This study takes stock of the exponential growth in the number of new civil-society organisations working in the HIV field in East and Southern Africa during the period 1996-2004. Kelly and Birdsall researched this development through a survey of 439 civil-society organisations in six countries and case studies focused on the evolution of community responses to HIV in specific communities in eight countries. The authors describe the types of civil-society organisations that emerged, their relationships with governments and donors, and their activities, organisational characteristics, and funding requirements. The data presented show that the vision of social mobilisation of HIV responses through community-level organisations has faced strong external challenges. Evidence from survey data, national HIV spending assessments, and case studies shows that in some respects the changing international aid environment undermines the prospects for development of the civil-society sector's contributions in HIV responses. Of particular interest is to understand how the "Three Ones" and the Paris Declaration on Aid Effectiveness have reshaped international funding for HIV responses. There has been relatively little attention paid to the impact of the new management and funding modalities - including national performance frameworks, general budget support, joint funding arrangements, and basket funds - on civil-society agencies at the forefront of community HIV responses. Evidence is presented to show that in important respects the new modalities limit the unique contribution that civil-society organisations can make to national HIV responses. It is also shown that the drive to rapidly intensify the scale of HIV responses has involved using community organisations as service providers for externally formulated programmes. The authors discuss this as a strong threat to the development of sustainable civil-society economies as well as to civil-society organisations' diversity and responsiveness. The ways in which civil-society organisations are responding to these challenges are discussed, pointing to possibilities for a new phase of development of the civil-society sector.

Abstract 

If you work at country level, or support those that do; if you are interested in capacity building; or if you want to know how AIDS financing, the Three Ones, and the Paris Declaration on Aid Effectiveness have affected civil society responses to HIV, then this is essential reading for you. Surveys in high HIV prevalence countries (Lesotho, Malawi, Mozambique, Namibia, Swaziland, and Zambia) and case studies in these 6 countries plus South Africa and Tanzania reveal the concerning effects that AIDS funding architecture has had on the work of community- and national-level civil society organisations. A ‘scaling out’ has occurred of medium-sized national non-governmental organisations with long, strong track records that had previously received financial and capacity-building support through direct funding from bilateral donors. Pioneering, ‘on the ground’ civil society organisations, often the heart of the community-driven response reaching those most in need, now have fragile futures due to the unpredictability of funding. Further, that funding does not include investment in basic operating costs, organisational planning, or capacity development. National-level and community-level civil society organisations act predominantly now in service-provision roles, often as sub-contractors without opportunities to develop capacity to design, plan, budget, or implement programmes that are not externally mandated. Clearly, there is a need for long-term strategic thinking at national and international levels about how best to strengthen civil society’s country- and community-level contribution to the response – it is losing its diversity and its voice.