Swedish-Norwegian Regional HIV/AIDS Team for Africa · 2 Getting Representation Right: Lessons from...

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©Copyright NAP+SAR 2010

Swedish-Norwegian Regional HIV/AIDS Team for Africa

NETWORK OF AFRICAN PEOPLE LIVING WITH HIV/AIDS FOR SOUTHERN AFRICA REGION

‘Getting Representation Right’

Lessons from PLHIV Experience on Global Fund Country Co-ordinating Mechanisms

& National AIDS Councils in Southern Africa

ACKNOWLEDGEMENTS

This report was compiled by workshop facilitator Sizakele Hlatshwayo and edited by Lisa O’Shea and Thanduxolo Doro. NAP+SAR would like to thank the Big Lottery Fund, SIDA, the Norwegian Ministry of Foreign Affairs, the Southern African AIDS Trust and Skillshare International for their generous support which made this workshop and report possible. The contents are the responsibility of NAP+SAR and do not necessarily reflect the views of our donors.

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Getting Representation Right: Lessons from PLHIV in the Global Fund CCMs and NACs in the SADC Region 1

Table of Contents

Page

Foreword from NAP+SAR’s Executive Director .................................................................................. 2

Abbreviations and Acronyms ................................................................................................................. 3

Executive Summary ................................................................................................................................. 4

Introduction .............................................................................................................................................. 5

Aim ............................................................................................................................................................. 6

Methodology .............................................................................................................................................. 6

Summary of Presentations ...................................................................................................................... 7

Sharing of Experiences ............................................................................................................................ 8

Key Issues for Advocacy Action & Recommendations ..................................................................... 10

Lessons Learnt ........................................................................................................................................ 13

Way Forward ........................................................................................................................................... 14

Feedback from Participants on the Workshop ................................................................................... 14

APPENDICES

Appendix 1: Presentations ..................................................................................................................... 16

Appendix 2: Programme ....................................................................................................................... 26

Appendix 3: List of participants ........................................................................................................... 28

Getting Representation Right: Lessons from PLHIV in the Global Fund CCMs and NACs in the SADC Region2

FOREWORD

In Southern Africa we are faced with what seems like an unbeatable epidemic. HIV and AIDS are severely affecting our communities and damaging the very social fabric which holds us together. It can take all of our energy just to deal with that impact. Globally the SADC region has the highest number of people living with HIV and AIDS(PLHIV) yet their voices are not heard in the decision making process. Yet PLHIV must be at the heart of efforts to influence the global agenda and resource allocation.

The Meaningful Involvement of People living with HIV/AIDS (or MIPA) is a widely acknowledged global principle but its real-world application is sadly diminished by what can be tokenistic participation by PLHIV in meetings or committees. In such settings the lone voice of a PLHIV can be lost amidst the scientific and governmental wrangling.

In recognition of this NAP+SAR has committed to develop PLHIV leadership in order to change the status quo. We have committed to increasing PLHIV influence in decision-making by engaging, training and coaching PLHIV leaders. This process focuses on understanding roles and responsibilities and on how to make represen-tation more effective, not only in any setting, but especially in National AIDS Councils (NACs) and Country Co-ordinating Mechanisms (CCMs) for the Global Fund.

We need skilled and seasoned advocates from the South and from within the borders of Southern Africa. This workshop was one attempt at building the capacity of PLHIV networks in order to ensure that the voices of PLHIV in Southern Africa are heard loud and clear.

In this document you will clearly hear the voices of PLHIV who represent communities on CCM and NAC boards across Southern Africa during this regional workshop organised by NAP+SAR. I would like to ac-knowledge and thank SIDA and the Big Lottery Fund for their support which made the training and this sub-sequent report possible.

To the leaders of AIDS service organisations we say ‘PLHIV representatives are our voices so please give them your support’. These representatives do not need home-based care but moral and technical support in meetings where they can advocate on behalf of others for improved home-based care amongst other things. We thank you for according them positions and we are encouraged. But as this report identifies, more needs to be done, for example, by supporting pre-meetings for each PLHIV representative to consult their constituency prior to meetings and to give space for feedback afterwards.

With the right skills we can put pressure on decision-makers at all levels to bring about the changes we need. By appropriately using influence, be it through representation or lobbying, we can make the case for change. So delivering better advocacy will in turn deliver better results for our communities. Stronger and more vocal communities mean together we can fight the epidemic head-on.

I hope that this text brings home some of the experiences and lessons learnt in the region, and, that it can pave the way for improved representation of PLHIV in the future. Happy reading!

Jefter MxotshwaNAP+SAR Executive Director


ABBREVIATIONS AND ACRONYMS

AIDS Acquired Immune Deficiency Syndrome

ART Anti-retroviral Therapy

BONEPWA Botswana Network of People Living with HIV and AIDS

CSO Civil Society Organisation

CCM Country Coordinating Mechanism

HIV Human Immunodeficiency Virus

LENEPWHA Lesotho Network of People Living with HIV and AIDS

LIRONGA EPARU Namibia Network of People Living with HIV and AIDS

MDG Millennium Development Goal

MIPA/GIPA Meaningful/Greater Involvement of People Living with HIV and AIDS

NAC National AIDS Council or Committee

NAPWA National Association of People Living with HIV and AIDS (South Africa)

NAP+SAR Network of People Living with HIV and AIDS in the Southern African Region

NGO Non-governmental organization

PLHIV People Living with HIV and AIDS

PMTCT Prevention of Mother to Child Transmission

RENSIDA Mozambique Network of People Living with HIV and AIDS

SASO Swaziland AIDS Support Organisation

SIDA Swedish International Development Cooperation Agency

SWANNEPWHA Swaziland Network of People Living with HIV and AIDS

UNAIDS Joint United Nations Programme on HIV and AIDS

UNGASS United Nations General Assembly Special Session on HIV and AIDS


EXECUTIVE SUMMARY

PLHIV involvement has been one of the cornerstones of Global Fund practice and NACs have made similar stipulations. Theoretically this is to allow PLHIV to influence decisions affecting their constituency and to ensure that the issues affecting PLHIV are fully addressed. Over the years, however, it has been observed with concern that PLHIV representation was often an act of window dressing. Many PLHIV felt that they did not meaningfully engage with the process enough to influence the outcome of decisions.

