Bold leadership and powerful community action to end AIDS

The Alliance played an important leadership role in 2017, championing neglected areas of the HIV response and challenging harmful policies. Through community action, we strived to ensure that no one is left behind in our collective efforts to achieve global goals on health, gender equality and justice.

1.6 million people

provided with or linked to HIV treatment, care and support

900,000 people

from key populations reached with prevention services

In 36 countries

the Alliance is playing a role in holding governments to account in enabling universal access to services, increasing domestic financing of the national HIV response, or upholding human rights

2 million people

reached with integrated HIV and sexual and reproductive health and rights services

600,000 people

reached by programmes addressing stigma, discrimination and social exclusion

85%

of community-based organisations who received a grant through the Alliance achieved planned programme and financial targets

Community action on HIV, health and rights

Result 1

Healthy people

Increase access to HIV and health programmes

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Alliance Linking Organisations continue to be global leaders in reaching key populations with HIV prevention services. We reached over 200,000 people from key populations in Africa with HIV prevention services in 2017 – 14% more than in 2016. This continues the steady increase since the beginning of our strategy in 2013, which is all the more remarkable given the increasingly hostile policy environment for lesbian, gay, bisexual and transgender (LBGT) people in Africa.

Our portfolio of projects under the Resilient, Empowered Adolescents and Young people (READY) umbrella is ensuring adolescents and young people receive sexual and reproductive health and HIV services in eastern, central and southern Africa. These projects not only provide and improve the quality of youth-friendly services, but foster young people’s leadership in the HIV response.

In addition to extending service outreach, we also invested in advocacy to intensify efforts on HIV prevention. In our role as an active member and contributor to the Global HIV Prevention Coalition, we worked with civil society activists from ten fast-track countries, building their capacity to participate in their respective national prevention roadmaps.

People reached with prevention services

Being a CATS has added so much to my life. When I help people living with HIV I feel proud. My dream is to become a fulltime counsellor, especially for adolescents and young people living with HIV

Ntsiki, Community Adolescent Treatment Supporter (CATS) in Swaziland

Standing up for women and girls’ sexual and reproductive rights

In early 2017, the Alliance secretariat made the brave and complex decision not to comply with the re-enacted and extended Mexico City Policy, aka the Global Gag Rule, which blocks US government global health funding to foreign NGOs involved in abortion advice and care.

We took this decision because the re-instatement of the Global Gag Rule threatens to end the global consensus on the need to integrate HIV and sexual and reproductive health and rights (SRHR) programmes, and potentially undermines the achievements of the Sustainable Development Goals, which emphasise the importance of delivering HIV services alongside family planning services.

To support Linking Organisations – many of whom rely heavily on US funding – navigate the Gag Rule, we undertook a thorough analysis of its potential impact. We continue to document the unfolding impact on HIV services to marginalised groups such as women who sell sex or use drugs, transgender women, and adolescent girls and young women who experience sexual violence.

The Alliance remains fully committed to meeting the rights of women and girls and has not wavered in the face of these threats. In support of the SheDecides movement, we launched the READY to Decide campaign to highlight the link between gender inequality and the rising rate of HIV in adolescent girls and young women in sub-Saharan Africa.

A youth group in the Malnicherra tea plantation in Sylhet, Bangladesh. The group raises awareness of sexual and reproductive health and rights, and has helped prevent early marriage in the area. © Alliance 2013

Result 2

Stronger health and community systems

Support community-based organisations to be effective and connected elements of health systems

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26 Linking Organisations have made sustained organisational improvements since 2013, catalysed by the Alliance accreditation system. This includes improving organisational capacity, governance and programme quality as a result of Alliance capacity building and organisational development initiatives.

Linking Organisations in turn provided grants and capacity building to 1,390 community-based organisations, 85% of whom met their programmatic and financial targets.

The accreditation process is also an opportunity for south-to-south learning, especially through peer review visits. In 2017 staff from nine Linking Organisation took part in an accreditation visit.

A decade of groundbreaking work under our SIDA-funded programme KP Connect came to an end in 2017. The programme built the capacity of Alliance Linking Organisations in 10 countries in Africa to engage and work with key populations. KP Connect was also part of our approach to Southern leadership, with the programme management under the responsibility of Positive Vibes, an Alliance Linking Organisation in Namibia.

