Team of Authors: Shona Schonning, Dennis Kamaldinov.

Author of the idea and editors: Anna Dovbakh, Elena German, Paata Sabelashvili.

Acknowledgements

The authors would like to express their sincere gratitude to Paata Sabelashvili, Elena German, and Anna Dovbakh, for the support they provided in the preparation of this manual. They also acknowledge inspiration taken from the material “Coordinating with Communities: Guidelines on the involvement of the community sector in the coordination of national AIDS responses” by ICASO, AfriCASO and the International HIV/AIDS Alliance. They also thank the participants of the seminar “ Increasing the Effectiveness of Interaction of Communities” , in Tallinn, Estonia for contributing too this manual.

Authors thank for cooperation national consortia of:

Armenia:
Real World, Real People - community of PLH
Potential of awakening - community of PUD
PINK Armenia - community of gay, bisexual and other men who have sex with men and trans people

Kyrgyzstan:
Otkrovenie - community of PLH
Rans Plus – community of PUD
Anti-SPID – community of gay, bisexual and other men who have sex with men and trans people

and Estonia:
EHPV - community of PLH
LUNEST - community of PUD
VEK LGBT - community of gay, bisexual and other men who have sex with men and trans people

This publication was developed by Eurasian Coalition on Male Health (ECOM) as part of the project, “Money Can Buy Health, If You Budget For it”, funded by the Robert Carr Civil Society Networks Fund (RCNF).

This handbook is intended for leaders and activists who want to build effective cooperation between communities of key populations affected by the HIV epidemic.

Everyone declares common goals and the achievement of these goals through joint efforts is very necessary; however, from time to time, not everything goes as we would like.

Cooperation between communities and the experience gained in the region of Eastern Europe and Central Asia is unique, with many good outcomes and many lessons learned. In this short handbook, we tried to analyze the experience of communities and answer the question “what works and what doesn’t why?”.

We tried to formulate a vision of the results of good cooperation and outline steps on how to organize work so that no one is afraid to share ideas and involve partners. We also explain how to avoid limitations in the exchange of information between communities or unclear conditions for joint work, in order to prevent disappointment from unrealistic tasks, burnout, and mistrust.

We describe very simple and practical steps for organizing representation, providing mutual support, evaluating cooperation, and further planning.

About the structure of the handbook.

One of the stages for the preparation of this material was a seminar/working meeting, where activists from Eastern Europe and Central Asia (EECA) countries shared their experiences with networking and developing national and regional consortia from different communities, and their vision of what helps and hinders the development of effective joint advocacy by different communities. This approach, through which we analyzed what helps and hinders us from achieving desired results, has informed the entire structure of the handbook.

By formulating the results and structuring the factors that helped or hindered the achievement of these results, we hope to help community leaders to develop their work on cooperation, overcoming barriers, and planning activities.

Which communities?

In this publication, by “communities”, we mean communities of key populations vulnerable to the HIV epidemic, primarily people who use drugs, sex workers, gay men, bisexual men, other MSM, trans people, and people living with HIV.

EECA	Region of Eastern Europe and Central Asia
LGBT/MSM	Lesbian, gay, bisexual and trans people/men who have sex with men
PLH	People living with HIV
PUD PWID	People who use drugs People who inject drugs
M&E	Monitoring and Evaluation
MDR	Multi-drug resistance
NC	National Committee on AIDS or Tuberculosis or Hepatitis
NGO	Non-governmental organization
NSP	National strategic plan
SW	Sex worker
TB	Tuberculosis

Increasing the level of knowledge and skills

The more developed the community, the more effectively it cooperates with other communities. It is necessary to expand knowledge about one’s community (including about its own diversity), and knowledge about other communities and their characteristics and issues they face (such as, drug policy and its consequences, sexual orientation, gender identity, human rights, etc.).

Activists need to know a lot (epidemiology, the situation in their country and abroad, research results, basic data on the community, existing recommendations and technologies, etc.). They also know how to do a lot (speak openly in public, prepare and give presentations, listen to and analyze what other members of the community say, formulate common problems and objectives, etc.).

Communication skills, management skills, and the ability to get out of conflict situations are all things that will help communities cooperate effectively.

The ongoing process of developing new activists and leaders

Communities need to ensure that the process of training activists and encouraging the emergence of new leaders from among them is ongoing and integrated into the activities of the community group. It would be a mistake if the community does not allocate due attention to the development of new activists, as there is a risk of stagnation and becoming dependent on particular leaders.

