1. The Constellation

2. HIV and AIDS
Our starting point… and our primary
focus

3. Increase in total annual resources for AIDS
Total annual resources available is 300$ per Person Living
with HIV

4. More new infections than people put on
treatment
People newly infected
Total 2.7 million
with HIV in 2007
People put on
Total 0,8 million
treatment in 2007

5. Data on HIV: UNAIDS report 2008
 Number of PLHIV increases: (i) new infections (ii) ARV
available
 HIV disproportionately affects injecting drug users, men
who have sex with men, and sex workers
 Prevention: 15–24 years of age account for 45% of all
new HIV infections and many young people still lack
accurate, complete information
 In only six years, the number of people receiving ARV
has increased ten-fold, reaching almost 3 million people
 12 million orphans in sub-Saharan in Africa

6. There is another reality…..

7. Uganda: trends in antenatal HIV
prevalence at selected sentinel sites
Nsambya Rubaga Mbarara Jinja Mbale Tororo Lacor
35
30
25
20
b
15
10
5
0
1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

8. What did we learn from countries that
made progress?
 People drive effective responses to HIV/AIDS, not
commodities.
 Service provision is required, but is no substitute to
people driven responses
 Progress depends on local ownership of the problem and
the solution

9. Implication for Global Strategy on AIDS
Prevention
Ownership Care
Mitigation

10. The Constellation
Stimulating and Connecting Local Responses
Founded in 2004
12 founding members from 5 continents
Now 65 coaches
Connecting communities in 20 countries from Asia,
Africa and Europe

11. Our Core Belief
 Communities can respond by themselves to their
own issues
They are able to envision, to act, to mobilise
resources, to assess progress, to adapt and to share

12. From AIDS to Life Competence
In a Life Competent society, we act from
strength:
 to acknowledge that issues concern us all
 to build our common dream and overcome obstacles
on the way
 to mobilize our capacities to reduce our vulnerabilities
and risks
 to allow everyone to live out their full potential, and
 to learn from our experience and share it with others

13. Another way of development thinking
We believe in our own We believe in people’s
expertise to provide solutions capacity to respond
We are in control We facilitate responses
We respond to need We reveal strengths
You have a problem Together, we have solutions

14. Another way of working
Facilitation teams support the spread of
Community Life Competence
 They build on the strengths of communities
 They work as a SALT team
S : Stimulate, Support
A : Appreciate
L : Learn, Link
T : Transfer, Team
 They support communities to become Life Competent

15. The steps of the Community Life
Competence Process
Step Step for the community Step for the facilitation team
1 Mobilize communit y & leaders Establish a relationship
2 Community generates their dream Facilitate dream building
3 Community assesses strengths, concerns, Self -assessment on AIDS
opportunities and threats Competence
4 Community sets targets and plans action Self -measurement of change
5 Community acts Follow- and link with available
up
services and communities
6 Community measures own progress, learns and Self -measurement of change
adapts
7 Communities share learn and capture good
, Peer assist, Knowledge Fair,
practices Knowledge Assets

16. Knowledge Fair Community
Knowledge assets Facilitators
We share
Peer assist
SALT
Self-measure change
After-Action-Review Initial SALT visit
we learn we
& adapt care
Self- Building
we Community
measure measure
we the dream
hope
change change
we
assess
we act
our
situation
Action plan Facilitate
SALT visit self-assessment

