Making the Money Work Better
In the Rime of the Ancient Mariner, a becalmed sailor, dying of thirst, cries out “Water, water everywhere yet not a drop to drink.” I’ve heard similar complaints from leaders of community groups. Millions of international dollars are available to assist AIDS responses for vulnerable children. But local organisations struggle to support affected children because so little reaches those at the community-level. And with a lack of African government-run safety nets, this means it’s left to the poor to provide their own resources to support the destitute. The June 2011 high-level United Nations meeting in New York on children affected by HIV and AIDS included funding community responses as a main topic of focus. I am a paediatrician working for the government of Zimbabwe and also a member of the Firelight Board and I chaired the session on funding.
Six speakers addressed this subject during the 2-day meeting. Rene Bonnel of the World Bank said that of the 4 billion dollars a year of AIDS funding being provided, $530 million was available for community HIV responses. But the actual amount that reached communities was only a small fraction of this. Once volunteer’s time is factored in, communities themselves provide 80% of their total funding. Nathan Nshakira confirmed this with studies from Uganda, Zambia and Tanzania. These studies suggest that communities provide more than twice as much support for vulnerable children than governments, PEPFAR, the Global Fund and UNICEF combined.
An example from Zimbabwe illustrates how political influences shift programme resources away from methods that directly benefit communities. A recently concluded $86M Programme of Support (PoS) for orphans and vulnerable children in Zimbabwe, which involved 32 NGO partners as intermediary organisations to support 150 smaller local organisations was cost effective according to Aaron Zinyanya from the Ministry of Labour and Social Services in Zimbabwe. However, the programme, funded by DFID (the UK government) and others was still terminated six months ago and replaced by a programme that provides support through the government of Zimbabwe. This programme that was getting resources to communities and affected families was replaced by another program that is unlikely to get significant amounts of support to vulnerable children. This is similar to what happened in Uganda in 2006 when the World Bank closed down its effective Community-Led HIV and AIDS Initiatives programme. My point is that effective programs that provide resources directly to communities exist and they need stable support that is not subject to political shifts to tackle important and difficult issues like HIV.
In an editorial I wrote in the New England Journal of Medicine in 2002, I stated “There is a need for innovative mechanisms to channel resources to community groups through intermediaries.... Local organizations are ideally placed to form partnerships with community groups and provide appropriate advice, training, capacity building, and grants. We will not have many more chances. There are tens of millions of orphans who need our help, and it is vital that external agencies learn from the affected communities and allow them to assume the primary role in providing support to these children.” We have got to make the money work better. Firelight Foundation is increasingly helping other donors to implement methods that directly reach communities. After ten years of funding grassroots organizations Firelight has seen that communities know how to solve their problems. Collaborating with government and intermediaries, community-based organizations are best positioned to implement effective and lasting change.
This article was written by Geoff Foster, a Firelight Foundation Board and Advisory Council Member. Read more about Geoff at www.firelightfoundation.org.