Preventing burnout

Burnout syndrome will inhibit the development of community organizations, and thus affect the external communication of activists and leaders with other communities. Activists and program staff who assist people with difficult situations every day can experience emotional burnout. The task of the community is to see and understand what is happening with people from the community (fatigue, feeling of helplessness, hopelessness, apathy, decrease in working capacity, sleep disturbance, loss of appetite, cravings for tobacco, coffee, alcohol, etc.), analyze the situation, and to take steps to provide support and prevent burnout in the future.

For prevention of burnout among activists, people must have a clear understanding of the boundaries of their possible influence. Before establishing goals, the group or its leader must have a realistic understanding of what they can influence and what they must accept as beyond their control.

Work with leaders

A leader can make mistakes and do wrong things, such as: being arrogant and selfish, not accepting criticism, being rude within the community and outside it, showing aggression and anger, or acting irresponsibly. This again confirms that leaders are also human and not immune to human weaknesses.

How can we help leaders improve themselves? What can the community do if it realizes that its leader is behaving inappropriately, or, as the face of the community, is creating a negative image of the whole group? Openness, transparency of decision-making within the community, accountability, and democratic procedures are mechanisms that can help in difficult situations.

Mechanism for the ongoing accountability of leaders to the community

If you realize that there are no transparent mechanisms in the group for the accountability of the leader to the community, you should suggest that one should be developed. Reports should be made regularly, at least once every 3 months, and can be formal and informal (written reports to mailing lists, Skype calls with questions and discussions). This helps the leader himself to feel needed and supported by the group. Meanwhile, such reports provide the community with the opportunity to learn together and develop more realistic tasks for their representatives or leaders.

External supervision

Try to ensure that the leader and other activists can be supervised by other more experienced managers or consultants. Such external supervision and analysis of specific situations that arise give leaders the opportunity to learn from their mistakes and see themselves from the outside. It is important that the supervisor is a person that people trust, so that he or she can analyze the situation and help understand what can be changed in communication and behavior. You can involve external stakeholders in these processes, for example, by requesting technical support from a donor or regional network in order to conduct such supervision or even recruiting a trusted volunteer for mentoring.

Evaluation of activities

The community may have mechanisms that allow for the assessment of the results of joint work and the activities of its leader. This may include community feedback and evaluation forms (including anonymous ones), or an external assessment, where an external consultant (or organization) is involved and carries out the evaluation process, by developing a specific system of quantitative and qualitative indicators for assessing the leader’s activities, analyzing documents, and conducting interviews with stakeholders.

External moderation in case of conflicts

Moderation is a process of communication for discussing and resolving conflicts (problems) in a group that helps participants achieve the desired result. The lead moderator does not have to be from the community, but he must be very good at using communication technologies and helping with the following: understanding the situation, goals, and expected results of conflict resolution, being able to elaborate on all of the issues and underlying contradictions of the conflict, deescalating the emotional aspects of the conflict, achieving an understanding by each opposing party of the positions, motives, and interests of the other party, finding joint solutions, reaching an agreement acceptable to all parties to the conflict, and, together with the participants, developing and establishing a plan for changes.

Developing an alternative group

Community work and activism are voluntary. If you believe that you have exhausted all opportunities to change the situation for the better, you can leave a group that does not meet your expectations and you can always organize an alternative process as you see fit. Be honest and professional!

By removing prejudices and changing stereotypes, we can achieve the following results:

• Communities work together without prejudices and stigma.
• Community members have information on issues related to other communities affected by HIV (behavior specifics, motivation, and development history).
• There are leaders in the community who serve as an example for building cooperation with and acceptance of other communities.
• The community has policies and procedures in place that provide for the following conditions: tolerant attitudes are a prerequisite for participation, and discriminatory attitudes towards “others” is a reason for exclusion from the group.
• The community has and upholds rules on interactions in the group (no condemnation, prohibition on certain words and expressions that stigmatize others).
• There is a plan of events organized and carried out jointly with other communities.

Example. A tolerant attitude is the key to productivity.
The Community Council was created for the first time in Ukraine in 2012 with 7 representatives of vulnerable groups: IDU, SW, MSM, trans people, PLH, former prisoners, and specialists working with vulnerable teenagers. One of the concerns was about how such different groups would interact. Would they be tolerant of one another, especially since there is a rather high level of homophobia among former prisoners, due to the prison subculture?
At the first meeting, the representatives of the communities developed regulations for the Council. One of the main provisions included the following: “A Council member can be expelled for a disrespectful or intolerant attitude towards another Council member or a representative of another community.”
The rule was adopted unanimously.
Subsequently, the Council of communities was reformed into the National Platform of Key Communities, which still operates to this day.