17. Steps of the process
building the dreams

18. Steps of the process
self-assessment
1 5
2 3 4
BASIC HIGH
We acknowledge openly We recognise our own
We recognise that
with others our concerns strength to deal with the
Acknowledgement We know the basic facts We recognise that HIV is a HIV/AIDS is a problem for
about HIV/AIDS and the challenges and seek
and Recognition about HIV/AIDS. problem. us and we discuss it
challenges it represents others for mutual support
amongst ourselves
for us. and learning.
We communicate We adapt and Our care and prevention We intentionally link care
Care and change of externally provided communicate externally activities are separate and We change because we and change of behaviours
behaviour messages about care and provided messages about dependent on external care. and work practices in
prevention. care and prevention. stimulus. ourselves and with others.
Our partnerships share
We (individuals, families,
We get together with common goals, and define
communities, service We address and resolve all
We don’t involve those some people who are each partner’s
Inclusion affected by the problem. crucial to resolve common
providers and policy
contribution. Religious
challenges facing us (not
makers) work together to only HIV/AIDS.)
issues. and community leaders
respond to HIV/AIDS.
get involved.
We are addressing
Identify and We aware of the general We have a clear strategy vulnerability in all aspects
We have mapped Our strategy is based on
address factors of vulnerability
vulnerability and risk.
to address vulnerability
good practices.
of the life of our group,
vulnerability and the risks affecting us. and risk. all are aware and involved
in responding.
We have processes for We learn, share and apply
We learn by what we do We see an improvement in
We share learning from learning and sharing which what we learn
Learning and rather than what we learn local responses as a result
our successes but not our we use sometimes. We systematically, and seek
transfer from and share with of our learning and
mistakes. seek people of experience people with relevant
others. sharing.
when necessary. experience to help us.
We measure our change We invite others to help
We measure our own
Our change is evaluated We begin consciously to systematically and can measure our change and
Measuring change by others. self measure.
progress and set targets
demonstrate measurable share learning/results
for improvement.
improvement. with others.

19. Does the AIDS Competence Process work?
Comparison of AIDS competence indicators pre- and post-community self
assessment in 5 Bangkok districts
Level
5 Level
Acknowledgment and 5
Inclusion
4
recognition 4
3
3
2
2
1
1
0 0
Ladkrabang Klongsan Nonchok Bangkae Nongkham Ladkrabang Klongsan Nongchok Bangkae Nongkham
Level
Level
5
Care and prevention 5 Identify and address
4 vulnerability
4
3
3
2 2
1 1
0 0
Ladkrabang Klongsan Nongchok Bangkae Nongkham Ladkrabang Klongsan Nongchok Bangkae Nongkham
Pre-intervention Post-intervention 19
Post-intervention
year 1 year 2

20. Does the Malaria Competence Process
work?
Comparison between group 1 (using malaria competence) and
group 2 (not using malaria competence), in Togo

21. Results
 Open discussions and increased demand for testing
Ex: Settlements in Papua New Guinea finally discuss HIV as their issue
 Improved inclusion of PLHIV
Ex: communities in India include PLHIV in their savings group
 People identify and address vulnerabilities
Ex: Street children in Philippines assess their risk and reduce their risky behaviour
Ex: In Sohm (the Gambia), on average 5 children would die from malaria every
year. Since the Self Assessment had been introduced, not a single child had died
in the village.
 Improved access to treatment
Ex: Truck-drivers in Katma, a trucker's stop in Uganda obtain HIV tests at night
 People mobilize own resources
Ex: The sex workers in Periyackulam district started a mutual financial support
services.They do not accept to have sex without condoms anymore
 Reflection on lessons learned, adapt and share with others
Ex: peer assists in Tent City where communities from all over PNG shared their
experience around the priority practices of Tent City

22. The potential of AIDS Competence
 Currently plans to scale up ACP in
 DR-Congo => PNMLS & World Bank
 Indonesia => UNFPA & Provinces
 South Africa => Department of Health, NGOs & Global Fund
 Six Asian countries => Asian Development Bank supports country teams to go to scale
 Implementation across religions and cultures
 Thailand => Norwegian Church Aid (NCA)
 Kenya between tribes
 Belgium in communities of different origins and cultures
 Great Lakes Region => PLHIV & Truck drivers
 Application of approach to other issues
 Malaria Competence with Roll Back Malaria
 Human Preparedness to Pandemic with IFRC
 Diabetes competence with Handicap International
 Disability & Aids Competence with Handicap International
 Reconciliation & AIDS with Melbourne University