The shared experience of the PLHIV workshop participants from across Southern Africa of the Global Fund and NACs certainly reflected this sentiment. This was attributed to a number of reasons including capacity to comprehend issues that are discussed in the CCM and NAC meetings, limited understanding of the role of a representative and the ensuing difficulty in reporting back to representatives’ constituencies. The latter is one of the most common criticisms laid against CCMs representatives by their communities.

Another challenge faced by PLHIV is the access to the Global Fund itself; during the workshop it was reported that often funds were used mainly for programmes which were not priority areas for PLHIV. Although PLHIV are critical to the regional and national response to HIV and AIDS pandemic, it is disheartening to note that country networks do not have control over funds which will impact greatly on them. For instance, although the Global Fund guidelines call for meaningful participation of PLHIV there is no network in the SADC region that is yet a principal recipient of the Fund.

Advocacy is instrumental to bring about change and, if governments and international agencies are to adhere to the Global Fund requirements, there is a need for a vibrant movement that will mobilise PLHIV and call upon governments and multinational agencies to properly address PLHIV needs. However PLHIV in the region seem to be dormant, often because of fatigue, burn-out and staff turnover. This silence is a major cause for con-cern since nothing will change unless the people at the forefront of the epidemic can make their voices heard. In doing so it is critical to know how to convey messages without bringing in emotions which could cloud the real issue at hand. PLHIV have been accused of reactionary responses and of bringing emotions to the table which has contributed to mixed receptions and some scepticism from other partners.

Having come thus far, there is a dire need for PLHIV to take stock of the achievements, challenges, constraints and strengths of approaches employed by all involved. PLHIV must be at the heart of efforts to influence the HIV/AIDS agenda and resource allocation. Communities are reclaiming their role and sending out a clear mes-sage; ‘It is not enough for PLHIV to be present in a tokenistic manner.’

Advocacy is critical to bringing about change, and seats on Global Fund and NAC bodies present a vital influ-encing opportunity. With the right skills and an enabling environment PLHIV can collaborate with decision-makers at all levels to tackle the epidemic.

Donors, NACs and the Global Fund must support PLHIV representatives to meaningfully participate and PL-HIV networks must address internal shortcomings. Getting representation right is the first step in getting bet-ter outcomes for our communities.


1 UNAIDS 2007 AIDS Epidemic Update2 UNAIDS2006ReportontheGlobalAIDSEpidemic,CountryProfiles

1.0 INTRODUCTION

The Network of African People Living with HIV in the Southern African Region (NAP+SAR) hosted advocacy workshops for Southern African members of networks of people living with HIV and AIDS, from the 28th of June to the 2nd of July 2010 at Esibayeni Lodge, Matsapha, Swaziland. This was a regional advocacy initiative which it was hoped could act as a pilot workshop for replication in other SADC countries and to leverage future programming. Two workshops were held concurrently and this report documents Getting Representation Right: Lessons From PLHIV Experience on Global Fund Country Co-ordinating Mechanisms & National AIDS Councils in Southern Africa’. Representatives came from six countries, namely Botswana, Swaziland, Lesotho, Namibia, Mozambique and South Africa. The second workshop was entitled Advocacy And Media Training For Networks Of PLHIV: Lessons And Resources From Southern Africa’ and it is documented in a separate report.

Context

According to 2007 statistics an estimated 33.2 million people around the world were living with HIV, includ-ing the 2.5 million people who acquired HIV in 20071. Sub-Saharan Africa remains the most seriously affected region and is home to about 22.5 million people living with HIV, with AIDS remaining the leading cause of death in the region. The Southern Africa region is the most severely affected within Sub-Saharan Africa. The 2007 UNAIDS report shows that this sub-region accounts for 35% of all people living with HIV and 32% of new infections and deaths. National adult HV prevalence exceeded 15% in eight Southern African countries in 2005. Prevalence rates are at their highest in Swaziland (33.4%), Botswana (24.1%) and Lesotho (23.2).2 In Mozambique (16.1%) the epidemic has again started to increase after appearing to stabilize in the early 2000s. South Africa is the country with the highest number of HIV infections in the world with over 5 million people living with the disease.

As the regional network in Southern Africa NAP+SAR facilitates capacity-strengthening across its 10 national network affiliates which are Angola, Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swazi-land, Zambia and Zimbabwe. NAP+SAR believe that ‘ensuring influence by people living with HIV and AIDS in HIV/AIDS responses and decision-making in the region’ is the best long-term way to help communities affected and infected by HIV and AIDS. NAP+SAR is committed to strengthening the advocacy capacity of national networks to enable them to bring about meaningful change in their communities and countries through effec-tive influencing.

Without sufficient skills the national networks of PLHIV cannot effectively influence either community, na-tional or regional decision-makers. Amongst the core functions of NAP+SAR regional secretariat is the provi-sion of technical support to national networks. This is to ensure that they have the requisite skills and capacity to enable them to meet their obligations as national networks and be accountable to their members. In sum-mary NAP+SAR’s aim is to bring about a strong voice PLHIV and to build their visibility. Advocacy capacity strengthening is a vital means of achieving this goal.


AIM

The primary aim of the workshop was to empower the CCM and NAC representatives of PLHIV to meaning-fully represent their communities.

The 12 participants for this workshop were drawn from leadership of each of the national networks mentioned above. These individuals represent PLHIV in policy decision-making structures, particularly on NACs and CCMs. There were two representatives at least from each country, save for Namibia.

The main topics covered included:

• Sharing ethical considerations of a representative

• Understanding what is expected of a leader

• Building competencies to influence decision-making processes

• Planning a regional lobbying reference group of PLHIV and country reference groups that are inclusive of all national PLHIV groupings

• Enhancing capacity for systematic approach to representation:

0 Understand steps in the process

0 Identify advocacy issues that require action

0 Develop goals and objectives and action plan.

• Developing practical advocacy skills:

0 Identify and understand target audiences for advocacy efforts

0 Understand what makes for effective influencing

0 Practice developing and delivering effective influencing strategies for face-to-face communication

0 Resource tracking (monitoring allocation of budget and follow-up activities, access records and reports and giving feed-back to constituency of PLHIV

METHODOLOGY OF THE WORKSHOP

The workshop was highly participatory, allowing attendees to share their experiences and learn from each oth-er. Formal presentations were made on technical issues and participants were given an opportunity to engage with the issues through plenary discussions. Group work, often in national clusters, also provided a platform for learning and sharing in smaller groups to allow all the space to debate.


2.0 PRESENTATIONS

The outputs of the workshop were informed by the following plenary presentations.