In order to change social attitudes and stereotypes, there are theories of “social attitudes” ¹

• Social attitude refers to the predisposition of a person and a group to react in a certain way to a certain phenomenon of social reality.
• An attitude is the readiness of a person to react reflexively in a certain manner in a certain situation. In other words, we act “automatically” unconsciously.
• By default, we have positive attitudes towards people with whom we have similar attitudes (“birds of a feather flock together:”, “like attracts like”).
• We have negative attitudes arising from people whose actions can threaten our understanding of how to live correctly.
• It is very important for communities to recognize stigmatizing attitudes towards key populations (PUD/LGBT/SW/PLH) that exist in society and within communities.

How do we change the attitudes of groups towards one another to be more tolerant?

Change in attitude towards the problem.

• More information. The logical method of changing attitudes does not always work, since a person may avoid information that can prove that his behavior is flawed (it is very difficult to accept that one has behaved incorrectly). It is necessary to continue to provide more information. The greater the amount of information, the greater the probability of change; however, there is a saturation limit.

Situations for change

• Opinion leaders. Inclusion in a prestigious, important group. The influence of other people on human behavior, attitudes, and norms (influence of other important people and group “pressure”) (for example, the first visit to an international conference);
• Formation of context. Formation a context in which behaving “incorrectly” is unacceptable and rejected by the group.
• Inclusion in activities. Certain situations can encourages a person to act “correctly” in spite of his or her attitudes; (for example, in small groups work during a training, where there is joint responsibility for completing a task in a short time, when there is no time to focus on ones prejudices.

The main conclusion is that when people begin working together, it helps them to overcome stereotypes.

How do we change the attitudes towards each other to be more tolerant

1 The theory was developed in the 20th Century from 1918 to the 1990s and was pioneered by several authors, including sociologists U. Thomas and F. Znanetsky, among others.

When different communities have similar goals, cooperation between them can help each community get the most out of the resources they have. Communities, through cooperation are able to provide mutual assistance and learn from each other. For outside partners, or for those who are the targets of advocacy work, community voices become more clear, and are amplified through cooperation. Cooperation makes advocacy efforts more effective.

When we organize cooperation well, we can achieve the following results:

• Participants of dialogue between communities are legitimate and accountable to their constituencies (transparent, democratic election and feedback procedures are carried out).
• There is a transparent system for collective decision-making.
• There is a system for the delegation of common representatives.
• The process may take place with professional facilitation.
• The cooperation process is documented.
• Joint decisions are made based on factual data and human rights.
• There are formalized procedures for cooperation between communities, including a communication system, exchange of current and strategic information, contacting donors, cooperation with the government, etc.
• There is a common vision of the communities for creating mutually beneficial conditions for cooperation between the government, donors, and NGOs (document, protocol, decisions, etc.).
• There may be a functioning coordinating body for cooperation between communities (community council, mechanism, secretariat, etc.).
• Communities inform each other about important external contacts, and provide their budgets to each other (including salaries).
• An external assessment of the activities and cooperation of the communities may be carried out.
• Communities evaluate their work and make plans for future work.
• There may be procedures developed for conflicts of interest, including the institution of community negotiators to resolve conflict situations.
• There are mechanisms for the protection of ethical principles.
• There are measures to increase community involvement in joint activities (projects, joint research, etc.).
• Joint fundraising and budget advocacy is carried out.

Example. General mailing list for LGBT leaders in Ukraine—a catalyst for effective cooperation.
The “lgbt-leaders” mailing list was initiated during a general meeting of leaders of different LGBT organizations in 2005, when there were no more than 15 of these organizations. Clear rules and prudent moderation ensured that this mailing list was a reliable platform for exchanging information within the movement. Thanks to this general source of information, everyone knows about the planned events of others, and there is an opportunity to take into account the experience of others or to help during crisis situations. Thanks to this common information space, the need and opportunity for leaders of the movement to meet in person at the national MSM-service and LGBT conference was recognized. Different organizations plan parts of the funding for this general conference. Thanks to this, 11 annual conferences of the LGBT movement have already been held in Ukraine, and now there are more than 60 LGBT organizations in the country.

This can be done as an informal agreement or more formally through a memorandum of understanding or another legally binding agreement. Issues that can be addressed in the agreement may include:

When we organize cooperation well, we can achieve the following results:

• How different communities will treat each other (emphasizing the importance of being non-judgmental and non-discriminatory).
• What language will be used (avoiding jargon whenever possible, always avoiding discriminatory language and identifying an appropriate working language that will not exclude people and will be understandable by all.) Sometimes translation into sub-regional languages may be necessary to ensure involvement of all groups affected by the problem..
• Confidentiality (ensuring that people can participate without fear of their status being disclosed publicly).
• Transparency (reaching a commitment to discuss issues openly and honestly).
• Intellectual property (clarifying who owns key documents and who can use them and how or, even better, deciding together that key documents and tools will be open source (with appropriate acknowledgement of their creators)).
• Key principles that will be promoted, such as gender equality or meaningful involvement of key affected populations
• Working practices, such as responding to each other’s e-mails within one week or always giving apologies if someone cannot attend a meeting.
• What the expected outcomes and outputs of the partnership will be, including, where appropriate, work plans and budgets.