23. External evaluations
UNAIDS Evaluation (2005)
"between 83% and 87% [of AIDS Competence Process users] are satisfied and
confident that the program achieves impact within communities. The AIDS
Competence Programme was found to be highly cost-effective when compared
to other programmes (0.10 to US$ 2.00 per person reached )”
WHO-UNICEF Evaluation Papua New Guinea (2009)
“The AIDS Competence Process is an effective approach in combating HIV/AIDS
through local empowerment. For its low-cost but often labor intensive input of
resources, the output has been substantial.”
Action Group on Local responses to HIV in India (2008)
“Stigma and discrimination is reduced due to greater clarity on the nature of the
epidemic, and greater reflection on the different driving factors of the epidemic.
The approach can be implemented with existing interventions, in order to
promote a more sustainable response.”
Roll Back Malaria evaluation of malaria competence (2008)
“It is possible to conclude that the Malaria Competence process is very likely to
foster a strong sense of community ownership. The self-assessment process led
to a surge in community-led initiatives to create greater community awareness
around malaria.
March 30, 2012 UNAIDS 23

24. Some of our Formal Partnerships

25. Challenges
 Scaling up of the approach
 Self-measurement of progress
 Use by and connection with private sector
 Innovative approach in a sometimes non-conducive
environment

26. Ways of working
Share
CST
Le
fer a
Trans rn
Membership

27. L L
L
S S L
S
ST ST S
ST T T
T
ST
T
L L
S S
L
ST ST
T T S
L
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L ST
S T
S
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ST L T
T
S
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T S
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L S
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T L
L S
S
S ST
T
ST
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ST
T
L
L
L L S
S
S S ST
ST T
T
ST ST
T T
constellation

28. S S
S
ST L ST L S
ST L T T
T
ST L
T
S S
ST L ST L
T T S
ST L
S T
S
S
ST L
T ST L
ST L T
T
S
ST L S
T S
ST L
T
ST L
T
S
S
S ST L
T ST L
T
ST L
T
S
S
S ST L
T
ST L
T
ST L
T
S
S
S S ST L
ST L T
T
ST L ST L
T T
constellation

29. Le
arn

30. L L L
S S
S L
ST ST S
ST T T
T
ST
T
L L
S S
L
ST ST
T T S
L
ST L
L S T
S
S
ST
T ST
ST L T
T
S L
S L
ST
T S
ST
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ST
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L
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L S
S ST
T ST
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ST L
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L S
L
S
S ST
T
ST
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ST
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L
L
L L S
S
S S ST
ST T
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ST ST
T T
constellation

31. Share

32. L L L
S S
S L
ST ST S
ST T T
T
ST
T
L L
S S
L
ST ST
T T S
L
ST L
L S T
S
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ST L T
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S L
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L S
L
S
S ST
T
ST
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ST
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L
L
L L S
S
S S ST
ST T
T
ST ST
T T
constellation

33. Share
G FT
Le
fer arn
Trans
constellation

34. Organizational Structure B B B
B
B C C B
B B
B B B B
B v v B
B C B C
B B board B B
v v
B board board B
B v v B
B Chair C B
C
B B B
B
board board
B
v CST v B
B
v B C
B B v
C B
B
B B B B
B
B B C
C B B
B B B

35. References
• UNAIDS 08 Report on the global AIDS epidemic
• Lamboray J-L, Legastelois, J Sida, La bataille peut être gagnée, Ed.
Atelier, 2004
• Jean Legastelois, les communautés relèvent le défi du SIDA en RD-
Congo, la Croix, 14 mars 2007
• Fritjof Capra: The Turning Point (…), Bantam Books (1984) ISBN :
0553345729
• Amartya Sen: Development as Freedom, Anchor Books ( 2000)
ISBN : 0385720270
• Fritjof Capra: The Web of Life, Flamingo (1997) ISBN : 0006547516
• Thich Nhat Hahn: Il n'y a ni mort ni peur. Éditeur, Pocket (4 mai
2005) ISBN : 2266149105
• Christian de Duve: A l’écoute de la Vie, Odile Jacob (13 mai 2005)
ISBN : 2738116299
• Chris Collison & Geoff Parcell: Learning to Fly: Practical Knowledge
Management from Leading and Learning Organizations, Capstone
November 2004, ISBN: 978-1-84112-509-1

36. Thank you for your attention
Our website
www.aidscompetence.org
Our community
www.aidscompetence.ning.com