is considerable debate and enquiry concerning the most
effective communication strategies for addressing HIV/AIDS
issues. James Deane, Executive Director of The Panos
Institute, prepared a background paper on this theme for the
for Development Roundtable, held in Managua, Nicaragua,
Nov 26 - 28 2001, and hosted by UNFPA. Links below are to the
relevant sections of the paper.
We are interested in both your reactions and your perspectives
on the most effective HIV/AIDS Communication. See the end of
the issue for initial questions and how to contribute.
WHAT'S NEW, WHAT'S NOT?
1. The last 2 years have seen intense debate over
different approaches to HIV/AIDS communication. In particular,
there has been a growing questioning of social marketing and
behaviour change oriented communication... two
developments...have focused debate on this area,
the...publication of a new framework on Communication produced
by UNAIDS, [and]...the work of the Rockefeller Foundation
[Communication for Social Change (CSC)]...
2. The UNAIDS Framework calls for refocusing
communication interventions on the basis of 5 key contextual
domains: (1) government policy, (2) socio-economic status, (3)
culture, (4) gender relations, and (5) spirituality. [It]
calls for moving away from individual-level theories and
models of preventive health behaviours...to more multilevel,
cultural, and contextual explanations and interventions...
3. The principles and approach of CSC have been
summarised as moving communication frameworks on
HIV/AIDS...away from people as the objects for change...on to
people as the agents of their own change; away from designing,
testing and delivering messages...on to supporting dialogue
and debate on the key issues of concern; away from a focus on
individual behaviours...on to social norms, policies, culture
and a supportive environment; away from technical experts in
"outside" agencies dominating the process...on to
the people most affected by the issues of concern playing a
SO, IS THIS NEW & DOES IT MATTER?
4. Specific criticisms of these approaches tend to fall
into 4 areas:
- Participatory, people centred communication has
been at the core of most mainstream communication thinking
and practice for many years...
- Some of these arguments are creating artificial
boundaries between different approaches and schools of
thought in communication...
- While the UNAIDS & Rockefeller...arguments
have emerged largely from practitioners on the
ground...they are weak when it comes to backing [them] up
with rigorous academic analysis, modelling and theory...
- Many of the ideas in documents such as the UNAIDS
Framework are difficult to translate into practice on the
ground, particularly within the setting of large
5. Proponents acknowledge some of these criticisms. Nevertheless, they
- Both the UNAIDS & Rockefeller processes were
centred on largely southern based, grassroots and civil
society focused and driven debates...[and] they appear to
have revealed a "disconnect" between funding and
some international agencies, and indigenous organisations
working on the ground...
- Systematically putting the principles of
participatory communication into practice on the ground
continues to be rare and much HIV/AIDS programming has
been highly vertical...
- Unless developing country societies and
communities are setting and driving the underlying
processes of change that are necessary to confront this
epidemic...future progress...is unlikely to be
- There is increasing interest in learning from and
adapting the rigorous thinking that goes into behaviour
change oriented interventions to communication for social
- CSC is suggesting a major change in approach
which involves institutions surrendering their agendas...
- Many communication initiatives are overly focused
on the symptoms of the HIV/AIDS pandemic (sexual
behaviours), rather than the underlying causes
(discrimination, marginalisation, disempowerment,
A CHANGING ENVIRONMENT
6. Although communication technologies have dominated
the discourse around recent developments in information and
communications, there have [also] been fundamental changes in
the wider communication environment...
- New technologies, principally in the form of the
internet and mobile telecommunications, are creating new
opportunities for disseminating information...
- A major liberalisation of the media in the
developing world, transforming...print and broadcast media
from a largely government owned, monopolistic and
uncreative environment to a more dynamic, popular,
democratic, creative and complex one...
- Liberalisation has led...to the emergence of [a]
consumer led...urban centred communication infrastructure,
one...less interested in the concerns of the poor,
and...decreasingly interested in providing news and
information to its audiences...
- State run broadcasting systems have found it
difficult to transform...into public broadcasting
- Globalisation and transnational ownership of the
media is resulting in...increasing numbers of mainstream
developing country media institutions being bought by
- Women continue to suffer marginalisation in and
from communication networks...
HIV BECOMES POLITICAL AGAIN: TREATMENT, STIGMA, MEN
7. Since the beginning of the epidemic... civil society
and AIDS support organisations in developing countries have
struggled to make their voice heard internationally... [and
unlike those formed around issues of women's rights, an]
international HIV/AIDS civil society coalition has not
emerged...perhaps because there was not a clear issue around
which concrete demands for action could be made...
8. At the end of the 1990s, that issue potentially
emerged in the form of access to treatment for HIV/AIDS.
Arguably for the first time, organisations in the South were
able to set their own agenda, demands and priorities...
Millions of people in South Africa, Brazil and elsewhere
who...formerly regarded the issue of HIV/AIDS as one of public
health and sexual behaviour have been drawn into a debate
marking it out as an issue of economic justice and human
rights. International lobbying has led to...concessions by
international pharmaceutical companies to reduce the prices of
ARVs and...to...concessions over intellectual property rights
at the WTO.
9. A growing movement to confront HIV/AIDS related
stigma is taking on a new profile and energy. UNAIDS has
designated the issue as the focus of the next World AIDS
CHALLENGE: IMMEDIATE ACTION OR NECESSARY REFLECTION?
10. 2 responses are facing communicators:
- The "emergency" response - the epidemic
is now so devastating that we need to rapidly scale up the
time, resources and energies putting the strategies we've
already developed into action on the ground, and less time
- Reflection leading to long term strategic action
- it is the demand for quick, measurable results that has
created a field made up of large, donor driven, top down
communication interventions which have...proved both
unsustainable in securing behaviour change and have not
addressed the underlying causes of the epidemic...and,
that the increasing complexity of developing country
societies, prompted by greater liberalisation, and more
complex media systems and horizontal communication
patterns in society demand fresh thinking and approaches.
SHOULD WE ACCELERATE AN EMERGENCY RESPONSE? OR IS IT TIME TO
ASSESS THE STRATEGIES USED SO FAR?
SHOULD WE CONTINUE WITH A PREDOMINANTLY BEHAVIOURAL APPROACH
WITH AN EMPHASIS ON SEXUAL BEHAVIOUR? OR SHOULD WE EXPAND THE
CULTURAL AND CSC BASED STRATEGIES PROPOSED BY THE UNAIDS &
DOES THE CHANGING COMMUNICATION ENVIRONMENT IN MOST COUNTRIES
DEMAND A CHANGE IN STRATEGY? OR CAN WE ADAPT THE PRESENT
STRATEGIES TO THAT NEW ENVIRONMENT?
SHOULD HIV/AIDS COMMUNICATION STRATEGIES BECOME LESS OR MORE
Have you discussed these issues within your organisation? We
would like to know your thinking. Please send insights to
Warren Feek email@example.com
Drum Beat seeks to cover the full range of communication for
development activities. Inclusion of an item does not imply
endorsement or support by The Partners.
Please send material for The Drum Beat to the Editor - Deborah