas such as nutrition, health, sanitation, and employment. The hub for the program is the Richmond Community Center, which houses a soup kitchen, a children’s library, recreational facilities, and health and education offices. From this hub, HISA’s staffs orchestrate outreach efforts to youth in the local community and neighboring areas.
While HISA runs several programs, one of their initiatives that the Rotary club of Carroll Creek helped launch in the community is Grass Roots Soccer. This is a global program that helps in fighting HIV by using soccer as a vehicle to engage children, and at the same time teach life skills and provide education on healthy behavior. Mary’s club has also supported other programs, including an initiative to deal with Fetal Alcohol Syndrome, a health issue that affects 15 percent of children entering elementary school in the area and may lead to permanent brain damage. Mary’s club support has been used among others to build awareness among youth about the dangers of drinking during pregnancy.
Mary focuses on fundraising, but she has also visited and volunteered with the project. She has seen HISA grow and its impact on children. She believes that “just showing up is important, to see how we can make a difference”, but for this it is also necessary to “understand that Africans have their culture and that we need to respect their cultures while also providing guidance”. Her advice to fellow Rotarians interested in service work is to “choose a certain area where they have a passion, and understand the needs of the people”.