Committed to empowering and building the capacity of people living with HIV and AIDS in the Asia Pacific region

EXECUTIVE SUMMARY

The Asia Pacific Network of People Living with HIV and AIDS (APN+) has been working to improve the lives of positive people since it was established in 1994. To continue supporting PLWHA in ways that matter APN+ has developed a five-year Strategic Plan (2006-2010) that sets out how it will conduct its work activities in the Asia Pacifi c region in coming years. This document provides a detailed account of how APN+ proposes to work toward its vision of a better world for PLWHA by undertaking work in the key areas of Advocacy, Capacity Building, Network Development and Knowledge Sharing.

By implementing these objectives APN+ shall systematically work toward empowering and building the capacity of people living with HIV and AIDS in the Asia Pacifi c region. In this strategic plan, APN+ acknowledge the important role supporting partners and other key stakeholders have to play in developing an effective and sustainable response to the needs of PLWHA. This plan provides those stakeholders with a clear understanding of APN+’s future work and how it intends to contribute to an improvement in the lives of PLWHA throughout the region. It is hoped that by sharing our vision for the future APN+ can walk hand-in hand with its partners toward a better world.

Acknowledgements and Dedications

APN+ would like to acknowledge the work and contributions of all volunteers, activists, staff and supporters who have been involved in maintaining and growing the Network over the years. Our special gratitude goes to past and present board members, co-chairs, steering committee and working group members, as well as the many advisers that have given their valuable time to guide the Network to where it is today.

WHAT IS APN+

APN+ is the network of People Living with HIV and AIDS (PLWHA) in the Asia Pacifi c region. It was established in Kuala Lumpur in 1994 in response to a number of specifi c issues facing PLWHA. These were the need for a collective voice for PLWHA living in the region, the need to improve communication and linkages with the Global Network of PLWHA (GPN+), and a need to help develop a more focused regional response to the widespread stigma and discrimination being experienced by PLWHA. APN+ is a peer-based organisation in which representatives must be HIV-positive. This unique understanding of what it is like for people to live with HIV and AIDS is one of APN+’s core strengths that enable it to represent PLWHA in the most effective and meaningful way.

APN+’s work over the past twelve-years has been primarily concerned with advocating for the rights of people living with HIV and AIDS at a regional level and building the capacity of positive people’s organisations. The main advocacy focus has been concerned with promoting access for PLWHA to treatments, care and support, advocating for the right to live free from stigma and discrimination and advocating for the greater involvement of people with HIV and AIDS (GIPA) in all levels of the HIV response. The capacity building focus has been aimed at supporting network member organisations to effectively represent their constituents and to improve their national and regional networking capabilities. In all of its work APN+ has been committed to ensuring gender equity and encouraging the involvement and active participation of women in all activities as well as marginalised groups, such as sex workers, transgender, men who have sex with men (MSM), injecting drug users (IDU), and mobile and migrant populations.

Since 1994 the geographical representation of APN+ has steadily grown and now extends to include members from 28 countries. At the time of developing this strategic plan (2006) those countries included Australia, Bangladesh, Cambodia, China, Cook Islands, East Timor, Fiji, Guam, India, Indonesia, Iran, Japan, Lao, Malaysia, Mongolia, Myanmar, Nepal, New Zealand, Pakistan, Papua New Guinea, Philippines, Singapore, South Korea, Sri Lanka, Taiwan, Thailand, Vanuatu and Vietnam. APN+ seeks to address problems PLWHA face in these countries by raising concerns and issues on regional and world stages. It does this through ensuring effective and committed representation on organisations such as the Asia Pacific Coalition of AIDS Service Organisations (APCASO), Global Network of PLWHA (GNP+), Seven Sisters Asia Pacific Coalition, International Treatments Preparedness Coalition, and wherever possible, on the Global Fund for AIDS, Tuberculosis & Malaria (GFATM) regional bodies and GFATM Country Coordinating Mechanisms (CCM).

