Networks for Development

Lessons Learned from Supporting National and Regional Networks on Legal,
Ethical and Human Rights Dimensions of HIV/AIDS

October 2000

 

Table of Contents

Preface

  1. Introduction
  2. Background
  3. Networks and Networking
  4. Conceptual Issues: A Networking Approach
  5. Supporting Regional Networks
  6. Supporting National Networks
  7. Lessons Learned for Impact & Sustainability
  8. Suggestions for Assessing Networks
  9. Case Study - Nicaragua
    Appendix 1-
    International Guidelines on HIV/AIDS and Human Rights issued jointly by the Office of the High Commissioner and Human Rights and UNAIDS
    Appendix 2-
    References & Resources

 

Preface

Sustainable human development and human rights are inter-dependent and mutually reinforcing. They share a common goal of promoting and protecting the dignity and well-being of all individuals.

This vision of development is seriously threatened by the HIV/AIDS epidemic. In heavily affected countries, particularly in sub-Saharan Africa, there is increasing evidence that demonstrates the negative impact that HIV/AIDS is having on households, health, education and farming systems, private businesses, public administration and many other spheres of social, cultural and economic development.

In all too many countries and communities, denial, fear, stigma and discrimination continue to fuel the epidemic and represent real threats to the people and communities most directly affected, as well as being obstacles to reducing the spread of HIV and mitigating its impact. The issues upon which policies and programmes are needed are often extremely complex: moral, ethical, social, cultural, economic, religious and legal factors must be taken into account.

States have primary responsibility for promoting and implementing policies and strategies that protect human rights. The international community of states, United Nations bodies, agencies and programmes, regional intergovernmental bodies and non-governmental organizations, including networks of various communities, also have critical complementary roles to play in terms of providing necessary support and capacity for national efforts.

Universal human rights standards can help to guide national responses to HIV/AIDS. Measures elaborated in the International Guidelines on HIV/AIDS and Human Rights, issued jointly by the Office of the High Commissioner and Human Rights and UNAIDS can assist States in translating international human rights norms into practical observance in the context of HIV/AIDS (see Appendix 1)

The potential of networks to form a critical part of local, national and regional responses to the ep idemic was recognized early by the UNDP, in part because sustained and effective multisectoral responses to HIV/AIDS depend just as much on personal and society-wide commitment as on interventions that external observers may view as necessary. Therefore, s upporting networks became a key area of UNDP activity on HIV/AIDS with a broad range (both thematic and geographic) of networks supported: including networks of people living with HIV/AIDS, and of particular relevance to this publication, networks on lega l, ethical and human rights dimensions of the epidemic.

This publication has been produced jointly with UNAIDS, with the principal aim of synthesizing almost a decade's experience of supporting the establishment and development of such networks. By the year 2000, thirty eight such networks had been established in four regions of the world. This publication brings together work from a number of sources including assignments undertaken for HDP by Anne Bernard (an Ottawa-based specialist in development and networks) and Julie Hamblin (an Australian lawyer with expertise in Human Rights and the HIV/AIDS epidemic and long-time associate of the UNDP HIV & Development Programme). Nadia Hijab (a New York-based development specialist) took on the daunting task of assembling and making accessible various documents associated with this project, including the preparation of the first draft of this publication. Within HDP, Ben Brown provided backstopping support for the country visits and oversaw the logistical arrangements. Prof. Babacar Kante, Dean of the Law School at St. Louis, Senegal and Advisor to the Africa Regional Network on Ethics, Law and Human Rights and HIV, and Miriam Maluwa, UNAIDS Secretariat Law and Human Rights Adviser, generously provided legal and human rights insights from their specialist perspectives. The final editing of this document was done by Mr. Peter Gordon, an associate of the UNDP/HDP who brought his extensive knowledge of HIV and development and enriched it and us.

However, this publication would have been simply inconceivable without the support and participation of each of the network partners. We have been privileged to share in their processes of reflection and learning, and for this we owe each of them a significant debt of gratitude.

The document is intended as a vehicle to support those interested in exploring the usefulness of networks as a development tool. Ultimately, however, the over-arching purpose is to support those struggling to address some of the complex legal and human rights issues which impinge so much upon the lives of all who are affected by this epidemic.

 

Mina Mauerstein-Bail
Manager, HIV & Development Programme
October 2000

 

 

1. Introduction

Purpose, Structure & Intended Audiences

The two principal aims of this publication are to synthesise and disseminate key lessons learned from a decade of experience supporting the establishment and development of networks.

The structure of the document is as follows:

  • Introduction
  • Background
  • Networks & Networking
  • Conceptual Issues: A Networking Approach
  • Supporting Regional Networks
  • Supporting National Networks
  • Lessons Learned for Sustainability and Impact
  • Case Study - Nicaragua
  • Suggestions for Assessing Networks
  • International Guidelines on HIV/AIDS and Human Rights issued jointly by the Office of the High Commissioner and Human Rights and UNAIDS
  • References & Resources

The primary intended audience for the Guide is of course UNDP staff, particularly those working in the field. However the Guide has been produced in such a way as to have broader relevance and appeal: for example, among those working in government, NGOs, donor agencies, UN agencies: in fact anyone considering offering support to networks in order to address a specific development challenge. It should also be useful to those, including activists, who are planning to establish networks. The distinction between these two groups is important: the role of the former is to facilitate the establishment of networks; the role of the latter is to participate in the networks they create.

Are networks the most appropriate mechanism to support capacity development? When and how should networks be formed? What factors should development professionals - in government, non-governmental organizations (NGOs), and the donor community - consider before supporting or establishing networks? This Guide explores these questions, drawing primarily on specific UNDP field experience in promoting networks in Africa, Asia and Latin America.

 

2. Background

The mandate of UNDP is to build national capacity to achieve and sustain human development, by providing sound policy advice, building capacities for action on issues that are critical for reducing poverty, supporting coordination and promoting democratic governance at all levels of society.

Working within this framework of sustainable human development, UNDP's response to the HIV epidemic has been based on a commitment to ensuring that responses to the problems of HIV and development arise from an enhanced capacity:

  • of individuals, communities and nations to understand the nature of the epidemic in their own contexts;
  • of individuals, communities and nations to find effective means of responding, which in turn depends on;
  • People and organizations in all sectors (government, NGOs, the private sector, health and development agencies, religious organizations, and others) to work cooperatively and communicate with each other about problem definition as well as resolution.

UNDP's involvement with the epidemic dates back to 1987 when it began receiving requests from governments to support HIV/AIDS programmes. In 1992 in response to the rapidly increasing spread of HIV globally and recognition of its implications for sustainable human development, the HIV and Development Programme (HDP) was established by UNDP and regional bureaux within UNDP also began to intensify their level of programming at the inter-country level, notably in Africa and Asia and the Pacific.

A United Nations Joint Programme on HIV/AIDS (UNAIDS), co-sponsored by UNDP, UNESCO, UNFPA, UNICEF, WHO and the World Bank, officially began work on 1 January 1996. 1

The role of UNAIDS, inter alia, is to promote and support more effective, mutually supportive and complementary cooperation within the UN system, with highest priority placed on supporting effective and sustainable multidimensional country level responses. As a co-sponsor of UNAIDS, UNDP works collaboratively with other cosponsoring organizations to contribute to the overall goals of this collaborative initiative.

Early on, legal, ethical and human rights dimensions of the epidemic were identified by UNDP as critical issues to be addressed if progress were to be made towards effective, multi-sectoral responses to the epidemic. Consequently national HIV/AIDS programmes were (and continue to be) encouraged to include these issues, as appropriate, within their national plans and strategies. At the global, regional and country level UNDP continues to work on these issues with relevant departments and agencies of government and civil society.

Following the creation of the UNDP HIV and Development Programme, a key initial activity involved the commissioning of a number of 'Issues Papers' on important (and sometimes neglected) topics by known experts. 2

At country level, through programmes and projects, UNDP has supported capacity building activities on human rights issues within the context of HIV/AIDS, as well as participating in joint UN system initiatives with the UNAIDS secretariat and Co-Sponsors.

In January 1998, UNDP issued a programming policy on "Integrating Human Rights with Sustainable Human Development". Three points of departure were identified for implementation of the policy:

  • Strengthening human rights capacities of national institutions
  • Integrating human rights into sustainable human development programmes
  • Playing a proactive role in the international dialogue on human rights and the follow-up to major UN conferences

In the context of UNDP’s role, both as a development agency with a policy on Human Rights and as a co-sponsor of UNAIDS, with a track record on legal, ethical and human rights issues, UNDP consistently works to integrate legal, ethical and human rights dimensions into its development programming and its projects.

Over time and through experience, thinking within UNDP on how best to address legal, ethical and human rights issues in the context of the epidemic has shifted from a narrow focus on law, the legal system and the specific role of lawmakers, towards a broader, more inclusive approach which focuses on capacity building with a wider cross-section of society. Specifically, those working in this field have learned that capacity needs to be built within both communities and individuals, and this needs to be an inclusive process involving stakeholders from all sectors of society, especially those affected by HIV/AIDS. In seeking ways to support action in these areas, and within the context of limited resources, UNDP has pursued new approaches to building capacity other than those which focus narrowly upon institutions. After considerable reflection and review, it was decided to support the creation of networks comprising individuals and institutions involved with legal, ethical and human rights dimensions of HIV/AIDS.

