AIDS, Community Resilience and Social Protection: Random Thoughts & Lots More Questions!

1. AIDS, Community Resilience and Social Protection:Random Thoughts & Lots More Questions! Stephen Devereux IDS Sussex

2. Introduction • Communities are often described as the strongest link in supporting PLWHA. • Paradoxically, communities are often the weakest link in both our understanding and our response. • Understanding “community resilience” requires defining and disaggregating communities. • Improving “social protection” responses requires building these insights into programming.

3. Defining “Community” [1] • A group of people living together (eg Heia Safari Lodge 12–14 March 2007)Defining feature = proximity • A group of people who share common interests or characteristics (eg. TAC, Heia Safari Lodge)Defining feature = affiliation When we use the term “community” we usually mean “proximity”. We should not underestimate the importance and power of “affiliation”.

4. Defining “Community” [2] “Affiliation communities” – common experiences, shared aspirations, mutual support, mobilisation for collective action around collective goals. “Proximity communities” – economic inequality, social stratification, power hierarchies, exclusion and marginalisation of vulnerable members. The naïve but pervasive assumption that “proximity” equals “affiliation” has: (1) undermined more sophisticated understandings of the complexity of real–world communities; (2) led to sub-optimal policy prescriptions and failed interventions.

5. Disaggregating “Community” [1] 1. Gender and Age: • “Extended women”: sub-groups within communities provide most care for the ill and orphaned. • Male resistance to behavioural change is often a major driver of continued transmission of HIV. • Selected age cohorts are often the most vulnerable (children, youth, older people) A fully gender-disaggregated approach to HIV & AIDS is needed, at household and community levels. Alternatively, a “cohort-disaggregated” approach may be needed: Women, Children, Youth, Men, Older people.

6. Disaggregating “Community” [2] 2. “Class positionality” What happens to “moral economy” and patron-client relations as HIV–prevalence spreads? Most social capital is “horizontal” (poor-to-poor). Most “vertical” social capital (rich-to-poor) is exploitative. • Patron is HIV–affected: Vulnerability of clients increase, because their social capital declines. • Client is HIV–affected: Need for assistance rises: (1) “Altruistic patron” might assist (up to a point); (2) “Instrumentalist patron” will not assist.

7. Disaggregating “Community” [3] 3. Social structure • The “Good” community [people share food] • The “Bad” community [people hide food] • The “Non”–community [urban alienation] • The “Mobile” community [high migration] • The “Resilient” community [“coping”] • The “Collapsing” community [“not coping”] = The “Changing” community [i.e. all !]

8. Implications for Response [1]Multi–sectoral impacts of HIV & AIDS =Multi–sectoral needs for social protection HIV & AIDS Livelihoods Demography Economy Social/ Political SOCIAL PROTECTION

9. Implications for Response [2]Multiple levels of HIV & AIDS impacts =Multiple levels of social protection needs HIV & AIDS Individual Household Community National SOCIAL PROTECTION

10. Implications for Response [3] • Communities are not homogeneous and are not amenable to simple generalisations. • Vulnerability / resilience varies within communities, across communities, and over time. • Action research should map community “typologies” onto dynamic trends in HIV–prevalence, and track how communities (or sub-groups) respond over time. • Track key determinants of vulnerability or resilience at community level: (1) Demographic structure? (2) Material resources? (3) Social cohesion? • Link community research to community response.

11. Implications for Response [3] Challenges for “scaling up”: • Impacts are felt at individual, household and community levels. • Most successful responses (local NGOs, CBOs, FBOs) have been at community level. • Don’t lose the advantages of interactions with communities, by “scaling up”. • Replicate!