This strategy paper takes stock of “best practice” experiences in supporting communities in their response to HIV/AIDS in several countries in Africa. It draws lessons from Burkina Faso, Côte d’Ivoire, Guinea, Malawi, Nigeria, and Tanzania and sheds light on methods that a growing number of organizations and individuals use to foster behavior change among people living in rural areas.
A fundamental lesson of integrated rural development projects of the 1970s and 1980s needs to be taken into account: it is impossible to successfully implement multi-sectoral programs by relying on central sector agencies and central coordination. Instead, such programs must be coordinated at district level and be executed by or in collaboration with communities. A truly national HIV/AIDS program is, in effect, a multi-sectoral one with several components executed by many actors. Local partnerships, consisting of key groups from the community, service providers and facilitators, should therefore plan and execute their own HIV/AIDS programs, combining their own resources with matching grants from donors or their own governments. These partnerships should obtain training and technical services from government agencies, the private sector, and NGOs.
The success stories presented in this paper are consistent with this lesson and prove that it is both possible and promising to implement HIV/AIDS programs that include several components and multiple sectors at the community level. The next challenge is to implement the recommendations outlined in this paper on how to scale-up the existing programs to the national level. This daunting goal can only be achieved if governments and international donors are willing to empower communities and their local governments with training and financial resources and then let them manage the local response.