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In December 1998, the Alliance marked its fifth anniversary. During its development, it has learned many lessons - both from its own experiences and those of others. Some of the most significant are about NGO support work and capacity building.

Since it started, the basic principles of the Alliance’s work have stayed constant. These include recognising that:

• The most effective action on HIV/AIDS is by local people at a local level. Hence, the Alliance has focused on building capacity at a local level, while also helping groups to access international resources and ideas.

• NGOs need a diverse range of skills and resources to respond effectively to HIV/AIDS. Hence, the Alliance has facilitated a combination of programmatic, financial and organisational support.

• Building NGO capacity requires attention to technical and organisational systems, as well as issues that overlap the two - such as strategic planning.

• Capacity building should be judged by its contribution not only to quality interventions, but also to a sense of ownership, and appropriate population coverage.

While the principles have stayed the same, the Alliance’s ways of working have expanded. Initially, the Alliance developed a “linking organisation” model – with local partner programmes providing comprehensive support to NGOs and community groups. Although the Alliance learned that it was vital to adapt this approach to the specific needs of local NGOs, this model worked in countries as diverse as Burkina Faso, Ecuador and the Philippines.

Now, the Alliance continues to support and value existing and potential linking organisations. However, it has also found it helpful and necessary to seek new ways of working. This is enabling the Alliance to widen the impact of its work, respond to specific needs, and make effective use of resources.

In India, for example, the Alliance is strengthening leading NGOs already recognised for their work in specific programme areas, such as working with injecting drug users. These NGOs are being helped to test and document “good practice” in specific areas and then to share their lessons and expertise with other NGOs. A variety of different approaches to replication and adaptation will be tested, including training programmes and CBO to CBO exchanges.

Whatever way it works, the Alliance has learned that focussing on capacity building and responding to local needs, are key to effective NGO support work and, in turn, effective community responses to HIV/AIDS.

Key components of the Alliance approach to capacity building and technical support
Transfer chart from Word.

Viewpoint: Working with NGOs to make a real difference
By Jeffrey O’Malley: Executive Director, The Alliance

Over the last decade, tens of thousands of community groups joined the AIDS prevention and care efforts of pioneers like Uganda’s TASO, Thailand’s EMPOWER and Brazil’s ABIA. But does the hugely expanded and empowered NGO sector really succeed in reducing risk behaviour and vulnerability, and improving quality of life for people infected with HIV? Are these NGO programmes sustainable? And do they reach sufficient numbers of the right people to really have an impact?

Those of us trying to mobilise and support NGOs to respond to AIDS must answer all these questions, but I would argue that our most significant challenge today lies in the question of scale and reach. For example, Africa has many of the world’s most experienced and competent NGOs working on AIDS, yet far too many reach only hundreds of people rather than tens of thousands or millions. This situation must change if we are really going to make a difference.

We must navigate between two dangers. On the one hand, intensive support to a limited number of high quality “boutique projects” might increase our confidence that we are succeeding at prevention and care, but only for a small number of people. On the other, the pressure to “make a difference” has led some large donors and governments to naively allocate huge sums of money to NGO activities on HIV in particular countries. It is possible that many of these projects will fail when inadequate safeguards and support systems in governments meet the technical and strategic limitations of many NGOs. In either case, we run a risk of squandering opportunities and undermining political will and financial support for NGO AIDS work in the years to come.

In trying to identify and promote “best practice” relevant to scale up and replication, we can learn from our failures as well as our successes. We should identify the obstacles that have stopped us from even trying to scale up or replicate some clearly successful and affordable interventions. We should also learn from the experience of promoting particular interventions without first ensuring adequate evaluation, only to find that they are less successful or affordable than hoped. Finally, we should learn from experiences whereby successful pilot projects failed on a larger scale, often because of difficulties in identifying and maintaining the key conditions that made the intervention successful in the first place.

But there are success stories as well. Although they are neither perfect nor all encompassing, we must applaud the fact that condom social marketing programmes have been both scaled up and replicated widely. More complex packages of community mobilisation, behaviour change interventions and services have been scaled up as well, especially through local “umbrella projects”, combining funds, technical assistance and policy support to NGOs.

Part of our challenge is to learn more about these scale up and replication processes through documentation, research and evaluation, in order to avoid past mistakes and to build on success. Perhaps the larger challenge is the political one, making sure that none of us look at our work in isolation, but build instead a sense of collective responsibility to get the work done.

Regional Workshops on NGO Support
At the end of 1998, the Alliance co-ordinated three Regional Workshops for its partners and other NGO support programmes. The workshops in Africa and Latin America focussed on the theme of NGO support work. The following are summaries of group sessions from each of these workshops:

Latin America: “SWOT” analysis of NGO support programmes involved in HIV/AIDS prevention
Strengths

• Years of experience with different communities.

• Transfer of technical approaches.

• Exchange of NGO experiences.

• Availability of funds.

• Resources for NGO capacity building.

• Trained people.

• Role of NGOs is understood.

• Institutions are mature.

Opportunities

• Receptivity of NGOs to technical and management support.

• NGOs already work in networks.

• Increasing demand for support.

• Regional and international provision of technical support.

• Co-ordination between institutions.

• Opportunities to work with other social movements.

Weaknesses

• Little co-ordination with other support systems.

