Executive Summary

Because of their central position in people’s lives, the mass media have unrivalled potential to inform and educate the general public. Yet in the response to AIDS only a tiny fraction of that potential has been tapped. In surveys around the world, radio and television are cited as key sources of information about AIDS by large numbers of people. But although there are examples of imaginative and highly successful campaigns, by and large, media coverage of the epidemic is not sufficient to keep the public well informed. There are still millions of people who have never heard of AIDS, and many more who harbour serious misconceptions about the disease.

UNAIDS has been encouraging greater involvement of the mass media in responding to the epidemic. It recently produced a report, The Media and HIV/AIDS: Making a difference, which highlights the many ways in which media organisations can make an impact. Besides offering channels for the communication of public health information and messages, the media can, for example:

• stimulate and lead open and frank discussion of HIV/AIDS;
• provide a platform for those most affected by the epidemic to air their concerns and views, especially people living with the virus;
• challenge stigma and discrimination by providing accurate information about HIV/AIDS, and positive images and role models of infected and affected people;
• encourage leaders to take action, and keep policy-makers and service providers on their toes;
• help create an enabling environment for prevention of HIV infection, and a supportive environment for the care of people living with the virus;
• take steps to give the epidemic the attention it deserves on the news agenda, and to prevent “AIDS fatigue” or complacency from allowing this attention to slip;
• build capacity through partnerships that allow for the sharing and transfer of skills and expertise with others.

However, using the mass media effectively in the response to AIDS presents major challenges. Sensitive health information and often difficult science have to compete for broadcast time and audiences with a myriad of other topics and interest groups, both commercial and non-commercial. And people from the very different worlds of the creative arts and science have to find a common vision and work together as equal partners.

There are many examples from around the world of people and organisations meeting these challenges. This report looks in detail at just a few, and focuses on the Republic of South Africa, which is home to the largest number of people living with HIV in the world. The purpose of the report is to describe the processes by which an original idea for using the mass media to address HIV and AIDS is put into practice, and to share the lessons of experience with all those who wish to do something similar. For example, it looks at:

• how target audiences are chosen;
• how partnerships are formed and decisions made;
• how topics are chosen and messages developed;
• the research process that underpins the production of materials; and
• what ethical issues are raised by addressing HIV/AIDS in the media, and how they are handled.

For this report, a UNAIDS consultant visited South Africa to interview a wide range of people working on the frontline, from project managers, researchers and media executives, to film-makers, audience groups, and people living with HIV who present their own programmes. The aim was to find out not just what has to be done in practical terms, but to gain some insight into the thrills and frustrations of working in the tough environment of the mass media, and to discover the secrets of survival and success. The organisations have very different histories, target audiences and ways of working, and represent a wide range of experience.

Soul City: a model of “edutainment”

In the early 1990s, Garth Japhet was working as a medical doctor in community clinics in the remote rural areas and black townships of South Africa. He found himself dealing constantly with diseases that were preventable and emergencies that should not have happened. This convinced him there was a pressing need to give people information to safeguard their own health, and he decided to work with the mass media.

Research suggested that the most effective way to reach large audiences with health messages was to incorporate them into a popular entertainment format designed for prime time-an approach known as “edutainment” because it sets out to educate and entertain at the same time. Dr Japhet wanted to create a vehicle that could deal with a range of health and development issues over an extended period and in a realistic context, so he chose soap opera for TV and radio, to be supported by print material. In 1994, Soul City, a drama set in a community clinic in a poor, crowded neighbourhood was launched.

The television drama is the centrepiece of a multimedia programme that includes in each series 13 hour-long television programmes and 60 15-minute radio dramas. Three 36-page colour illustrated booklets address in greater detail the issues raised in the dramas and are serialised in national newspapers and then distributed as booklets through the newspapers, clinics and nongovernmental organisations. In addition, there is a wide range of outreach materials and services.

Today, the Soul City Institute for Health and Development Communication is an established institution. It has a staff of 50; over 100 contract workers; strong professional relationships with a host of partners in the media and creative fields and in research, education, health and development; and ongoing support from a number of core donors and sponsors.

Soul City’s original target audience was “disadvantaged South Africans”, which, as a result of apartheid, meant predominantly black people. However, the drama goes out on prime time TV and so attracts a hugely diverse audience. In 1999, multimedia drama for children aged between eight and twelve years, called Soul Buddyz, was launched.

All materials are developed on a solid foundation of research which accounts for around 75% of the time and 15% of the budget of each edutainment series. Because the work-load is cyclical, and many skills are required intermittently, Soul City employs a core staff to run the project, and buys in expertise as necessary on a contractual basis.

The Community Health Media Trust: giving a voice to people living with HIV

The Community Health Media Trust (CHMT) was established in 1998 by two Cape Town men, Jack Lewis, who runs a film company called Idol Pictures, and Zackie Achmat, of the Treatment Action Campaign (TAC). They realised that, although South Africa had one of the most serious HIV epidemics in the world, none of the coverage about it in the mass media spoke directly to people living with the virus. Together they set up a non-profit company specifically to address issues of concern to HIV-positive people, such as their rights, the quality of services, and access to treatment.

The programmes are broadcast under the series name, Beat It, and have an activist slant. They have been putting pressure on government to improve treatment services and provide antiretroviral drugs. Until the government announced a comprehensive treatment plan in 2003, CHMT’s editorial stance, which often criticized the government, made it hard to sell the Beat It series, and impossible to work with the state-owned South African Broadcasting Corporation (SABC). The company eventually secured broadcast time for the first three series of Beat It with an independent commercial broadcaster, albeit with much more limited audience coverage. Then, with a change in the political climate in 2003, CHMT managed to secure a part¬nership deal with SABC Education, an organisation that provides educational programmes to the national broadcaster and other outlets. The deal was for 26 half-hour television programmes to be made by CHMT, with each partner financing 13 programmes.

