The Three Ones

In April 2004, UNAIDS launched a new framework for improving efficiency in the global struggle to combat the spread and impact of HIV and AIDS. The initiative is called the Three Ones, and refers to:
-One national framework that provides the basis for coordinating the work of all partners;
-One National AIDS Coordinating Authority with a broad multi-sectoral mandate, and
-One agreed country level monitoring and evaluation system.
We consider whether this new framework works for HIV positive women with examples from Lesotho and Swaziland.

The First Two Ones
- One national framework that provides the basis for coordinating the work of all partners
- One National AIDS Coordinating Authority with a broad multi-sectoral mandate

How can we overcome obstacles to achieving meaningful participation of people living with HIV and AIDS in the design, development, and implementation of a national AIDS framework and coordinating authorities? How can we ensure the representation of people living with HIV and AIDS included the voices of often marginalised groups, such as women, young women, sex workers, injecting drug users and people with disabilities living with HIV and AIDS? While these groups of people share the common agenda of living with HIV, individual experiences of living with the virus are complex and diverse. The documentation on the Three Ones talk about the importance of setting priorities, but whose priorities? And how will this process take place?

Despite long years of verbal commitment to the GIPA principle (the Greater Involvement of People living with HIV and AIDS) from governments, multilateral agencies and civil society organisations alike, the experience of most people living with HIV and AIDS is that their opinion is rarely sought out or acted upon. The areas in which HIV positive people's activism is mostly to be found (though rarely acknowledged) is in the service delivery of care, support and counselling for other HIV positive people due to the lack of resources provided to this field by the authorities. The majority of this work is voluntary, invisible and unrecognised. Few attempts are made by governments or programme staff to involve people living with HIV and AIDS in the design, development, or delivery of programmes or services supposed to address the impact of HIV and AIDS, or in related governance, research or monitoring and evaluation. When attempts are made, they tend to be tokenistic nods to the GIPA principle but lacking in any real exploration of what GIPA stands for.

Representation of people living with HIV and AIDS is disproportionately small and that includes in the development of national policies and in national coordinating authorities. How will the proponents of the Three Ones ensure that future practice is any different? The national coordinating body in Lesotho - Lesotho AIDS Programme Co-ordinating Agency (LAPCA) - is about to be replaced by the National AIDS Council, which will be an umbrella body for an HIV/AIDS Forum and National AIDS Secretariat. The HIV/AIDS forum consists of 14 places, one of which has been reserved for an HIV positive person. This is clearly not enough, and also raises concerns about gender issues being addressed. This concern is heightened by the fact that the Three Ones documentation is completely gender blind. We ask - what will the 3 Ones do to ensure that the rights of HIV positive women are brought to the table and adequately addressed?

Rarely is the voice of people who are already marginalised in society, and thus also within the positive community, listened to, even though they may be among the most adversely affected by the pandemic, such as HIV positive women, young women, sex workers, injecting drug users, gay men, disabled women and men, among others. Such tokenism not only excludes the voices and concerns of the under-represented groups, but also gives rise to a situation of gate-keeping, making it even harder for the non-represented to gain a platform. In countries where women have no legal status as adults, how likely is it that women living with HIV and AIDS will be granted access to that platform unless commitments to grant access are expressly made and adhered to, and as a matter of routine rather than exception? In fact documentation on the Three Ones lists stakeholders as governments, bilateral and multi-lateral donors, UNAIDS and other UN agencies in the workings of the national coordinating body. Is civil society not a stakeholder then? What about positive people and vulnerable people? Who will decide who the partners are and how much weight each partner carries in the decision making process?

ICW is also very concerned that in countries like Lesotho where there is tight control and very small space for civil society to operate, a national framework could stifle the relationship between government and civil society even further, or pay lip service to civil society involvement. Will some civil society organisations become the voice of others? How will grassroots activists be able to access and influence decision making around issues that effect our lives?

For GIPA to be realised in any meaningful way, two things need to happen as pre-requisites:
a) capacity building among women and men living with HIV and AIDS so that the skills required for meaningful engagement at government, civil society and international policy levels are there within the positive community, and
b) training in the arenas where we want meaningful involvement to take place (workplaces, service providers, government ministries, national AIDS councils / coordinating bodies, NGOs, international policy makers, etc) for a greater understanding of what GIPA means