Over the years APN+ has developed considerable expertise in many aspects of HIV and AIDS. This expertise includes advocacy, counselling, governance, HIV and gender, HIV-related discrimination, human rights of PLWHA, implementing GIPA, networking, organisation development, PLWHA in the workplace, self-care and empowerment, treatments, and working with vulnerable and marginalised groups. APN+ has also developed a comprehensive range of skills and experience in key programme management and implementation fi elds related to HIV/AIDS. These include social research, education and awareness raising, training, resource production, positive speaking, advocacy, evaluation, and grants management.

In addition to the work activities described above APN+ offers a proven record of responsibility and accountability in its work. This has resulted in a strong reputation with stakeholders for good organizational governance and fi nancial management, establishing and maintaining strong links with HIV-positive people in Asia Pacific and around the world, and successfully collaborating with key donors and partners on projects and issues of key importance. At the time of writing APN+’s main funding sources included the American Foundation for AIDS Research/TREAT ASIA, International Federation of Red Cross Red Crescent Societies, Levi Strauss Foundation, POLICY Project (with funds from USAID), and Tides Foundation/Collaborative Fund. Support and technical assistance have been provided by NAPWA Australia and GNP+.

This document outlines how APN+ proposes to build on its unique skills and strengths in working toward its vision of a better world for PLWHA.

APN+ STRATEGIC PLANNING PROCESS

After 12 years of working to empower and build the capacity of PLWHA in the Asia Pacific region the APN+ Steering Committee recognized that for the Network to remain focused and effective in its work it would be necessary to embark on a comprehensive strategic planning process. This need to develop a clear and focused long-term strategy has stemmed from a number of factors that include APN+’s increasing influence in the Asia Pacific HIV/AIDS sector, its growth in regional membership, and its continued maturity as an organisation representing PLWHA.

This strategic plan was developed over an eight-month period beginning in August 2005. The process began by consulting widely with all APN+’s stakeholders and concluded in a two-day strategic planning workshop involving more than 40 network representatives. The aim of the process was to help focus APN+’s future strategic direction and objectives, and through this better help define the network’s role in the regional response to the HIV epidemic. A key aspect of the process was to invite stakeholders to raise issues that they felt were essential to the continued success of APN+. These issues were collated over a period of several months, grouped into themes of strategic importance, and finally taken forward to the strategic planning workshop for detailed and careful consideration as to how the network could most effectively respond to the needs and challenges raised.

This is the first document to articulate APN+’s long-term strategic directions and objectives. It is designed to provide APN+, as well as partners, governments and other key stakeholders with a clear understanding of APN+’s future work and how it aims to contribute to improving the lives of PLWHA throughout the Asia Pacific region.

FROM STRATEGIC ISSUES TO STRATEGIC DIRECTIONS AND STRATEGIC OBJECTIVES PLANNING PROCESS

APN+’s strategic focus has been traditionally associated with strengthening the capacity of PLWHA and providing a platform for their voices to be heard in the Asia Pacific region. This has been realised by supporting country national networks to advocate on behalf of PLWHA, by building their capacity, and through strengthening partnerships with key stakeholders. Following the stakeholder consultation exercise the network recognised there was a need to address a number of additional strategic issues if it were to continue to effectively represent PLWHA in the Asia Pacifi c region. These issues were grouped into four main themes and became the directions in which APN+ would need to move in the coming five-years. These strategic directions build on the solid core foundation of the network’s existing work and are:

In this plan APN+ has aimed to incorporate these new strategic directions into its work as a means of building on its current core strengths. This is refl ected in an updated mission statement developed during the strategic planning workshop that clearly outlines APN+’s values, what it does, and what it aims to achieve through its work by 2010.

The workshop participants developed fi ve strategic objectives that were clear, focused and sufficiently broad in scope to enable APN+ to grow its work in creative and exciting ways. These are expressed in the symbol of the diamond that will form the basis of APN+’s work.

APN+ MISSION STATEMENT

The values of equity, the meaningful involvement of PLWHA (GIPA) and universal human rights perspectives guide everything we do in our work.