It was believed that success and longer-term sustainability would be more likely if it were possible to bring together individuals and groups from government, (judicial, legislative and executive branches at both national and other levels), representatives of the private sector, academia, civil society organizations, especially associations of people living with HIV/AIDS, together with human rights groups. It was hoped that this resulting broad coalition of interested parties would be able to address pertinent issues within their own national, provincial and local contexts. 3

In order to pursue this concept operationally and with urgency, UNDP began to support this approach to networking. To date, support has been provided for the creation and the operations of networks at national and regional levels in some 38 countries and four regions.

Addressing human rights, ethics and legal dimensions of the epidemic required working with a broad range of partners including: government officials in different ministries at the national level and with local government, with development as well as with human rights NGOs, with people living with HIV or AIDS (PLWHA), activists, academics, the private sector, legal professionals, religious organizations, development agencies, HIV community organizations, and those in related fields such as gender, young people and labour organizations.

A note published by HDP in 1996 on "Legal and Ethical Networking: Enabling a Community Response" identified the actual and potential functions of these networks as:

  • providing space for reflection on and consensus-building around difficult issues,
  • exchanging information about experience and expertise,
  • providing expertise and services,
  • linking local issues to national and international policies,
  • advocating the rights of PLWHAs, and
  • capacity building of communities and nations to address complex HIV-related legal, ethical and human rights issues.

 

3. Networks and Networking

Some Definitions:

Development The first Human Development Report (1990) affirmed that the process of development should "create a conducive environment for people, individually and collectively, to develop their full potential and to have a reasonable chance of leading productive and creative lives in accord with their needs and interests" (p. 1). Successful development, therefore, supports change from a non-conducive to a conducive environment.

Capacity Development UNDP's policy bureau defines capacity development as "the process by which individuals, organizations, institutions and societies develop abilities (individually and collectively) to perform functions, solve problems and set and achieve objectives" (Management Development and Governance Division, Technical Advisory Paper 2, 1997).

Networks & Networking A distinction should be drawn between networking as an activity, and networks as a mechanism. The HIV/AIDS Networking Guide produced by the International Council of AIDS Service Organizations (ICASO) notes that there are no fixed definitions for "networking": the definition of networking used by ICASO is: "a process by which two or more organizations and/or individuals collaborate to achieve common goals" 4 The term "network" is to "refer to the set of organizations and/or individuals that join in collaboration".

Anne Bernard defines networks as social exchange arrangements, noting that "networks depend for their success and durability on members who commit to one another on a personal level for joint exchange, action and learning" 5

Following on from the above definitions, some of the potential benefits of networks become clearer. If sustainable development, at least in part, involves a process of change towards a more enabling environment, then this process will require different types of capacity within different groups at different times. Ironically, the resources and mechanisms that give institutions their sustainability – for example, staff, space, organisational structures - may not necessarily be compatible with the flexibility required to respond promptly to a constantly changing situation. However collaborative arrangements between institutions, groups and/or individuals – ‘networks’ – may, in many situations, be the most appropriate way of building the capacities necessary to manage a changing environment.

"Networks, as loosely-coupled arrangements of social exchange, co-operation and mutual support, would allow for widely varied membership and iterative action. They would be a way of supporting the mix of initiatives needed to define the increasingly varied ethical and legal issues confronting affected individuals and groups in their different settings and circumstances. And they would serve to generate the kinds of adaptive strategies and multiple capacities needed for managing them. Beyond what traditional institutions were able to do, networks would have the potential to be flexible, broadly participatory and non-directive and quick to act". (Bernard p.1).

 

Characteristics

The characteristics of networks vary depending upon the functions they perform, and the context in which they are established. While one of the strengths of networks is their flexibility, nonetheless there are some shared characteristics across all networks. Some of the most essential characteristics of networks are: 6

  • venues for social interaction through exchange and mutual learning,
  • member-ownership and interpersonal commitment to shared objectives and means of action, and
  • capacity for responsive adaptation in the face of variable local contexts, including opening opportunities, creativity, and risk-taking.

and their:

  • cost-effectiveness, since they involve a pooling of resources; and
  • speed of response and flexibility, since they are in theory unhampered by rigid structures.

Networks can come together in relation to specific themes. Within the context of the HIV/AIDS, there are networks dealing with subjects as diverse as children, drug use, lesbians, gay men and other men who have sex with men, women, migrants, people living with HIV/AIDS, sex workers, and ethical, legal and human rights issues.

Networks can be formed at many levels: local or sub-national, national, regional and international. Working arrangements may vary considerably between being very loose and informal at one end of the spectrum, to having formalised operational procedures and structures including governing body, premises and staff, at the other.

Networks are not institutions. Undoubtedly they can complement institutions, but networks lack the depth and continuity of a strong institution, qualities which are necessary for sustained capacity development, programme delivery and generation of policy at national and local levels. Networks can mobilise interest, foster communication and transcend barriers.

Functions

Networks can perform different functions. Some networks perform more than one function, while a single network can perform different functions over the course of its existence. The ICASO HIV/AIDS Networking Guide identifies four main functions for networks: generating and share information and analysis, advocacy, skills and capacity building, and building solidarity.

Terry Smutylo, Director of the Evaluation Unit at the Canadian International Development Research Centre, noted that a review of IDRC experience had identified three different types of networks: task-oriented and mutual-support arrangements; capacity-building, exploratory and catalytic; operational and research. 7 The primary function of the UNDP-supported networks was intended to be capacity-building. However, the majority of those that were successful were multi-functional: providing mutual support to deal with law reform, enabling more forceful advocacy to articulate human rights, improving communication between groups and between urban and rural areas, and helping develop capacity to deal with difficult issues in a rapidly changing environment.

 

4. Conceptual Issues: A Networking Approach

The integration of ethical perspectives and principles of human rights is an essential element of a comprehensive national response. Within the context of UNDP's response to the epidemic, the primary purpose of networking is to strengthen the capacity of countries to develop consensus on appropriate legal, ethical and human rights responses to the epidemic. Networks are consistent with participatory and non-directive approaches, allowing for locally meaningful and relevant solutions to emerge in response to local characteristics and conditions. The networking process should ensure that responses are meaningfully reflected in people’s daily lives.

Networks can be a forum for bringing together key stakeholders including people living with HIV, ethicists, lawyers, health professionals, human rights and women’s advocates, and others, to work together towards building consensus on effective responses to the diverse challenges raised by the HIV epidemic. Potentially, networks are an important capacity-building mechanism. They can be uniquely flexible and sensitive to changing needs and situations, and strong in consensus-building and the implementation of sustainable solutions.

An important principle in the establishment of networks is to identify and draw upon existing resources in order to create a multi-disciplinary, non-hierarchical, flexible group of informed, engaged and courageous individuals, groups and organisations. With support the group will work towards defining itself and establishing priorities for its activities, according to the local characteristics of the epidemic and the specific interests and capacities of its members.

At the national level networks can develop a multi-dimensional perspective on the role of human rights, ethical and legal principles and practice, for example in securing the rights of people living with, and affected by, HIV/AIDS. They can advocate for appropriate social and legal reform, including the identification and promotion of guiding principles to be considered in all aspects of HIV policy. Networks can also advocate for improved services for people directly affected by the epidemic.

In this context, regional networks can support those working at national level by addressing regionally-specific issues and by working in partnership with national, regional and international networks in related areas. Regional networks can support the objectives of constituent country networks; stimulate exchange of ideas, experiences, and strategies across national networks and address issues of a regional nature such as trans-national drug trade, population movement and labour issues.

In formulating and promoting capacity building for addressing legal, ethical and human rights issues, HDP has conceptualised networks in a particular way, leading to an approach consisting of a number of distinct principles:

  • Capacity should be built at the national level
  • An approach to capacity building which does not focus exclusively upon institutions
  • The involvement and participation of a broad range of actors from different sectors of society to explore and address the complex issue raised by the epidemic within the given national context
  • Networks should be functional first at national level before regional networking can provide 'added value'

The importance of networks as an effective and efficient means of realizing sustainable development objectives is increasingly recognised. While the language and concepts of networks and networking have gained increasing currency through their ‘virtual’ contexts, nonetheless, networks for fostering social change are more than virtual entities: they are social, economic and political arrangements which, at best, enhance capacity and promote collaboration amongst various groups towards the achievement of concrete goals.

There is also a growing recognition of the critical importance of local responsibility for creating and sustaining networks and of the 'added value' which effective networks lend to individual action by providing platforms for shared experimentation and learning across sectors, geographical boundaries, professions and cultures.

Yet there is still much to be learned:

  • about how networks can be catalyzed, strengthened and supported,
  • about their composition, management and financial support needs, and
  • about how they can be self-reflective, learning mechanisms which complement more traditional instruments such as human resource and institutional development.

In particular, there is a need for more systematic information and deeper analysis in order to understand what "success" and "failure" might mean in relation to networks.

 

5. Supporting Regional Networks

HDP has supported networks in three regions - Asia, Africa, and Latin America. This section provides a narrative account of each network's context, purpose, functions, results, and difficulties encountered. The material upon which this section is based comes from field visits conducted in mid-1999 and early 2000 and provides at best ‘a snapshot’ of a moment in the history of these networks. Undoubtedly things will have changed since then. The subsequent section identifies some of the key lessons learned from this ‘snapshot’.

Asia and the Pacific

An Inter-country Consultation on Law, Ethics and HIV 8 was held in Cebu, Philippines, 3-6 May 1993 organized by HDP. This meeting brought together most countries of the Asia-Pacific region. Participants adopted and endorsed a Statement of Belief which included a call for the active participation of people affected by the epidemic, as well as the building of partnerships amongst communities, governments and the legal, health and other professions. Participants also agreed upon a proposal to establish a Network within the region in order to address the legal, ethical and human rights dimensions of the epidemic.

