Derived from their direct, day-to-day, in country and community, work experience and analysis of the HIV/AIDS pandemic, the community of people and organisations using communication and media strategies to address HIV/AIDS strongly encourages HIV/AIDS policy makers and funders to adopt the following common themes and objectives as integral to their strategic direction and financial investments.

These policy and investment proposals are also derived from substantive programme experience, lessons learned from addressing other relevant, major development issues [eg the civil rights and womens movement] and evaluation and research data on these approaches [see reference below].

THE REALITY

Though there may be just a few small signs of progress - see the UNAIDS report released just before this Conference - the harsh reality remains that HIV/AIDS continues to be a massive development issue upon which there has been only the slightest possible dent from the [perhaps] hundred billion dollars of investment over the past 20 years. In our view this is because the HIV/AIDS policy emphasis has insufficiently included a central focus on the core drivers of this epidemic - including multiple concurrent partners, stigma, discrimination, transactional sex and other significant social and economic factors.

HIV/AIDS is a complex issue in whatever context it manifests. It is the communication community that best understand how to take effective action within those complex dynamics. The following programmatic package is essential for effective HIV/AIDS action across the full smorgasbord of HIV/AIDS issues - as relevant to ART understanding and uptake as to changing social norms around concurrent partnerships.

1. GO DEEP, GO LONG!

Even if a vaccine arrived tomorrow [and we are a long way from that] HIV/AIDS is still a long term issue deeply entrenched in social, cultural and economic norms, beliefs and contexts. There are no simple solutions. We need to think long term and address the deep issues in each and every individual context.

Policy Suggestions: Work with children beginning to develop their skills at discussing friendship, care, respect, emotional openness and other building blocks for later healthy sexual relationships; Work in support of national and local media focusing on ways in which stigma, discrimination and prejudice can be removed from their coverage of HIV/AIDS issues and that their publics can both receive more accurate information and be engaged in debate on these important issues; Work at national, local and family levels exploring healthy family dynamics that support dialogue on the really difficult sex-related issues that drive the epidemic; Include a "social drivers" component in all policy and funding initiatives.

Investment Requirement: That 50% of all HIV/AIDS investments are focused on the core beliefs, norms, policies and social and economic dynamics that establish the context for the growth of HIV/AIDS issues.

2. ALL HIV/AIDS IS LOCAL...and NATIONAL

HIV/AIDS scenarios differ from local context to local context and from country to country. For too long the global HIV/AIDS community has supported - sometimes inflicted - a few pre-established programming priroities and patterns. That needs to change.

Policy Suggestions: A much higher emphasis on support for the judgments of locally and nationally commenced HIV/AIDS initiatives, under autonomous local/national leadership and decision making, establishing and implementing the priorities and interventions they think will make a big difference. This will more effectively harness a much broader range of local and national resources, talents and energies relative to each unique context. Mistakes will happen - but the organised global effort has hardly been mistake free!

Investment Requirement: Move quickly to a situation in which 50% of all financial investment in HIV/AIDS action is for locally and nationally commenced and managed HIV/AIDS focused groups and organisations.

3. REFLECT: DEBATE!

The emergency style beginning to the AIDS response continues to set the policy tone for the nature of the action that takes place. But many countries are struggling [and have struggled for a long time] to reduce HIV/AIDS rates in any significant way. Public and private reflection, debate and dialogue are central components of all social change/movement processes that have demonstrated progress and continue to have positive traction - eg civil rights, tobacco, the womens movement, human rights, anti-apartheid.

Policy Suggestions: Now is the time to encourage, as a matter of formal policy outlined by policy makers and funders, the engagement of all those affected by HIV/AIDS or engaged in HIV/AIDS related action, to take a step back, reflect on the issues and action to date and to debate the best ways forward in their context.

Investment Requirenent: That funding be shifted from international and nationally formulated "message" driven policy and communication processes to support for programmes and processes that encourage countries and communities to reflect, discuss and debate the analysis of the HIV/AIDS situation in their contexts as a core component of the porogrammatic action.

4. THE CLOSER YOU ARE THE LOUDER THE VOICE

HIV/AIDS will only be significantly addressed when the response moves from being driven by technical experts on the individual elements of the HIV/AIDS problem, to being led by the people most affected. Technical should support not lead. No major global issue that is rooted in significant cultural, social norm and economic circumstances, as is the case with HIV/AIDS, has ever been resolved without the voices of the people most affected being the most prominent in describing the issues and defining the acceptable response.

