Transcript presentation PPT

China’s evolving AIDS policy: the
influence of global norms and
transnational NGOs
Joan Kaufman, Sc.D
Heller School, Brandeis University
Harvard Medical School and Harvard Kennedy School of Government
Conference on Civil Society and Nonprofits in China
Harvard University, January 22, 2011
Transnational civil society movements –
the “Third Force”
Relevant Perspectives
 soft power - legitimacy of messages about social justice, moral
authority and claim to represent public interest and common
good (Florini 2000)
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“boomerang effect” – civil society groups bypass the state and
appeal to trans national networks and institutions as well as
foreign governments (Keck and Sikkink 1998)
However
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True transnational civil society activism in China limited by the
political space allowed it by the party/state (Beja, 2008)
(e.g. AIDS versus reproductive rights)
China’s AIDS response:
1985 (first case) versus now
Then
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Denial
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Stigma and victim blaming
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Criminalization – arrest and punish drug users
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Foreigners disease
Now
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State Council leadership (SCAWCO) and multi sectoral collaboration
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NGO community involved in AIDS response (174 in Yunnan alone) but
mostly MSM and PLWHA
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Strong pragmatic policy response and free treatment program
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Many international partners
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“Harm reduction” programs with police (sometimes)
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Acceptance of stigmatized groups: MSM and PLWHA
Innovations in global governance for HIV/AIDS
(Sidibe, Tanaka, Buse, Global Health Governance, IV:1 Fall, 2010)
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Political commitment/accountability for a
health issue (UNGASS, etc)
Expanded political space for affected persons
Use of a human rights discourse (right to
health, access to essential medicines)
Novel arrangements in the global health
architecture (creation of a Global Fund;
UNITAID)
Global Norms for an effective AIDS
response at country level (promoted by UNAIDS
and global institutions)
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Participation of HIV positive persons (PLWHA) – the
“GIPA Principle – Greater Involvement of Persons Living
with HIV/AIDS”
Peer approaches to service provision – NGOs that
represent at-risk groups
Multi sectoral government collaboration – especially
police
Harm reduction – public health over law enforcement
goal – approaches reduce transmission of HIV for illegal
groups like drug users and sex workers
Treatment Access
Many transnational NGOs engaged in global
organizing and advocacy on HIV/AIDS
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Access to Essential Medicines - International
Treatment Preparedness Coalition, Treatment Action
Campaign, MSF
Participation of stakeholders – GNP+, Global Alliance
of Sex Workers
NGO place at the table for governance - Global Fund
and its “Country Coordinating Mechanism (CCM)”
Business Responsibility - Global Business Council on
HIV/AIDS, Product Red
Sustainable Financing– UNITAID, Advance Market
Commitments
Mechanisms for Introducing Global Norms
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UN system – UNGASS and UNAIDS
(e.g.
mandated reporting on civil society)
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Funding Mechanisms - Global Fund for AIDS,
TB, Malaria (CCM – the mandated governance requirement)
Donor programs (e.g. AIDS Public Policy Training Project,
Asia Pacific Leadership Forum)
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Networking at International and Regional
AIDS Conferences
Global organizing over the internet
China - Transnational Civil Society
connections
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Global Network of People Living with HIV/AIDS
(GPN+ ) – China “branch” established with FF
funding
Sex Workers – Global Network of Sex Worker Projects
and China Sex Worker Network – red umbrella
campaign used in Vienna then repeated in Wuhan
(8/3/10) calling for legalization of sex work
China Global Fund Watch linked to Global Fund
Observer
China AIDS NGO-Action list serve (internet) closely
linked to offline activism
International NGO list serves (SEA-AIDS, Human
Rights List serves)
Example - Yirenping
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Online Hepatitis B campaign against
labor discrimination
Protected in policy documents but hard
to enforce
Extended to HIV
Global Fund for AIDS, TB, Malaria
Global Fund ($424 million over 6 rounds)
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round 3 initially rejected and comments on
IDUs/China led to acknowledgement of central
China blood scandal
CCM requirement and election process
20% of funds set aside for NGOs
NGO work committee
Insights from the AIDS NGO scene –
How does this relate to philanthropic practices
in China?
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Big movement possible for “allowable issues” (Beja)–
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Limiting factor on real social movements is the limit
on branch organizations except through GONGOs
(AIDS versus reproductive rights)
(progress pre and post SARS)
(e.g. China GNP+ could provide mechanism for PLWHA to sue
government for blood related infections)
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Local governments don’t want to give $ to NGOs
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Social welfare orgs – charitable and humanitarian –
okay for service but stricter limits on rights advocacy
(national contracting mechanisms?)
(e.g. Wan Yanhai, Ye Haisen, Asia Catalyst, etc)
Summary of the China AIDS epidemic in 2009
•
People living with HIV
740,000
•
Number of AIDS
105,000
•
New HIV infections
48,000
•
Deaths due to AIDS
26,000
•
HIV prevalence
0.057%
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45% increase in incidence in recent years