2.1 Background to Global Fund by Thembi Nkambule, SWANNEPHA

The aim of the session was to outline the origins of the Global Fund and to make participants aware of their own advocacy role in ensuring adherence by all stakeholders. This session also formed the basis of all discussions held during the duration of the workshop.

Thembi Nkambule, the Executive Director of SWANNEPHA, gave a short background to the Global Fund. She explained how PLHIV have been involved in the development and initiation of the Global Fund since April 2001’s ‘Abuja Declaration’. She outlined the timelines of PLHIV involvement in the Global Fund Events since 2001 to November 2004 when CCM requirements indicated that there should be proven involvement of PLHIV in the CCM of every country before the Global Fund grants could be approved. In concluding her presentation she asked salient questions which formed a solid framework for the workshop:

Questions to ponder:

Below are questions to ponder that formed the basis of the discussion for the workshop:

(i) Whilst we are sitting in the CCMs/NACs are we doing enough?

(ii) Are we representing the people?

(iii) Are we doing what we are supposed to be doing?

(iv) In the CCMs/NACs are our voices heard-government always brings the Principal Secretaries/Permanent Secretaries and we are junior people- are we doing enough to ensure that our voices are heard, if they are, are they at the same level?

(v) Our representatives are hand-picked by government – are we not missing out on the people who have been hand-picked because we shun them but if we do not engage them, who is going to push our agen-das?

(vi) We need to find ways of supporting and keeping the momentum – do we give the representatives the necessary support or are we just criticising them and making their work more difficult?

(vii) What have we achieved after 10 years with the Global Fund?

(viii) In some countries it is still debated if PLHIV should even sit in the CCM/NAC, in this context what are we doing about it?

(ix) Information sharing – why are we not sharing amongst ourselves?

(x) Do PLHIV representatives at CCMs and NACs meet with constituencies to share their experiences?

(xi) Are we documenting our successes and experiences on how we have influenced the national response to HIV and how we have managed to move-on regardless of the challenges?

(xii) The internal squabbles within our networks- we normally have issues amongst ourselves-the governance issues which then lead to the partners not believing in the network or having a justification for not sup-porting the network, how are we going to harness that?


(xiii) We have the CCMs/NACs through which we can raise our issues:

• If we have only one person representing us there, is it possible for that person to raise the issues ef-fectively?

• If we don’t support that person inside the CCM/NAC, will that person manage without our sup-port?

• We need to work on our governance issues to ensure that we are not ridiculed by our partners

• We are not receiving money from global fund – Swaziland is not the only network that is not receiv-ing the Global Fund money but we are not talking about it in our CCMs/NACs.

2.2 Global Fund Structures and Guideline – by Vulindlela Msibi, Executive Secretary, CCM Swaziland

The aim of the session was to take participants through the structures of Global fund for participants to appreciate on what grounds are they in the CCM and also to share the guidelines required for accessing the grant and the roles and importance played by PLHIV in all the processes.

Vulindlela Msibi from the Swaziland Global Fund CCM Secretariat presented on the Network at the Global Fund CCM. He outlined the composition of the CCM representatives and tried to answer some questions raised by representatives sitting in the CCMs of different countries.

He also outlined how the CCM operates and power limit of the CCM and its secretariat due to the agreement which lies between the Global Fund Board and Principal Recipients (PR). He also touched on how the Global Fund works to avoid conflict of interest among some PRs and Sub-recipients

2.3 Ethical Considerations of a Representative – by Zanele Dlamini, SINAN Director

The aim of this session was to assist CCM/NAC members understand the importance of ethical issues as represen-tatives of their different networks to ensure that there are no conflict of interest between them their members and partners, how to maintain an objective position, the dangers and tips that can assist members to present their cases without being emotional

Zanele Dlamini’s presentation focused on the leadership qualities of both CCM and NAC representatives. He underlined the importance of being prepared and of making evidence-based and informed decisions when representing people on different bodies.

3.0 SHARING OF EXPERIENCES ON SERVING ON CCMS AND NATIONAL AIDS COUNCIL (NACS)

All National AIDS Council and Global Fund CCM representatives from the six different countries were given an opportunity to share their experiences of serving in these bodies. Their experiences were as follows:

Background to CCM/NAC involvement by networks

Participants felt that some of the challenges faced by networks in the CCMs/NACs were due to the manner in which they came to be in the boards and CCMs. Countries had different experiences as to how they became members of the CCMs and NAC boards.


In most countries there were no networks, but different organisations working on HIV and individuals who had disclosed their status. They were hand-picked to be part of the CCM, in essence they were not representing their constituencies but themselves. There are those countries where networks were already in existence like South Africa. In Botswana although there was no network individual PLHIV were very active in advocacy work.

In Namibia, the network was very active, but when Global Fund money came they were told there was no mon-ey for coordination, then the network was faced with serious challenges. They are in the process of addressing these with the support of NAP+SAR.

Challenges of serving in the CCM and the NAC

• Understanding documents and technical reports in the CCM was cited as a key challenge. Some narrated how they were serving as co-chair of the CCM but struggled to understand the CCM language and others were reluctant to continue attending meetings.

• In Mozambique for instance the case is worsened by the fact that CCM meetings are held in English despite the fact that the majority of people speak Portuguese. The reason cited is that they are accommodating in-ternational officers who are part of the CCM.

• Not having a platform to engage with constituency members was cited as a challenge. This deprives members of an opportunity to give feedback on the CCM deliberations and get guidance from commu-nity members.

• Confusion over particular roles on the CCM was another issue that affected representatives. An instance was shared of one country where representatives were informed that they are actually serving on their behalf but not as representative of the PLHIV community.

• Some representatives felt that CCM responsibilities have added an additional work burden to their daily work and feel overwhelmed.

• Not being able to influence the agenda of CCM or NAC meetings is a key challenge to a number of rep-resentatives. They shared that in most cases the agenda is drawn up without their input.

• PLHIV may be competing against one another and it can be difficult to speak with one voice and push for one agenda. For example, some organisations are pushing their own agenda, this is frustrating to the CCM representative who speaks on behalf of everyone and also opens room for criticism from partners that the PLHIV is not united.

• Members feel that it is not easy to raise an advocacy issue either as a board member or as a CCM repre-sentative. Those who have tried to do so were told it is not the right platform, yet they do not know any other channel through which they can table their issues. Many felt that this showed there is a need for more education on the exact role of representatives.

