Community-based approaches to tackling Global Health Challenges Mike Podmore

2 Jacquelyne Alesi

3 Global consultation with young people living with and affected by HIV

The key priorities Human rights, including sexual and reproductive rights Comprehensive sexuality education Access to safe, comprehensive services and knowledgeable, ethical, supportive, and qualified health service providers Meaningful youth participation in all aspects of decision-making Addressing gender-based violence

Community-based approaches The International HIV/AIDS Alliance model

Established in 1993 An innovative alliance of nationally based, independent, civil society organisations Dedicated to ending AIDS through community action Who we are

40 independent, national Linking Organisations working across four continents Our model 7

Community System Strengthening Framework – Global Fund, 2009 Frameworks that firmly position the critical role of civil society in the response: 8 Investment Framework – Lancet, June 2011

Most studies are randomized controlled trials to test the efficacy of medical interventions Community approaches are difficult to quantify and measure and there have not been enough studies In we worked with the London School of Economics and Political Science (LSE) to examine and document the role of community mobilisation across Alliance HIV programming. In 2013, the World Bank concluded a three year evaluation of the impact of the community response to HIV and AIDS. This large scale research included country studies in Burkina Faso, India, Kenya, Lesotho, Nigeria, Senegal, South Africa and Zimbabwe and provides strong evidence The challenge of evidence: 9

1. Peers engaged to deliver services 5 community-based approaches that work Community members take leading roles in programmes 3. Programmes respond holistically to community priorities 4. Enhanced community & social capital 5. Communities socially and politically mobilised

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Health in the Post-2015 Framework

Universality, solidarity, and gender equality Health is a human right and a public good The unfinished business of the MDGs – 4, 5 and 6 Leave no-one behind Health is a precondition for and outcome of sustainable development Evidence-based, include financial targets and have robust monitoring mechanisms at all levels Civil society must be recognised as an actor in its own right and supported as both mobiliser, service provider and advocate Key principles: 13

UHC as key instrument to its realisation and would have two interlinked targets: 1)Universal access to quality healthcare 2)Financial risk protection Plus 3) A target related to health outcomes - ending preventable mortality and morbidity at all stages of life 4) A target related to enabling health behaviour (social determinants of health) Proposed goal: Ensuring healthy lives at all ages 14

The community has the power to tackle Health challenges if they are recognised and supported to do so. Mike Podmore