Importance of Capacity Building Importance of Capacity Building and Empowering the TB, TB/HIV and Empowering the TB, TB/HIV

Community ActivistsCommunity ActivistsByBy

Francis George ApinaFrancis George ApinaNETMA+ KENYANETMA+ KENYA

Stop TB Partner’s forum Stop TB Partner’s forum Rio de Janeiro 24Rio de Janeiro 24thth March 2009 March 2009

Rationale for Community Activist Rationale for Community Activist empowermentempowerment

The Global Stop TB Strategy agenda The Global Stop TB Strategy agenda number 5 emphasised on number 5 emphasised on

Engaging people with TB and affected Engaging people with TB and affected communities as a vehicle for delivering:communities as a vehicle for delivering: Community participation in TB CareCommunity participation in TB Care Advocacy, communication and social Advocacy, communication and social

mobilization (ACSM)mobilization (ACSM)

Rationale Cont…Rationale Cont…

The empowerment of the community has The empowerment of the community has been codified as a key component of TB been codified as a key component of TB control strategies, yet the full scope of this control strategies, yet the full scope of this element of the strategy is yet to be fully and element of the strategy is yet to be fully and well defined. well defined.

To a greater extent the community also To a greater extent the community also have their own interest which should not be have their own interest which should not be ignored if you want to do business with themignored if you want to do business with them

Why Capacity Building for Why Capacity Building for TB, TB/HIV Community activists?TB, TB/HIV Community activists?

Its critical that Activist posses the necessary Its critical that Activist posses the necessary competence, skills, knowledge and right attitude competence, skills, knowledge and right attitude for them to be effective in their participation in for them to be effective in their participation in lobbing and advocating for desired change in the lobbing and advocating for desired change in the society. society.

Its difficult dealing with bureaucratic systems that Its difficult dealing with bureaucratic systems that characterize the running of most Government characterize the running of most Government systems particularly in Africa and developing systems particularly in Africa and developing countries, who are disproportionately carrying countries, who are disproportionately carrying the greatest burden of TB and HIV than the rest the greatest burden of TB and HIV than the rest of the World. of the World.

Why capacity Cont…Why capacity Cont…

Capacity building and empowerment plays Capacity building and empowerment plays an important role in shaping up and an important role in shaping up and sharpening the activists for daunting job of sharpening the activists for daunting job of advocating for the rights of the marginalized advocating for the rights of the marginalized and vulnerable groups in the society. and vulnerable groups in the society.

Some of as are products of such Some of as are products of such empowerment, (MSF-Belgium invested in empowerment, (MSF-Belgium invested in me in 2004 in a treatment literacy workshop me in 2004 in a treatment literacy workshop that totally changed my destiny).that totally changed my destiny).

Why capacity cont…Why capacity cont…

As the community’s watchdog the As the community’s watchdog the activists, should have special activists, should have special capabilities of monitoring National capabilities of monitoring National TB and HIV programs with a view TB and HIV programs with a view of making then more responsive to of making then more responsive to the community health needs. the community health needs.

Why capacity Cont…Why capacity Cont…

Effective activism should be based on facts not Effective activism should be based on facts not opinions, Research or evidence based advocacy opinions, Research or evidence based advocacy is critical tool should motivate the activist response is critical tool should motivate the activist response to a health phenomena, based on this its to a health phenomena, based on this its imperative that the TB, TB/HIV activists imperative that the TB, TB/HIV activists understands fundamentals of research process understands fundamentals of research process and their findings as a key informant of the and their findings as a key informant of the advocacy planning and processes, including advocacy planning and processes, including monitoring and evaluation of the outcomes .monitoring and evaluation of the outcomes .

Why capacity Cont…Why capacity Cont…

Activists as community educators, leaders Activists as community educators, leaders and informers, they are the key component and informers, they are the key component in health system response at the community in health system response at the community level, the effectiveness of their input is level, the effectiveness of their input is subject to the level of information, subject to the level of information, knowledge, attitude and understanding of knowledge, attitude and understanding of key variables that affects the community.key variables that affects the community.

After building our capacity After building our capacity what can we bring to the what can we bring to the

table?table? Demanding AccountabilityDemanding Accountability from “high from “high

level” leadership: Moving from Rhetoric to level” leadership: Moving from Rhetoric to Action and developing TB/HIV Score Action and developing TB/HIV Score Cards in our countries.Cards in our countries.

EngagementEngagement in policy processes such as in policy processes such as CCMs, UNITAID and Global Fund Board.CCMs, UNITAID and Global Fund Board.

Collaborate with other whistle Collaborate with other whistle blowersblowers :e.g. Media to place such findings :e.g. Media to place such findings in the ‘public domain’.in the ‘public domain’.

