1. The Constellation

2. HIV and AIDS Our starting point… and our primary focus

3. Increase in total annual resources for AIDS Total annual resources available is 300$ per Person Living with HIV

4. More new infections than people put on treatment Total 0,8 million People newly infected with HIV in 2007 People put on treatment in 2007 Total 2.7 million

5. Data on HIV: UNAIDS report 2008 Number of PLHIV increases: (i) new infections (ii) ARV available HIV disproportionately affects injecting drug users, men who have sex with men, and sex workers Prevention: 15–24 years of age account for 45% of all new HIV infections and many young people still lack accurate, complete information In only six years, the number of people receiving ARV has increased ten-fold, reaching almost 3 million people 12 million orphans in sub-Saharan in Africa

6. There is another reality…..

7. Uganda: trends in antenatal HIV prevalence at selected sentinel sites

8. What did we learn from countries that made progress? People drive effective responses to HIV/AIDS, not commodities. Service provision is required, but is no substitute to people driven responses Progress depends on local ownership of the problem and the solution

9. Implication for Global Strategy on AIDS Prevention Care Mitigation Ownership

10. The Constellation Stimulating and Connecting Local Responses Founded in 2004 12 founding members from 5 continents Now 65 coaches Connecting communities in 20 countries from Asia, Africa and Europe

11. Our Core Belief Communities can respond by themselves to their own issues They are able to envision, to act, to mobilise resources, to assess progress, to adapt and to share

12. From AIDS to Life Competence In a Life Competent society, we act from strength: to acknowledge that issues concern us all to build our common dream and overcome obstacles on the way to mobilize our capacities to reduce our vulnerabilities and risks to allow everyone to live out their full potential, and to learn from our experience and share it with others

13. Another way of development thinking We believe in our own expertise to provide solutions We believe in people’s capacity to respond We are in controlWe facilitate responses We respond to needWe reveal strengths You have a problemTogether, we have solutions

14. Another way of working Facilitation teams support the spread of Community Life Competence They build on the strengths of communities They work as a SALT team S : Stimulate, Support A : Appreciate L : Learn, Link T : Transfer, Team They support communities to become Life Competent

15. The steps of the Community Life Competence Process

16. Community We share Building the dream Initial SALT visit Facilitate self-assessment Action plan SALT visit Self- measure change Self-measure change After-Action-Review Knowledge Fair Knowledge assets Peer assist we care we hope we assess our situation we act we measure change we learn & adapt Community Facilitators SALT

17. s Steps of the process building the dream

18. 1 BASIC 234 5 HIGH Acknowledgement and Recognition We know the basic facts about HIV/AIDS. We recognise that HIV is a problem. We recognise that HIV/AIDS is a problem for us and we discuss it amongst ourselves We acknowledge openly with others our concerns about HIV/AIDS and the challenges it represents for us. We recognise our own strength to deal with the challenges and seek others for mutual support and learning. Care and change of behaviour We communicate externally provided messages about care and prevention. We adapt and communicate externally provided messages about care and prevention. Our care and prevention activities are separate and dependent on external stimulus. We change because we care. We intentionally link care and change of behaviours and work practices in ourselves and with others. Inclusion We don ’ t involve those affected by the problem. We get together with some people who are crucial to resolve common issues. We (individuals, families, communities, service providers and policy makers) work together to respond to HIV/AIDS. Our partnerships share common goals, and define each partner ’ s contribution. Religious and community leaders get involved. We address and resolve all challenges facing us (not only HIV/AIDS.) Identify and address vulnerability We aware of the general factors of vulnerability and the risks affecting us. We have mapped vulnerability and risk. We have a clear strategy to address vulnerability and risk. Our strategy is based on good practices. We are addressing vulnerability in all aspects of the life of our group, all are aware and involved in responding. Learning and transfer We learn by what we do rather than what we learn from and share with others. We share learning from our successes but not our mistakes. We have processes for learning and sharing which we use sometimes. We seek people of experience when necessary. We learn, share and apply what we learn systematically, and seek people with relevant experience to help us. We see an improvement in local responses as a result of our learning and sharing. Measuring change Our change is evaluated by others. We begin consciously to self measure. We measure our own progress and set targets for improvement. We measure our change systematically and can demonstrate measurable improvement. We invite others to help measure our change and share learning/results with others. Steps of the process self-assessment

19. 19 Level Acknowledgment and recognition Inclusion Care and prevention Identify and address vulnerability Pre-intervention Pre-intervention Post-intervention year 1 Post-intervention year 1 Post-intervention year 2 Post-intervention year 2 Does the AIDS Competence Process work? Level omparison of AIDS competence indicators pre- and post-community self assessment in 5 Bangkok districts Comparison of AIDS competence indicators pre- and post-community self assessment in 5 Bangkok districts

