What have we learned? How can we move forward?

1. What have we learned?How can we move forward?

2. Charity may be abolished.It should be replaced by justice. - Norman Bethune

3. Civil society organisations Political economy context Globalisation Neo-liberal economic policies Social-cultural system; Forms of collectivity, traditions, social power, marginalisation Health sector HIV AIDS Social capital Levels and forms of economic development in various countries

4. Taking the long view – some overall concepts • The HIV/AIDS epidemic is one of the crisis points in complex, multi-level political-economic-social systems • Single-focus, linear or single level intervention will not work. • Short term approaches may not be sustainable and genuinely effective approaches may not yield short–term results • Crystallisation of mutually reinforcing multi-level action stretching across levels is required. • Cross-level social solidarity is a key ingredient and catalyst though not a ‘magic bullet’

5. The political economy context • Human society in the late 20th century and early 21st century is in a state of tremendous flux. Corporate globalisation and neo-liberal economic policies have led to massive social impacts • Weakening of traditional communities: migration, commercialization of local economy, privatization and erosion of community resources • Growing inequities within communities and in societies as a whole • Weakening of public institutions and services which help to anchor social capital • Now the ‘tide is turning’ and opportunity to roll back neo-liberalism

6. The social-cultural context: Communities • Collectivity in traditional communities had certain protective features; however these were unequal and often restrictive too • Now traditional communities are weakening, however cultural values of solidarity and compassion do exist • ‘New collectives’ can emerge from the womb of the old as in case of tribal people’s organisations in India; traditional solidarity combined with greater internal equity and democracy

7. The social-cultural context:Marginalisation • Growing social inequities, expansion of the informal sector contribute • Patriarchy and gender inequities reinforce marginalisation of specific groups which are at risk of HIV: CSWs, MSM, positive women • Reversing marginalisation essential for greater inclusion of such groups – combination of empowering groups and sensitising larger society • ‘Shifting the entire curve’ rather than only targeting groups

8. Civil society organisations • Need to differentiate among a wide range of CS organisations • Spectrum of basing on community-rooted resources and initiative vs. external resources and initiative • Membership organisations and funded NGOs as two ‘types’ with intermediate forms • Each have specific role to play, but long term sustainability of community based organisations likely to be higher

9. Role of the Health sector • Re-orienting health services and re-claiming the health system to deal with HIV/AIDS: health rights of PLWHA • Need for strengthening of public health system along with structured accountability mechanisms e.g. community monitoring • Public health system as a site to strengthen social capital • Need for long term alliances between HIV/AIDS groups and Health groups towards establishing Health rights and strengthening health systems

10. Some features of effective Rights-based responses • Rights-based responses - SANGRAM, Sonagachi, TAC • Context of social organisation for rights, larger socially conducive setting • Strong collectives of directly affected persons • Able to open up spaces at larger level due to strategic alliances

11. Crystallisation of social capital • Support to existing community initiatives, groups and community-based organisations • Rights as a focus for bonding, bridging and linking social capital • Local spaces need to be linked with spaces in the system for larger change • ‘Creative conflict’ may play a role in opening up and using spaces in the system • Combination of rights based struggles with creative alternatives

12. Politics • Power • Public systems • People and people’s organisations • Progressive social change

13. If there is no struggle, there is no progress. Those who profess to favor freedom, and yet deprecate agitation, are men who want crops without plowing up the ground. They want rain without thunder and lightning. They want the ocean without the awful roar of its many waters. This struggle may be a moral one; or it may be a physical one; or it may be both moral and physical; but it must be a struggle. Power concedes nothing without a demand. Frederick Douglas