Before LILO I only understood key populations at a scientific level…we fight stigma on a daily basis, yet we are stigmatising people in our personal life, even if it’s not intentional. LILO helped me realise I needed to connect at a more emotional level and that’s what I did. I have now reached a higher level of appreciation

LILO participant, Cote d’Ivoire

The LILO effect

LILO (Looking In, Looking Out) is a workshop methodology that helps individuals develop more positive attitudes towards LGBT people and sex workers. The workshops provide participants an opportunity to explore issues around gender identity, sexual orientation and sex work, and has been tailored for use with health service providers, police, and policy makers.

LILO was a catalyst for change in many Linking Organisations, and the partners they work with. Alliance Nationale Contre le SIDA (ANS-CI) in Cote D’Ivoire for example, has overcome stigma and discrimination in their organisation and now have members from key populations on their staff and board.

One of the additional benefits of ‘the LILO effect’ has been the willingness of organisations to adopt a more person-centred approach. In Senegal, for example, it meant that programme staff incorporated aspects of sexual diversity into their programming for sex workers so that sexual and reproductive health services were more inclusive.

Winnie Nyawira is a young woman who sells sex and who is enrolled in the methadone programme at Malindi general hospital in Kenya. © Corrie Wingate/Alliance 2017

Result 3

Inclusive and engaged societies

Advocate for HIV, health and human rights

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The Rapid Response Fund, supported by the Elton John AIDS Foundation, benefitted over 13,000 people, either directly with emergency support or indirectly by mitigating the threat to services that these emergencies pose. The fund responds to crises affecting access to HIV services for men who have sex with men and LGBT people. It has also supported community-based organisations to advocate for improved legal and policy environments for LGBT people.

Achievements within the Partnership to Inspire, Transform and Connect the HIV response (PITCH) programme range from the constitutional court in Indonesia rejecting a petition to fast-track criminalisation of LGBT people, to winning a case in Kenya’s court of appeal declaring forced anal examinations on people who are accused of same-sex relations unconstitutional.

The Alliance maintained its leadership in the drug policy space in partnership with the International Drug Policy Consortium and the government of the Netherlands in 2017. We were particularly active at the Commission on Narcotic Drugs, pushing to protect and promote the progressive attitude towards harm reduction displayed at UNGASS 2016, which threaten to backslide through the recent vilifying reactions of some governments against people who use drugs.

25-countries-diagram

When I went to the police [after being attacked] I was further victimised. It would be different now, I’d know where to go.

Kaluso, 28 year old transgender woman in Malawi, after CHeRA, recipient of Rapid Response Fund grant, turned the superintendent into an ally of LGBT people

First ever needle and syringe programme in Uganda

In September 2017, the Ugandan Ministry of Health granted a landmark authorisation to Community Health Alliance Uganda (CHAU) and Ugandan Harm Reduction Network (UHRN) to launch, in four districts, the first ever needle and syringe programme in Uganda.

CHAU and UHRN are partners in PITCH, a five-year nine-country advocacy and capacity-strengthening programme. With the support from PITCH, CHAU and UHRN carried out a rapid assessment and population size-estimation study of people who use drugs, providing key evidence for their advocacy for harm reduction services. UHRN also organised a visit to Kenya for Ugandan decision makers to learn about the harm reduction programme run by KANCO, another PITCH partner and Alliance Linking Organisation, and empowered and inspired community activists to speak out for harm reduction services.

Needle and syringe kit. © Alliance

Addressing discrimination and violence against people most affected by HIV

With support from the Rapid Response Fund, community based organisation CHRR conducted an investigation into homophobic violence at Dzaleka Refugee Camp in Malawi. Following this they organised a two-day training for refugee authorities on the rights and specific needs of LGBT persons, conducted awareness raising activities and sensitised the camp protection committees. They also provided emergency support to LGBT asylum seekers and trained some of them in case reporting of abuses.

Challenges remain, but as a result of this work there have been significant improvements in the support provided to LGBT asylum seekers, especially those at risk of abuse and violence. Plan Malawi, with support from UNHCR, has provided a safe house to LGBT asylum seekers at risk of violence.