Example. “Country dialogue” in Kyrgyzstan as join process and informational platform
Once started as temporary mailing list for all communities and civil societies in Kyrgyzstan to discuss documents for a GF national proposal, a mailing list called “national dialogue” for several years served as the only information sharing platform accessible to all, where events were announced, joint representatives from several communities were elected, and documents were discussed. This happened thanks to clear purpose of the discussion (to build a united voice and make messages from communities and civil society heard by the state in relation to planning and implementation of the HIV response). One moderator of the mailing list who was trusted by all different communities supported information sharing (asked for announcements, supported discussion and decision making with equal participation by all).

Ways to improve communication include:

• Ensuring open, transparent and professional communication: This involves (a) being open to sharing information freely and widely; (b) building collaboration rather than competition; (c) maintaining confidentiality, and (d) treating people with respect.
• Ensuring active, multi-directional communication: Members of the communities should communicate proactively with their representatives, instead of simply expecting to receive information.
• Reaching out to communities broadly: Helping communities reach out not only with NGO leaders and activists, but with a wide range of community representatives, including those that are geographically or socially isolated or who may speak a local language differing from the one used at the national or regional level. Holding meetings outside of capital cities, in more remote areas and/or translating key documents into local languages can help.
• Agreeing on communication roles and responsibilities: This involves (a) identifying which individuals or organizations are responsible for specific communication tasks and (b) holding each other accountable if responsibilities are not met (e.g., if newsletters are distributed late) but doing so respectfully and in a cooperative rather than conflictual way.
• Using appropriate, simple, accurate and respectful language:
  • Using the most widely spoken local language or producing resources in several languages.
  • Not using terms that are incorrect or offensive.
  • Avoiding jargon, and translating terms and ideas into information that is easily accessible to community groups.
• Identifying appropriate and effective means of communication:
  • Communicating to different types of audiences through a combination of creative and practical formats, such as newsletters, websites, briefing papers and e-bulletins; not disseminating all information via e-mail if most community sector groups do not have computers. It is important to find other means to reach these groups, such as face-to-face meetings, if they can’t be reached electronically.
  • Using databases and websites to facilitate knowledge management and ensuring that information can be disseminated rapidly and efficiently.
  • Using agreed formats for reporting and communication, keeping records for monitoring and evaluation and capacity building.
• Keeping communication regular and ongoing. Communication should be regular and ongoing and in line with communication strategies but when needed, ad hoc communications are also important. For example, if someone went to a conference and learned about a new resource or new donor that is relevant for all partners, it would be appropriate to communicate immediately about the interesting news.
• Coordination and secretarial support.
  • Some partnerships can benefit from hiring a common coordinator or establishing a secretariat to facilitate their work together.

Example. The Chace the Virus Campaign.
During the International AIDS Conference in 2018, regional networks including: the Eurasian Coalition on Male Health (ECOM); the East Europe and Central Asia Union of People Living with HIV (ECUO); the EECA Sex Workers’ Alliance; the Eurasian Harm Reduction Association (EHRA), the Eurasian Network of People Who Use Drugs (ENPUD); the Eurasian Union of Adolescents and Youth “Teenergizer”; the Eurasian Women’s Network on AIDS (EWNA); and the Sex Workers’ Rights Advocacy Network (SWAN) came together to make a campaign that was heard around the world. With the slogan, “Chace the virus, not people!” they made a loud and visible call during and after the conference. A crucial factor in bringing these networks together was organizational support provided AFEW International and EHRA. AFEW provided logistical, administrative and financial support while leaving communities to take the lead on developing the campaign. As such, each felt ownership and contributed to the campaign.

