International NGO International NGO Perspective on Perspective on

Transformative Roles in Transformative Roles in HIV, Nutrition and Food HIV, Nutrition and Food

SecuritySecurity

World AIDS Day 2008, World AIDS Day 2008, Irish Aid SeminarIrish Aid Seminar

Connell Foley (Concern)Connell Foley (Concern)

Content & FocusContent & Focus

Givens/AssumptionsGivens/Assumptions Work of INGOs in these areasWork of INGOs in these areas Civil Society and INGOsCivil Society and INGOs Role of International NGOs in HIV, Role of International NGOs in HIV,

Food Security and Nutrition.Food Security and Nutrition. ConclusionsConclusions

Assumptions/GivensAssumptions/Givens

1.1. The global HIV epidemic is still outpacing the global The global HIV epidemic is still outpacing the global response (33 million living with HIV and AIDS; 300 m response (33 million living with HIV and AIDS; 300 m directly affected!).directly affected!).

2.2. Poorest disproportionally affected and most vulnerablePoorest disproportionally affected and most vulnerable3.3. Vulnerability of those living with HIV and AIDS increased Vulnerability of those living with HIV and AIDS increased

by lack of food and poor diet/nutrition (++ food & fuel by lack of food and poor diet/nutrition (++ food & fuel price increases etc.)price increases etc.)

4.4. Preventing new HIV infections is key to reversing the HIV Preventing new HIV infections is key to reversing the HIV and AIDS epidemic. and AIDS epidemic.

5.5. There is no cure but ARVs are effective where they can There is no cure but ARVs are effective where they can be accessed, afforded and taken properly.be accessed, afforded and taken properly.

6.6. There are still major historical, religious cultural and There are still major historical, religious cultural and educational barriers to behaviour change and prevention.educational barriers to behaviour change and prevention.

7.7. HIV continues to decimate productive populations HIV continues to decimate productive populations including those trying to fight poverty and HIV and AIDS including those trying to fight poverty and HIV and AIDS (government services, NGOs, other institutions).(government services, NGOs, other institutions).

8.8. Many resources are being directed at the problem.Many resources are being directed at the problem.

INGOs/Concern: Food Security and INGOs/Concern: Food Security and NutritionNutrition

Food Security via:Food Security via:– Agricultural production and productivityAgricultural production and productivity– LivestockLivestock– Disaster Risk ReductionDisaster Risk Reduction– Capacity building of services (Ag Ext; Vets etc.)Capacity building of services (Ag Ext; Vets etc.)– Microfinance (rural and urban) – some specific targetingMicrofinance (rural and urban) – some specific targeting– Livelihood diversification and optionsLivelihood diversification and options– Social ProtectionSocial Protection

Nutrition:Nutrition:– Diversification of food production and accessibilityDiversification of food production and accessibility– Dietary diversificationDietary diversification– Kitchen gardensKitchen gardens– Behaviour change in preparation and use of foods Behaviour change in preparation and use of foods

(Positive Deviance/Hearth Model)(Positive Deviance/Hearth Model)

Models of DevelopmentModels of Development

Economic Growth ModelEconomic Growth Model Inward investment; international markets and Inward investment; international markets and

international trade; goods value chaininternational trade; goods value chain

Sustainability ModelSustainability Model Minimising vulnerability and risk; diversifying Minimising vulnerability and risk; diversifying

income sources and livelihoods options; income sources and livelihoods options; environmental sustainability and positive environmental sustainability and positive management.management.

Is the dominance of the one model appropriate to Is the dominance of the one model appropriate to all contexts?all contexts?

INGOs/Concern: HIV and AIDS INGOs/Concern: HIV and AIDS InterventionsInterventions

Mainstreaming via:Mainstreaming via:– Laying FoundationsLaying Foundations by highlighting the issue by highlighting the issue– Internal MainstreamingInternal Mainstreaming – staff attitudes and behaviours – staff attitudes and behaviours– External MainstreamingExternal Mainstreaming – ensuring that Food Security – ensuring that Food Security

and Nutrition programmes include H&A susceptibility and Nutrition programmes include H&A susceptibility and vulnerability as part of contextual and problem and vulnerability as part of contextual and problem analysis and that interventions reduce risk to analysis and that interventions reduce risk to programme participants and reduce likelihood of programme participants and reduce likelihood of participants (and the programme) being negatively participants (and the programme) being negatively affected.affected.