As follow-up, the UNDP regional project on HIV and development worked with the Center for Economic Policy Research and Analysis (CEPRA) at the University of Colombo, Sri Lanka, which was funded to create a regional network of committed individuals and institutions in relation to legal, ethical and human rights issues. A full-time staff member was included in the project. UNDP conducted three regional training workshops on HIV law and law reform in Colombo, Sri Lanka, Beijing, China, and Nadi, Fiji and supported a meeting in Bangalore, India, organized by the Indian Law Institute. The reports and papers of these workshops have been published and widely disseminated in the region. A newsletter was produced by CEPRA, partnerships formed (especially at the national level in Sri Lanka) and several publications produced by the project for dissemination throughout the region. 9

At the same time, at both regional and country levels, UNDP was beginning to work increasingly with NGO groups such as the Lawyer’s Collective in Mumbai, India, and Alterlaw in the Philippines. Both are groups of lawyers who were working on human rights cases and who became involved with HIV issues because of the persistent rights violations associated with people living with HIV/AIDS. Most of the cases undertaken are pro-bono thus no fees are paid by those who lodge complaints.

During 1997, the regional project undertook an assessment of the UNDP-funded work which had been undertaken by CEPRA. The assessment suggested that while impact had been achieved in Sri Lanka, the goal of a regional and self-sustaining network was yet to be achieved. The project held a stocktaking and planning meeting with participation from UNDP Country Offices, UNAIDS, and individuals from different countries and groups in the region, including lawyers’ associations, universities, associations of PLWHAs, and judiciaries. The meeting produced a framework for action consisting of five components:

  • Contextualization and translation of rights and standards pertinent to the HIV problem
  • Systematic development of a critical mass of individuals committed to ethics, law and human rights
  • Empowering people living with HIV and those vulnerable to infection
  • Analysis and evaluation of advocacy tools

Building capacities of individuals and organizations to become advocates and activists; and moving towards a common vision and direction for concerted action. 10

 

Africa

During 1992/3 the UNDP global programme supported a series of preparatory activities in seven African countries. In October 1993 a planning meeting was held in Accra, Ghana, in order to establish a regional network on ethics, law and HIV and to organize a larger inter-country consultation. Follow-up missions were held to help prepare for the consultation and to clarify the memberships and objectives of national networks. At the inter-country consultation held in Dakar, Senegal, in June 1994, the African regional network was launched. The Dakar Declaration of Principles was issued defining a legal and ethical framework for an effective and compassionate response to the many difficulties associated with the HIV epidemic. The declaration has since been used as a tool for advocacy and as a reference for national networks and other groups.

Following the Dakar meeting, national networks turned their attention towards creating an enabling environment. Two new national networks were launched in Central African Republic, and South Africa joining the existing group of seven countries. At the same time the UNDP regional project in Dakar began to assume the role of coordinating some of the activities of the regional network, and of organizing country-to-country technical assistance to help launch new networks and to strengthen existing ones. Following a meeting of the network in Kampala, Uganda, and at their request, the regional project hired a full-time staff member to focus on the support of the network. This intensified support resulted in the formation of five more national networks, publication of a regional newsletter and identification of additional financial support from partners including UNAIDS and GTZ.

At the national level, networks began to gain visibility and to attract support from donors including UNICEF, UNDP Country Programmes and UNAIDS. Participation in regional and international conferences raised the visibility of the network and drew attention to these issues.

Impact deriving from national networks has included:

  • In Kenya, sensitization workshops and articles written for the local press on the law and HIV
  • In Uganda, the expansion of the national network to several regions in the country, publication of a newsletter, initiation of a comprehensive review, in collaboration with the government, of legislation with a view to amending laws to prevent the further spread of HIV and discrimination against those already infected
  • In Democratic Republic of the Congo, the network has conducted surveys on attitudes among employers towards people living with HIV/AIDS, and on the extent of women’s ability to protect themselves against HIV infection. Follow-up surveys indicate positive changes among both groups.
  • In South Africa, the national network has been extended to nine of the country’s provinces. Network members have lobbied successfully for a new HIV policy in prisons and have contributed to a recent government decision to abolish HIV screening as a prerequisite for employment in government service.

 

Latin America and the Caribbean

HDP has provided extensive assistance in the initiating phase of the Latin American and the Caribbean Networks on Human Rights, Ethics, Law and HIV. This has included support for the regional planning process, for the attendance of regional participants at meetings of the networks in other regions, and initial seed money to national networks to assist in their establishment. To this end, members of LACCASO have participated in two regional meetings in Africa and in Asia/Pacific.

Following participation in the Asia and the Pacific meeting, a planning meeting that included representatives from LACCASO, PAHO and UNDP was held in New York, 30-31 March 1994, to consider the establishment of a similar network in Latin America and the Caribbean. Participants attended from Costa Rica, Mexico, Nicaragua and Venezuela. This meeting identified the following issues as among the most pressing in the Latin American and the Caribbean context:

  • Discrimination
  • Breach of privacy and confidentiality
  • Stigmatisation and defamation
  • Medical and social research ethics
  • The impact of HIV on indigenous peoples
  • Long-term travel restrictions for people living with HIV/AIDS
  • Issues pertaining to vulnerable groups: including people in prisons, men who have sex with men, and minority groups generally
  • Issues pertaining to the protection of women and children

This resulted in a pilot phase to explore the possibility of establishing national networks bringing together lawyers, legal activists, advocacy groups, educational representatives, NGOs, and people living with HIV/AIDS in order to address these issues and to identify an integrated response to the epidemic. During this phase, participants agreed to serve as focal points for the networks within their own countries and to facilitate the establishment of similar networks in other countries in the region. Priority was to be given to those countries where there was awareness of the importance of these issues, where groups and individuals were active and interested in participating, and where there was national commitment. An HDP sponsored training workshop was held in early 1995 and included many of the key actors from Latin America and the Caribbean in order to build capacity and promote understanding of the development issues which networks were likely to face.

UNDP/HDP, PAHO and LACCASO agreed to field exploratory missions to Argentina, Barbados, Brazil (Recife and Sao Paulo), Chile, Colombia, the Dominican Republic, Ecuador, Haiti and Honduras as a second stage of activities. These countries were identified as possible network participants.

Acción Ciudadana Contra el SIDA (ACCSI) from Venezuela and Colectivo Sol from Mexico were invited to conduct exploratory missions to Brazil, Argentina and Barbados in order to explore interest in, and to examine the feasibility of, establishing national networks. These exploratory missions assisted in the identification of facilitators, participants and resources for national networks, as well as organisations and individuals to function as catalysing focal points for future national networks.

Since 1995 some 5 countries are participating in a major network, addressing the ethical, legal and human rights dimensions of HIV/AIDS. HDP has provided training and support to these networks, especially in Argentina, Brazil, Paraguay, Mexico and Venezuela; has monitored technical assistance and funding needs and has begun the process of documenting the development of these networks. Inter-regional exchanges of experience have also been encouraged and facilitated by UNDP via training workshops, seminars and other means.

HDP has also provided technical advice to national governments, e.g. Nicaragua and Paraguay, on proposals for HIV-related law reform and a process of HIV law reform has been undertaken by the network in Nicaragua. 11

UNDP’s development partners (including the UN Commission on Human Rights, the European Community, NGOs, UNAIDS) have expressed interest in this approach to networking. Efforts are underway to identify additional resources to strengthen and expand country and regional networks and to enhance the capacity of the institutions within the region with which UNDP has been working.

During an Inter-agency Strategic Planing Meeting on Ethics, Law, Human Rights and HIV/AIDS, Venezuela, 22-25 January 1997, HDP, in collaboration with LACASSO UNAIDS and other partners met to identify priority needs and short and long-term goals for the network. A proposal was developed to generate financial support from UNAIDS. HDP will continue to support the establishment of Networks on Human Rights, Ethics and Law, and to assist governments in implementing or reviewing current legislation on human rights and HIV-related issues. Groundwork has been initiated in Nicaragua, to an extent in Paraguay, and will be expanded to Honduras.

In the years since the launch of national and regional networks, with support from UNDP, a number of developments have taken place. From the standard setting perspective, the Office of the High Commissioner for Human Rights (OHCHR) and UNAIDS, following two international consultations, jointly published and launched the International Guidelines on HIV/AIDS and Human Rights. 12 Further, the UNAIDS Secretariat has collaborated with the Inter-Parliamentary Union (IPU) published and launched the Handbook for legislators on HIV/AIDS and Human Rights. 13 Both publications have been disseminated widely.

UNAIDS has also been working with the United Nations human rights machinery and advocating for the integration of HIV/AIDS-related human rights within these bodies. In this regard, inter-alia, UNAIDS published the Guide to the UN Human Rights Machinery for AIDS service organizations, people living with HIV/AIDS and others working in the area of HIV/AIDS and human rights;13 assisted the UN Commission on Human Rights in the drafting of resolution 1999/49 entitled The protection of human rights in the context of HIV/AIDS. This Resolution was adopted unanimously by the United Nations Commission on Human Rights and co-sponsored by 59 states from all regions.

Further, UNAIDS coordinated an annual theme day of the Committee on the Rights of the Child, held on 5 October 1998. Entitled "Children and Young People Living in a World with HIV/AIDS".

Training key national partners, namely, HIV service NGOs, human rights NGOs, political leaders, National AIDS Programme Managers, People Living With HIV/AIDS and staff of UN agencies has also been another focus of UNAIDS work, Regional consultations have been held in Brazil, Thailand, and Uganda and in Washington and Geneva on ethical issues arising in vaccine development. An ethical Guidance Document building on these consultations has been issued as UNAIDS policy paper. 15

Additionally, UNDP has approved a policy on Human Rights, which calls for integration within all programmes, ICASO has prepared materials for NGOs on the International Guidelines on HIV/AIDS and Human Rights, and APCASO is pursuing a programme of training and capacity building on human rights issues in the region.

