Leaders are important in advocacy against HIV/AIDS for a number of reasons. They have
credibility within their mandates; provide a rallying point for decision and action; help to
define issues and possible, acceptable solutions; have the authority to require others to do
what is necessary; can organize communities and groups for effective responses to the
epidemic; and can help to mobilize and distribute internal and external resources.
Under these circumstances, advocacy may play four key roles:
Advocacy can explore new sources of funds; Advocacy can encourage Governments, civil society groups and development partners to provide more funds for HIV/AIDS prevention and control. In this regard, it is encouraging that more and more African countries are earmarking budgetary resources to combat HIV/AIDS;
Advocacy needs to be directed at ensuring that scarce resources are utilized in the most cost-efficient manner. In the case of the United Republic of Tanzania, for example, there appears to be some debate among stakeholders as to the most efficient way to utilize the allocated funds when they become available. Should they be under the control of the Ministry of Health, through the national AIDS control programme, or be split among identified sectors? The country can ill afford such uncertainty, and advocacy efforts need to be deployed to accelerate a consensus; and
Advocacy can be used to promote equity in the allocation of resources, ensuring that women’s and youth groups obtain a fair share.
Many have argued that the most effective antidote to the spread of HIV/AIDS in Africa is for Africans to change their sexual behaviour, as heterosexual transmission accounts for about four fifths of the HIV infections on the continent. However, the record of BCC interventions, along with promotion of the use of condoms, has been dismal thus far. Although the purpose of advocacy is not to affect behaviour directly, it can be used to improve the environment and effectiveness of behaviour change programmes. In Ghana, the support of the National Population Council and the Ministry of Health has enabled the Ghana Social Marketing Foundation (GSMF) to expand its condom promotion programme to become a major plank in the national HIV/AIDS-prevention and family planning programmes. According to the 1999 Ghana Demographic and Health Survey (DHS), the GSMF programme accounts for two thirds of condom use. The current enviable position of the GSMF is the result of over two decades of persistent advocacy with media institutions, religious bodies and government officials to accept a large-scale condom programme through a social marketing approach. By comparison, the condom social marketing programmes in C te d’Ivoire, Ethiopia and the United Republic of Tanzania are still in their infancy, with limited coverage and market penetration.