Policy Suggestions: Support genuine national and community consultations - sadly many such processes at present have the look and feel of thinly disguised selling of programmes and ideas rather than listening, learning and supporting; Support moving people living with/directly affected by HIV/AIDS from the margins of policy making and investment/financial decisions to be central, "loud" and influential; Place a much higher priority on supporting the voices and perspectives of sex workers in HV/AIDS policy and decision making forums - local community, national and global policy and decision making decision fora.

Investment Requirement: Double the present levels of financial and strategic support for local, national and global networks of people living with HIV/AIDS and ensure that those networks have prominent places in all HIV/AIDS related decision making fora.

5. CULTURE RULES

Different languages means different concepts and understandings; disease, illness and death have very different explanations and meaning in different cultures; the concept of "prevention" has a full range of meanings; and hundreds of other examples. We are all to some extent captured by our own culture - the norms, behaviours, expectations and beliefs that we ascribe to such key HIV/AIDS strategy concepts as fidelity, abstinence, safety, relationships, negotiation, authority, family, friendships, care, trust, etc will all be informed and shaped by each of our cultures - and the sub-cultures within those cultures.

Policy Suggestions: We can no longer afford to ignore these important cultural differences and subtleties because they do not fit a global or national plan of action. It is these cultural issues that have eroded and undermined those plans. Many HIV/AIDS policies and strategies seem to treat culture as neutral, irrelevant or an obstacle. Instead we should recognise and embrace culture and work from that base in a discursive and reflective manner seeking the changes required. This is real stuff.

Investment Requirement: Double the levels of financial investment in communication processes that are rooted in local and national cultural traditions and/or practices - for example from local decision making fora and traditional drama forms to the modern language, art and music variations of young people within those communities and common, important national stories, symbols, icons and points of resonance.

6. TRANSFORM GENDER

A radical change is required in the way gender is communicated across all HIV/AIDS communications: presently women are generally portrayed as passive, submissive, and sexy but not sexual; men are generally portrayed as dominant, aggressive, only wanting sex; and, language, music and color are used to reinforce gender role perceptions. For example a gender analysis of HIV communication campaigns in Latin America and the Caribbean demonstrated sexual roles/relationships tend to be simplified, particularly fidelity. If overall HIV/AIDS action is to be effective this communication pattern needs to change.

Policy Suggestions: That a much higher emphasis be placed on analysis of the gender perspectives in HIV/AIDS communications. That that analysis - in concurrence with the other elements above - primarily involve people most affected by HIV/AIDS and local and national actors. The results of those analyses would then feed private dialogue and public debate on the gender related HIV/AIDS issues and interventions.

Investment Requirement: Analysis and debate of gender perspectives should be a central part of all HIV/AIDS funding processes.

7. OUR LIVES - OUR RIGHTS

There are numerous human rights issues at the core of the HIV/AIDS problem and response. Confidentiality re health status; equitable access to services and health products; free choice re sexual consent; gender equity; reproductive rights; absence of discrimination re sexual preference; and many other vitally important rights. These rights need to be not only respected and advanced but to be central to an effective, long term HIV/AIDS response. The ends will never justify the means when it comes to the possibility of compromising human rights for imagined HIV/AIDS success.

Policy Suggestions: As an important element of both the "Reflect: Debate"; "Gender", "Culture" and "Voice" programme elements to facilitate and introduce human rights issues and factors as part of those processes.

Investment Requirement: Analysis and debate of humna rights perspectives should be a central part of all HIV/AIDS funding processes.

8. COMMUNICATION SKILLS

Seeking long term norm changes; supporting local and nationally driven action; facilitating reflection and debate; working across and within different cultures; helping to amplify the voices, analysis and ideas of the people most affected by HIV/AIDS; and, addressing the very sensitive gender issues at play in HIV/AIDS requires very skilled communication personnel. Harnessing these skills has proved problematic. Almost everyone regards themselves as a communicator - because they can communicate. But this no more makes them a communicator then saying everyone is an epidemiologist because we can all count. And HIV/AIDS communication processes are too often confused with communication product production: media releases, poster design, video production, entertainment script writing, etc. That is not communication.

Policy and Investment Suggestions: As a policy and funding priority the identification and training of a significantly increased cadre of HIV/AIDS communicators.

THE DATA

There is significant data to support the approach outlined above. That data can be accessed and then reviewed amongst the many evaluation summaries at http://www.comminit.com/en/taxonomy/term/36%2C11%2C86%2C250/all

LEARNING MORE

There is so much more to learn to ensure that these approaches are even nore effective: this requires wide ranging consultations and a debate and reflection process on how to even more effectively tackle the social drivers of HIV and their distinct character in each national context". It would aim to bring together at the national level all the current research and experience on the social drivers in that particular context. This would be integrally linked to wide ranging public consultations on the real barriers and social issues driving HIV.