There are a number of factors that help different groups cooperate with each other. Some of these include:

• Understanding each other. To cooperate well, communities must understand each other’s missions, understand what problems each face and understand where their missions overlap. They must have a good understanding of what resources (including funds, skills, knowledge and partners) each can contribute to the partnership. They must also have a good understanding of what weaknesses each group might have that may need to be addressed or compensated for.
• Intersectionality. Intersectionality refers to overlapping social identities. There are often people who in one way or another pertain to more than one community. Mobilization of such people can help spread understanding and reduce prejudice and stigma between groups. These people can be invited to help build bridges between the representatives of different communities they represent

  Example: Intersectionality highlighted within the Whitenoise movement
  The White Noise Movement in Georgia was created to reform punitive drug policies. Before that, it was believed that there is little or no overlap between people who use drugs (PUDs) and LGBT community. The White Noise Movement made it clear that the movement is open to all communities regardless of any factor. When mobilizing community, the organizers made sure that everyone was represented and no one was left behind for example by demonstrating that the drug problem is not a masculine problem and women suffer the consequences of it even more harshly; or that the PUD community also consists of LGBT people and that they are similarly oppressed by the police as other drug users and maybe even more. This gave a good starting point for interaction between communities, not only among their leaders. As a result, during public demonstrations, care is taken that women and LGBT people are seen also to be at the forefront of the fight for humane drug policies. As a result, this strategy helped communities understand each other and realize that system that they are all fighting a system that makes them all vulnerable.

• Honesty and transparency and regular and strategic communication. When communities actively share information about their goals, activities, and resources, trust can be built and ways to be mutually supportive can be identified. It can be helpful for organizations to have a communication strategy that addresses the information needs of their partners so that important information gets communicated through the appropriate media and format. Sometimes face-to-face meetings will be needed and other times information can be communicated electronically using newsletters or social media. It can be helpful to share communication strategies with partners and adjust them to take in to account each other’s needs and to accommodate joint information activities
• Personal communication skills. Cooperation requires not only sharing of information but the skills to listen carefully to partners and communicate in a way that will be respectful and helps promote understanding.
• Resources for meetings, communication and facilitation. Some communication can take place without any cost but often it is important to hold a meeting, or publish a document, or carry out other activities that require resources. It is beneficial for all partners to contribute resources to an initiative in proportion to their capacities.

Cooperation between different communities can be hindered by many factors including:

• Competition for resources. When resources are scarce, communities may be in competition for what is available (though competition can arise not only due to lack of resources). Communities can compete for funding and for attention of policy makers and other stakeholders. In any case, it is usually unhealthy and inhibits use of opportunities to cooperate and to make advocacy more effective.
• A monopoly of one organization on representing communities in decision-making structures can hinder cooperation. Decision making structures often do not make space for all communities to be represented. Sometimes those that are represented may not use their positions to ensure that the voices of all communities are heard.
• Formalism in interactions. Sometimes communities are involved in decision making processes in a tokenistic way or only to please a donor. Their participation is not meaningful. This happens when these communities do not have the opportunities or skills to define, express and garner support for their own priorities.
• Lack of funding, staff, skills, and opportunities to hold consultations on priorities and develop strategies. While groups may have clearly definable needs and there may be clear solutions to addressing those needs, some groups, without technical support (such as professional facilitation for example) or adequate staff time, may not be able to articulate those needs and solutions in ways that influence the decisions of other stakeholders.
• Lack of mechanisms for improving interaction with each other. If groups have not systematized their cooperation or partnership, they may miss many opportunities to support each other and to amplify each other’s voices.
• Prejudice, stigma and discrimination. Just as prejudice, stigma and discrimination can lead to policies and practices that make some communities vulnerable and block their access to needed services, these factors can also interfere with different communities’ abilities to cooperate with each other.

Example. Joint hepatitis B and C project by different communities.
Cooperation between different community organizations of people using drugs and LGBT was not always were good in Ukraine. Sometimes it was formal without good understanding of needs and challenges faced by each other. A good example of effective cooperation was built on a joint project to start Hep B vaccination and Hep C testing and insuring access to treatment for key affected populations. The “Gay Alliance” and “Eney,” as two partner organizations, managed to develop good relations on different levels which lead to effective implementation of a joint project.

Having clearly-identified common priorities and goals is the single most important factor in inspiring people to work effectively together. A common understanding or priorities and goals first and foremost answers the question “why?” – Why are we working on this? Why are we cooperating? Why is it worth it to overcome our differences? Why is it worth it to link or share our resources?

By having a common vision of what they want to achieve, communities can achieve the following results:

• Participants of the dialogue between communities are legitimate (transparent democratic election procedures are carried out).
• The process is facilitated professionally and is documented.
• There is a mechanism for the representation of joint interests before the government and donors.
• Joint decisions are made based on factual data and human rights.
• The decision-making process is transparent and there is accountability to constituents.
• The overall agenda focuses on a limited number of priorities.
• There are measures to increase community involvement in joint activities (small grants, allocation of responsibilities, equal support, joint research, etc.)