• To counter this Mozambique shared their method which involves insisting on having time to consult with their constituencies before signing, no matter how late it is in the process. They do this at an over-night retreat to look at the documents (which are written in English)to translate and to make inputs. This was found to be good practice that could be replicated in all other countries, where possible.

• Misdirection of Global Fund money by NACs: PLHIV expressed concern over the creation of new in-stitutions in the form of NACs with a large fleet of cars and huge administration staff, whilst traditional PLHIV structures are left to disintegrate.

‘I am not proud to be infected but I am proud to be doing something to

make a difference’


4.0 KEY ISSUES FOR ADVOCACY ACTION & RECOMMENDATIONS

Deliberations at the workshop raised a number of issues and concerns including; capacity issues, relationships with governments and partners (including other civil society organisations), governance issues within networks and also areas for programming at national and regional level. Below is a summary of the issues raised. Each country then developed an advocacy plan based on critical areas identified in their countries.

1) Lack of clear understanding on the Global Fund Processes

• The meeting observed that they knew little about the background to Global Fund and that the processes and guidelines are opaque to most PLHIV. They felt that information about the Global Fund was not popularised. Without this knowledge the PLHIV cannot verify if the guidelines are being followed.

• The role of the CCM remains unclear to network members. It needs to be unpacked to allow network members a true greater and meaningful involvement.

2) Accountability of CCM representatives

• Accountability of representatives was highlighted as a critical issue. It is not clear to whom the CCM members are accountable and seemingly there is no platform for them to share their CCM experiences with their constituencies or to get a mandate for these constituencies.

• The method of election of CCM representatives can be problematic. Some are elected and some are appointed. However when members are appointed by their government it becomes difficult for them to be accountable to their members or critical of government.

• Recommendation: Since NAPSAR is a regional organisation and sits at SADC level, it is bet-ter placed to advocate for election methods for representatives other than by appointment to ensure representatives are accountable to their constituencies.

• Recommendation: There is need for PLHIV to raise the standard as representatives in the CCMs and NACs to ensure that they act as a voice for their constituencies. Most participants expressed a concern that they did not have a genuine voice in the boards because of the techni-cal documents and the high-level discussions in the meetings.

• To assist representatives it was suggested that representatives need to have planning and feed-back meetings through reference groups. This would prepare them for making meaningful inputs in the meetings and permit proactive participation.

3) Lack of a reporting forum/platform between CCM representatives and their constituencies

• One of the frustrations faced by CCM representatives is the fact that there is no platform where they can report back to their constituencies and update their members on CCM deci-sions and challenges. This would also allow representatives to get feedback on their members stance on particular issues. The relationship between CCM members and their constituencies need to be strengthened. This will actually ease the load on CCM members who have to meet expectations from constituencies, partners and also their employers.


• Recommendation: Establishment of a Reference Group that will assist the representatives with technical documents and also be a voice of the larger group.

• Countries shared that there are usually no funds for constituency members to meet. It was reported that Global Fund does not pay for more than six meetings. To that end it was sug-gested that probably members should use other existing forums like AGMs, national network meetings or training workshops.

• CCM representatives are not fully apprised of the power they wield and at times find them-selves pushed to sign documents against their constituency’s standpoint. Participants shared instances where the signing power has caused strife between representatives and their con-stituencies who were secretly asked by NACs to sign urgent reports and consequentially lost credibility with members. One participant said ‘As people who are in CCMs we are in discon-nect with our constituencies, by the time you know what to do, everyone is angry with you’.

• Advocacy Action: ‘Power of our signature’: The requirement of PLHIV signature on Global Fund documents offers a significant advocacy opportunity. PLHIV could use this opportunity to lobby for specific needs.

4) Capacity of CCM representatives

• The capacity to engage with technical documents and with issues in CCM meetings came up as a critical issue. CCM representatives can feel overwhelmed amidst a sea of lengthy technical documents and intimidated by highly experienced officials. CCMs are dominated by senior government officials like Principal Secretaries yet a majority of PLHIV who sit on CCM are not technical officers and this compromises the level of participation of CCM representatives. This deprives since PLHIV do not feel as if they are on the same level as others.

• PLHIV networks either lose their experienced staff to inter-national NGOs or are not able to attract staff who would feel more at ease in such a setting.

• Advocacy Action: Having more CCM representatives from PLHIV networks could assist. It was raised that there is a need to explore why the networks lack professionals.

5) Lack of accessibility of Global Fund money by PLHIV networks

• Although the Global Fund distributes significant amounts it was not felt to be accessible to PLHIV, shown by the fact there is no country network that is a principal recipient in the re-gion. Inadequate capacity to cope with the rigours of grant management was cited as the reason.

• Assistance is required to improve management of donor funds: both to manage existing funds and attract new sourc-es. The language and ranking of organisations by donors was also mentioned as a challenge. Most PLHIV organisations could not receive funding or extension thereof because they were labelled as ‘no go’ or could not meet the ‘making money

Put differently by someone else, ‘you end

up losing interest in attending the meetings

because you are not making a meaningful contribution but at the same time even if you are not in the meeting you feel guilty because you are representing

your constituency, but in actual fact are you

really representing them?’

‘There is no qualifica-tion for being HIV

positive, but you have to read all those technical documents as a repre-sentative and represent your constituency’. One

participant said.


work principle’. This was due to poor absorption of money and performance based criteria, as a result the Southern African Region’s performance is rated ‘poor’ and ruled out of funding.

• Recommendations: It was suggested that a comprehensive study on ‘accessibility’ of grants and grants management for PLHIV organisations should be carried out. This will assist in as-certaining the challenges faced by organisations and deal with issues of building institutional and technical capacities within the organisations. Training on ‘Result Based Management’ was suggested as it is required by a majority of donor agencies.

• Advocacy Action: Donors need to be engaged on the issue of supporting operational costs and understanding ‘lack of capacity’. This was highlighted as a serious challenge as organisations normally do not have resources to meet operational costs.

• PLHIV organisations need to be capacitated to meet the standards and requirements by donor partners in running projects. Similarly ‘lack of capacity’ needs to be unpacked as it can also mean a lack of resources and not just skills. Governments’ capacity has been more than suf-ficiently enhanced, whilst the capacity of PLHIV networks is left unaddressed.

6) Networks and governance

• It came out that there is need for the leadership of the networks, namely management and boards, to be trained on their responsibilities. During the discussions it transpired that some of the in-fights are caused by the lack of clear understanding of the different portfolios. For instance a board may feel that the secretariat is not involving and recognising them enough whereas the secretariat may feel they have a mandate over certain decision. The lack of clarity therefore may lead to a loss of trust and create divisions.

