'HEALTH SECURITY, DRUG USE AND HIV/AIDS': INNOVATIVE PARTNERSHIPS
Els Klinkert

View the accompanying powerpoint presentation.

Introduction
"A global disaster is taking place which is not receiving the response it deserves. Yet every day hundreds of people are dying. The name of this silent disaster is AIDS."

Almost 25 million people have died of AIDS since the beginning of the epidemic. Thirteen million children have lost their parents to AIDS. More than 40 million people world-wide already carry the virus. Unfortunately, this figure will continue to rise. Current forecasts paint a bleak picture. UNAIDS, the UN agency coordinating the fight against HIV/AIDS, predicts that the virus will spread rapidly in the Caribbean, Asia and the former Soviet republics.

Factors creating a fertile setting for the epidemic are increased mobility, drug trafficking, growing unemployment and economic insecurity. Especially young people who do not finalize their secondary schooling, who have little perspectives on a decent job form a very vulnerable group to become HIV-infected.

The effects of the epidemic become more and more apparent. HIV/AIDS affects entire families and households in the most direct way. The families of AIDS victims are faced with high medical expenses, funeral costs and loss of human resources. But AIDS not only strikes at household level, the epidemic will also negatively effect the workplace, schools and national economic development. The epidemic will form an additional burden on the public health and other services sector, education, agricultural and economic sector.

The large number of underlying factors of the further spreading of AIDS and the various negative effects of the epidemic on different sectors of society has led many organizations to the conclusion that they alone can not fight the disease successfully. No single organization, whether it is in The Netherlands, Thailand or in Eastern Europe or Central Asia, is able to develop and implement an adequate response to HIV and AIDS.

In recent years, the AIDS epidemic has led to surprising new partnerships between a wide range of actors. This is indicative of the urgency of the AIDS problem. More and more organizations have realized that the only way to achieve progress is by joining forces. Partnerships have emerged at different levels: the international level, the national and the local level.

Innovative Partnerships
In many countries and regions governmental and non-governmental organizations (NGOs), the business sector, the pharmaceutical industry, networks, international foundations, development banks and the UN-system have entered a new area of working: forming partnerships.

Global level:

Global Fund to Fight AIDS, Tuberculosis (TB) and Malaria
A well known example is the Global Fund to Fight AIDS, Tuberculosis and Malaria. Realizing that good health and economic growth are profoundly linked, the Global Fund was established to address three major killer diseases. The Funds' objectives are ambitious:

• to fund programs that provide treatment, prevention, and support;
• to dramatically increase global resources dedicated to fighting AIDS, TB and malaria; and
• to scale up the efficiency with which those resources are applied.

Though the G8 has been useful in securing resources, the Fund is very much a broad partnership between developed and developing countries, and between public and private sectors. The Board of the Fund includes representatives of donor and recipient countries, private business and non-governmental organizations as well as communities affected by the three diseases.

UNAIDS
UNAIDS, the well-known Joint United Nations program on HIV/AIDS is in itself a partnership program. It was set up to intensify the fight against HIV/AIDS and to coordinate the activities of seven UN agencies (UNICEF, UNDP, UNFPA, UNESCO, WHO, the World Bank and UNDCP) in the field of HIV/AIDS. The ILO only recently joined the UNAIDS program. UNAIDS has forged several partnerships, and two of them deserve special attention.

• UNAIDS/ "International Federation of Red Cross and Red Crescent Societies (IFRC)" / "Global Network of People Living with HIV and AIDS (GNP+)"
  National Red Cross and Red Crescent Societies having the infrastructure and human resources to provide care to poor and sick people are encouraged to use the knowledge and experience of GNP+ to fight stigma and discrimination against people living with HIV/AIDS. Training materials have been developed to equip staff of national and local Red Cross and Red Crescent Societies to address HIV/AIDS in a proper and non-discriminating way.
• "International HIV/AIDS Alliance"
  Another partnership linked to UNAIDS is the "International HIV/AIDS Alliance." This Alliance, based in the United Kingdom, is an international non-governmental organization that supports community action on HIV/AIDS in developing countries. Distribution and sharing of information is one of their strengths. The toolkits and training guides are used all over the world.