• Slow and inflexible in adapting approaches.

• Lack of monitoring of processes and indicators to measure impact.

• High turnover of staff.

• Dependency on donors.

• Lack of critical analysis.

Threats

• Weak National Programmes on AIDS.

• Dependency on external bodies – such as donors and the church.

• Re-structuring of state bodies, and elimination of AIDS Programmes.

• External funding goes to other emergencies in other regions.

• Lack of priority given to HIV/AIDS within Latin American society.

Africa: “Brainstorm” on how NGO support programmes can better identify the technical support needs of NGOs involved in HIV/AIDS care and support:
Examples of technical support needs re. care and support:

• Managing treatment.

• Keeping up-to-date about care work.

• Managing income-generation projects.

• Developing community groups.

• Accessing testing.

• Project development.

• Monitoring care work.

• Caring for orphans.

Current ways of identifying technical support needs:

• Analysing NGO reports

• Carrying out field visits to see NGOs’ community work.

• Holding group discussions with local stakeholders.

• One-to-one work with NGOs – to share experiences and adapt them to their context.

Ways to improve identifying technical support needs:

• Listening to the concerns of NGOs.

• Validating and following-up on the needs identified.

• Encouraging NGOs to participate in identifying needs.

• Prioritising the needs that were identified by the NGOs themselves.

News update
Miguel Cruz and Carlos Mora

Miguel Cruz and Carlos Mora from “Amigos por la Vida” died in November and December of 1998 in Guayaquil, Ecuador. They were both gentle men who were full of energy and determination in their work for human rights and care and support for people living with HIV/AIDS.

New programme in Zambia

The Alliance has begun work in Zambia, one of the countries most affected by HIV/AIDS. The Alliance will establish partnerships with local groups to build capacity in HIV-related community mobilisation and technical support provision, for a broad range of health and development CBOs and NGOs. In addition, HIV/AIDS expertise will be provided to a range of other activities reinforcing the Government of Zambia’s efforts to decentralise and integrate health services.

Initially, most of the work will be implemented through a four year, USAID-funded project led by John Snow International (JSI) and involving many local groups such as the Churches Medical Association of Zambia. Beginning with DfID and Glaxo Wellcome funds, the Alliance will also pursue independent partnerships with groups involved in NGO support, to build skills in participatory assessments, facilitate the sharing of lessons about low-cost approaches to care, and increase attention to the epidemic amongst non AIDS-specialist groups.

Strengthening PLHA organisations in Brazil

Towards the end of 1998, in conjunction with Pela Vidda /Rio de Janeiro and Pela Vidda/Niteroi (Brazilian NGOs of people living with and affected by HIV/AIDS), the Alliance ran an introductory workshop on external relations and sustainability, based on the Alliance toolkit "Pathways to Partnerships". The workshop was supported by the Brazilian National AIDS Programme and DfID. It took place during the VIII National Meeting of People Living with HIV/AIDS and brought together representatives from 33 Brazilian NGOs and PLHA networks. Based on this experience, a programme of follow-up activities has been developed for 1999 in conjunction with local state and non-governmental partners and on the theme of developing local capacity in external relations and sustainability.

Supporters:

• Alliance secretariat: the Danish International Development Agency (DANIDA) has begun funding the Alliance with a two-year commitment for 1999 and 2000; the Swedish International Development Agency (Sida) has confirmed additional support for Alliance activities in Africa.

• Linking organisations: KHANA is discussing with the Government of Cambodia and the World Bank a possible role in assisting in financial and technical support to local NGOs; IPC, Burkina Faso, has secured direct support from UNFPA; COMUNIDEC, Ecuador, has secured direct support from the World AIDS Foundation; PHANSuP, the Philippines, has secured supplementary direct support from the Japanese International Co-operation Agency; HASAB, Bangladesh, has secured direct support from UNAIDS.

Resources:

• The Alliance’s first toolkit – “Pathways to Partnerships” - is available in English free of charge from the secretariat. It is designed for NGO support programmes and trainers, to use in helping NGOs to develop strategic partnerships with other sectors.

Personnel:

• Linking organisations: Swarna Kodagoda, formerly of CARE International, has joined Alliance Lanka, Sri Lanka, as Executive Director; Ruthy Libatique, formerly of Kabalikaat, has joined PHANSuP, the Philippines, as Executive Director; Kim Suor, formerly of PADEK, has joined KHANA, Cambodia, as Programme Director.

• The Alliance secretariat has been joined by: Anne Scott, formerly an Alliance consultant, as Senior Programme Officer for South Asia; Divya Bajpai, recently graduated with an M. Phil in Development Studies, as Programme Assistant for Asia; Elaine Ireland, formerly a European Information Officer, as Programme Assistant for the Inter-Regional Programme; Helen Parry, formerly an HIV/AIDS Health Promotion Officer, as Programme Officer for Documentation and Resources; and Matthew Greenall, recently graduated with an MA in Human Rights, as Programme Assistant for Africa. Arletty Pinel has left the secretariat to become Associate Director, Behaviour Change Intervention, with FHI in Arlington, USA. Kate Gibson has been appointed as Programme Officer for Latin America.

Alliance News

Volume 4, No 1, April 1999 (no 7)

• NGO Support Work