• To that end NAPSAR assured the participants that this area was identified in a regional study and programmes for training were scheduled3.

7) Competition within networks

• Networks members do not always work as one body and that may lead to internal divisions which set back normal work and distract members. There is a need for networks to work as a united force, find a niche and avoid working in compartments and silos.

8) Programming issues for NAP+SAR

• Recommendation: It was suggested that members should pay subscriptions to meet NAPSAR halfway and show commitment to the network.

• Recommendation: There is a need to hold regional meetings for the NAC/CCM representa-tives, to bring one CCM/NAC representative from the different countries to host a CCM and NAC representatives platform at regional level where they can develop a common regional strategy and agree on how to feedback their constituencies.

• Advocacy Action: Members should document their concerns and frustrations and take them to Global Fund head office in Geneva through NAPSAR.

3 N.B.NAP+SARranaleadershipdevelopmentworkshopfocussingongovernanceinSeptember2010forboardandsecretariatmembersfrom9ofitsaffiliatenetworks.ThiswascarriedoutinpartnershipwithSkillshareInternationalwiththesupportoftheBigLotteryFund.


9) The impact of HIV on every person - CCMs are serving the nation at large

• It is important for governments to realise that the work done by PLHIV is not just for their own benefit but for the citizens at large in every country. PLHIV must effectively influence what is happening as they represent all citizens. Therefore interventions should also have that in mind- for instance governments invest in education because of the belief that it will benefit the entire nation not just improve the situation for individuals.

• NACs, CCM and all those involved in HIV work need to know that it is not about them sitting in the roundtables but it is about people out there in the different parts of the countries, the whole nation. It is important for representatives to interrogate why they are in the CCMs and also why they feel they are not fully participating in the CCM s meetings.

• HIV is not just affecting the individuals but it is a development issue and the linkages between HIV and every person are not underscored. There is an attitude that HIV is affecting someone out there. Sometimes the people working on HIV do not identify with HIV.

10) Links with civil society and PLHIV organisations

• It was observed that there can be a ‘disconnect’ between PLHIV organisations and other civil society organisations.

11) Relationship between PLHIV organisations and government

• It was observed that relationships between PLHIV and government are not always smooth. There is a need to look at the greater and more meaningful involvement with government representatives.

12) Documentation of experiences: amplifying voices of PLHIV

• Participants registered concern that PLHIV have contributed so much to the response on HIV but such ‘stories’ have not been shared. Organisations must document regional PLHIV success stories as a lobbying tool, to celebrate success and for learning purposes. It was suggested that NAPSAR as a regional initiative is best placed to run such a project telling the untold personal stories of responses to HIV in the region.

• Participants at the workshop were able to relate some of the emotional experiences they have gone through, their sources of strength and the difference they have made in their own coun-tries as individuals and networks. The conclusion was that ‘there are still a lot of stories that successors in the advocacy work need to know and use it to encourage themselves when the going gets tough.’

5.0 LESSONS LEARNT

• Reading and understanding documents before signing is key. A retreat to read documents is nec-essary at times: In Mozambique, to ensure that they understand what is being signed, the network go for a retreat to look at the report and make their comments before signing. However if the report comes late it is problematic.

• Imposed capacity does not work: transformation can only happen when it comes from within and in most cases it is imposed on networks. To that end, such interventions are likely to hit setbacks.


When a highly educated person is brought into the network secretariat, membership may then detach themselves from those people. It is important for networks not to disconnect from their members as they become more and more professional.

• Expressing concerns in a more objective manner is preferential to being emotional. Members must move to a level whereby their contributions are communicated so that someone hearing it does not read emotions behind the issues.

• It is important for a network to be in control and to make objective decisions and not driven by partners. At times networks are pressurised to come up with structures they do not understand and they are not ready for. For example, in Swaziland in 2009, there was so much pressure for the network to come up with a technical committee but they refused until they were ready to do so

• The informal approach in facilitation is more effective as people tend to be tense in workshops and then close up. However once they feel they have not come to be lectured upon but that their views are worthy they loosen up and everyone is free to talk. The CCM workshop afforded a safe space for participants to air their feelings even share sensitive issues and that built rapport and strengthened the bond of participants in the workshop.

• The reflections used during the workshop were heralded by participants as having allowed them to ‘self-reflect’ and to examine their feelings and emotions. It allowed them to see the importance of taking care of themselves, of being aware of who you are as a person, what you like, what you want, how you feel and being able to vocalise that without necessarily being emotional.

• Participants should prepare a paper prior to attending this sort of workshop summarising their is-sues as CCM representatives. If possible this summary should be submitted before the meeting to ensure that experiences of all countries are incorporated fully. As it is some countries were able to share broadly and some had limited information at hand to share.

6.0 WAY FORWARD

As a way forward, participants developed action plans for their countries which encompassed the following action points:

• Reporting back to the networks

• Sensitizing NACs and CCMs on the issues raised

• Working on balancing representation to the benefit of PLHIV community

• Establishing reference groups.

7.0 FEEDBACK FROM PARTICIPANTS ON THE WORKSHOP

• “The workshop has boosted my confidence and now I will be able to represent my constituency with confidence in the CCM.”


• “I now believe that there are certain qualities they saw in me for me to be in the CCM.”

• “I came here full of issues not knowing where to release but the workshop allowed us to offload amongst ourselves and we came with solutions from amongst us.”

• ”Sharing from different countries gave me an insight on how we want to go about learning from indi-viduals; openness discussions, to share documents from the region”

• “Thank you everyone for freely sharing, we have been in this work for long some of us since 1992 and have been fighting and discussing with government for making treatment available, we come a long way but we need to continue fighting.”

• “The workshop impacted on us in spite of the language.”

• “We had a lot of contributions and lessons learnt.”

• “The workshop was good.”

• “The experiences taught me that I can still be a better person, that I can still do a better job in the CCM and be a better representative of CCM in my country. I will not be intimidated anymore, if continuously given the necessary support.”

• “For the first time in my life, I was able to speak freely in an international workshop in English at my own level and I did not feel intimidated.”


APPENDIX 1

PRESENTATIONS

PRESENTATION 1:

Background on NAPSAR & Objectives of the Workshop, by Thanduxolo Doro, NAP+SAR Programme Manager

Outline

• NAP+SAR

• Priority Areas

• Key milestones

• This workshop

NAP+SAR?