Programmes:Programmes:– Building capacity of CSOs working on HIV issuesBuilding capacity of CSOs working on HIV issues– Linking the poorest to key services (VCT, ARVs etc.)Linking the poorest to key services (VCT, ARVs etc.)– Trying to stop the spread of the pandemic through Trying to stop the spread of the pandemic through

prevention-focused activities such as KAP and BCC prevention-focused activities such as KAP and BCC strategies/activities.strategies/activities.

Civil Society Perspective?Civil Society Perspective?

International NGO International NGO ≠ Civil Society≠ Civil Society

(Like NGO view of “government” – not (Like NGO view of “government” – not analytical enough of the different elements)analytical enough of the different elements)

Media is part of civil society – article in Irish Media is part of civil society – article in Irish Newspaper in 2008 saying that: “Africa gives Newspaper in 2008 saying that: “Africa gives nothing to the world except AIDS”… mixed nothing to the world except AIDS”… mixed reaction suggests civil society and public reaction suggests civil society and public opinion does not have a singular perspective.opinion does not have a singular perspective.

Types of Possible Partners for ConcernTypes of Possible Partners for Concern

Civil SocietyCivil Society

Local NGOs.Local NGOs. CSO alliances, networks, CSO alliances, networks,

coalitionscoalitions Community based Community based

organisationsorganisations Trade or other unionsTrade or other unions Professional associationsProfessional associations Media organisations Media organisations Religious organisations Religious organisations Cooperative/social Cooperative/social

movementsmovements Microfinance institutionsMicrofinance institutions Training organisationsTraining organisations International organisationsInternational organisations Poverty research institutesPoverty research institutes Universities/academic Universities/academic

institutesinstitutes

Government and Inter-Government and Inter-GovernmentGovernment

Sectoral departments and Sectoral departments and administration at:administration at:

Village levelVillage level District levelDistrict level Municipal levelMunicipal level Provincial levelProvincial level National levelNational level Locally elected councils Locally elected councils

and officialsand officialsNOTE: Different and NOTE: Different and

appropriate levels of appropriate levels of government to work government to work withwith

Bilaterals (e.g. Irish Aid, Bilaterals (e.g. Irish Aid, DFID) DFID)

Multilaterals (e.g. EU, Multilaterals (e.g. EU, UN, World Bank)UN, World Bank)

Private SectorPrivate Sector

Food research Food research companies companies

Pharmaceutical Pharmaceutical companies companies

Banks, e.g. Banks, e.g. DEPFADEPFA

For-profit For-profit consulting consulting agenciesagencies

Are there special issues with Are there special issues with HIV+ Organisations?HIV+ Organisations?

Historically, due to perceived ‘death-Historically, due to perceived ‘death-sentence’: sentence’: – Strong activism (nothing to lose – ‘stand up for your Strong activism (nothing to lose – ‘stand up for your

rights’rights’– Personal volatility causing management and Personal volatility causing management and

governance volatility??governance volatility??– Higher loss of members and turnover of leadership?Higher loss of members and turnover of leadership?

Our experience alerts us to this possibility!Our experience alerts us to this possibility!

The Marginal Woman Farmer in The Marginal Woman Farmer in MozambiqueMozambique

Her Needs:Her Needs: Support from family, kin, community, extension agents, Support from family, kin, community, extension agents,

patrons (political)…patrons (political)… Inputs (seeds, tools, credit…) from private sector, CBOs, Inputs (seeds, tools, credit…) from private sector, CBOs,

NGOs, extension agents and other government outreach NGOs, extension agents and other government outreach workers.workers.