• Select legitimate participants to take part in the dialogue. Representatives of communities should be chosen by their own communities. This is usually done easily by groups that already have established unions or networks and can be more challenging for groups that don’t already have formal decision-making structures. For informal groups, people will have to be more casual about selecting representatives from amongst themselves. Sometimes communities may decide to invite experts from outside their communities to participate that they can benefit from their knowledge. It is always important to make sure that it is clear that these outside experts are there to advise and that decisions will be made by the community leaders themselves.
• Agreement on procedures regrading decision-making and the roles and responsibilities of those participating. Making sure procedures for making decisions (ie voting or arriving at consensus) is important. An example of rules for decision making for a committee can be found here http://rusaids.net/ru/term/
• Professional facilitation. Facilitation may be done by a respected leader (respected by all communities) or if there are tensions between the communities, an outside facilitator may be contracted. The terms of reference for the facilitator should be designed by the community and approved of by participants. Eventually a group of communities may choose to work with a regular coordinator.
• Evidence-based and human rights based decision making. When scientific evidence and respect for human rights guide decisions, arriving at consensus is easy. Solutions to many controversial issues can be seen clearly when evidence rather than opinion is examined and when human rights principles rather than judgements guide decisions. Since all of our communities face human rights violations and struggle with lack of application of evidence based policies, it can be easy for them to find common ground.
• Transparency in decision-making and accountability to constituencies. It should always be clear to participants (and the people they represent) what decisions are made, how and why. Protocols of decisions made should be taken. They can serve both to record the decisions for future use and to communicate the decisions to the outside world (including the constituencies of those participating in the group) and the partners who will be helping the group pursue its objectives.
• Interactive processes which are designed help people find commonalities rather than focus on differences should be used. For example, it is better to focus discussion of common values rather than individual behaviors.
• Focus on a limited number of priorities. Each community will come into the discussion with a long list of problems that need to be solved. Defining a limited number (often 3 – 5) priorities to address will help the groups focus on what is most important and will often help lead them to agreement.
• Recognition of alternative points of view. Consensus can be supported by recognizing areas where there are differing opinions. This can help maintain consensus on main points while recognizing that opinions may differ on less significant aspects.
• Documenting positions. This can take many forms and differing forms may be appropriate for different purposes. A group may work to develop a “policy brief” or “position paper” to clearly express their beliefs on a specific issue and useful talking points and arguments supporting those beliefs readily visible in a brief statement. It may opt to develop a “strategic plan” to outline a full strategy for achieving a set of specific objectives over a specific period of time.

Example: Policy briefs help different groups develop a common vision in Kyrgyzstan.
In Kyrgyzstan, A consortium of three organizations (AntiAids Association, Rans Plus and Otkrovenie, representing LGBT, PWID, and PLHIV respectively agreed to work together on budget advocacy and promotion of social contracting mechanisms. Once they agreed on a common objective, they worked together to develop messages for a policy brief on the subjects. Working together enabled them to learn more about the budget advocacy and social marketing and to learn from each other. While drafting the paper they developed a common vision on the topics and agreed on arguments that can be used when talking to state officials and the press. They were given technical assistance in developing the paper by the regional network part of Eurasian regional consortium which enabled them to make the paper though the opinions it contains were those of the authoring organizations.

The image below summarizes the steps (described above) to coming to a consensus on a position or strategy.

Below are factors that help groups reach consensus. Keeping them in mind and speaking about them explicitly can help get to consensus.

• Common Problems. While there are certainly differing needs among different communities many of the problems they face are similar or have similar roots such as stigma, criminalization, inadequate healthcare services.

  Possible problems that can unite the interests of communities

  

• Involving like-minded people. Involvement of “like-minded” people (especially those who value human rights and evidence based policy) will make it easier to reach consensus.
• Solidarity. The willingness to stand up for or at least recognize each other’s rights is essential. It is beneficial for all to have each other’s support. Solidarity may not come right away but is likely to form as group members gain experience working together and helping each other.
• A belief in equity. When people fundamentally believe in equal human rights and the need to strive for equity in access to needed services and medicines, coming to agreement on priorities is eased.
• Readiness to compromise. Different communities will come to the table with different sets of problems. To reach consensus, each should be willing to compromise.
• The advantages of a united voice. An understanding that working together is more effective than working against each other. It certainly does not serve our advocacy purposes for those targeted by our advocacy efforts to see us arguing and disagreeing with each other. We can accomplish much more with a united voiced and mutually supported efforts.
• Sharing resources. Resources (financial, material, specific skills) are limited and by working toward common goals, we gain the opportunity to share resources. An understanding that pooling resources enables us to achieve more.