• Network of African People Living with HIV, Southern Africa Region

• Secretariat of 5 staff based in Johannesburg

• Angola, Botswana, Lesotho, Malawi, Mozambique, Namibia, Swaziland, South Africa, Zambia and Zim-babwe for now,

Priority Areas

• Strengthening capacity of member networks

• Information sharing and knowledge management

• Coordination

• Advocacy: When you disagree on disputable matters, how do you disagree? Do you disagree with anger, with hostility, with contempt, with condemnation? Or do you disagree with love, with concern, with humility, with tenderness?

Key Milestones

a) Capacity assessment

b) BLF funding for 6 networks

c) NAP+SAR Research on

0 Positive health, dignity and prevention

0 Access to Insurance by PLHIV

0 Access to treatment by PWD

0 Health care workers attitudes to PLHIV

0 Integration of AIDS services to broader health care


d) Regional workshops

e) Technical support

This workshop

• Share case studies

• Enhance our competencies to influence

• What is expected of a represenative

• Compile a report

• Base for more advocacy work

• Arrangements

1. Advocacy & Media group

• Botswana (3), Lesotho(3), Mozambique (3), South Africa (3) and Swaziland (14),

• Facilitator: Sizakele

2. NAC & CCM representatives

• Botswana (2), Lesotho(2), Mozambique (2), South Africa (2), Swaziland (2) and Namibia (1)

• Facilitator: Comfort

• Thank you

PRESENTATION 2:

Background to Global Fund by Thembi Nkambule, Director, SWANNEPHA

How did the Global Fund begin?

• Over the past two decades, the HIV epidemic has swept across the world, killing millions and infecting millions more. Few governments have been willing or able to invest appropriate resources to confronting this global crisis, especially since the disease disproportionately affects poor nations. Kofi Annan, the Secretary General of the United Nations, was the first high-profile person to make a public call for a ”war chest” or global fund to be organized to fight AIDS. His voice was soon joined by many others, includ-ing PLHIV, who were keen to see a new and innovative approach to tackling AIDS (and subsequently tuberculosis and malaria, two other deadly diseases wreaking havoc worldwide).

• Below is a brief history of the Global Fund from 2000, when it was no more that an idea in a few people’s minds, to midway through 2004, by which time it had pledged over US$3 billion in grants to 128 coun-tries. There are plenty of sources for additional information on the Fund’s history, including the Global Fund website www.theglobalfund.org so we will not go into great detail here. The timeline below should, however, give an idea of how rapidly the Global Fund came into existence and how quickly it has begun to make a difference in people’s lives.


• In this context it is important to remember and acknowledge the tremendous work and activism of PLHIV and their allies since 1984. For years, PLHIV and others have advocated tirelessly for additional resources to be channeled into combating the global HIV pandemic. Without the efforts of these col-leagues and friends, many of whom are now dead, this greatly enhanced level of resources to fight HIV, TB, and malaria that the Global Fund represents would never have become available.

2000

• July In his closing speech at the 13th International AIDS Conference in Durban, South Africa, former South African President Nelson Mandela calls for “total inclusiveness in the struggle against AIDS.” He goes on to say, “Let us not, however, underestimate the resources required to conduct this battle. Partner-ship with the international community is vital.”

• The G8 endorses new AIDS, TB, and malaria targets at a summit in Okinawa, Japan. Ministers agree that existing bilateral and multilateral efforts are not sufficient to channel the additional resources needed to scale up the response to these epidemics. They make a commitment to support innovative partnerships, including those comprising NGOs, the private sector, and multilateral organizations, to fight the three diseases.

• WhatistheG8?

• The Group of 8 (G8) consists of eight of the world’s wealthiest or most influential nations, including Canada, France, Germany, Italy, Japan, Russia, the United Kingdom, and the United States. G8 heads of state meet annually to discuss major economic and political issues facing their domestic societies and the international community as a whole. Other government officials, including finance and foreign minis-ters, meet separately during the year.

2001

• April At the African Summit in Abuja, Nigeria, UN Secretary General Kofi Annan makes a public call for a “war chest” or global fund to be set up to fight AIDS. African leaders support this idea, and the vision is expanded to include other diseases of poverty, such as TB and malaria.

• June Participants in the United Nations Special Session on AIDS (UNGASS) in New York endorse the need for a global fund. The Declaration of Commitment, which calls for the establishment of a global health fund, is agreed. It is drafted with the input of many PLHIV and non-governmental representatives after much successful lobbying and advocacy on their part.

• July At the G8 meeting in Genoa, Italy, members voice unanimous support for the new (as yet non-existent) fund and make over US$1.5 billion in pledges.

• August A Transitional Working Group (TWG)–which includes Joseph Scheich, International Coordina-tor of GNP+ among its members–is formed to begin drawing up the policies and principles (the Frame-work Document) on which the Global Fund will base its work. A technical support Secretariat is set up in Brussels, Belgium.

• September Consultations on the formation of the new fund take place among December stakeholders in all regions.

2002

• January The Global Fund is formally created at its first board meeting in Geneva and registered in Swit-zerland.


• April At the second board meeting, the first round of proposals totalling US$600 million over two years to programs in 36 countries is approved.

• August Charles Roy, alternate board member for the delegation of communities living with the diseases, dies on August 24.

• December Initial disbursements of grants commence.

2003

• January Joseph Scheich, ex-TWG member and board member for the delegation of communities living with the diseases, dies on January 15.

• At the fourth board meeting, the second round of proposals, totalling US$900 million over two years to 72 countries, is approved.

• March Representatives from PLHIV and civil society organizations meet in Paris to discuss the future of the Global Fund. Sharing concerns that wealthy countries are not contributing enough to the Global Fund, they agree to work together to promote more adequate funding, and the “Fund the Fund” advo-cacy initiative is born.

• May “It Starts with Us” a fundraising campaign initiated by PLHIV, is launched publicly to highlight the fact that the Global Fund is in dire need of additional funds. Along with “Fund the Fund,” it is one of many examples highlighting how PLHIV and other civil society groups have taken a lead in the response to the HIV/AIDS crisis.

• Brigitte Symalvwe, member of the communities living with the diseases board delegation, dies of cerebral malaria and HIV.

• June Additional pledges are made by the G8 during a summit in Evian, France.

• October At the Global Fund’s sixth board meeting in Chiang Mai, Thailand, Round 3 proposals are ap-proved, totalling US$623 million over two years.