20. Does the Malaria Competence Process work? Comparison between group 1 (using malaria competence) and group 2 (not using malaria competence), in Togo

21. Results Open discussions and increased demand for testing Ex: Settlements in Papua New Guinea finally discuss HIV as their issue Improved inclusion of PLHIV Ex: communities in India include PLHIV in their savings group People identify and address vulnerabilities Ex: Street children in Philippines assess their risk and reduce their risky behaviour Ex: In Sohm (the Gambia), on average 5 children would die from malaria every year. Since the Self Assessment had been introduced, not a single child had died in the village. Improved access to treatment Ex: Truck-drivers in Katma, a trucker's stop in Uganda obtain HIV tests at night People mobilize own resources Ex: The sex workers in Periyackulam district started a mutual financial support services.They do not accept to have sex without condoms anymore Reflection on lessons learned, adapt and share with others Ex: peer assists in Tent City where communities from all over PNG shared their experience around the priority practices of Tent City

22. Currently plans to scale up ACP in DR-Congo => PNMLS & World Bank Indonesia => UNFPA & Provinces South Africa => Department of Health, NGOs & Global Fund Six Asian countries => Asian Development Bank supports country teams to go to scale Implementation across religions and cultures Thailand => Norwegian Church Aid (NCA) Kenya between tribes Belgium in communities of different origins and cultures Great Lakes Region => PLHIV & Truck drivers Application of approach to other issues Malaria Competence with Roll Back Malaria Human Preparedness to Pandemic with IFRC Diabetes competence with Handicap International Disability & Aids Competence with Handicap International Reconciliation & AIDS with Melbourne University The potential of AIDS Competence

23. External evaluations September 4, 2015 UNAIDS 23 UNAIDS Evaluation (2005) "between 83% and 87% [of AIDS Competence Process users] are satisfied and confident that the program achieves impact within communities. The AIDS Competence Programme was found to be highly cost-effective when compared to other programmes (0.10 to US$ 2.00 per person reached )” WHO-UNICEF Evaluation Papua New Guinea (2009) “The AIDS Competence Process is an effective approach in combating HIV/AIDS through local empowerment. For its low-cost but often labor intensive input of resources, the output has been substantial.” Action Group on Local responses to HIV in India (2008) “Stigma and discrimination is reduced due to greater clarity on the nature of the epidemic, and greater reflection on the different driving factors of the epidemic. The approach can be implemented with existing interventions, in order to promote a more sustainable response.” Roll Back Malaria evaluation of malaria competence (2008) “It is possible to conclude that the Malaria Competence process is very likely to foster a strong sense of community ownership. The self-assessment process led to a surge in community-led initiatives to create greater community awareness around malaria.

24. Some of our Formal Partnerships

25. Challenges Scaling up of the approach Self-measurement of progress Use by and connection with private sector Innovative approach in a sometimes non-conducive environment

26. Membership Share Transfer Learn CST Ways of working

27. S T L ST constellation S T L ST S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L

28. S T L constellation S T L ST S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L

29. Learn

30. S T L ST constellation S T L ST S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L

31. Share

32. T S T L ST constellation S T L ST S T L S L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L S T L

33. Learn Share Transfer GFT constellation

34. CST board B B B B C B B B B C B B B B C BB B B C B B B B C B BB B C B B B B C B BB B C B B B B C B B B B C B B B B B B B B B B Chair Organizational Structure v v v v v v v v v v

35. UNAIDS 08 Report on the global AIDS epidemic Lamboray J-L, Legastelois, J Sida, La bataille peut être gagnée, Ed. Atelier, 2004 Jean Legastelois, les communautés relèvent le défi du SIDA en RD- Congo, la Croix, 14 mars 2007 Fritjof Capra: The Turning Point (…), Bantam Books (1984) ISBN : 0553345729 Amartya Sen: Development as Freedom, Anchor Books ( 2000) ISBN : 0385720270 Fritjof Capra: The Web of Life, Flamingo (1997) ISBN : 0006547516 Thich Nhat Hahn: Il n'y a ni mort ni peur. Éditeur, Pocket (4 mai 2005) ISBN : 2266149105 Christian de Duve: A l’écoute de la Vie, Odile Jacob (13 mai 2005) ISBN : 2738116299 Chris Collison & Geoff Parcell: Learning to Fly: Practical Knowledge Management from Leading and Learning Organizations, Capstone November 2004, ISBN: 978-1-84112-509-1 References

36. Thank you for your attention Our website www.aidscompetence.org Our community www.aidscompetence.ning.com