"The Global Business Council"
The Global Business Council is a rapidly-expanding coalition of international businesses dedicated to combating the AIDS epidemic through business sector's unique skills and expertise. The Council focuses on enhancing policy leadership and aims to increase the involvement of the business sector. The Global Business Council assists national business organizations by providing technical advice and advocacy support.

Regional Level:

Asian Harm Reduction Network
An outstanding partnership active in Asia is the "Asian Harm Reduction Network." This regional network supported by the Netherlands is based in Chiangmai in Thailand. It promotes pragmatic approaches to the prevention of drug use and HIV/AIDS. Their experience shows that attempts to reduce the harmful effects of drug use are almost invariable successful. Needle exchange and drug replacement therapy, as components of a comprehensive public health approach, are intended to reduce rather than eliminate harm. The Asian Harm Reduction Network provides support to the establishment of other national and regional networks, to the training and support of individual and organizations and disseminates information.

Every day the network issues an electronic newsletter providing up-to-date information on drug use, HIV/AIDS and policy developments in the region. The network is open and every organization is able to join them.

In April 2003 the 14th International Harm Reduction Conference will be held in Chiangmai. It is expected that delegations coming from a large number of countries and organizations will attend the conference.

National level:

Governmental and non-governmental organizations
Co-ordination and cooperation at the country level is also a necessity to stop the epidemic. In the Netherlands, the Ministry of Health joins forces with non-governmental organizations - as, for example, the 'AIDS Fund' and the 'Netherlands Society of People Living with HIV/AIDS' - to fight the epidemic. The Ministry of Health formulates national policy and sets quality standards. The NGOs take care of prevention campaigns and provide health and legal services to people with HIV and AIDS. Due to the fact that these NGOs are well aware of the needs and the position of the most vulnerable groups like injecting drug users, homosexuals, commercial sex workers and migrants, they are in a much better position than the government to provide tailor-made services.

National Business Councils
More and more companies are recognizing that HIV infection and AIDS can affect productivity and profitability. In an increasing number of countries - including Brazil and Thailand - companies have formed business coalitions to pool resources and help each other to respond better to the crises in their workplaces and communities. Effective workplace programs can be set up by a company at a fraction of the current rising financial cost of AIDS to the business. Overall advice is that companies should not wait for the government or health sector to take action for them.

Public - private partnerships
Combining the expertise and infrastructure of the commercial sector with the strength of the mass media and the policy setting by the government can obtain significant results in the response to HIV/AIDS. Almost all prevention programs focusing on condom promotion involve the private sector. Sometimes the private sector is ahead of government policies and in that case the business advises governmental organizations. For example, the Netherlands Ministry of Foreign Affairs is consulting the beer brewery Heineken on its HIV/AIDS staff policy. This international company Heineken is much further ahead in caring for its employees than the Ministry of Affairs for its embassy staff abroad.

The latest news on forging innovative partnership relates to the company of Coca-Cola. Coca-Cola has started cooperation with GlaxoSmithKline (pharmaceutical industry), PharmAccess International and the Population Services International, both NGOs, to provide prevention and care programs for the employees of Coca-Cola.

How to build partnerships?
Forging partnerships might look very easy. It is not. There are a number of conditions that need to be fulfilled for effective and successful partnerships.

1) Political will is of utmost importance. It is very important that the top level management of the organization supports and encourages the forging of partnerships. Courage is required to realize that cooperation and coordination with other partners is a necessity to win the battle against the AIDS epidemic.
2) Knowledge of your organization's strengths, weaknesses, opportunities and threats is important in building partnerships. You have to know what you can offer to others and what you need from other partners.
3) All members of the partnership should support the overall objective of the cooperation
4) Clear rules and regulations for every partner in the partnership. Each partner should know its responsibilities, mandate and tasks. Mutual agreed working relations are useful for the functioning of innovative partnerships.
5) Ensure the participation of the target group in your partnership. If you aim at adolescents, young people, be assured that their voice is being heard and enable them to take part in the decision-making processes on strategies and activities. Be assured that girls and young women are involved as well as boys and young men.
6) Involve People Living with HIV/AIDS in the partnership. People living with HIV/AIDS are not a part of the problem, they are part of the solution!

In conclusion, the HIV/AIDS epidemic affects us all. Only through commitment, co-operation, coordination and mutual respect we will be able to beat this dreadful disease.

Thank you.