There are a number of factors that can inhibit different community groups from seeing common priorities and having common goals. These can include:

• Lacking a common platform for communicating, for example, if none of the groups has a space where all can come together for a meeting or if there isn’t an established committee to deal with decisions that need to be made with input from all regularly.
• Limited understanding of the benefits of working together. Sometimes people may not understand right away what the benefits of working together such as sharing responsibilities, information or having a louder united voice.
• If each group has not identified its own priorities, it is challenging to see common priorities
• Group leaders may not be ready for common work either because they feel they are too busy with their ‘own’ work or they may not see the advantages for their own groups in the common work.

• Requiring or encouraging cooperation. Donor policies that require or encourage cooperation between communities can be helpful. They are especially helpful when that cooperation is required throughout the grantmaking process, starting with proposal preparation, through grant implementation and including monitoring and evaluation.
• Providing funding for cooperation. To encourage cooperation donors can offer support for consultations, meetings, professional facilitation, publications, regular coordination, technical support etc.

• Pool funding to make up for inadequate funding from donors. If donors wont support directly a certain meeting or a certain paper, communities may decide to each allocate some funds to make it happen.
• Communicate needs to donors. Civil society groups should communicate their needs to donors. They should be proactive in giving donors feedback about what policies support effective cooperation. This can be done by:
• Making consolidated appeals for funding to donors. A fundraising campaign may openly target multiple donors and even evoke “competition” among donors to support a particularly important initiative. Such initiatives are more likely to get attention and support if there are multiple community groups making an appeal together.
• Holding meetings with donors. This can be done individually to discuss priorities with a particular donor but it can also be done with multiple donors at once. The latter approach adds transparency to the process. Each participating donor knows that they are being exposed to ideas about the same priorities. It also gives donors an opportunity to communicate with each other about how to complement each other’s work.
• Publicizing a common position paper or policy brief with a call to donors for action. Such papers (especially when they are ‘signed’ by multiple organizations) can get donors attention. It is important to distribute such papers widely and also to present and discuss them at various meetings and conferences.
• Action 2: Highlight best practices and lessons learned. Civil society groups can highlight good practices and also those which were problematic so that these lessons can be used in future planning. It is important to remember that communities can and should influence donors’ strategies!.

There are a number of factors that can inhibit different community groups from seeing common priorities and having common goals. These can include:

• Competition. While competition between NGOs can be healthy in some ways, to enable identification and selection for funding those NGOs which are most capable of effectively completing certain tasks, the wrong kind of competition can widen the divide between organizations and/or communities that would achieve more if they cooperated.
• Inadequate funding for all prioritized communities. Donor objectives sometimes address needs of multiple groups, but funding for meaningful involvement of all groups is sometimes not available. For example, funding decisions might be made based on epidemiological information which is available – which may not reflect the real degree to which some populations are affected by the epidemic. This leads to some groups being excluded from dialogue and/or to unhealthy competition between groups.
• Inadequate funding for advocacy and cooperation. In section 2 above, the need for funding to support cooperation is addressed. Cooperation can require funding for consultations, meetings, professional facilitation, publications, regular coordination, technical support etc. When funding for these is not adequate, cooperation can be hindered.
• Donor priorities prevail (payer decides)

• Decriminalization. Governments should move to decriminalize key affected populations for the human rights benefits, public health benefits and the benefit of better cooperation for involvement in policy dialogue and service provision of key affected populations.
• Fighting stigma and discrimination. Governments can take efforts to counter sigma and discrimination in the general public, among healthcare and social workers, and among decision makers.
• Support Meaningful involvement Governments should enable the participation of affected populations in dialogue. Representatives of key populations should be selected by those communities themselves and should be given opportunities to communicate with their constituents.
• Policies that do not inhibit the work of civil society and NGOs. Governments should ensure that there are not laws which inhibit the work of NGOs and the free expression of civil society.
• Funding. Governments should ensure that funds are available for the work of NGOs including funding for services, methodological and or analytical work as well as work to engage in dialogue at national and local levels.
• Partnership. Governments or individual allies within governmental institutions should welcome partnership with groups that are pursuing common objectives (such as those related to public health or human rights.

• Criminalization and discrimination of affected populations on top of making them more vulnerable to HIV infection, challenges their ability to be meaningfully involved in dialogue – it can even challenge their ability to publicly let their identity as part of a stigmatized or criminalized community be known. This can also hinder the type of cooperation that makes their interaction with governmental institutions more fruitful.
• Inadequate funding. As mentioned above in relation to donor policies, government policies which do not fund all affected groups adequately can lead to unhealthy competition, inadequately funded processes of communication and consultation.
• Exclusion of some groups from meaningful involvement. Sometimes governments will “cherry pick” representatives for participation in dialogue, leaving out some groups that should be represented or selecting activists or selecting those which the communities they ‘represent’ did not select. This precludes full meaningful cooperation.
• Imposing patterns of cooperation from the state. When communities are not in control, some of the critical steps needed to develop common positions and strategies can be missed, leaving communities without consensus or clear plans for moving forward.
• Corruption. Despite the best efforts by communities, sometimes corruption influences decisions more than evidence of effectiveness or the principles of human rights.

