Moving the fight from the boardroom to the ground

The war against HIV/AIDS, which has too often been fought in plush offices and conference centres, needs to be reclaimed by people in developing countries, who are most affected, or it will continue to be a losing battle.



This was the message from the Global Citizens Summit in Nairobi, Kenya, organized by international anti-poverty agency ActionAid, and attended by a broad range of organisations in the field of HIV and AIDS to discuss using social mobilization to "repackage" the HIV response.



"The fight against HIV did not originate in boardrooms - in the US, the momentum came from gay activists propelling HIV onto the national agenda," said Leonard Okello, head of ActionAid's global HIV team.



"In Uganda it came from poor women forming TASO [The AIDS Support Organisation], which has since grown into a national model for community-based care, and in Senegal it came from community and religious leaders - it was citizens rising up to make their voices heard and to put AIDS on the agenda. We need to go back there."



Participants pointed out that although community-based organizations did the lion's share of HIV-care work, they received a fraction of global AIDS funding.



The Bungoma Orphans, HIV/AIDS and Poverty Organization (BOHAPO), in western Kenya, supports orphans and widows in the area with food, money for transport to the hospital, and school uniforms, but has never received any funding from the government or international NGOs; it relies on the local community and sporadic individual donations from abroad.



"A lot of HIV money goes to paying for offices and other administration costs," said Edwin Walela, founder of BOHAPO. "It would be better if that money went straight to helping the widows and orphans - the government gives them ARVs [antiretrovirals], but then they have no money to buy food so they are still dying ... they need more help."



Brian Kagoro, ActionAid's Pan African policy manager, said it was time donors started directing funds to where they actually worked and involved people living with HIV who were often left out of policy discussions about the pandemic.



"We need to stop chasing the money and let the money chase the people's ideas. We talk about people being infected and affected by HIV, but we don't think of them as people with ideas of their own about their condition."



He called for a global mass movement, built on the resilience and determination of people living with HIV, to replace "this grasshopper movement that hops from conference to conference."



Participants also highlighted the need to put more pressure on governments to make good on their commitments. "We've stopped expecting our governments to keep their promises, and so there is no reaction, no anger from us when they don't," said Salil Shetty, director of the UN Millennium Campaign. "We need to find that anger and channel it, not to politics, as we so often do, but to water, to education, to HIV."



He cited the example of South Africa's Treatment Action Campaign, which used legal advocacy and grassroots mass-mobilization to get the South African government to provide free ARV therapy, generic drugs and greater commitment to the needs of people living with HIV.



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