 

6. Supporting National Networks

The Philippines

PLWHAs in the Philippines Today

The fact that no cases of PLWHA violations have been brought before the country's Human Rights Commission is not seen as proof that there are no problems.

Pushed by a combination of fear and shame, PLWHAs are electing not to stay in home communities where they believe they will be ostracised, not to apply for work where they believe they will be tested, and not to seek help from public medical facilities where they believe treatment is poor and staff uncaring and uninformed.

At the same time, PLWHAs are being pulled to Manila and the other larger urban areas as the only places where medical care and drugs are, in principle, available. In fact, medical care in urban areas is not easily accessible to most PLWHAs, for reasons of cost and staff discrimination. Drugs, even for opportunistic infections and pain, are too expensive for PLWHAs, most of whom remain unemployed. There is no protection against quack drug trials, PLWHAs are not clear what rights they have to full disclosure on the implications of these trials, or to protection from any harm they are caused through unethical practices employed.

Bernard, April 1999 Mission Report

 

A 1999 UNDP mission to the Philippines highlighted the contrast between the current situation in terms of the response to the HIV epidemic and that which existed in 1992 when HDP first initiated activity in the country. At that time, with the exception of Thailand, no Asian country had reported significant levels of HIV infection, and few governments saw the epidemic as a priority issue. More significantly, ethical and legal issues associated with the epidemic were little discussed. While there was emerging concern among NGOs about discrimination against people living with HIV, there had not yet been very many opportunities to debate these issues and consider strategies for addressing them.

It is within this context that UNDP stimulated interest in networking on ethical, legal and human rights dimensions of HIV/AIDS through the Inter-country Consultation on Law, Ethics an HIV, in Cebu, in 1993. 16 A number of key actors from the Philippines participated in this Consultation and later came together in an informal network, including:

  • The manager of the Department of Health AIDS Programme,
  • Alterlaw, a lawyers' collective (which was forging regional links with the Lawyers' Collective in Bombay and with Pink Triangle in Malaysia),
  • Kabalikat, an NGO working on HIV, which was beginning to collaborate with Alterlaw,
  • A representative of the human rights desk of the Integrated Bar of the Philippines.

The diverse skills and interests of these and other partners were drawn together by the Philippines National AIDS Committee in its working party on legal and ethical issues. Each network member brought specific resources and expertise to the group. Their work resulted in the passage of the "Philippines AIDS Prevention and Control Act of 1998", and contributed to the development of an enabling environment within which responses to the epidemic could be formulated. Significantly, with the passage of the law, the need for networking also seemed to pass. The decline of this network could be attributed to the following:

  • A change of actors: the National AIDS Committee was replaced by a new Philippines National AIDS Council, which was recognized as an official body by the new Law, with 19 government departments and agencies, and 7 NGOs. Some NGOs were critical of the process that led to the selection of Council members, and observers noted that these appeared to exclude those groups which were most active on the issues. There was also a change of leadership at the Health Department's AIDS programme, possibly leading to less open and cooperative relations with NGOs.
  • The sense that, with the passage of new legislation, the important work had already been done and there was no need for continued interaction and support.
  • Burn-out amongst network partners or decreasing conviction of the value of participation in the network given the additional time and effort required, over and above each member’s day-to-day work.

Whatever the reasons, the end of a network does not necessarily signify ‘failure’. The flexibility inherent in a networking approach implies that networks can be formed and disbanded as the need arises: networks should not be formed or sustained for their own sake. However, the need and demand for action on ethical, legal and human rights dimensions of the epidemic persist and grow with the passage of time. One example is the task of ensuring the systematic and comprehensive application of the new law at all levels and in all sectors.

"We believe that the law must promote an environment that enables, encourages and sustains voluntary behaviour change and the care and support of those affected. This requires the empowerment of individuals and communities to protect themselves against HIV, and that people living with HIV remain integrated within society and free from all forms of discrimination….

"We believe that the development of effective responses to the HIV epidemic requires, above all, the active participation of people affected by the epidemic, as well as the building of partnerships amongst communities, governments and the legal, health and other professions."

From the Statement of Belief adopted at the Inter-country Consultation on Law, Ethics and HIV, Cebu, Philippines, May 1993

Some of the demand was being met by Alterlaw, which was providing support 17 for a large number of HIV legal advocacy training projects, within the Philippines as well as in other countries in the region. On the other hand, at least in 1999, it appeared that NGOs working on HIV still did not tend to address legal and ethical dimensions of HIV. By contrast, human rights NGOs continued to focus their work mostly upon civil and political rights, to the exclusion of economic, social and cultural rights, an approach mirrored by the country's Human Rights Commission.

Given the increasing recognition of the multi-sectoral nature of the causes and consequences of the epidemic together with the need for inclusive and expanded responses, the level of current need in the country, existing capacity and wealth of experience of networking in the region, a network on legal and ethical dimensions of HIV/AIDS may still have value, for example in facilitating exchanges of information and experience. In this way, lines of communication among stakeholders could be kept open until such time as the specific need and opportunity arose for more organised capacity-building activity. A number of NGOs were planning to suggest to the National AIDS Council that a sub-committee be established which could reach out more broadly and informally to a wider range of actors than those currently represented on the Council. The mission concluded that such a network would have the potential to succeed. It would be a response to a real situation: value the diversity of social relationships and have immediate benefits, including inputs to the Council's strategy.

 

Uganda

We, the participants at the Intercountry Consultation of the African Network on Ethics, Law and HIV, affirm that any action, whether personal, institutional, professional or governmental, in response to the HIV epidemic, should be guided by the following principles:
  1. Responsibility…
  2. Engagement…
  3. Partnership and consensus-building…
  4. Empowerment…
  5. Non-discrimination…
  6. Confidentiality and privacy…
  7. Adaptation…
  8. Sensitivity in language…
  9. Ethics in research…
  10. Prohibition of mandatory HIV testing…

From the Dakar Declaration, 1 July 1994

 

Uganda is increasingly identified as a ‘success’ in terms of its national response to HIV/AIDS. Explicit political commitment from government, understanding of the multi-sectoral dimensions of the epidemic, attention to issues of discrimination, and work at the community level, are all cited as important ingredients of this success. In short, critical elements of an enabling environment exist in this country.

The Uganda Legal and Ethical Network (UGANET) was established in 1994, following a series of in-country consultations and an Inter-country consultation sponsored by UNDP which was held the same year. 18 At the time of its formation, UGANET had no formal structure other than a task force which oversaw the activities conducted on a voluntary basis by members. Meetings were held in the members' own offices. Soon after its establishment, the task force reached a decision that the Network could not possibly function effectively within such a loosely defined structure. 19 UGANET therefore registered as an NGO and established a permanent secretariat, with an elected chairperson and secretary. In early 1999, it had a membership of approximately 70 organisations, a task force of 19 people to oversee activities, and a salaried 6 person secretariat (although funding was precarious). Membership was broad, comprising organisations and individuals representing the law, medicine/health, people living with HIV/AIDS, HIV/AIDS-related NGOs, human rights organisations, religious bodies, academics, governmental structures, and traditional practitioners. The task force met approximately once a month, and operated primarily through six sub-committees focusing respectively on: programme development, editorial, advocacy, finance, research, and international public relations.

UGANET came into being in an environment already rich in NGO networks, 20 many of which contributed to its membership and activities:

  • The National Guidance and Empowerment Network of People Living with HIV/AIDS in Uganda (NGEN+) comprises 16 sub-networks, 15 district-level groups and a separate group for army personnel. At all levels, PWA members are encouraged to "make the network behave like a family circle", to offer each other fellowship, a sense of hope, and information. Training is provided on a range of issues, from how to care for those who become ill to how to prepare funding proposals. NGEN+ strengthens its constituent base by reaching out proactively to communities in order to urge PLWHAs to "come out", pointing out that NGEN+ members are living successfully with HIV disease through better access to health-related options and mutual support.
  • The AIDS Support Organisation (TASO). This well-known organisation began spontaneously as PLWHAs recognised the value of coming together for mutual support, information sharing and financial assistance. TASO is now established nation-wide and engages in advocacy for more HIV-sensitive policy development and legal change.
  • AIDS Information Centre (AIC) - including the Post-Test Club and the Philly Luttaya Initiative (PL Initiative). Begun in 1990, this is an important resource in the Ugandan national response. AIC has an extensive testing and counselling service in and around Kampala with outreach to rural areas. Voluntary testing is promoted as a critical route towards counselling and mutual support. The latter task is the focus of the 4,000 member Post-Test Clubs and the PL Initiative, a support and information network of people have been HIV tested (both positive and negative) and named after the much-revered Ugandan advocate and self-proclaimed PWA who gave a human face to HIV/AIDS in the country.