• Changing attitudes within communities. This can be done through education, making visible examples of leadership of different communities and mutual support visible, intersectionality, empowering leaders who do not stigmatize other groups.
• Changing attitudes within society as a whole. Reducing stigma is not simple but working with the mass media and making the voices of community leaders heard can have an impact.
• Similar problems can bring groups together. Stigma’s harmful impact on human rights and access to health is similar for different groups and this fact can help groups come together, find empathy for each other and develop common goals.

Example: In 2018, the White Noise Movement in Georgia got a sudden boost in public support at home and abroad in response to police brutality. White Noise had been working to advocate improved drug policy, doing so by bringing people together through Tbilisi’s bourgeoning club scene. The club Bassiani had become a safe space not only for people who use drugs but for the LGBT community and for anyone who shared a love for techno music. After the club responded to several instances of drug related death in Tbilisi by initiating an “early warning system” to get the word out about bad drugs, the club was violently raided by police. The raid sparked a response that brought the movement to a new level. Within hours, clubs all over the cities closed their doors and moved their speakers to the city center where over 10,000 people eventually gathered for what has been called a “Raveolution,” demanding (and receiving) an apology from the government for the harsh actions by the police. What had started as a much smaller movement got much bigger in the face of uniting adversity.

• Work with the mass media. Work with the mass media including trainings for journalists, rewards for writings that counter stigma, exposing journalists to conferences or discussion forums where stigma is addressed. Mass media campaigns can be helpful.

  Example: When opioid substitution therapy programs in Kazakhstan were at risk of being closed due to political pressures, communities responded with a mass media campaign through which families of OST clients appeared on television speaking about how OST had impacted families positively. To change the situation, it was important that an advocacy letter to the President of Kazakhstan was signed by more than 60 civil society organizations from all around the globe. Solidarity advocacy meetings to support OST program in the country were organized by community leaders near several Embassies in different countries. Full report on all the actions.

• Making community voices heard. Community representatives can appear open status (revealing their status as a member of their community) on mass media or in decision making forums. One of the most powerful tools against stigma is when someone shows that they have overcome self-stigma and are ready to open their status to the world.
• Calling out promoters of stigma. When specific journalists or public figures promote stigma, activists can directly point out their errors and harmfulness of their words through letters or direct actions.
• Participative research. Instruments like the Stigma Index (which focuses on HIV related stigma) can be used. It is a guide for community led research that helps the community understand and present stigma that exists within the general population or health care professionals.
• Leveraging intersectionality. Even without formal structures, intersectionality (when a person is simultaneously connected with two or more affected communities, can be leveraged for community mobilization that engages multiple communities.

• Stigma.The single most influential factor in society as a whole which can hinder cooperation between communities is stigma which has many faces such as: xenophobia; homophobia; narkophobia; racism etc. While stigma is directed from the society towards its specific groups, stigmatizing attitudes may be also prevalent within each community, among members of one community toward another community, or stigma of one community may be so great that another community fears to lose face by associating with them.

• Regional projects of the Global Fund and other donors which bring communities and governments together to examine common problems and effective solutions to them that have been applied in neighboring countries.
• High Level Meetings like the meeting of regional Health Ministers and Vice Ministers which was held in the context of the AIDS 2018 conference
• Promoting WHO/UNAIDS strategies (“90-90-90”, “О”)
• Geopolitical influence. Sometimes bilateral interaction around specific issues can be helpful
• Informational interventions.Greater access to media resources by communities
• Regularly calling attention to issues such as HIV, TB, HCV.
• Using community leaders and existing mechanisms to evaluate quality of services and regularly provide feedback
• International expertise. International expertise can be helpful when there is not expertise within the region that can be used for learining

• Lack of strategic information in communities. Sometimes communities, governments or approaches that have proven to be effective in addressing them.
• Misinformation (in government and society) about the situation in communities.
• Political conjuncture (authoritarian trends in some countries of the region) including laws that inhibit the work of non-governmental organizations of freedom of expression
• Geopolitical situation and speculation in country political platforms. Positioning on topics like HIV and or rights of key communities can be speculated upon by governments (in both the east and west) to accentuate a growing rift between the countries.
• Insufficient amount of research and statistical data for joint work between communities. Sometimes the most basic information is missing including rates of HIV infection among communities or population size estimates of communities is missing, not to mention missing data on access to services along the cascade of care.
• Outdated protocols (lack of resources for changing normative documents).
• Lack of monitoring of the quality of services.