As PLWHA we have unique knowledge about the challenges of living with HIV and AIDS and through our own diverse lived experiences are able to understand the views and needs of PLWHA. We use this knowledge to represent individuals, and marginalised and vulnerable populations who are often unable to effectively represent themselves. We represent PLWHA on the world stage by proactively sharing information and knowledge, through building alliances and partnerships, through capacity building, by conducting training and workshops, and by undertaking research.

As a network we conduct our work by advocating for access to prevention interventions, treatment, care and support (Universal Access); and campaign to reduce the stigma and discrimination experienced by PLWHA through public speaking and advocating for prevention interventions. We campaign so PLWHA can live in a world free of self-stigma and self-denial of HIV/AIDS so they can access the support they need. We campaign for all organisations to embrace PLWHA supportive policies in an effort to remove stigma and discrimination. We acknowledge that many PLWHA in the region live in poverty, lack access to adequate services, and are prepared to work in partnership with others to address this.

As a network we aim to empower our Members through setting our own priorities. We work to build the skills of PLWHA in ways that aim to improve their quality of life, so communities can develop sustainable ways of living with HIV and AIDS in non-discriminatory, transparent and accountable ways. We aim to co-ordinate the regional PLWHA response and encourage good practice models. We support our members to mobilise their resources for achieving greater impact in their work, and to help them engage in network development, advocacy, knowledge sharing and capacity building in their own right, and consequently future fundraising for network activities is crucial. We want an environment in which all PLWHA have access to appropriate services and treatment and through selfcare are able to manage living with HIV and AIDS and contribute to prevention efforts. The network structure devotes particular attention to the needs of women living with HIV and AIDS. The network structure relies substantially on voluntary efforts, and there is a paid secretariat.

As the regional PLWHA Network we strive for closer co-operation with national PLWHA country networks. Through our expertise in linking with communities we support the development of national PLWHA networks as well as sub-regional PLWHA issues and efforts. Through a partnership approach our aim is to support Members of APN+ to be seen as the leading authority and representative of PLWHA in their own countries.

We aim through regional networking to mitigate the impact of HIV on our communities and address the imbalances that adversely affect marginalised and at risk populations to reach our vision of a better world for PLWHA.

The remainder of this document details how APN+ will implement its ‘mission’ as a means of realizing its vision.

STEPPING-UP ADVOCACY FOR PLWHA IN THE REGION

Meaningful involvement of PLWHA and the Greater Involvement of PLWHA… requires true participation, which in turn cannot be achieved without complete empowerment and we need to walk together. To do this WE need action, WE need committed leadership and WE need to bring back real community driven advocacy and where it doesn’t yet exist WE need to develop it.
(Maura Elaripe Mea, APN+ Network Member – Igat Hope)

For APN+, advocacy means promoting human rights for PLWHA and fi ghting discrimination related to HIV/ AIDS. This includes advocating for rights to health, access to treatments including treatments preparedness and care and support (Universal Access), freedom from degrading treatment, privacy, liberty and security, work, choosing partners and family, shelter, property, freedom of association and education. As the respected and collective voice of people living with HIV and AIDS in Asia and the Pacifi c region, APN+ is in a unique position to advocate for PLWHA. We support representatives on a range of important committees and decision making bodies, including:

Promoting the greater involvement of people with HIV and AIDS (GIPA) in all levels of the HIV response is a central feature of our advocacy work. GIPA has been endorsed in multiple forums (including the UN General Assembly), yet despite widespread offi cial support, implementation remains slow and inadequate, and PLWHA continue to report high levels of stigma and discrimination in many aspects of their working lives. As a concept GIPA remains poorly understood by those individuals and organizations responsible for its implementation, even among health care workers and government officials. There is still relatively little commitment to involving and integrating positive people in programmes providing HIV care, support, prevention and education, and few governments or non-government organisations include positive people in responses to HIV/AIDS at national or local levels. A key aim for APN+ is to rectify this lack of understanding, better promote and advocate for GIPA, and argue for the importance of PLWHA in the response to the epidemic.