To live in a place of tolerance, peace and love are the desires of Matofu (41), his son Suphi (10), and Didier (27). While living at Dzaleka refugee camp in Malawi, they experienced horrific homophobic attacks. © Gemma Taylor for the Alliance

Result 4

Foundations for impact

A stronger Alliance partnership that is evidence-based and accountable to communities

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As a global alliance of civil society organisations, ‘Southern leadership and shared responsibility’ has always been a central driver of the Alliance’s approach.

In 2017 we reviewed the impact of our leadership initiatives for directors and senior managers of Linking Organisations to help us refine our approach to leadership development. We also formed an Alliance Membership Committee, responding to a request from Linking Organisations to be part of decisions regarding suspension and termination of Linking Organisations membership.

We made great strides in improving the quality of the Alliance’s programming by developing our policies on gender. We developed a good practice guide to gender-transformative HIV programming, embedded a focus on gender in all HIV programming areas in the Alliance accreditation standards and criteria, and produced a guide for Linking Organisations to the Alliance approach to gender equality.

The Alliance developed a new monitoring system, Wanda, which we are piloting in PITCH to document progress towards advocacy goals, and in READY+ where young people will be using mobile phones to collect data. The benefits of Wanda include the ability to track people and the services they receive over time, easy entry and analysis of both quantitative and qualitative data, and access of real-time data by project partners.

I think if it was not for the IMPM [International Masters in Practicing Management] and especially the coaching to reflect back on, I don’t think I would be as resilient as I am now… participating in the IMPM and coaching has equipped me with a toolbox of things that enable me to feel like ‘It’ll be ok, I’ve got this’.

Flavian Rhodes, executive director of Positive Vibes, Alliance Linking Organisation in Namibia and southern Africa

Building capacity to respond to human rights violations

In 2017, the Alliance rolled out Rights, Evidence, Action (REAct), a community-based system for monitoring and responding to human rights-related barriers in accessing HIV and health services, in the PITCH programme. Representatives of LGBT organisations from Kenya, Mozambique, Nigeria, Uganda and Zimbabwe were trained in using REAct and adapting it to the circumstances in their respective countries.

The training team included Richard Lusimbo from Sexual Minorities Uganda (SMUG), a PITCH partner and network of 18 LGBT organisations that has implemented REAct since 2014. Richard combined technical training with sharing his organisation’s hands-on experience of developing, implementing and improving REAct within a highly hostile environment for LGBT communities.

The participating organisations are now adapting and implementing REAct in their own countries. Alongside more and better documentation of and response to individual incidents, this will result in unprecedented evidence of the reality of human rights violations against LGBT communities, which will inform local and international advocacy for upholding and protecting their rights.

Richard Lusimbo, SMUG research and documentation manager, at REAct training. © Eddy Mokaya for the Alliance

The Alliance’s global partnership extends across 29 countries and our programmes reached people in 43 countries in 2017

Rapid Response Fund grants ▼

Burundi, Cameroon, Dominican Republic, Democratic Republic of Congo, Ghana, Haiti, Jamaica, Kenya, Malawi, Nigeria, South Sudan, Swaziland, Tanzania, Zimbabwe, South Africa, Uganda

Integrated HIV and sexual and reproductive health and rights programmes ▼

Bolivia, Botswana, Burkina Faso, Burundi, Cambodia, China, Cote d’Ivoire, Ecuador, El Salvador, Ethiopia, Haiti, India, Indonesia, Kenya, Morocco, Myanmar, Namibia, Peru, Senegal, South Africa, Swaziland, Tanzania, Uganda, Vietnam, Zimbabwe

Programmes addressing stigma and discrimination ▼

Bolivia, Botswana, Burkina Faso, Burundi, Cambodia, China, Cote d’Ivoire, Ecuador, El Salvador, Ethiopia, Haiti, India, Indonesia, Kenya, Morocco, Myanmar, Namibia, South Africa, Tanzania, Ukraine, Vietnam, Zimbabwe

HIV prevention activities for people who use drugs ▼

Bolivia, Burundi, Cambodia, China, Cote d’Ivoire, Ethiopia, India, Indonesia, Kenya, Myanmar, Senegal, Tanzania, Uganda, Ukraine, Vietnam

Rapid Response Fund grants ▼

Integrated HIV and SRHR programmes ▼

Programmes addressing stigma and discrimination ▼

HIV prevention activities for people who use drugs ▼

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