Three Years of the Red Cross Global Alliance on HIV in the Americas 2008-2011

Background:
The Global Alliance on HIV (GA HIV) was launched in the Americas in 2008 as part of the global effort to consolidate and harmonize the Red Cross Red Crescent’s response to the HIV/AIDS epidemic. A central purpose of the GA HIV was to provide a cohesive framework for the broad variety of National Society activities, while enabling National Societies to tailor their programmes to local needs. Fourteen National Societies in Latin America and the Caribbean have reached over 5.6 million people with HIV prevention messages or direct services in the period from 2008-2011.

Key findings and lessons learned:
The GA HIV has had a profound effect on the way in which the National Societies of the Red Cross Red Crescent in Latin America and the Caribbean approach their work in HIV/AIDS. The concepts of integrated planning and working with partners on a consolidated response to the epidemic in their countries have strengthened the National Societies’ role as an important contributor to their respective national AIDS’ responses. Programmatically, the GA HIV has provided an appropriate model for working with the most marginalized populations at higher risk of HIV in the region. The relatively flexible funding provided multilaterally though the Federation Secretariat has enabled each National Society to tailor its programmatic approaches to local needs and to complement other funding sources. The GA HIV has also contributed to learning for the entire organization. The key lessons learned are listed below:

Prevention of new HIV infections
- National Societies can effectively work with key populations.
- Working with key populations requires positive, tailored messaging.

Care, treatment and support
- Strengthening the capacity of relevant government agencies and local partners through training is an important role for the Red Cross in many countries in both Latin American and the Caribbean.
- Advocacy for the rights of people living with HIV (PLHIV) needs to be an important component of programmes working with people living with HIV from key populations.

Stigma and Discrimination
- The involvement of stakeholders from key populations in designing and implementing training for National Society staff and volunteers has helped break down internal resistance to working with these groups.
- Working with HIV and violence prevention requires understanding that youth can be victims of violence and of stigma related to violence.
- Combined advocacy, media and social mobilization can be powerful means of educating the public on Stigma and Discrimination.

Institutional Change
-  The GA HIV has led to greater integration of HIV/AIDS within National Societies in the region.
- The GA HIV has strengthened the capacity of National Societies to work in partnership with others on the National AIDS response in their countries.

Resource Mobilization
- The private sector is a potential funding source that should be tapped more extensively.
- Public sector funding is difficult to access but can result in expansion and sustainability.

Purpose/objective:
The GA HIV was structured to provide a more cohesive approach to HIV/AIDS programming by focusing interventions on the attainment of four key outputs:
- Preventing further HIV infection.
- Expanding HIV care, treatment, and support.
-  Reducing HIV stigma and discrimination.
- Strengthening National Red Cross Red Crescent Society capacities to deliver and sustain scaled-up HIV programmes.

This report will examine the extent to which these outputs have been achieved among the 13 National Societies which are currently involved with the GA HIV in Latin America and the Caribbean and the lessons learned to date. While not a comprehensive evaluation of the GA, the analysis will attempt to ascertain the extent to which the GA HIV objectives are being accomplished and how the GA HIV has contributed to change at the National Society level.

Methodology:
Information for this report comes from four principal sources:

Reports: Reports from the National Societies who are GA HIV members and consolidated reports of the America’s Zone were consulted as part of the data collection effort for this report.

Presentations: Representatives from 14 National Societies, America’s Zone staff, as well as from the Norwegian, American and Canadian Red Cross participated in a meeting on Lessons Learned and Future Programming held in December 2011 (see attached participants’ list Annex A). The case studies were largely drawn from presentations at this meeting and in addition, the major lessons learned were identified by working groups of the National Society managers.

Most Significant Change stories: The Most Significant Change methodology is a story-based, participatory technique often used for assessing organizational change. While the full methodology was not used here, the story-
development component was used to elicit information on organizational change from the National Society managers. The representatives from the GA HIV members wrote stories about how the National Society had changed as a result of the GA HIV.

Interviews: Selected managers from National Societies and the America’s Zonal office were interviewed about the impact of the GA HIV on their organizations and on the work being conducted in HIV.

Recommendations:
Program

- National Societies reported that there is still a need to effectively address stigma and discrimination within National Societies (this was felt most keenly in the Caribbean). Their goal is to create model environments which are highly supportive of and welcome the participation of PLHIV and key population groups at most risk of HIV.
- While there have been substantial gains in the level of commitment to HIV at the National Societies some respondents see a need for continued efforts to increase commitment at the most senior levels of the National Societies.
- Urban risk and violence are key issues affecting the region and the GA HIV should continue to strengthen capacity for violence prevention as a component of programming.
- As the needs in the region have evolved beyond awareness-raising, prevention programming needs to sharpen the focus on behaviour change.
- There is a need to ensure that the integration of gender concepts is incorporated into HIV programming, especially into youth programming.

Planning, management and evaluation

- South to South and peer support efforts between National Societies has been perceived as highly successful and National Society managers called for expansion of this modality for the provision of technical assistance. The Secretariat should continue and intensify its efforts to serve as a facilitator for south-south exchanges and should develop appropriate knowledge management strategies to share tools and learning across the region
- The interruptions caused by the annual funding cycle is something that should be addressed with urgency as it hampers programme implementation
- Managers identified a need to strengthen the PMER system, clarifying definitions of indicators and strengthening the data collection system, as well as creating a more comprehensive and results-oriented monitoring and evaluation system.
- While integration has been achieved in a lot of places, reporting on integrated activities remains a major challenge. Going forward it is important to develop ways to report on integrated activities more fully.
- Technical support is required for the development of resource mobilization strategies and the acquisition of capacity for resource mobilization at all levels. National Societies need to be open to new partnerships and strategic alliances that may facilitate future funding. Support and commitment at the senior management level of the National Societies will be required to assist in identifying new sources of funding and allocate appropriate resources to bolster the GA HIV programmes as necessary.