2004

• June At the eighth board meeting, Round 4 proposals are approved, totalling US$968 million over two years to 69 countries.

• The communities living with the diseases delegation receives a vote on the Global Fund Board (previ-ously it had been one of several non-voting members, along with WHO, UNAIDS, and the World Bank). This is a historic and emotional moment in the history of the Global Fund, and it is hoped that this vic-tory for PLHIV representation will be replicated elsewhere, including on CCMs.

• July The first Global Fund Partnership Forum is held in Bangkok, Thailand, with 400 participants, in-cluding many PLHIV. The issue of PLHIV participation on CCMs and the need for more stringent re-quirements to ensure this participation is hotly debated.

• November At the ninth board meeting in Arusha, Tanzania the board approves several CCM require-ments. Among the requirements is that all CCMs must show evidence of membership of people living with and/or affected by the diseases. CCM members representing the nongovernmental sector must now be selected by their own sector, based on a documented, transparent process. CCMs are also required to put in place and maintain a transparent, documented process to ensure the input of a broad range of stakeholders, including CCM members and non-members, in proposal development and grant oversight processes.


• This decision marks a victory for many PLHIV and their advocates, who have worked long and hard to make this happen.

PRESENTATION 3:

Presentation by Vulindlela Msibi, Executive Secretary, Swaziland Global Fund Country coordinating Mechanism (CCM) June 29, 2010, Esibayeni Lodge, Matsapha, Swaziland

1. SALUTATIONS:

MASTER OF PROCEEDINGS

SWANNEPHA Leadership

Distinguished SADC Participants

Ladies and Gentlemen

2. INTRODUCTION

Thank you for inviting me to be part of this important NAP+SAR advocacy initiative at SADC level. I will en-deavour to highlight the Global Fund practices in the context of Country Coordinating Mechanisms [CCMs] with involvement and meaningful participation of PLWHIV.

3. It is imperative to emphasize that Global Fund is a financing mechanism created by a UN Resolution in 2001 to fight the world’s three most devastating diseases: HIV, TB and Malaria. The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) is a multi-billion dollar international financing mechanism that aims to increase the availability of funding by directing money towards areas of greatest need. The organisation works as a partnership between governments, civil society, the private sector (including businesses and foundations) and affected communities by combining resources towards fighting HIV and AIDS, Tuberculosis and Malaria through grant programmes.

4. The official aim of the Global Fund is to: “attract, manage and disburse additional resources through a new public-private partnership that will make a sustainable and significant contribution to he reduction of infec-tions, illnesses and deaths, thereby mitigating the impact caused by HIV/AIDS, tuberculosis and Malaria in countries in need and contributing to poverty reduction as part of the Millennium Development goals.” 1

5. In January 2000 at the G8 conference in Okinawa, Japan, it was recognised that there was a need for greater resources to fight AIDS, tuberculosis and Malaria. 2 This recognition was further supported by the United Na-tions (UN) former Secretary-General, Kofi Annan in 2001 3 and contributed to the Global Fund’s foundation in January 2002 in Geneva, Switzerland. Just three months later, the grant board approved the first round of grants for 36 countries.

6. An important part of any country’s funding application process is the negotiations that take place with their Country Coordinating Mechanism (CCM). In every country that wishes to receive funding from the Global Fund, a CCM will be set up to help organise and submit grant applications to the Fund and monitor their


implementation. A CCM will generally be made up of a broad range of representatives from government agen-cies, NGOs (Non-Governmental Organisations), People Living with HIV or AIDS, local community and faith-based organisations, individuals working in the field and private sector institutions.

7. In the context of our country, among constituencies, Swaziland Network of People Living with HIV or AIDS [SWANNEPHA] sits on the Swaziland CCM. This is in line with Global Fund policies, guidelines and require-ments.

8. As matter of fact, for any country applying for Global Fund grants, CCMs must show evidence of member-ship of people infected or affected by the diseases- It is pleasing to note the Kingdom of Swaziland meets this requirement as SWANNEPHA sits on the CCM and is also a Sub Recipient-i.e. it has a grant agreement with NERCHA (National AIDS body) which is the Principal Recipient. Even in other structures of the CCM e.g. the Executive Committee, SWANNEPHA also has a seat.

9. Further, our National Multi-Sectoral Strategic Framework 2009-2014 which informs our national priorities in HIV and AIDS response, also embraces the principle of Greater Involvement of People infected or affected by the diseases.

10. Conclusion: It is imperative to highlight that the Global Fund partnership is a unique platform which brings together stakeholders; including communities living with the diseases to achieve a sustainable and significant reduction in infections, illnesses and deaths due to HIV, TB and Malaria. Importantly, national PLHIV networks of every nation that receives Global Fund grants should be empowered to use the pre-existing structures to ensure their views are accommodated-after all they are the reasons we even have these structures. There is a need to increase the advocacy at every level to create the awareness about the interest of the infected and affected.

11. Even now, countries are busy developing their proposals to Global Fund and the input of the PLWHIV is critical-I am sure you are taking advantage of this global initiative to advance your communities’ inter-ests. I strongly believe in a future generation that is free of HIV and AIDS. We all have to play our respec-tive roles-play them well and go beyond talking!

May the Almighty bless you-I thank you!

PRESENTATION 4:

Ethical Considerations of CCM Representatives: AIDS Context Presentation by Zanele Dlamini, Esibayeni Lodge, Matsapha Swaziland. 29th June 2010

Introduction

• The Global Fund requires that recipient countries and those who aspire to be recipients must establish Country Coordinating Mechanisms.

• The CCM is often made up of a variety of stakeholders, each representing an active constituency with an interest in combating one or more other three diseases: AIDS, tuberculosis & malaria.


Impacting the Community

• Vision, ownership, focus, succession, communication, responsibility, change, courage, strategic plan, ac-tion, resources, commitment, character, competence, chemistry and transformation.

CCM Responsibilities

• Terms of reference should be clearly stipulated and in written form, preferably signed.

• Global Fund objectives aligned to National Strategic Framework indicators and results shared.

• National monitoring and evaluation frameworks documented and shared.

• Financial management of Global Fund resources transparent and defined.

