Development agencies are international and local non-governmental organisations like OXFAM and Save the Children’s Fund, as well as foreign state development bodies like Britain’s Department for International Development, and international organisations like the World Bank. Many are involved in efforts to promote positive change in HIV/AIDS affected countries. They can do this in three ways: firstly, through funding, secondly, by building capacity within the affected country to fight poverty and tackle the disease, and thirdly, through advocacy to seek to raise global awareness of the suffering of developing countries through HIV/AIDS and to provide anti-retroviral drugs to sufferers.
Firstly, development agency funding is vital to many of the developing countries worst affected by HIV/AIDS. Aid donors can fund efforts to help raise public awareness of the threat of the disease through poster, film, drama, dance, music and workshops. This needs to be done in a culturally sensitive way and to engage the public. They have sought to put information about the nature of the disease and its prevention into the public domain, and to fight the stigma and discrimination experienced by sufferers.
Secondly, donors can help build the capacity of the affected country by putting in place measures that attack the underlying menace of poverty which provides a fertile ground for HIV/AIDS. While this is a broad based approach, it includes measures that directly impact on the disease, namely the training of medical and support staff to go out to the community to help mitigate the affects of HIV/AIDS.
Thirdly, development agencies are pivotal in showcasing the devastation wrought by the disease to the rest of the world. Through such advocacy work, they seek to raise global awareness and to motivate citizens of developed countries to put pressure on their governments and the big pharmaceutical companies to act to alleviate the human tragedy that is unfolding in Africa.
The work of Sport Relief has been important in the first and third respect. The initiative has funded an international non-governmental organisation, Healthlink Worldwide, to support HIV/AIDS affected children in 20 villages in Nigeria They are seeking to replicate the successful Ugandan model of ‘memory books’ as a store of emotional support for the children. Moreover, the publicity around the initiative has raised awareness among the British public of the HIV/AIDS situation in Africa.
But such efforts are at best piecemeal, and at worst hopeless if the political will to confront the disease is not present in the affected country. The Ugandan Government has demonstrated such political will and has formulated an integrated response to HIV/AIDS involving both the public and private sectors. Such an approach was both transparent and bold. It involved a massive public awareness campaign and high level government commitment to combating the disease. This strong political will was underpinned by donor readiness to help financially, and international and local NGOs commitment to deliver a wide range of innovative interventions.
One such innovation was the creation of Post Test Clubs (PTCs). Growing out of the Ugandan Government’s establishment of voluntary counselling and testing services, PTCs have sprung up to meet the lack of formal provision of after care services because of the non-availability of life-saving anti-retroviral drug treatments. Created at the community level, PTCs seek to build on and extend the capacity of the extended family and community to mitigate the effect of HIV/AIDS, which has been under extreme stress. PTCs are thus integrated at the local level and sustainable. They are small, organised groups of families, typically around 100 members, who following HIV testing come together to offer each other support. Their shared HIV status provides a powerful bond between them in a society that is only slowly learning to de-stigmatise HIV sufferers.
PTCs encourage members to share the trauma, sadness and burden of HIV/AIDS. They provide emotional support to cope with the news of infection and what it means for the individual and their family, as well as practical support in the form of childcare, succession planning, and micro-credit opportunities to pay for food supplements and medical care.
Succession planning is particularly important in supporting the AIDS sufferer, preparing the survivors and protecting their inheritance. Thus, infected parents are encouraged to produce ‘memory books’ in which they put down their cherished memories of their time with their children and communicate their hopes for them. They are helped in planning for their children’s education, and preparing a will so that there is legal transparency regarding property inheritance. The children are helped to take over the responsibilities of the dying relative and given guidance in life skills and vocational training to strengthen their earning capacity. Guardians are provided with micro-finance opportunities to help them assume the responsibility of the orphans’ welfare, as familial responsibilities are so frayed that there have been cases of relatives seizing property and abandoning orphaned children.
PTCs provide a positive bond among members. Their success has encouraged others to come forward for testing and has enabled many to escape the fear and isolation that can accompany a positive result. But such efforts in mitigating the impact of the disease are only a holding measure. What is really needed is for HIV sufferers to be given anti-retroviral drugs.