For APN+ addressing work-related stigma and discrimination is a key component of our advocacy work. To help overcome this discrimination APN+ conducts advocacy training programmes that promote understanding amongst PLWHA and representative groups (including other stakeholders) of their rights and how to advocate for those rights. We also produce literature that outlines the basic rights to which people with HIV are entitled and how positive workplaces may be built. APN+ importantly supports people to self-advocate by providing training material for HIV-positive speakers. This enables positive people to use their own ‘voice’ resulting in more informed discussions and better HIV responses, as well as helping to foster positive perceptions of PLWHA. The result of this training is often stronger advocates and means PLWHA are seen as contributors to national and regional solutions, rather than being perceived negatively as people always dependent on help from others.

In all of its work APN+ is committed to supporting positive women’s advocacy. In many communities the disadvantage of being HIV-positive is exacerbated by gender discrimination. Women with HIV are especially vulnerable to discrimination, exploitation and violence, and APN+ is committed to working in ways that enable positive women to respond to the many issues that directly affect them. APN+ also recognise that sex workers, transgender, IDU, MSM, orphans, youth-and many migrant workers are equally marginalised and in need of advocacy support. APN+ is committed to supporting and representing these groups.

In addition to continuing with many of its existing approaches to advocacy work, APN+ aims to develop its approaches by becoming increasingly organised and targeted in the way it advocates for and with PLWHA. A major change for APN+’s future work comes in stepping-up advocacy through providing guiding leadership as a way of raising issues affecting PLWHA more prominently. In terms of promoting a better understanding of
GIPA, APN+ aims to proactively develop a greater awareness of the importance of its role in the context of the HIV response and the various ways PLWHA can contribute to HIV responses.

APN+ will increase raising awareness on how GIPA can be practicably implemented (for example through peer support, peer education, advocacy, public education, counselling, programme planning and implementation). APN+ will also help identify key areas where policy and legal reform are required, such as in public health policy and legislation. These reforms include the involvement of women, human rights (including rights to inheritance and property), gender based violence, access to treatments and prevention services (including the lobbying of pharmaceutical companies for more affordable treatments), access to voluntary confidential counselling and testing, an end to mandatory testing in clinics and hospitals, and the economic empowerment of PLWHA. APN+ will also increase its orientation to advocating in areas of sexual and reproductive health, and for the protection and rights of orphans and vulnerable children.

To continue moving forward with its work of advocating effectively for and with PLWHA in the region, APN+ has set itself the following strategic objective to guide its future work:

To provide leadership by actively advocating from the regional level for the equal rights of all PLWHA as well as ensuring full participation and representation in the response to HIV/AIDS.

A key factor in ensuring the successful implementation of this objective will be to support representatives on important committees and decision making bodies, in ways which Network members feel comfortable, and appropriate in their own country contexts and ensuring that they in turn provide feedback to the community through the Network.

STRENGTHENING THE CAPACITY OF NETWORK MEMBERS

But not all of APN+’s work is concerned with grand institutional capacity building approaches. APN+ also recognises that individual positive people need adequate skills and opportunities to participate fully in the response to HIV/AIDS. Skills training is necessary to increase people’s capacity to manage their own lives effectively while living with HIV. Positive people need skills to build their own networks, carry out their own research, design and implement their own programmes, and engage in dialogue with government to design and develop policies that will protect their rights and improve their quality of life. Most importantly, positive people need the capacity to plan, monitor and evaluate their own projects—no matter how small— in maintainable and sustainable ways. This requires sourcing and providing financial support just as any other organisation relies on funding to maintain its activities.

APN+ also recognises the importance of building the capacity of PLWHA to care for themselves and other positive people. This is essential in countries with inadequate health services or where stigma and discrimination make self-care the only current option. Many PLWHA benefit from counselling and peer support. This helps them come to terms with the impact of being HIV-positive, often empowers them and helps them cope better with stigma and discrimination, or supports them in disclosing their status to family, partners and friends. APN+ will continue to develop these necessary peer training resources that help build the skills of PLWHA to provide psychological and emotional support and counselling. Though peer support more PLWHA are likely to raise their awareness on access to services, the importance of self-care, and ARV/OI adherence.