Why we need itWhy we need it Advocacy/Lobbing in: Advocacy/Lobbing in:

Demanding for increased allocation of resources for TB/HIV through Demanding for increased allocation of resources for TB/HIV through International Funding Mechanisms such as the Global Fund, International Funding Mechanisms such as the Global Fund, PEPFAR, Multilaterals (World Bank), etcPEPFAR, Multilaterals (World Bank), etc

Utilizing evidence based data from research to demand for Utilizing evidence based data from research to demand for investment in better care and interventionsinvestment in better care and interventions

Building Community Support for TB/HIV careBuilding Community Support for TB/HIV care CSOs/Activists groups bridging the ‘health workers crisis by actively CSOs/Activists groups bridging the ‘health workers crisis by actively

engaging in :engaging in : Home based Care Home based Care Treatment literacy activities Treatment literacy activities Adherence Counseling/SupportAdherence Counseling/Support TB Case detection and defaulter tracingTB Case detection and defaulter tracing Continual Psychosocial Support among others. Continual Psychosocial Support among others.

Cont…Cont…

Reminding leadership of ‘failed promises” Reminding leadership of ‘failed promises” & demanding urgent action& demanding urgent action2001 : Abuja Declaration – 15 percent 2001 : Abuja Declaration – 15 percent

budgetary allocation to HIV/AIDS, TB and budgetary allocation to HIV/AIDS, TB and MalariaMalaria

Maputo Declaration : African Health Maputo Declaration : African Health Ministers Declaration of TB as an Ministers Declaration of TB as an EmergencyEmergency

UNGASS DeclarationUNGASS DeclarationG8 commitments to Universal Access: G8 commitments to Universal Access: Where is the $60bn budget deficit? Where is the $60bn budget deficit?

ICW-EA and TAG TB Project.ICW-EA and TAG TB Project.

Success Success Network of Men Living with HIV/AIDS in Kenya (NETMA+) Network of Men Living with HIV/AIDS in Kenya (NETMA+)

and other CSOs in Africa is working in collaboration with and other CSOs in Africa is working in collaboration with ICW-EA/TAG TB/HIV project in redefining our ICW-EA/TAG TB/HIV project in redefining our organization’s TB, TB/HIV advocacy agenda for 2009. organization’s TB, TB/HIV advocacy agenda for 2009.

This documents will be the road map that will navigate the This documents will be the road map that will navigate the TB, TB/HIV activities in our organizations for up to five TB, TB/HIV activities in our organizations for up to five years. years.

The partnership has added a lot of impetus in creating a The partnership has added a lot of impetus in creating a deeper understanding of TB/HIV Collaborative policy and deeper understanding of TB/HIV Collaborative policy and the 3 Is initiative of reducing TB burden in PLHIV the 3 Is initiative of reducing TB burden in PLHIV community. community.

Lessons LearntLessons Learnt

Scientific based advocacy is a powerful form of Scientific based advocacy is a powerful form of advocacy, it brings out the validity and reliability of advocacy, it brings out the validity and reliability of the cause for our persistent demand for logical the cause for our persistent demand for logical dialog with key stakeholders. dialog with key stakeholders.

Our unity is our strength, if we put our voices Our unity is our strength, if we put our voices together as members of TB, TB/HIV community with together as members of TB, TB/HIV community with shared values and demands, then our voices will be shared values and demands, then our voices will be head beyond our borders. head beyond our borders. If the community are empowered their roles changes to If the community are empowered their roles changes to

partners from being patients or clients.partners from being patients or clients.

Opportunity for NETMA+Opportunity for NETMA+

The developed TB, TB/HIV advocacy work plan The developed TB, TB/HIV advocacy work plan has proposed annual budget of USD 50,000 per has proposed annual budget of USD 50,000 per district and we are targeting to work in 10 most district and we are targeting to work in 10 most effected Districts in Kenya in the next 5 yearseffected Districts in Kenya in the next 5 years

We believe that this document and skills acquired We believe that this document and skills acquired from the ICW/TEG workshop will assist us in from the ICW/TEG workshop will assist us in identification of partners who will support the identification of partners who will support the budget deficit in our TB advocacy plan.budget deficit in our TB advocacy plan.

We are able to expand our networking and We are able to expand our networking and collaboration with other activists in Africa and collaboration with other activists in Africa and beyond, share experience and replicate the best beyond, share experience and replicate the best practices. practices.

RecommendationsRecommendations

If the Global Stop TB strategy dream of a world free of TB If the Global Stop TB strategy dream of a world free of TB by 2050 is to be attained then, community empowerment by 2050 is to be attained then, community empowerment must addressed with equal strength. must addressed with equal strength.

What is required is a more innovative approach to building What is required is a more innovative approach to building capacity of the TB, TB/HIV activists through Strategic and capacity of the TB, TB/HIV activists through Strategic and Sustainable Involvement and Investment in People living Sustainable Involvement and Investment in People living with TB, TB/HIV (SSIIP). with TB, TB/HIV (SSIIP).

This approach will ensure that the TB, TB/HIV community This approach will ensure that the TB, TB/HIV community activists empowerment programs occupies a significant activists empowerment programs occupies a significant space in the partners top funding priorities.space in the partners top funding priorities.

Parting shotParting shot

We innovate or we We innovate or we evaporate!evaporate!

Thank you for Thank you for listening to me listening to me