A number of government partners also interact with UGANET. They include:

  • The Uganda AIDS Commission, (UAC), established specifically to support the government's commitment to a multi-sectoral approach to the epidemic, moving away from a narrow health focus towards broader cross-ministry collaboration and partnership. Being based in the office of the President gave the Commission high political profile and commitment, and direct access to the President. It should be noted however that in mid-1999 efforts were made to relocate the Commission to the Ministry of Health.
  • The Human Rights Commission is a new organisation but already it is addressing a broad spectrum of human rights issues, including HIV/AIDS (unlike its counterparts in the Philippines and Kenya). While it is not an official member of UGANET, its Chairperson and senior research officer participate as individuals.
  • The Uganda National AIDS Control Programme (NACP) is the technical arm of the STI initiative based in the Ministry of Health. It is the largest HIV/AIDS initiative in the country with programmes implemented from national to local levels. Like the AIDS Commission, the NACP promotes a multi-sectoral approach. UNDP funding enabled creation of specific NACP positions in several key line ministries, including Justice, Defence, Police, Prisons and others, to assess and take preventative and remedial action on the epidemic as it affects their respective staff and client populations. This has included some collaboration with UGANET on legal and ethical dimensions, for example, ensuring proper protection of army personnel who participate in vaccine trials and developing draft guidelines on HIV in relation to prisoners' rights.

Against this background of rich and diverse experience, UGANET's comparative advantages include the fact that it advocates action in an area - legal and ethical issues - in which none of its partners are working in a wholly systematic way. In addition, its nationwide reach is valued, as is its capacity to work with a range of stakeholders, from PLWHA groups to the President's office, government departments and donor agencies.

Prior to 1998, the Network made a major contribution to the drafting of a variety of bills including those on domestic relations, defilement, commercial law, and the health act. In addition, it helped in the application of the law, for example, working with the Ministry of Public Service to review policies on recruitment, non-discrimination in the workplace and access to training, the Network expects to collaborate further on monitoring application issues. The Network is perceived as having contributed to a more enabling environment for the legal and ethical dimensions of the epidemic, creating awareness of the need for protection and reviewing legal reforms for HIV sensitivity, for example, contributing to the working to propose a law allowing a woman who has lived for two years with a man to inherit the property after his death.

From 1998, UGANET's activities were focused on the area of capacity building at district level through 3-day sensitisation workshops implemented in 20 districts Uganda and on the production and distribution of the newsletter.

The first phase of the Network’s existence was funded almost entirely by UNDP in Kampala. This funding enabled the network to establish a secretariat and implement a number of activities. During the second phase (from 1997 to 1998), the World Bank/Government of Uganda STI (sexually transmitted diseases) Programme provided funding.

According to partners and Network personnel and members, the areas in need of further strengthening and development include: securing more direct participation by PLWHAs, greater investment in the capacity of network members to participate in working towards the network's objectives, participatory development of a focused agenda and a more effective managed structure. In March 1999 UGANET held a Strategic Planning Workshop in the course of which a number of important issues were considered:

  • The network's comparative advantage and programme of work. Possible options to be explored include a focus on policy-level advocacy or a concentration upon a specific and narrow action-oriented programme, such as establishing community legal and ethical information centres. One pressing area is systematic assessment and analysis of how human rights and ethical issues are evolving in Uganda and whether this is improving or deteriorating, generalising or localising? Are contemporary issues becoming less specifically 'legal' in nature, more intractable? For example, what is the current perception of the issue of women living with HIV/AIDS having children, of the circumstances in which children should be tested, of how communities respond to those who 'irresponsibly' infect others. These kinds of questions could be better identified and explored through a body forum such as UGANET. The Network could also provide sensitivity training to the more than 20 human rights NGOs which, while not yet specifically engaged with the epidemic, could contribute significantly to these very issues through their activities. Another area for potential development is engaging and supporting local agencies, resource persons and other 'gatekeepers' to consider specific, relevant areas of law and ethics, for example with respect to traditional practices e.g. circumcision, wife inheritance and care of orphans.
  • How can UGANET work more effectively with PLWHAs? An inherent dilemma for the network is determining how it can reach out from national to local levels at the level of formal law, but also work to create a community of members based upon local, and informal legal-ethical concerns. Some PLWHA networks perform this latter function very well, suggesting the possibility of UGANET finding ways to form linkages with them, a network-of-network arrangements, without either losing its own identity.
  • Should the network attempt to create new structural arrangements in order to address additional goals? For example, the permanent Secretariat might concentrate upon developing a referral function, while one or more task forces could focus on advocacy and programme planning functions. The Network needs to find ways of building capacity within existing agencies and programmes: for example, by strengthening capacity in terms of understanding and application of legal and ethical issues as these relate to the daily work of these agencies; training in monitoring human rights abuses and appropriate ways of responding; or through skills transfer for resource mobilisation. In turn this raises the question of the extent to which the network serve as a capacity development mechanism (serving an inward-oriented HRD function for its weaker members) in contrast to building on the capacities of its stronger members in order to initiate outreach action (serving an outward-oriented support function for the broader community)? The focus and resource needs of the two agendas are different and each requires explicit planning, action and impact evaluation.
  • How can the Network reduce dependence on donor agencies and increase its ability to mobilise resources on a local basis? Consideration could be given to income raised from the Network membership, setting of quality standards for preparation of project proposals, and 'piggy-backing' on the resource base of existing services.

 

PLWHAs in Uganda

Amongst the issues faced by PLWHAs in Uganda are:

  • The medical system's unwillingness or inability to take the epidemic seriously, leading to limited access to drugs, limited availability of testing sites, and few counselling services, and a denial of the right to effective health care.
  • Discrimination against PLWHAs in employment, housing and access to insurance, which exacerbates and is fed by the problem of poverty.
  • Limited ability of the system to protect the most vulnerable, e.g. children and youth, and inadequate attention to the at-risk situation of sex workers who lack education and consistent access to condoms.
  • Over-reliance on high levels of information about HIV/AIDS to reduce high-risk behaviours, especially of youth.
  • Insufficient knowledge among PLWHAs and others on rights with respect to testing, care, access to services, and a reluctance among PLWHAs to press for redress.
  • The ethics around mother-child transmission, now becoming an important mode for HIV transmission, e.g. how to balance protection and care of the mother with prevention of infection for the child, and the rights and responsibilities of the father.
  • The need to educate PLWHAs not just of their rights, but also of their responsibilities e.g. not to spread the infection and to engage, in so far as they are able, in the normal life of their communities.
  1. Bernard, June 1999 Mission Report

Kenya

The UNDP-supported Kenyan Legal and Ethical Network (KELIN) collaborated with a range of stakeholders on an analysis of the epidemic, produced as Sessional Paper No. 4 on HIV/AIDS under the auspices of the Ministry of Health in order to state Government policy and enable the Government to progress. The paper was never passed by Parliament and did not lead to new laws, policies or actions by Government. Despite the paper's recommendation of the establishment of a National AIDS Commission, this was yet to occur by mid-1999. KELIN and others continued to urge that the paper's recommendations be implemented, pointing to experience in Uganda as a positive model for the establishment of such a body.

KELIN's mandate focuses principally in the national, formal legal and policy sphere, and this is where its impact can be most readily seen, The chairperson is a well known Nairobi lawyer. The co-ordinator is also a lawyer. Together, with what appear to be their own domestic and international networks of contacts in senior positions of law, politics and government policy, they have given the work of KELIN a very sound formal law base. While KELIN has an active member of the PLWHA community within its core team (herself a founder of several of the main PLWHA support groups in the country), the network appears to have had less success in engaging with Kenyan communities of people living with HIV/AIDS. By mid-1999, KELIN had not yet acquired legal status.

 

PLWHAs in Kenya

The situation of PLWHAs in Kenya is marked by:

  • Insufficient availability of antiretroviral drugs and inadequate care and follow-up by doctors in administering them, as well as non-availability of medication for opportunistic infections and the high cost of health care.
  • A dramatic increases in the number of HIV/AIDS orphans and the lack of attention to assuring their basic human rights in terms of protection, care and development.
  • Lack of a comprehensive regulatory framework for managing the epidemic, although there are a few stand-alone actions, e.g. the Ministry of Health is reviewing the Public Health Act, and other agencies are considering the issue of insurance.
  • No established HIV/AIDS component in primary or secondary school curricula - a failure of perhaps crisis proportions considering the incidence among young people. Such efforts as are made by national and international bodies are uncoordinated and face opposition from those opposed to sex education in schools.
  • Lack of clarity around the HIV/AIDS core rights and protection issues for example in relation to confidentiality and testing, balancing this against the need for protection and prevention.
  • Another issue concerns growing public pressure for the criminalisation of "knowingly" infecting someone with HIV, without sufficient consideration of the negative implications of such legal action.
  • Lack of serious and comprehensive HIV/AIDS research, resulting in insufficient knowledge generally about the status and implications of the ethics of HIV/AIDS, and of these issues within the particular socio-cultural context of Kenya.

Bernard, June 1999 Mission Report

 

A number of non-governmental networks are active in Kenya. Key actors include:

  • The Kenyan AIDS NGO Consortium (KANCO) which began in 1989 as an informal network of a small number of NGOs working on HIV/AIDS. By 1994, the Consortium had become formalised with a secretariat, resource centre and long-term programme of work together with fairly consistent donor support. KANCO represents a useful example of the kind of time-line, incremental nature, and continuing reflection-revision characteristic of sound network development from the bottom-up. It has built itself on the basis of individuals and groups wishing to be involved and currently has a partner membership in excess of 600. KANCO engages with a wide range of actors (including government departments), and with an equally broad range of issues, including contributions to the Session Paper.
  • Women Fighting AIDS in Kenya was established in 1993 as women began to realise their need for counselling, home care services, help with income generating activities, training on how to access resources, and general mutual support. With funding from several sources, it works principally as a network, drawing on and providing resources in collaboration with a number of other HIV/AIDS support organisations - including KELIN, to which it sends referrals.
  • The Association of People Living with AIDS in Kenya is one of several HIV/AIDS support organisations in the country, all of which are relatively resource and capacity-poor, but nonetheless dedicated to the protection and care of PLWHAs basically through networking mechanisms. The Association is spearheading an effort by several groups to form an umbrella organisation to institutionalise their relationship, and better manage capacity and resources.