The new series, called Siyayinqoba1 Beat It, was launched on SABC television in September 2004. Each 30-minute episode starts with a documentary short segment that provides background on an AIDS issue. This is watched by the programme presenter, an HIV-positive individual, in the company of a support group of people living with HIV. The group members who are the same each week to encourage identification by the audience take up the issues raised by the documentary segment and discuss them in the light of their own experiences. An expert comes in near the end of the programme to explain or expand on the technical information.

Material from the Beat It television programmes has been repackaged to produce a series of training videos, each one covering a single topic in detail. For trainers who may have limited knowledge of HIV and AIDS, CHMT has produced facilitators’ notes to accompany the videos, and the packages have been sold to a wide variety of customers, including nongovernmental organisations, private companies and civil service organisations such as the police. In addition, CHMT supplies material to the Mindset Health Channel, a satellite broadcast channel that delivers free education to patients and health-care workers in clinics and hospitals across South Africa. Launched in 2004, the Channel is a public-private partnership involving the Department of Health. It aims to broadcast to all 4000 public health facilities in the country by 2009.

Takalani Sesame: big issues for small children

In 1969, Sesame Street, a television programme aimed at fostering the intellectual, cultural and emotional development of pre-school children, was launched in the United States of America. The action revolved around the fictional street, where a cast of ‘Muppet’ characters interacted with children and adults. The programme developed a worldwide reputation, and has been adapted for broadcasting in more than 140 countries.

Sesame Street came to South Africa in 1996. Initially, material produced in the United States was dubbed into local languages for broadcasting to South African audiences. But there were formidable challenges in addressing children from such diverse cultures and backgrounds. Therefore, the South African Department of Education (DoE) which recognised the potential of Sesame Street to deliver Early Childhood Education (ECE) was keen to have the programmes created and produced locally. In 1997, the United States Agency for International Development (USAID) provided Sesame Workshop (the US-based parent company) with a grant to develop South Africa’s own version of Sesame Street, and in July 2000 Takalani2 Sesame was launched officially on television.

Sesame Workshop is a non-profit educational organisation that works in cooperation with the Public Broadcasting Service (PBS) in the United States to air its programmes there. In South Africa, it has formed a five-way partnership with USAID, the Department of Education, the SABC, and Sanlam, a financial services group that is the corporate sponsor. Sesame Workshop also collaborates with local production companies and advisers.

Takalani Sesame’s audience is pre-school children aged between three and seven years and their caregivers. The programmes are targeted especially at the population disadvantaged by apartheid - the seven out of eight children who have no exposure to Early Childhood Development (ECD) services. In the United States and everywhere else, Sesame Street is broadcast on television only. But in South Africa, where 30% of homes still do not have television, a radio version of Takalani Sesame and an outreach initiative were launched.

In a season, Takalani makes some 104 television and 100 radio programmes. Typically, half the programmes are adaptations of material that originates in the United States, while the other half use locally-generated material and feature a cast of South African Muppets made especially for Takalani in the United States. The 30-minute television programmes are broadcast daily on two SABC channels and the 12-minute radio programmes go out three times a week in four different language versions, with regular repetitions to aid learning.

The objective of all Takalani Sesame programmes is to encourage children to develop self-esteem, to respect and appreciate others, and to develop basic skills with letters and numbers, life skills and a life-long love of learning. The programmes teach by example, presenting positive role models and positive behaviour. An outreach programme deepens the educational impact of the broadcasts through training educators and parents in the use of related printed materials, videos, audio-tapes, and web-based information.

Besides providing pioneering radio programmes, Takalani was the first Sesame project to tackle the issue of HIV and AIDS. In September 2002, a five-year old girl Muppet with golden fur called Kami joined the show. Kami is an HIV-positive orphan whose mother died of AIDS. Her primary role is to humanize and destigmatize people living with HIV, and to open up discussion about issues such as coping with illness and loss.

The lessons of experience

This report ends by looking at the lessons of experience that should help others who want to work with the mass media in the field of HIV and AIDS. Some examples include the following.

• Producing a pilot programme is an important first step in getting a new initiative off the ground.
• The more popular appeal an idea has, the easier it will be ‘sell’ to the media and to donors.
• Using a mix of media enables a project to make the maximum impact on the general public.
• Mass media projects involve many participants with different skills, viewpoints and ways of working.
• For such projects to succeed, teamwork is essential. So too is good management.
• Buying in services and expertise on a contractual basis is often the most cost-effective and efficient way of working.
• In educational broadcasting the review and decision-making processes are more complex than usual. Production companies need to be aware of this, and to take it into account in negotiating time schedules and budgets, or else it causes stress and friction.
• Involving creative people such as scriptwriters and producers in the develop¬ment of messages-and even in field research where appropriate-can help them acquire a depth of knowledge and insights that are invaluable when it comes to making programmes.
• Enabling the general public to interact with a mass media project encourages awareness, debate and personal identification with the issues.
• Rigorous research is the key to effective use of the mass media for social purposes. It guarantees the quality and reliability of the product and its relevance to the target audience.
• The effect of appearing on nationwide television can be dramatic even for people who are already open in terms of their HIV status.
• Encouraging people to open up during interviews can release powerful feelings, including expectations that the interviewer will be able to help resolve their problems. Such expectations can be overwhelming if interviewers are not properly prepared.
• Organisations driven by a sense of mission need to be careful not to exploit the sense of commitment in their staff.
• Success breeds success. Continued support from media organisations and funders depends on proof that a project is achieving its goals.