While APN+ aims to continue with these key capacity building approaches, the change for the future comes in attempting to better understand the needs of individual country members, and how they can be best supported to recognise and support the needs of the people that rely on them most. This begins with developing a thorough understanding of those needs, including the current skills and knowledge available to meet those needs, and an understanding of how the network’s internal and external resources can be most effectively utilised to provide the required support.

To continue moving forward with its capacity building activities, APN+ has set itself the following strategic objective to guide its future work:

To further develop the capacity of APN+ networks in the areas of skills, knowledge and attitudes, responding to identif ed needs and using a range of internal and external resources that allow organisations and individuals to grow and sustain their networks.

Ensuring that APN+ is able to meet this objective and overall Mission is also dependent on building the capacity of its own secretariat and steering committee. In recognition of this, APN+ has also developed an objective aimed specifically at  addressing a number of internal organizational development issues, such as developing a comprehensive human resource strategy so network members are more ably supported. APN+ recognises that initiatives to improve the overall management functions of the network, which include developing effective systems, structures, policies and procedures; particularly those related to reporting, communication, fundraising, and monitoring and evaluation are key to this plan’s success. To meet this aim APN+ has set itself the strategic objective:

To develop the capacity of the APN+ secretariat and steering committee in core leadership and management areas in ways designed to efficiently and effectively support network members in achieving their own country missions and objectives.

The two strategic objectives above are inextricably linked: network members need to develop their capacity and the success of this depends on APN+’s capacity to support them and their communities in the most able and professional way. APN+ will embark on fulfilling these joint objectives by creating a human resources development strategy that considers the needs of the network at all levels.

FOSTERING AND STRENGTHENING STRATEGIC ALLIANCES THROUGH NETWORK DEVELOPMENT

APN+ has a reputation for effective networking and building partnerships and alliances aimed at better responding to the needs of PLWHA. Much of this networking is orientated toward the core work areas of advocacy, increasing cooperation and sharing knowledge. For many PLWHA, speaking out is difficult—sometimes dangerous. They report a sense of alienation and isolation, and are frequently discriminated against by their families, communities, work places and in health care settings, and are often the subject of violence. As a way of helping overcome these discriminatory barriers, APN+ supports representative PLWHA to build their own networks. This is important in countries were such networks would only come into existence with the external aid of APN+ and its partners, as has been the case in Lao for example. Here, APN+ has, in partnership with other agencies, helped the Lao Network of PLWHA (LNP+) to foster relationships with other groups of positive people within the country. This development of strategic alliances has enabled LNP+ to align its own activities with those of APN+, thus strengthening the network at both a country and regional level. Similar support programmes have been undertaken in China and Cambodia, and the aim will be to continue to work toward fostering and strengthening these types of strategic alliances through network development in innovative and supportive ways.

Fostering strategic alliances is also important for infl uencing policy development and ensuring continued funding support from donors. In terms of policy development, APN+ aims to support country governments in creating appropriate laws and policies aimed at respecting diversity and the rights of people living with HIV and AIDS. With regard to funding, APN+ aims to use this strategic plan as a means to assure donors of its commitment to responding effectively and adequately to the needs and concerns of PLWHA by being the leading voice for positive people in the region.

APN+ also uses its networking influence to provide and support a positive presence and focus at international and regional AIDS conferences and other forums. By bringing its expertise to conferences and forums in this way APN+ is able to raise issues affecting PLWHA on themes such as GIPA, prevention, positive advocacy and positive sexuality. By using its unique strengths as leverage APN+ is committed to ensuring that conferences and forums pay proper attention to issues for PLWHA, and to ensure that GIPA principles and the issues of our communities are reflected in conference proceedings. APN+ also plays its part in bringing positive people together from across the region where they can build coalitions for change and share strategies to overcome barriers to securing better health care.

Since its formation in 1994 APN+’s network membership has strengthened considerably. This growth means there is a need to begin planning strategically for the future in the ways APN+ creates and maintains its networks, including its reasons for entering into these partnerships. To continue moving forward with its work of fostering and strengthening strategic alliances through network development, APN+ has set itself the following strategic objective to guide its future work:

To build and strengthen the network of all PLWHA organisations at regional, sub-regional and national levels in meaningful partnership with governments, donors and civil society as a way of advancing the APN+ positive agenda.