The Government created a Standing Committee on Human Rights in 1996 which acquired a Secretary and staff in 1999, seconded from the Attorney General's office where the Committee is situated. While HIV/AIDS is said to be an important dimension of the Committee's work, it had yet to appear among more than 4,000 complaints received by mid-1999.

Against this background, and according to feedback from partners, KELIN's principal strength lies in communicating the legal, ethical and human rights dimensions of the epidemic. This includes:

  • Addressing the right formal law issues, i.e. those perceived to be the most critical in terms of contributing towards an enabling environment. Through seminars for provincial and national court officials, for the Attorney General's Office and for the Law Society, among others, the Network has contributed to expanded knowledge on, and a more positive official attitude towards, legal aspects of the epidemic, and raising awareness of the need for practice guidelines pertaining to the treatment of PLWHAs.
  • Networking among lawyers at provincial levels, an important emerging resource base for referrals. However, it is not clear whether, or how effectively, these lawyers are able to educate local communities. KELIN's position is that it lacks the funds necessary to undertake systematic outreach training.
  • Providing most of the legal and ethical input to the Session No. 4 Paper, while it has been unsuccessful, like other NGOs, in mobilising action on the passage and application of the paper. Through its Chair, KELIN has been reviewing the guidelines which are included in the Paper and building a consensus among members of parliament for eventual application. KELIN believes that it has been able to convince the Attorney General of the need to develop HIV/AIDS-specific legislation, but has been told that without donor funding, the government is unwilling to move forward.

The most serious problems KELIN faces are lack of funding together with established secretariat and offices. While it has been possible to secure some funding from the UNDP Country Office on a 'per activity' basis, the Network has so far been unable to secure funding from other donors, either directly or through Government. Lack of a secretariat leads to difficulty in co-ordinating meetings and plans of work, and in collecting and exchanging information and training materials. This is leading to an overall sense that the Network is 'losing steam', unable to expand and extend its functions in a consistent way. KELIN has tended to focus at the level of formal law, without necessarily identifying and interpreting issues sufficiently well for communities and especially for PLWHAs to understand. One contributory factor has been the lack of funds while another has been the preponderance of lawyers and legal expertise among the membership.

One PLWHA group, for example, claims that none of the recommendations it made at the past several meetings had been acknowledged. It was felt that PLWHA were invited to the meetings but that these do not actually reflect their particular interests. It was felt that the membership was essentially superficial and the service provided unsatisfactory. The underlying issue appears to be that the Network is not perceived as a sufficiently reciprocal relationship.

In June 1999, KELIN decided to collaborate with KANCO on a forward looking assessment, exploring the following questions and issues:

  • How can KELIN establish a more visible and stable "presence"? Clearly, some form of secretariat structure is required. While a network can certainly operate well as a loose structure, nonetheless it requires a base, a focal point with whom members, users and wider communities can relate. A secretariat also helps to ensure that the concept of the Network amounts to more than, (rather than reducible to), its individual high-profile leaders. KELIN has also perceived the need to register as a separate legal entity, enabling it to set its own agenda, to solicit funding from donors and to involve new partners.
  • What is the network's comparative advantage? A number of PLWHA support groups claim they are already working in areas of ethics and law at the community level and that what they need from KELIN is information, analysis and referral backstopping. Others disagree, urging that KELIN reach out more in these areas. All acknowledge that KELIN is the only NGO at the level of national policy and law, and many perceive it to be the sole agency with the capacity to interpret from national level to grassroots, whether directly or through collaboration with PLWHA groups, government departments, local administration or the private sector.
  • What are going to be the core goals of the network? How will it balance between addressing the needs of communities and PLWHAs, and setting an agenda based on what it knows to be the gaps in the policy, legal and research/knowledge environments of HIV/AIDS in the country? Each goal requires somewhat different programmes of work, timelines, member expertise and resources. How could the Network work more effectively in partnership with traditional groups such as Associations of Elders which are also attempting to resolve friction arising from social ethics of HIV among community members? How could KELIN mobilise community reflection on the ways in which traditional laws and legal mechanisms could be brought to bear on HIV/AIDS issues?
  • How can KELIN develop the capacity it needs to network more effectively? There was broad consensus that the network needed to strengthen its own ability to reach out to a broader membership base, to be inclusive and to manage internal diversity. Several suggestions were made for workshops with resource persons coming both from Uganda and elsewhere in the region where networking experience has also been strong.

 

7. Lessons Learned for Sustainability and Impact

It seems fairly evident that the four networks have each helped to create more conducive environments for action on the HIV/AIDS epidemic. This is certainly a positive contribution to development, as defined at the beginning of this Guide. The networks' results have ranged from reforming the legal framework, to advocacy of the issues, provision of expertise, skills development and training, and learning and exchange of information and expertise.

The networks have also clearly built capacity, as defined at the beginning of this Guide: they performed a number of functions, and enabled members to set and achieve objectives. However, the extent to which the capacity developed has been sustainable in driving change from a non-conducive to a conducive environment is less clear. Moreover, the impact the networks have had is not commensurate with the scale of the epidemic. Even what could be termed as the most successful of all four networks - the Nicaraguan HR/Network - had difficulties in translated its main outcome, the legislation on HIV/AIDS, into impact on the lives of those affected.

Particularly in the case of Africa, as Kante et al noted in their Evaluation, where HIV/AIDS is spreading relentlessly, "We continue to witness increasing numbers of illegal and unethical practices directly attributable to the epidemic. The questions that need to be posed have to do primarily with a review of the efficacy of the networks at both the regional and national levels, and areas of support required by these networks to enable them accomplish originally stipulated objectives. These questions must necessarily address issues of conceptualisation, modes of operation, cultural groundedness, capacities (technical and financial), strengths of the network that can be built upon as necessary areas of growth, and the overall future development of the networks" (p ii).

What aspects of the network's functioning resulted in this mixture of strength and weakness? What are the conditions necessary for successful networks? Bernard's Asia mission report describes these as:

  • Purposes, procedures and membership are determined on the basis of a sound understanding of broad context;
  • A catalytic and committed "leadership", individual or group, is in place and is knowledgeable about the issues, able to identify key actors and ready to respond constructively and iteratively to windows of opportunity; and
  • Prospective members are facilitated in "buying into" the rights and responsibilities of membership.

Kante et al identified "certain key features which would be necessary for these structures to operate truly as networks", which included:

  • Common interest evolved out of a shared and deeply perceived need for action;
  • Extreme clarity of objectives and focus of network;
  • Volunteerism and commitment;
  • Injection of external resources by the network members for the benefit of the network;
  • Benefit derived by all members from their association with the network; and
  • Strictly non-hierarchical.

To what extent do the four networks reviewed meet such criteria? This Chapter draws on the experiences of the four networks in eight areas: need; level; purpose, goals and functions; membership; leadership; structure; resources; communication; monitoring and evaluation; and roles of donors. The eight areas are not intended as a checklist for development practitioners or network members, but rather issues to address in supporting, establishing or managing a network as a mechanism to achieve development goals. Each section concludes with a list of questions to be addressed regarding each issue.

a. Need for a Network

The first issue to be addressed is whether there is need for a network. In this regard, it is worth recalling the simple yet powerful statement in ICASO's HIV/AIDS Networking Guide: "Those of us who are involved in HIV/AIDS work network because the problems that we are trying to address are too large for any of us as individuals or organizations to face on our own" (p. 1).

There is no question that the legal, ethical and human rights dimensions of HIV/AIDS are a "large problem", as can be seen from the issues faced by PLWHAs in all four country contexts. Moreover, evaluation and other reports about the experiences of the UNDP-supported networks revealed that, even in the case of the least successful of the 38 networks, they were the only voices raised about this problem.

Bernard described efforts to deal with these issues in Asia as "embryonic". Kante et al stated, "The networks on ethics, law and HIV are the only bodies at country level currently attempting to address issues pertaining to the human rights of individuals as well as redefine the legal/ethical environment in the wake of HIV/AIDS". Thus, in promoting and supporting the establishment of these networks, UNDP had identified a clear need that was not being addressed.

Was a network an appropriate mechanism to address this need? Again, the answer is yes.

  • First, the number of partners that had to be brought together was extremely large, diverse, and multi-level. Even UGANET in Uganda, which involved 70 organisations covering law, medicine and health, HIV/AIDS as well as human rights NGOs, religious bodies, academics, government bodies, and others, was found to have not sufficiently involved PLWHAs.
  • Second, the network mechanism made it possible for a range of expertise, experience and professional responsibilities, reflecting the main health, human rights, legal and HIV/AIDS knowledge sites of a country, to come together in a relatively formalised and sustained way to create a new paradigm.
  • Third, a network made it possible to define tasks, take action, and move on to other tasks, as well as to evolve membership in line with changing needs.

Questions regarding need: Is there a real need to be addressed? Does a network mechanism fit the task?

 

b. Level

The experience of the four networks showed that the national level was an appropriate one at which to form the networks. However, the attempt to establish regional networks was unsuccessful in the case of both Asia and Africa. In both cases, UNDP had established regional projects with salaried coordinators to, inter alia, support the initiation and management of national networks, providing technical assistance and funds, as well as support to regional network coordination. The Asia regional project was head-quartered in Sri Lanka, while the Africa regional coordinator was most recently based in Uganda.

