The Nigeria-AIDS eForum A Model for Public Policy Advocacy on HIV/AIDS

The Nigeria-AIDS eForumA Model for Public Policy Advocacy on HIV/AIDS Journalists Against AIDS (JAAIDS) Nigeria 44B Ijaye Road, Ogba, Lagos, Nigeria Web:www.nigeria-aids.org Email:jaaidsng@nigeria-aids.org

Nigeria in profile • 120 million people – Africa’s most populous nation • 70% literacy rate • 60% of population aged 12-35 years old • Large concentrations of highly-populated cities: Lagos (10m), Ibadan (5m), Kano (3m) • Commercial and economic capital – Lagos; political and administrative capital – Abuja • Federal republic with 36 states

HIV/AIDS Situation Source: Nig Health Ministry sentinel survey 2001 • 5.8 percent prevalence: first highly-populated country to cross the 5% epidemiological threshold • 3.5 million people living with HIV: third highest in Africa • Only estimated 10% of PLWA know their actual HIV status • Estimated HIV population by 2005: 4.5 million • Estimated HIV prevalence by 2005: 6.0%

HIV prevalence by states (2001) Source: Nig Health Ministry sentinel survey 2001 Sokoto (2.8%) Katsina (3.5%) Yobe (3.5%) Jigawa (1.8%) Kebbi (4.0%) Zamfara (3.5%) Borno(4.5%) Kano (3.8%) Kaduna (5.6%) Bauchi (6.8%) Gombe (8.2%) Niger (4.5%) Kwara (4.3%) Plateau (8.4%) Adamawa (4.5%) FCT (10.2%) Nassarawa (8.1%) Oyo (4.2%) Kogi (5.7%) Taraba (6.2%) Osun (4.3%) Ekiti (3.2%) Benue (13.5%) Ogun (3.5%) Ondo 6.7%) Edo (5.7%) Enugu (5.2%) Lagos (3.5%) Anambra (6.5%) Ebonyi (6.2%) Cross Rivers (8.0%) Delta (5.8%) Imo (4.3%) Abia (3.3%) Rivers (7.7%) Akwa Ibom (10.7%) Bayelsa (7.2%) < 2.0% 2.0 – 3.9% 4.0 – 5.9% 6.0 – 9.9% > 10.0%

Nigeria vs. global HIV/AIDS burden (2001) Source: Nig Health Ministry sentinel survey 2001 Debriefing of PE Trainers – Survey (1) 1 of every 12 persons living with HIV in the world lives in Nigeria!

National response structure • HIV/AIDS Emergency Action Plan launched in April 2001 as 3-5 year anti-AIDS strategy • AIDS response driven by government through the National Action Committee on AIDS (NACA) • Before 1999, little participation by civil society in policy-making and implementation process • Before 1999, mono-sectoral approach to HIV/AIDS response, driven by health sector only • Multiplicity of NGOs, but most concentrated in capital cities; weak capacity for monitoring oversights • Of recent, greater involvement of civil society in public policy making

Gaps in national response • Poor participation of civil society in policy processes • Decision-making limited to civil service bureaucrats • Policy process heavily influenced by donor agencies and multilateral institutions • National response mechanism not accountable to the citizenry • Weak civil society capacity for effective monitoring of government programmes • Communication seen in terms of prevention information dissemination (IEC), not in terms of accountability • Civil society influence on response structure weak and beggarly

Intervention by JAAIDS Critical question:What platform would allow and provide citizen participation and intervention in the HIV/AIDS policy process in an unfettered and inexpensive manner? Solution: A discussion platform that would provide: • Independence of opinion • Equal status to all participants • Free or cheap to use, easy to join and easy to exit • Multiplicity of perspectives and multisectoral in membership • Participation by the media to provide exposure opportunity and watchdog back-up

Intervention by JAAIDS – cont‘d Solution: An email discussion platform that will be media-driven, commonly-owned and strategically-positioned as a public eye on the national HIV/AIDS response Advantages: • No need for expensive physical structure or membership formalities • Cheap medium (email), free membership • Media capacity, yet not conventional media • Absence of censorship by govt or disgruntled interests • Borderless readership – serving local and diaspora audiences