Steps to Effective Planning

• Plan to Plan

• Determine your primary purpose

• Assess the situation

• Prioritize the needs

• Ask the right questions

• Set specific goals

• Communicate and clarify

• Identify possible obstacles

• Have an open system of planning

• Manage and direct your resources

• Monitor and correct

• Study the results

Ethical Issues: AIDS Context

• Stigma & discrimination ;Human rights approach; Multiple concurrent partners; Delaying sexual debut; Male circumcision & condom use; PMTCT; Family planning

• Orphaned & Vulnerable Children; People living with HIV and ART; Community outreach; The media and ethics; Documentation; Monitoring & evaluation; Studies and surveys


Ethical Issues related to HIV/AIDS

• 1. HIV testing; 2. HIV treatment; 3. Research; Confidentiality, informed consent, end of life, research design, conflict of interest, vulnerable populations and vaccine research.

Three Widely Used Ethical Principles for Reporting on HIV

1. Respect for persons- respecting decisions, autonomy and protecting those lacking decision making capacity.

2. Beneficence- acting in the best interest of patients, research participants, minimizing risks of research.

3. Justice- requires that people be treated fairly.

Confidentiality

• Medical records and disclosure

• Public health authorities & legal authorities

• Reporting using codes

• Anonymous testing

• Reporting without legal penalty

• Intended disclosure to prevent serious harm

• Exposure to invasive procedures

Health Care Workers Obligations

• Health care workers’ obligations are to act in the patient’s best interests also mandate disclosure of HIV infection and in some cases, restrictions on clinical activities.

Pre-natal HIV Testing

• Pregnant women are often being tested for HIV as a routine part of pre-natal care. This can violate au-tonomy; it has psychosocial risks; may also undermine prevention efforts.

End-Of-Life Issues

• Palliative care for terminally ill patients.


• Psychosocial support and counselling.

• Discussions on burial and child custody and support issues.

• But with Anti-retroviral Therapy such issues have been brought to the minimal.

Research Issues

• Research with human participants raises ethical concerns because people accept risks and inconvenience primarily to advance scientific knowledge and to benefit others.

• Although some research offers the prospect of direct benefit to research participants, most research does not.

Research Design

• It is unethical to expose research participants to the risks of research study unless the design is suffi-ciently rigorous that the results will be valid and generalised.

• Clinical trials usually require preliminary laboratory and animal research.

Informed Consent

• Many participants enter research studies to benefit personally.

• The expectations of the potential research participants may complicate obtaining informed consent in the research context.

• Some may do it to please their health care provider, who may be a researcher.

Vulnerable Participants

• Children

• People living with HIV

• Pregnant or lactating mothers

• Mentally challenged persons

• Prisoners

• Economically/ educationally disadvantaged persons


Conflict of Interest

• Some conflicting interests are inherent in research e.g. some health care providers gain prestige, grants, and promotions through their research work. Accordingly they have a personal interest in recruiting participants in their studies such financial ones.

• It is an acceptable element of research, in part, if it is open and acknowledged.

CCM Leadership Expectations

• Character and Compassion

• Courage and Competency

• Conviction and Commitment

HIV Vaccine Trials

• HIV vaccine trials pose unique risks to participants. Because participants may react positively to certain HIV antibody tests, face limits on international travel and eligibility to certain jobs, face stigmatisation from family or community.

• UNAIDS May 2000 on HIV preventive vaccine research-18 specific guidance points.


APPENDIX 2

PROGRAMME

NAP+SAR ADVOCACY WORKSHOP

Esibayeni Lodge - Swaziland

Day OneTuesday 29 June 2010

TIME TOPIC FACILITATOR

FACILITATOR, SIzAKELE HLATSHWAYO, SWAzILAND

08h00 – 08h30 Registration

08h 30 - 08h45 Welcome Remarks &, Introductions SWANEPHA

09h00 - 09h15 Background & Objectives NAP+SAR

09h15 – 09h30 Ground rules & Expectations Facilitator

09h30 – 10h00 Presentations on Advocacy Framework & BLF project NAP+SAR

10h00 – 10h30 TEA BREAK

10h30 – 11h15 Global Fund’s guide on structuring NAC and CCM’s Vulindlela Msibi

11h15 – 11h30 Role of networks at NAC’s & CCM’s are we fulfilling it Thembi NKambule

11h30 – 12h00 Open discussion with recommendations Facilitator

12h00 – 13h00 Presentation on ethical considerations of a representa-tive

Z. Dlamini

13h00 – 14h00 LUNCH

14h00 – 15h00 Discussions Facilitator

15h00 – 15h30 Tea break

15h30 – 16h30 Identifying an issue & Developing Goal & Objectives on observed discrepancies

Group work

16h30 – 17h00 Reflections & Evaluation

Day Two Wednesday 30 June 2010

08h30 – 08h45 RECAP


08h45 – 09h30 Selecting target audience Group work

09h30 – 10h00 Present group work covering

Issue of concern; goal; objectives and target audience

Facilitator

10h00 – 1030 TEA BREAK

10h30 – 13h00 Presentations continue Plenary

13h00 – 14h00 LUNCH

14h00 – 15h00 Discussions Plenary


15h30 – 16h00 Forming a National Reference

Group of PLHIV Group work

16h00 – 16h30 Developing ToR for the

Reference Group Facilitator

16h30 – 17h00 Reflection & evaluation

Day Three Thursday, 01 July 2010

Time Topic Facilitator

08h30 – 08h45 Recap

08h45 – 10h00 Presentations of groups’ work covering: process of forming the reference group and its ToR

Plenary


10h30 – 12h30 Discussing implementation: Reporting back; How and when to consult others; what dynamics can be antici-pated and how to overcome them.

12h30 – 13h30 Lunch and end of workshop 2


APPENDIX 3

LIST OF PARTCIPANTS

CCM WORKSHOP

# Name & Surname Organisation

1. Kenny Sebeti NAPWA

2. Jeremiah Shetunyenga Tonata PLWHA network of Namibia

3. Joselia Mbanze Kuyakana-Mozambique

4. Julio Romos Mujojo RENSIDA

5. Bheki Ngwenya NAPWA

6. Patrick Mngometulu SWANNEPHA (IISO)

7. Bongani Kunene SASO/SWANNEPWHA

8. Mohali Mabote LENEPWHA-(NAC)

9. Thomas Monese LENEPWHA (CCM)

10. Ntebaleng Thetsane LENEPWHA

11. Robinson Dimbungu National Aids Coordinating Agency Botswana

12. David Ngele BONEPWA

13. Thanduxolo Doro NAP+SAR

14. Thembi Nkambule SWANNEPWHA-Secretariat

15. Sizakele Hlatshwayo Facilitator

16. Vulindlela Msibi CCM-Swaziland-Presenter

17. Zanele Dlamini Presenter

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