An evaluation conducted in 1997 of the Asian regional network found that impact could be noted in Sri Lanka, but that the goal of a self-sustaining network throughout the region was not achieved. As for Africa, in 1997 15 country networks came together for a strategic planning meeting, and decided to set up four sub-regional networks as a way to address the fact that the regional network was not functioning as envisaged. Each of the sub-regional networks would address a specific issue, and cover a number or countries. However, this arrangement also did not function, and Kante et al suggested in their Evaluation that these be "abandoned" due to lack of "human and material capacity".

Experience shows that sub-regional or regional networking on certain issues is likely to be successful when strong national networks exists. As Bernard put it "Any networking at supra-national level (regional or sub-regional) will be sustainable only to the extent it builds on a base of national capacity and priorities. Even then, it may flounder if the benefits it brings to members are less than the energies required to make it work. Any intervention to support networking at regional or sub-regional levels has three main modes of entry: find ways to strengthen and/or extend the mandate of existing networks; identify strong national actors and facilitate their coming to see value to their own work in sharing at a more generalisable level; begin farther back in the process, and promote local networking capacities in the selected issues, trying gradually to introduce one to the other toward the eventual development of some form of network-of-networks arrangement".

Questions regarding level: At what level does the network add most value: local, national, sub-regional, regional? Are national networks strong enough to establish a sub-regional or regional network? Do they see advantages in doing so?

c. Purpose, Goals and Functions

The four networks had multiple purposes and goals and performed multiple functions. After some five years of experience, Network members believed that clarity around their primary purpose and goals would help to identify the functions to be performed, how to organize the network and what resources to secure.

For example, the Uganda Network UGANET had initially defined five objectives:

  • To strengthen collective and institutional capacity in responding to HIV/AIDS and to enhance sharing of experiences, resources and information on HIV/AIDS.
  • To promote advocacy against obstacles to the prevention of the further spread of HIV and to empower communities through provision of legal information, assistance and training.
  • To actively participate in the development of an appropriate policy framework, programmatic approaches and strategies related to HIV/AIDS and to contribute to law reform programmes in Uganda.
  • To encourage the elimination of all social and cultural practices that hinder efforts to prevent the spread of the HIV epidemic and to encourage positive social and cultural practices that promote HIV/AIDS prevention.
  • To co-operate and collaborate with national, regional and international networks and all organisations, both in the public and private sector.

Similarly, KELIN in Kenya set out a number of objectives at the start, which included legal and ethical education at all levels, protection of the legal rights of PLWHAs, data collection on the status of legal and ethical AIDS issues, liaison between NGOs and the Government, and input to policy and law making.

As was noted by UGANET members at their strategic planning workshop and in other fora in mid-1999, there was a need for focus - either policy-level advocacy, or action-oriented programmes for the community, or systematic assessment and analysis, or capacity-building. KELIN members also reviewed their options in mid-1999 and discussed clarity around their core goals: should they address the needs of PLHWA communities, or the gaps in the policy, legal and research environments? Each of the goals identified by the two networks implied different programmes of work and timelines, member expertise and resources.

The Nicaragua HR/Network had set itself a very clear task at the start: the passage of a law on HIV/AIDS. However, after the law was passed, it was not institutionalized and applied (as was the case in the Philippines and Kenya). In discussions in early 2000, the HR/Network reviewed a range of objectives from which to choose to advance the process. Should it become a lobby group, or focus on outreach to the communities to communicate their rights under the new law?

The above discussion is not intended to imply that a network should have only one goal. Rather, that there should be clarity regarding the primary purpose for which the Network was established, and the recognition that different goals may require different arrangements: task forces can be set up by the Network to address each defined goal; networking with institutions or other networks can provides ways to address different goals.

The process of identifying goals and functions must also be closely related to efforts to understand the country context and, within that, the roles played by other actors, who should participate in the discussions. For example, it is clear from the experience of the two African networks that their work at the level of formal law was useful, but it was not immediately related to the lives of PLWHAs.

As Kante et al put it, "There was a particularly strong divergence of views in Uganda between the network on ethics, law and HIV and the networks of people living with HIV/AIDS. There was clearly a feeling that the focus of the network and the issues addressed by it were not reflective of the reality in the country. Additionally, in spite of the numerous district training programmes undertaken by the network, there was still no infrastructure in place to address the real issues faced by ordinary Ugandans in rural communities. Furthermore, the use of already existing infrastructure (however informal), such as networks of PLWHA for instance, and other support organisations (e.g. TASO) had not been incorporated into the network’s plans for expansion and growth in areas of the country where the real impact of the epidemic was increasingly becoming more devastating" (pp 22-23).

The fact that none of the four networks were able to translate the laws or rulings they had helped to pass into impact on people's lives, implied that a set of functions had not been considered at the outset, such as outreach to the communities to inform them of their new legal rights and how to secure them, or training of judges and lawyers in the new aspects of the law.

Questions regarding purpose, goals, and functions: What is the network's comparative advantage? Is the purpose clearly stated and agreed to by members? Are too many goals being considered? Can the network establish the right mechanisms to address each goal? Do other bodies have the same goals? Is there clarity around the terms "purpose", "goals", and "functions"? Are the proposed functions being performed by others? Have the most important stakeholders participated in setting the purpose, goals, and functions? What avenues exist for feedback from beneficiaries?

d. Membership

Clarity around purpose, goals and functions helps to define the membership of a network, and what skills and experience are needed. As Bernard noted regarding the two African networks, "It is a major strength and a major weakness of both networks that the range of their potential agendas is very wide - from matters of constitutional law through to norms of traditional culture; and so, too, is their range of potential front-line members - from rural community-level PLWHAs living in poverty and without either education or a platform of action, through to influentially well-connected, sophisticated and articulate lawyers and political activists".

In fact, an important issue that needs clarification is whether individuals and institutions are network members or beneficiaries. If individuals or institutions are members of the network, then they will need to: bring the skills and expertise necessary to address goals and perform functions, as well as find value arising from their membership.

"Members of a network are the network. If members do not have the knowledge and/or skills necessary to do the work of a task-based network, the logic for their expending the effort and commitment needed to make a network work will be lost. Networking is a voluntary arrangement. People may become members because they are invited; they will stay members because they see in the association a way to realise specific value to themselves and/or to the goals they are trying to achieve. The better the match between the goals and working methods of the network, and the aspirations and capacities of its members, the more sustainable and successful the association will be. The HR/Network has been particularly successful in this regard. During and even after completing the task of drafting the AIDS law, it appears to have been able to attract and keep as an appropriately strong membership because it has allowed them to find their own space for participation and to realise immediate and direct benefit from their association. According to several, they were able to learn from each other" (Nicaragua mission report).

If individuals and institutions are beneficiaries of the networks, then convenors need to establish whether the network does indeed meet their priority needs, and to find ways for the beneficiaries to articulate these in a way that reaches network members. According to one successful PLWHA network in Uganda, "Networks work when they can approach people where they are, appeal to their most pressing concerns and address their felt needs".

Knowing how to handle the different needs of members, beneficiaries and fellow travellers makes for a successful network. As the manager of Ugandan AIDS Control Programme put it, "They don't even have to be members as such - agencies like the police would find it difficult to join. But a network can bring these institutions together, put the situation on the table and then help them work through how they can move. Each will then work out responses which suit itself, but are coherent overall. The network co-ordinates, facilitates and advocates, and different organisations can access its agenda in their own ways. In this way, the network can be as wide as the problem is, day by day".

The flexibility inherent in networks also means it is possible - indeed necessary - to change members to meet changing needs and agendas. In the case of the HR/Network, "Members continued to be purposively and personally selected. Criteria were expressly qualitative. Less concerned with formal position, geographic representation or numbers, individuals were identified on the basis of their 'fit' to the goals of the proposed network: specifically, their ability to influence public policy; their proven commitment to human rights; and their readiness to be open, to collaborate and to share their learning. Each brought expertise. Besides providing the convening function as secretariat, the Foundation brought a comprehensive knowledge of HIV/AIDS".

Questions regarding Membership: Do members have the right skills and experience? Are they primary contributors to the network or primary beneficiaries of the network? If they are contributors, what value does the network add to their day to day work? If they are beneficiaries, what avenues do they have to make their real needs known to the network? What do they get from the network that they cannot get elsewhere? What do they contribute to the network that no one else can? In cases where the network has evolved its goals or tasks, do member skills and experiences still fit?

e. Leadership

As in any area requiring change, leadership is critical. UGANET, for example, believes that its capacity to carry out its programme has been due to very powerful leadership, the individual commitment of team members as well as the good will it has generated amongst key partners such as the Uganda AIDS Commission and the Ministry of Health.

Networks are not easy to lead, and the kind of leadership necessary will depend on the network's purpose and functions. For example, a simple convening and facilitation role is appropriate to an information exchange network. The more ambitious the goals, the more complex the leadership role required. An advocacy network will require leaders well able to articulate the issues and to mobilise constituencies.

Networks undertaking specific tasks need even more "delicate handling". On the one hand, there has to be enough direction to keep members on-track and the action moving. On the other, enough room has to be created to let members use their expertise and build the relationship in ways they feel appropriate.

In the case of the task-oriented HR/Network, the Nimehuatzin foundation served as leader, co-ordinator and member: "The nature of the leadership provided to the HR/Network has without doubt been the key both to its formulation and to its success. Particularly relevant to the limited structural cohesion available in a network and, in this case, to the very busy schedules of members, the ability of the secretariat to facilitate learning and promote inclusion were important. It brought, according to several, a sense of rigor, discipline and 'an obviously informed and persistent commitment' to all activities; 'the Foundation did its homework'.

