The last two years have seen intense debate over different approaches to HIV/AIDS communication. In particular, there has been a growing questioning of social marketing and behaviour change oriented communication, and increased interest and debate focused in the field of Communication for Social Change, an approach to communication that focuses less on changing individual behaviours and more on empowering communities and societies to tackle the underlying issues of discrimination, poverty and marginalisation that are driving the epidemic in the first place. As these issues are closely related to the substance of the Roundtable, this section seeks to explain some of the main issues involved.

Two developments in particular have focused debate on this area, the first the publication of a new framework on Communication produced by UNAIDS, the second the work of the Rockefeller Foundation in this area.

2.1.1 UNAIDS New Communication Framework

The UNAIDS framework made a series of recommendations and set out a new framework for HIV/AIDS prevention. The conclusions of the framework were summarised very effectively in a paper prepared for UNAIDS by Arvind Singhal(2):

"The UNAIDS framework calls for refocusing communication interventions on the basis of five key contextual domains: (1) government policy, (2) socio-economic status, (3) culture, (4) gender relations, and (5) spirituality. These contextual domains, while they lie outside the control of individuals, have a significant influence on their HIV/AIDS-related health behaviours. In essence, the UNAIDS framework calls for moving away from individual-level theories and models of preventive health behaviours (health belief models, theory of reasoned action, stages of change, hierarchy of effects model, social cognitive theory, diffusion of innovations, and others) to more multilevel, cultural, and contextual explanations and interventions (McKinlay & Marceau, 1999; 2000)"

2.1.2 The Rockefeller Foundation Communication for Social Change Network: behaviour change depends on social change

The findings of the UNAIDS report strongly echoed the work and conclusions of a network facilitated by the Rockefeller Foundation which brings together communications actors and experts, ranging from grassroots and community based NGOs through to international NGOs and major multilateral and bilateral organisations. The Foundation's conclusions argue that while mass education campaigns aimed at changing individual behaviour play an essential role in AIDS prevention, they are highly unlikely to be successful or sustainable unless they are accompanied by deep-rooted social changes which will only result from internally driven change processes, including informed and inclusive public debate.

Many millions of dollars have been spent on individually targeted education campaigns, and many of these campaigns have had important impacts. Increasingly, however, concern is mounting that these campaigns are at best insufficient, in achieving the kind of long term, sustainable and rooted changes in society that are required for HIV/AIDS to be confronted.



The principles and approach associated with Communication for Social Change has been summarised as moving communication frameworks on HIV/AIDS...

• away from people as the objects for change...and on to people and communities as the agents of their own change
• away from designing, testing and delivering messages...and on to supporting dialogue and debate on the key issues of concern
• away from the conveying of information from technical experts...and on to sensitively placing that information into the dialogue and debate
• away from a focus on individual behaviours...and on to social norms, policies, culture and a supportive environment
• away from persuading people to do something...and on to negotiating the best way forward in a partnership process
• away from technical experts in "outside" agencies dominating and guiding the process...and on to the people most affected by the issues of concern playing a central role

Further details of this thinking can be found on the Roundtable (www.comminit.com/roundtable2/), The Communication Initiative (www.comminit.com) and Rockefeller Foundation (www.rockfound.org) websites.