Her Risks, Susceptabilities and Vulnerabilities:Her Risks, Susceptabilities and Vulnerabilities: Who supports her to minimise these?Who supports her to minimise these? Women kin; close friends, church, voluntary groups Women kin; close friends, church, voluntary groups (Civil Society as voluntary group support and structured (Civil Society as voluntary group support and structured

social capital but civil society also as a set of principles of social capital but civil society also as a set of principles of ethical behaviours)ethical behaviours)

Issue of how much time she has to give to care/work. Time Issue of how much time she has to give to care/work. Time poverty?poverty?

Issue of personal agency and resilienceIssue of personal agency and resilience

Key NGO Changes since 1993Key NGO Changes since 1993

Programme Approach – larger, thematic, Programme Approach – larger, thematic, multi-level, multi-partner, micro-macro multi-level, multi-partner, micro-macro links…links…

Partnership Model – various sectorsPartnership Model – various sectors Policy AdvocacyPolicy Advocacy Linking with PRSPs, government policies Linking with PRSPs, government policies

and strategiesand strategies Analysis of target groups, contexts and Analysis of target groups, contexts and

issues becoming more systematic, issues becoming more systematic, professional… and complexprofessional… and complex

NGO’s Engagement with Private NGO’s Engagement with Private SectorSector

Concern and Valid InternationalConcern and Valid International Concern and Valid NutritionConcern and Valid Nutrition Concern and DEPFA BankConcern and DEPFA Bank Concern and Kerry GroupConcern and Kerry Group

No more the ideological knee-jerk reaction No more the ideological knee-jerk reaction though suspicions over value sharing though suspicions over value sharing remain.remain.

Why not partnership with pharmaceutical Why not partnership with pharmaceutical companies?? (but limits…)companies?? (but limits…)

Concern’s Engagement with ResearchConcern’s Engagement with Research

Valid InternationalValid International IFPRIIFPRI IDSIDS Centre for Global Health, TCDCentre for Global Health, TCD INTRACINTRAC (ODI, ICRAF, ICRISAT, CIEd…)(ODI, ICRAF, ICRISAT, CIEd…)

Importance of evidence and stronger M&E; Importance of evidence and stronger M&E; key component of operational and action key component of operational and action research)research)

Dilemmas for INGOs IDilemmas for INGOs I HIV is not the only issue HIV is not the only issue

central to poverty and central to poverty and vulnerability!!vulnerability!!

Many issues to be taken Many issues to be taken into consideration – risk, into consideration – risk, vulnerability, inequality, vulnerability, inequality, exclusion, poor exclusion, poor governance, governance, environmental threats, environmental threats, livelihoods, water, other livelihoods, water, other diseases, poor diseases, poor education…education…

Focus on holistic analysis Focus on holistic analysis of all key issues in a of all key issues in a context and design context and design interventions based on interventions based on the more critical of the more critical of these.these.

Get around question of Get around question of “Who designs….” (bias!)“Who designs….” (bias!)

Dilemmas for INGOs IIDilemmas for INGOs II Aid architecture and processes:Aid architecture and processes:

– Sector Wide Approaches (Swaps) - Sector Wide Approaches (Swaps) - – Aid effectiveness (Paris Dec) processes and Aid effectiveness (Paris Dec) processes and

implicationsimplications– Vertical funds and changing funding processes…Vertical funds and changing funding processes…

NGOs getting sucked closer to bilateral rolesNGOs getting sucked closer to bilateral roles NGOs pressurised to produce evidence – sucked NGOs pressurised to produce evidence – sucked

closer to research roles and processescloser to research roles and processes Constant dilemma between humanitarian Constant dilemma between humanitarian

imperative (keeping people alive; meeting basic imperative (keeping people alive; meeting basic needs) and facilitating long-term and deeper needs) and facilitating long-term and deeper transformation of communities and societies.transformation of communities and societies.

Constant dilemma between outcome and processConstant dilemma between outcome and process

Move to partners – if intermediaries, huge issue of Move to partners – if intermediaries, huge issue of sub-contracting for service delivery v. sub-contracting for service delivery v. transformative/facilitating institutions…. So many transformative/facilitating institutions…. So many layers of weak capacity… effective???layers of weak capacity… effective???

Are INGOs losing their niche?Are INGOs losing their niche?

