On June 21–23, a training workshop on budget advocacy was held on the Dnieper in Kiev.
The key question we were seeking to answer was how to influence budgetary processes in our countries to secure public fund allocations for HIV-related services. First and foremost, budget advocacy is about working together, which is critical but also challenging; this new environment makes us shift from competing with each other to reaching a consensus between our communities.
Common ground: All those involved in the workshop and consequent implementation on the country level appear to speak different languages. Some people speak from the grounds of epidemiology, while others speak from the grounds of finance, or monitoring and evaluation, or community-based experience. We need patience and dedicated efforts to understand each other while translating between the different “languages” we speak.
Seeking state budget funding for HIV programs, we will focus on the value just as much as on the money, to ensure the quality of HIV programs and to address the barriers that make programs inefficient and expensive. For instance, if a country purchases HIV tests but nobody wants to get tested (for various reasons), the tests will expire for no purpose and the country would just waste this money.
The HIV care continuum refers to an uninterrupted sequence of HIV-related services that people go through, i.e. (1) a HIV program client who decides to have a HIV test and is tested negative will continue being engaged in HIV prevention programs; (2) those tested HIV positive will further be involved in treatment, care and support programs. A meaningful participation of communities is an integral part throughout the HIV care continuum process.
Developing your arguments for budget advocacy requires caution and discretion. It is important to keep in mind that clumsy proof points could rather fuel stigma towards key populations. For example, we want to advocate for methadone-based substitution therapy using a message like this: “people who use drugs won’t need to steal money to buy illegal drugs to have a dose if they have access to methadone therapy.” However the meaning conveyed could be misread as “those on methadone are good, those who continue using drugs are bad.” To improve our advocacy message, we need either going into details to clarify the idea or choosing some other unambiguous proof point.
Choosing advocacy messages to communicate with government officials, we should avoid perceiving our target audience as narrow-minded and stereotypical, otherwise our proof points can miss the target leading to an increased stigma towards communities. For instance, an advocacy message such as “Invest in HIV prevention for key populations, this is how you have your kids (or: general population) protected against HIV” conveys an underlying idea—“it’s all the fault of key populations”—which may increase stigma and discrimination.
Before you approach budget advocacy, identify community priorities related to HIV services. It is important to do this in a framework which is different from standard need assessments.
What shall we focus on first when we start identifying priorities: prevention, treatment, or care?
As we all know, HIV issues are far from being the main priority for any community. Therefore, it is important to start with real top priority issues, such as identifying key factors to fostering enabling environment: what do you need to make community members feel more safe and comfortable living in your country?
Building community solidarity: Every community has its own understanding of priority issues, but there are always common priorities that can unite communities in joint advocacy efforts. Try to take it forward: while participating in a meeting or an ad-hoc with a focus on program development, every one of us can speak up not only for their community, but for other communities to articulate specific peer priorities as well.
Identifying community priorities in the framework of “what are we capable of doing ourselves as a community” rather than just "what do I need," we can get a real opportunity to achieve a more meaningful involvement through pursuing the guiding principle of Nothing For Us Without Us.