In addition to continuing with many of its existing work activities, APN+ aims to strengthen its networks by forging sub-regional networks under the umbrella of the main Asia Pacific network. This approach has the advantage of facilitating closer regional cooperation and coordination amongst network members that share many cultural cooperation also enables those more developed members to provide support and guidance to emerging network neighbors without the need for continual secretariat intervention, thus helping generate a more sustainable network. Part of this process will be to develop terms of reference and memorandums of understanding to help define relationships, and also to illustrate to governments and other key players in the HIV/AIDS field the reach APN+ has across and within nations.

Ensuring effective regional cooperation also relies on good communication. A key task for the future will be to establish a communications strategy that enables the APN+ secretariat to proactively engage with its members and stakeholders and through this process will come to better understand the networking abilities and needs of its membership. Wherever possible, the network will continue to strengthen its membership to ensure adequate representation of PLWHA from the region.

INCREASING KNOWLEDGE SHARING AMONGST NETWORK MEMBERS

APN+ has long been concerned with raising awareness and sharing knowledge of HIV/AIDS issues related to enhancing the lives of positive people. This is done to combat stigma and discrimination; promote a better understanding of GIPA and the rights of PLWHA, as well as to enhance understanding of the many other issues that affect the quality of life of positive people. This awareness raising is frequently undertaken through producing accessible, reader-friendly publications that help inform HIV-positive people and their families, communities and workplaces about issues affecting PLWHA (such as their human rights and the latest developments in medicines and treatments).

In addition to raising awareness APN+ has also been engaged in conducting research-based studies that help highlight the discrimination and diffi culties faced by PLWHA in the region. Recent examples include AIDS Discrimination in Asia (2004)1 - a two-year study (2000-2002) into the widespread discrimination that more than 700 PLWHA face in India, Philippines, Indonesia and Thailand; a baseline survey of GIPA and stigma and discrimination in the Greater Mekong Region conducted for the POLICY Project; and a current peer led project (conducted jointly with the Red Cross Red Crescent Movement) assessing the impact on PLWHA of the 2004 tsunami in the countries of India, Indonesia, Sri Lanka and Thailand. Such pioneering work is generally well received and illustrates to the wider community the unique understandings obtained when PLWHA do research for, and with, positive communities.

In addition to continuing with many of its existing approaches to sharing knowledge, APN+ aims to build on its work in this area by becoming increasingly skilled in the way it conducts research and produces publications. A key change for APN+’s future work comes in increasing the level and range of knowledge sharing amongst network members in a number of key areas. These include awareness raising on new initiatives concerning treatment education, literacy and advocacy as a way of helping PLWHA become better informed about anti-retroviral therapies, and the appropriateness and application of ARV and OI management, drug compliance, adherence, and managing side effects. APN+ also aims to make better use of information technology by making its publications accessible via the Internet in more accessible, and wherever possible, multi-language friendly formats.

To continue moving forward with its knowledge sharing activities APN+ has set itself the following strategic objective to guide its future work:

To strengthen the exchange of knowledge and information among PLWHA, their networks and other key stakeholders through undertaking research, developing publications, providing trainings and securing adequate resources for the purpose of responding effectively to the needs of PLWHA in the region.

Working effectively toward this objective will require supporting network members to become more proficient in undertaking research and writing publications. For APN+ this is a particularly challenging area of work, but nevertheless an exciting one in which network members can practice finding their voice on issues that concern them most.

TOWARDS A POSITIVE FUTURE

In implementing this strategic plan APN+ acknowledge that its network members face very different cultural and contextual challenges in their work. In recognising these constraints this strategic plan has been designed to enable network members to select activities that are most appropriate to the context of their home countries. Actively advocating for the rights of PLWHA, for example, will be a more challenging process for some members than others. This plan recognises those challenges and enables members to select the most appropriate activities (identified in APN+’s annual work plans) from each strategic objective—based on an understanding of their current and developing operating context. In this way, the network is able to proceed step-by-step, some large - some small, toward its mission, but always within the developing capabilities of each network member.