Community understanding and development.Community understanding and development. Building social capital and supporting local institutions Building social capital and supporting local institutions

(especially of the poor) and their development.(especially of the poor) and their development. How to empower extremely poor people and help them to How to empower extremely poor people and help them to

influence the factors which affect their livesinfluence the factors which affect their lives Learning and innovation around this niche. Learning and innovation around this niche.

Reality?Reality? On HIV, do IEC but seem to achieve little behaviour change On HIV, do IEC but seem to achieve little behaviour change

(weak BCC).(weak BCC). Mainstreaming can be evaporation if not careful.Mainstreaming can be evaporation if not careful. Trying to do everything creates an issue of depth and Trying to do everything creates an issue of depth and

effectiveness (yet narrow effectiveness often means lack of effectiveness (yet narrow effectiveness often means lack of synergy and ‘virtuous and reinforcing circles’).synergy and ‘virtuous and reinforcing circles’).

INGO RoleINGO Role

Linking the poorest to the policies, institutions Linking the poorest to the policies, institutions and processes for long-term change (duty-and processes for long-term change (duty-bearers; rights)bearers; rights)

Building capacity – confidence, continuity, Building capacity – confidence, continuity, empowering, taking responsibility as well as empowering, taking responsibility as well as demanding rightsdemanding rights

Supporting good local governance and making Supporting good local governance and making sure that the poorest have a say in decisions sure that the poorest have a say in decisions which affect them…which affect them…

Creating CIVIL SOCIETY as a key component of Creating CIVIL SOCIETY as a key component of open, transparent societies (assumption that this open, transparent societies (assumption that this supports extreme poverty elimination as well as supports extreme poverty elimination as well as wider goal of human development – freedom etc.)wider goal of human development – freedom etc.)

Learning and innovation in each context and to Learning and innovation in each context and to share between contexts – ‘proof of concept’ and share between contexts – ‘proof of concept’ and ‘proof of application’.‘proof of application’.

Hub ModelHub Model

Commissioning Agency

ClientService Delivery Agency

NGO

(Joint Forest Management Committees)

Government

Participation

Agreement Governance & Feedback

Searching for Alternative and Effective M&E SystemsSearching for Alternative and Effective M&E Systems

Conclusion – Aid EffectivenessConclusion – Aid Effectiveness

How are NGOs effective?How are NGOs effective? Debate often ends up in issue of client satisfaction Debate often ends up in issue of client satisfaction

or “accountability to beneficiaries” – how do they or “accountability to beneficiaries” – how do they judge us?judge us?

Concern’s and MANGO’s “Listen First” action Concern’s and MANGO’s “Listen First” action research suggests that revisiting research suggests that revisiting quality of quality of participationparticipation is the key element in making the is the key element in making the organisation more accountable to beneficiaries.organisation more accountable to beneficiaries.

What is our ‘added value’? Surely it is that of What is our ‘added value’? Surely it is that of facilitating change at community level and facilitating change at community level and empowering/building capacity of extremely poor empowering/building capacity of extremely poor people to be able to influence decisions which affect people to be able to influence decisions which affect them and to have greater control over their lives.them and to have greater control over their lives.

EndsEnds

Composition of Civil Society:Composition of Civil Society:   General agreement onGeneral agreement on::

- Religious organisations, churches, temples, mosques- Religious organisations, churches, temples, mosques - Social clubs- Social clubs - Women's groups- Women's groups - Private schools and colleges- Private schools and colleges - Free press and independent media- Free press and independent media - Consumer associations- Consumer associations - Labour or trade unions- Labour or trade unions - Professional associations and cooperatives- Professional associations and cooperatives - Community-based organisations (CBOs)- Community-based organisations (CBOs) - Non-governmental organisations (NGOs)- Non-governmental organisations (NGOs)  Argued overArgued over::

- Tribe, clan (hereditary relations)- Tribe, clan (hereditary relations) - Business/for-profit associations/organisations- Business/for-profit associations/organisations - Political parties (esp. that in a ruling government)- Political parties (esp. that in a ruling government) - Extremist "un-civil" groups such as extremist political - Extremist "un-civil" groups such as extremist political

or religious groups.or religious groups.