EXECUTIVE SUMMARY
Communities were the first responders to HIV three decades ago, and they remain essential in advocating for a robust response to the epidemic, delivering services that can reach everyone in need and tackling HIV-related stigma and discrimination. Working alongside public health and other systems, community responses are critical to the success and sustainability of the global response to HIV.
There is now wide recognition that community responses must play an increasing role in addressing the epidemic in the years ahead. The Strategic Investment Framework, published in 2011, identifies community responses as a “critical enabler” of service delivery. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has estimated that to achieve bold HIV treatment and prevention targets set in 2014, investments in community mobilization and services must increase more than threefold between 2015 and 2020 (1).
Much of the critically important work in making progress in the response to HIV and implementing a Fast-Track approach that lies ahead—including broadening the reach of services, supporting retention in care, increasing demand, monitoring quality, advancing human rights and combatting stigma and discrimination—can only be achieved with a strong community voice and presence.
This report draws on multiple sources to document the many ways in which communities are advancing the response to AIDS, and the evidence for the effectiveness of these responses. Core areas of community-based activities include advocacy, service provision, communitybased research and financing; each of these areas is illustrated by examples of communitybased actions.
A World Bank study of HIV service delivery from 2010 to 2012 found that community-based efforts are a “cornerstone” of the response to AIDS and represent substantial value relative to financial investment in the sector (2). Studies from countries as diverse as Cambodia, South Africa, the United Republic of Tanzania and Zimbabwe point to the effectiveness and costefficiency of community-based HIV services. Numerous studies from around the world document the success of community health workers in enhancing the reach, uptake and quality of HIV services.