The Nigeria-AIDS eForum – Humble beginnings • First started in December 1998 as a monthly email bulletin of news and events about HIV/AIDS in Nigeria • Then known as the Nigeria-AIDS Bulletin • Initial subscriber list: 9 persons • Within six months, subscription list grew to over 250 • By January 2000, subscribers grew to 374 • Due to need to better manage the growing list, decision made to transform list into a formal discussion forum • Nigeria-AIDS eForum created on Yahoogroups (formerly eGroups) in January 2000 as moderated discussion list • Over 1300 subscribers by end of 2000

The Nigeria-AIDS eForum – Humble beginnings (2) • In April 2001, moved to own website: www.nigeria-aids.org • Currently, over 3100 direct subscribers (by email): estimated secondary (pass-on) subscribers: 1500 • Estimated web subscribers: 500 • Estimated daily audience: 5000 journalists, activists, policymakers etc in Nigeria and diaspora • Over 3000 messages posted on the eForum since January 2000 till date • Currently, 60% of subscribers work in Nigeria; 40% based in other African countries, Europe and N/America

What takes place on the eForum? Members: • Discuss current issues about HIV/AIDS in Nigeria and abroad • Ask questions on HIV-related events and processes • Seek for information on suitable contacts, resources • Pose queries on any aspects of HIV/AIDS in the country • Post information about themselves or their organisation • Receive reports on new research findings, studies etc • Receive information about grants, resources, job vacancies, conferences, meetings etc • Start or participate in debates on any HIV-relevant issue

Sample of postings to the eForum • “I am worried that government and funding agencies do not see the needs of (orphans) as urgent enough to programme around them, otherwise why is the new policy silent on this issue?” • “We have just launched a website on sex work in Nigeria. The address is…Please feel free to send us your comments” • “The President has just appointed a 35-year old minister for Women and Youth Affairs,…is this a political effort to respond to the call of the youths, or a decoy?” • “We are looking for ideas and suggestions for a new morning programme on TV…or any ideas on the kind of inserts that people would like to watch in the morning?” • “Last year, the federal health ministry announced a treatment programme that would use inexpensive generic antiretrovirals imported from India to treat Nigerians. 10,000 patients were to be treated during the first year, and then the program was to be scaled up. I would want to know what happened to this program?”

How does the eforum run? • It is a moderated forum (postings are edited/vetted for clarity, decency or brevity before being disseminated) • Anyone can post (send a message), including non-subscribers, at no cost • Subscribers receive email messages (average 4 per day) in their email inbox; non-subscribers can read daily postings online on the forum website • Anyone can subscribe, un-subscribe and re-subscribe at anytime and at no cost • Past postings archived on website for easy reference • Anyone can ask any question, start debate on any topic • Moderators are experienced, independent journalists; aligned to no political or commercial interests

How does the eforum run? (2) • Moderators sometimes draw attention to emerging issues or provoke discussion on any issue • Discussions are linked to past or on-going national or international programs; subscribers invited to comment • Moderators sometimes forward asked questions directly to affected officials for comments • Media participation ensures that many discussion themes find their way to the popular press, thus presenting additional pressure points for influence • Discussions also cross-referenced to other related listservs e.g. AF-AIDS, Afro-NETS etc • Operational costs fully subsidised by JAAIDS; completely free of any donor or government interests

What kind of people are on the eForum • HIV/AIDS activists and NGO workers • Journalists and media organisations • Policy makers and government officials • People living with HIV and caregivers • Donor agencies with projects in Nigeria • International NGOs working in and out of the country • Educational institutions and human rights activists • National and international NGO networks • International organisations and UN agencies • Health documentation and resource centres • Donor agencies

Example of public policy advocacy • In August 2001, launched an Open eConference on the eForum to review the Nigerian national AIDS strategy, in collaboration with the National Action Committee on AIDS and the POLICY Project/Nigeria • The Open eConference lasted for six months, and received funding from USAID and the Nigerian govt • 12 discussion themes on current and emerging HIV/AIDS issues in Nigeria were identified through a consultative process and designed, with each discussion period lasting two weeks • Over 170 contributions received from Nigerians and non-Nigerians on the eForum during the period