"Meetings, for example, were held on a regular basis and, according to members, were well-organised: with advance agendas, assigned tasks, consistent follow-up, and meeting minutes which were 'taken to each member for confirmation and comment'. Members were made to feel effectively involved and informed; and that good use was made of their time". In short, the Foundation "led by the quality of its input rather than its control over the process". (Bernard)

Questions regarding leadership: What leadership skills do the network's stated purpose, goals and functions require: defining a vision, articulating aims, mobilising constituencies, arbitrating differences? What managerial skills will help provide leadership: facilitating processes, enabling members to contribute, ensuring programmes remain on track?

f. Structure and Resources

All four networks reviewed had a core: a non-governmental foundation in the case of Nicaragua, the government-sponsored National AIDS Committee working group in the case of the Philippines, and a secretariat and chair in the case of the Uganda and Kenya networks.

As the manager of the Ugandan AIDS Control programme noted, "You don't need a very large structure; you need a full-time core group, some form of secretariat, which is able to organise core issues and then draw from existing expertise on an issue by issue basis. It should be able to have an eye on the ground, to do analyses, to bring people together and harmonise their expertise. It needs to be interdisciplinary. And it needs to let those who are its members feel a sense of belonging, a closeness with the problem. Otherwise, they will feel coerced when asked to do something for free. The key is to be spontaneous as new issues emerge, and members need to feel able to bring these in as they evolve".

That said, the experience of the four networks shows that, contrary to what might be popular perception, some structure is needed to support even informal exchanges. A balance needs to be found between too loose a structure that drains potential and continuity, and too heavy a structure that stifles initiative and innovation. Certainly, having too many goals may result in a top-heavy structure that needs serious funding, which may not be forthcoming.

More importantly, the experience shows that a network needs its own resources, over and above what is available to each network member. In the case of both African networks reviewed, evaluators agreed that they needed "external resources if they are to move effectively toward changing and renewing their mandates. At the moment, both networks are running on little more than the voluntary energies of a few core staff, and it is unrealistic to think this is enough to do much more than keep the issues on the policy table" (Bernard).

Kante et al also found the networks they reviewed to be so under-resourced as to be unable to deal with the problem at hand. While UNDP provided seed funding and support for capacity development. In some instances UNDP resources were allocated on a project-by-project basis and did not cover core costs. The Uganda network was better resourced than the Kenya network, one factor making it possible for UGANET to achieve so many positive results (another factor is the more enabling environment in Uganda vis a vis Kenya). However, UGANET continued to rely on external donors for resources, and by mid-1999 it was not clear where additional funds were to come from.

It is not being argued here that external donors must provide resources ad infinitum. Rather, that sufficient resources need to be provided for start-up - and that the capacity to secure resources should be an important issue for realistic discussion in any attempt to establish networks. It is not yet certain what the future of the HR/Network will be. The consensus of members is that, while it should continue, it should do so with probably a shift in focus and wider parameters. This impending next stage of its evolution will likely be more challenging than the first. The pertinent actors, tasks and expected outcomes will not be as clear or as limited. A new configuration of the HR/Network is likely to imply its becoming more exploratory and open-ended. Its goals, procedures, membership and requisite skill-sets will be broader, less readily or definitively "selectable". A series of suggestions were made by members and observers as to future development.

  • Engage in active outreach Because the official rate of HIV/AIDS infection is still low, and because the message of their right to protection under the law has not yet reached many of those who are affected or at risk, the mobilising framework of the HR/Network could be to take the law and its developmental perspective directly to communities on a wide-reaching, capacity development basis so as to ensure its fair and universal application.
  • Expand learning Towards this end, members of all three Foundation networks could work more closely together, given that, together, they reflect all levels of society: community, professional and technical, political and policy. Joint meetings, workshops and training would add to the competence and confidence of each network. Sharing the dissemination skills and radio and publication outlets of the Communication Network, and the outreach materials and mechanisms of the Community Network would contribute significantly both to getting information about the new law into communities and grounding it in practice .
  • Engage in lobbying Government When members of the National Assembly and Government change, much of the previous knowledge and interest is lost. It is important for the HR/Network to find a way of keeping these links renewed. This is especially important as the government begins to take action in committing resources to work on HIV/AIDS.
  • Institutionalise the concept It is important that the experience and knowledge gained by individual HR/Network members is grounded in the work of their own institutions in order to enrich the enabling environment for action.

The information and development specialist Richard Heeks draws attention to what he calls resource-deficit participation: "Those introducing participation can make a mistaken assumption about the innate resourcefulness of individuals and groups: assuming that they are latently capable and resourced and that these capacities merely need to be uncovered through participation. In reality, this is not so. Members of organizations, like members of communities, often have heavy existing workloads and have no time to invest in new processes of participation" (p. 4).

With the exception of the Nicaragua network, the extent of resources needed for the functioning of a network was not sufficiently recognised nor made available. The issue was not just one of financial resources, but also of human resources, for example building where necessary the capacity to network: setting up and fostering communication, supporting member ownership, collaborative programme planning and application and regular monitoring. The networks needed to find the time and resources to invest in their members' skill and experience, and not just to draw on their members.

One crucial missing element in terms of resources appears to have been information technology, a surprising finding for a review of network experience. The African networks, national and sub-regional, lacked computers, let alone access to email and Internet. The use of information technology to support networking or networks did not emerge as a factor in discussions in the Philippines or Nicaragua.

On the one hand, this finding should help clear up the misconception that networks are about information systems: as this experience shows, they are very much about human skills, experiences and capacities. However, it is surprising that with present-day knowledge of how information technology can be used as a tool to support networking, it should not even feature in discussions. This indicates that this area should be given more attention in programme design, and tackled during monitoring and evaluation.

Questions regarding structure and resources: What structure is best appropriate for the task? What structure will best engage members and respond to the reality of resources? What resources - financial, human, information technology - are needed to accomplish the goals and perform the functions? What investment needs to be made in capacity? Where will resources be secured and at which stage: members, beneficiaries, government, national donors, international donors?

g. Monitoring and Evaluation

UNDP undertook formal evaluations of the networks it supported, which provided the occasion for the networks themselves to assess achievements and identify constraints. For example, the Nicaragua HR/Network was at a juncture by early 2000 where it needed to "take stock, reassess what it has done; what the current needs, gaps and resources with respect to HIV/AIDS and human rights are, and how its own capacities fit into these. This could take the form of a situation analysis, looking at the evolution of the epidemic and of the human rights issues within that, who the other actors are and what the possibilities for collaboration are, who its partners and associates should be".

During their evaluation of the African networks, Kante et al had discussions about the kind of indicators that determined how well a network was able to perform within its national set-up: the profile of its membership; the personal relationships which members have established with various partners in-country, especially government, NGOs; its visibility and capacity to convene and mobilise at the highest policy levels around issues of human rights, law and ethics within the context of HIV; the degree to which the network had established a real and practical relationship with associations of people living with HIV/AIDS, and was addressing their concerns; and the awareness and understanding of the UN system about the network itself and its role in the entire national response.

The Africa evaluators also underlined the importance of deciding up front on the indicators to monitor the effectiveness of the networks, including: What are the main advantages and disadvantages of this network approach? Can these structures constitute a force for the massive mobilisation of communities required to bring about the desired socio-ethical and legal changes? What will be needed to strengthen these structures?

The experience shows that monitoring and evaluation should be factored into network's functions at the start so that the information necessary to remain on track can be collected as the network evolves.

Questions to be addressed: Has the network clearly stated its expected short-term outputs, medium-term outcomes, and longer-term impact? What indicators have members agreed to use at each stage? At what point is it useful to assess progress? Who should be involved from within the network, from the community, from outside the country? Who will undertake regular monitoring and documenting of experience? How many regular evaluations will be conducted, and who will be responsible?

h. Donor roles

In the case of the networks under consideration, UNDP played four main roles. To begin with UNDP/HDP was the party that identified the need, and introduced the proposed approach at inter-country consultations. Because of its global and local positioning, UNDP is able to identify critical development problems, and this contribution should not be under-estimated. The method UNDP used to introduce the problem as well as to propose the approach - the inter-country consultations - in and of themselves encouraged thinking around this issues at the national level, as the Philippines experience shows.

UNDP's second major role was to provide funding, directly through HDP and the global programme, through regional programmes funded and managed by UNDP Regional Bureaux, and through country programmes managed by country offices. In some cases, this generated national ownership and commitment, as in the four networks under review. In other cases, the idea did not take hold, as at the sub-regional level (as explained in III/b), as well as in some national contexts such as Cote d'Ivoire (see the Evaluation by Kante et al).

As discussed above, the level of funding required was not always in line with the need and the networks' requirements for sustainability. As Kante et al stated, "It was clear to the team that most of the networks expected greater involvement from UNDP/Regional Project, especially as regards financing their activities. As one member of the Congolese team put it, UNDP/the Regional Project's approach to the networks could be likened to 'a mother having a beautiful child, then abandoning the child.' But herein lies a crucial problem not only of some of these network, but the entire approach to 'developmentalism' in Africa where it is perceived that societal transformation is dependent on an external environment" (p. 37).

Again, it should be stated that the point here is not that donors should provide funding in perpetuity, but rather that sufficient start-up funding be provided, and that support of the capacity to fund-raise - given the need for resources - should be addressed in programme design. In this regard, a question for external development partners to consider is: what conditions need to be in place before funding and other support is terminated?

However, although funding is important, two other donor roles were equally important and, with hindsight the experience, should perhaps have been given more prominence by external development partners:

  • Monitoring and evaluation - For an initiative which was new in every respect - from concept through to the mechanisms used - it would have been useful for donors to support ongoing monitoring and evaluation to identify the points at which financial resources were critical, member capacity wa