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To end the world’s deadliest diseases, invest in civil society

by Allan Maleche | The Global Fund
Thursday, 12 July 2018 10:02 GMT

* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.

When civil society has a seat at the table, they give a voice to the communities most at risk of or heavily affected by AIDS, TB and malaria

When it comes to dealing with global health challenges, representatives of civil society may not always be the most popular people in the room as they press for prioritizing marginalized and stigmatized groups.  Yet, they may be the most impactful in ensuring that progress is made. The fact is that in the fight against HIV/AIDS, tuberculosis (TB) and malaria, civil society is an instrumental partner in advocacy and implementation. This sometimes means that it has to show some muscle. 

We saw that very clearly in the beginning of the AIDS movement. There were times when the community was ahead of just about everyone else in terms of knowledge about the epidemic. AIDS showed what a difference advocacy can make. And civil society advocates were and remain agents of change. 

For more than 15 years, civil society has worked closely with the Global Fund to Fight AIDS, TB and Malaria, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and other programs to ensure accountability and, often, engage in service delivery, including working as ambassadors to vulnerable communities. 

One of these ambassadors is Nelson Wanyonyi Osiemo, a lawyer living in Kenya. Since attending a Global Fund-supported legal training on HIV and the law, Osiemo has been a tireless advocate in cases involving people living with HIV. In particular, he has fought for their rights to privacy and protection from discrimination at home and in the workplace.

One of Osiemo’s litigation victories has forced Kenyan health insurers to rethink their policies of offering different medical coverage to people living with HIV. This follows a definitive ruling by the Kenyan HIV and AIDS Tribunal in March, finding it is unlawful and unfair for a medical insurer to discriminate against patients living with HIV by developing a special policy for them. The tribunal also granted the petitioner KSh 3 million (approximately $300,000) in damages for discrimination and breach of privacy rights.

Civil society organizations are at the heart of everything the Global Fund does. Their delegations participate actively in guiding Global Fund strategy and overseeing its policy and work. At the country level, civil society participates actively in decision-making processes through membership in the Country Coordinating Mechanism (CCM), the national committee that is responsible for developing funding requests and overseeing implementation of grants in every nation the Fund assists. Civil society also plays a key role at the local level through community-based organizations, which often serve as implementers. These groups are able to work effectively with populations and communities that are not always reached by government efforts, as Osiemo’s work demonstrates. 

There is no doubt that civil society is central to an effective response to HIV, TB and malaria. When civil society has a seat at the table, they give a voice to those communities most at risk of or heavily affected by the three diseases. That’s why recent efforts to restrict civil society activity are alarming. In 2017 alone, one study found that 109 countries acted to close, repress or obstruct civil society space. Efforts to debase or attack civil society must be rejected as tools to destroy, not help. 

The backing of civil society should stand as a key priority for U.S. and other international major financing efforts to end the three epidemics. Investments now to bolster the capacity and reach of civil society stand to yield outcomes valuable to U.S interests and health security: advancing nations’ self-sufficiency; moving toward epidemiological control of HIV, TB and malaria; and decreasing the potential for another public health crisis, such as the Ebola outbreak in 2014.

The United States, in combination with like-minded donors, should apply its resources, voice, unrivaled diplomatic political network – in partnership with partners like the Global Fund - to help to ensure civil society is not left behind.

Allan Maleche is a human rights lawyer and is currently the Board Member of the Developing Countries NGO Delegation to the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria. He is also Executive Director of the award-winning human rights organization, the Kenya Legal & Ethical Issues Network on HIV and AIDS (KELIN).