Example of public policy advocacy – cont‘d • In addition, six Key Correspondents (KCs) recruited to interview and report perspectives of grassroots Nigerians from each of the country’s geo-political zones • The KCs contributed over 40 articles and interviewed over 100 people for their stories • All stories posted on the eForum and website • eConference generated lots of press reaction and follow-up articles appeared in local papers and TV • Summaries of all the discussions were compiled and presented to NACA for action – some already being implemented by NACA and other agencies • Summaries also compiled into a book and widely disseminated among stakeholders

What people say about the eForum(Authentic subscribers‘ comments) • “The eForum has been a significant contributor to education and awareness in the health field “ – Bunmi Makinwa, UNAIDS, South Africa • “The eForum has made Nigeria better known, especially its activities on HIV/AIDS” – OA Dada, Sagamu, Nigeria • “It has been educative, informative and useful” – Funmi Olatunji, Lagos, Nigeria • “It is really informative and covers issues beyond, but which are pertinent to, Nigeria and Africa at large” – Nolwaso Gaza, University of Pretoria, South Africa • “It is truly my most reliable source of current information from individuals on the continent” – Didi Emokpare, Chicago, USA • “It was difficult to stay in touch with events in Nigeria, until I was linked up to this email group. It provides an invaluable resource to me and I am sure to many others” - Pamela Brown-Peterside, New York, USA • “Your discussion forum is remarkable by the wealth of information provided. Congratulations!” - Nance Monot, Switzerland • “The most remarkable thing about the eForum is that it is free! So much information for free…almost unbelievable” – Alash’le Abimiku, Baltimore, USA

Achievements and lessons learned • The Nigeria-AIDS eForum has been widely quoted as a model of a successful country-based advocacy platform • Grant support to the eConference by Nigerian goverment a confirmation of its recognition as a valuable public advocacy tool - “The JAAIDS construct is unique as it employs the eforum as an information exchange platform for HIV/AIDS. This has been recognised all over the world as a best practice…” (Statements from a report by NACA, September 2003) • eForum postings widely quoted in Nigerian press • In 2000, the eForum was overall winning entry at the Highway Africa Award for Innovative Use of New Media • Success of Nigeria-AIDS has influenced several other country-focused listservs e.g. Kenya-AIDS, AIDS-India etc

Achievements and lessons learned – cont‘d • Email networking a marvelous leveler, provides equal pedestal for everyone, also can provide anonymity • Email still an elitist medium – dependent on infrastructure roll-out (PCs, phone lines, Vsat, ISP reliability etc) • Need to open up to audiences outside capital cities – more Key Correspondents? • Ownership of Nigeria-AIDS eForum by journalists an advantage – draws respect and attention of policymakers • Low budget project: 100% of costs borne by JAAIDS • eForum example shows that even a low-usage media (email) can be deployed for public policy intervention • Points to the need to intensify roll-out of internet technology outside capital cities, to villages and hamlets

Background - Journalists Against AIDS (JAAIDS • Established as a media-based NGO in August 1997, fully operational and registered November 2000 • Mission:To provide innovative communication interventions that will facilitate positive behavior change to reduce the spread of HIV/AIDS in Nigeria/Africa • Objectives: • Promote informed discourse on issues related to HIV/AIDS and reproductive health in the media • Promote and ensure a culture of transparency, accountability and inclusiveness in the national response to HIV/AIDS • Provide HIV/AIDS information needs of the media and other members of the public • Promote participation of citizenry in HIV/AIDS policy development and implementation processes

Background - Journalists Against AIDS (2) • Email discussion forum - the Nigeria-AIDS eForum - is our most popular project, but complements other media-focused and advocacy projects, including: • An advocacy project to drive implementation of access to HIV/AIDS care and treatment policies in Nigeria • A project to curtail stigma and discrimination against PLWA in the media • Multi-level training programmes to improve quality of media coverage of the epidemic • Establishment of first-ever Media Resource Centre on HIV/AIDS and reproductive health in Nigeria • Launched website www.nigeria-aids.org that has become reference online resource centre for HIV/AIDS in West Africa

Thankyou - Merci beaucoup Visit the Nigeria-AIDS eForum at: www.nigeria-aids.org

The Nigeria-AIDS eForum A Model for Public Policy Advocacy on HIV/AIDS