Successful funding mechanisms to foster civil society: which way forward in China?

HIV Australia | Vol. 12 No. 2 | July 2014

By Cai Lingping, Li Yue, RD Marte and Chris Connelly

Experiences from the CHAIN, APCASO and AFAO Community Advocacy Initiative on the Investment Framework program in China.

China is at a cross road in its HIV response – a transition from international funding towards a fully domestically funded response.

How this transition is managed, and the models of funding that are developed to support civil society, will determine the continuity of existing civil society organisations and the overall future effectiveness of the response.

Over the past ten years, China has made significant progress in scaling-up its HIV response. The central government has moved to strengthen coordination among HIV-related ministries and issue policies to support effective implementation of the National AIDS Strategic Plan.

Government funding at all levels for the response has also increased significantly, with central funding increasing from RMB 120 million (USD 19.35 M) in 2002, to RMB 2.06 billion (USD 323.5 M) in 2010, 2.2 billion (USD 354.8 million) in 2011, and an estimated RMB 2.8 billion (USD 451.6 million) in 2012.¹ ² ³

This means that China is one of very few countries in Asia that domestically funds the majority of its HIV response. As of 2012, 88% of China’s HIV funding is reported to be domestically sourced.⁴

Chinese civil society and community-based organisations (CBOs) play significant roles in the country’s HIV response.

Under external funding from the Global Fund and Gates Foundation, civil society has been able to grow in China in an unprecedented way.

Numbers of community-based organisations across the country have multiplied, providing different models for community engagement in various aspects of the response.

The crucial role of Chinese civil society and CBOs is recognised by the Chinese government, with the Chinese premier Le Kiqiang in November 2012, publicly declaring the government’s commitment to funding civil society and CBO involvement as a critical part of the HIV response.

However from that public statement to the present, the government has been stalled in developing a viable funding mechanism to operationalise its commitment.

At the same time, international funding sources are withdrawing from China, making it increasingly difficult for many civil society and community-based networks and organisations to secure funding to continue their work and sustain established networks.

Civil society was in urgent need of a platform to discuss China’s HIV funding situation and the role of civil society in the HIV response.

The DFAT-supported Community Advocacy Initiative on the Investment Framework (CAI-IF) program aimed to provide this platform.

Implemented by a collaboration of China HIV/AIDS Information Network (CHAIN), Asia Pacific Council of AIDS Service Organisations (APCASO) and the Australian Federation of AIDS Organisations (AFAO), the program worked to enable Chinese civil society and CBOs to take stock of their country’s HIV funding scenario – particularly regarding community mobilisation, identify challenges and bottlenecks, and plan strategies together to begin advocacy on funding issues.

From late 2012 to early 2014, CHAIN, with support from APCASO and AFAO, conducted a series of workshops to develop the capacity of Chinese civil society and CBO partners to critically engage with and use the Investment Framework to advocate for more effective financing of the HIV response in the country.

Since the Chinese government has now taken over funding the HIV response from external donors, effective engagement between civil society and CBOs is crucial.

The Investment Framework has galvanised civil society and CBO dialogue, advocacy and strategising around ensuring that the Chinese government effectively : 1) funds CBOs in sufficient amounts and in a transparent and accessible manner; 2) funds civil society work on critical enablers; and 3) supports synergies between health and HIV departments and broader development ministries and sectors.

A notable aspect of this phase of the program was the readiness with which civil society took on Investment Framework thinking and approaches, and adapted these to their own HIV funding situation.

Under the CAI-IF program, CHAIN also led a nationwide survey of civil society to explore and document Chinese CBO perspectives on HIV funding.

The survey was a collaboration of almost 100 representative civil society and community networks from all over the country, and represents a significant achievement for civil society in China itself.

Civil society organisations contributed their perspectives and experiences to provide clear recommendations for the Chinese government, international donors, and civil society. Advocacy under the CAI-IF program culminated in a national CBO-government-development partners workshop in May 2014, titled ‘Investing in CBOs Towards a More Effective HIV Response in China: An HIV Investment Framework from Community Perspectives.’

This workshop was significant for being the first CBO initiated meeting between Chinese government and Chinese CBOs at the national level on HIV issues.

Key findings and recommendations from the survey of Chinese CBO perspectives on HIV funding presented to government in the workshop included the need to:

develop clear policies and systems, via consultation with CBOs, to ensure that government invests in CBOs, establishes systems to support CBOs involvement in the HIV response and makes CBOs involvement a standard policy
develop clear policy guidelines and a CBO service list on key government HIV investment areas
invest in CBOs to work on developing an enabling environment, including on anti-discrimination, gender equality, livelihoods, advocacy, legal aid and monitoring
set up a government information disclosure system at central and local levels to ensure CBO access to information.

Recommendations to international development partners included the need to continue funding for Chinese CBOs in areas of capacity building and in areas of critical enablers and synergies with the development sector – areas that may be difficult for Chinese government to support – as well as continued encouragement and assistance to Chinese government to practise transparency in HIV funding and support CBO institutional development.

The Community Advocacy Initiative on the Investment Framework, and the work of CHAIN, APCASO, AFAO and all the civil society partners in China is considered by many in-country partners to be ground-breaking as the start of a new way for CBOs and government to work together.

This work provides a platform for civil society and CBOs to mobilise and rally around the issue of the country’s HIV funding. It also facilitates a nationwide collaboration of civil society to articulate and document funding experiences and recommendations.

The recommendations were put to government representatives at the first civil society/CBO-initiated meeting, where these representatives listened to community recommendations on HIV funding, and heard about positive experiences of civil society participation and leadership in China.

The program has facilitated clear articulation of civil society and CBO issues via the survey and national workshop, enabling community perspectives on HIV funding to reach relevant decision-makers.

Key messages from the community can hopefully be incorporated into the development of the mechanism for civil society to receive government funding.

In partnership with UNAIDS China Country Office and the National AIDS Commission, CHAIN continues to work to feed the CBO recommendations to higher levels of government to influence decisions on future Chinese HIV funding.

Cai Lingping is Manager at the China HIV/AIDS Information Network (CHAIN).

Li Yue is Project Officer at the China HIV/AIDS Information Network (CHAIN).

RD Marte is the Program Manager at Asia Pacific Council of AIDS Service Organisations – APCASO.

Chris Connelly is International Programs and Policy Manager at AFAO

References

1 The current exchange rate is around USD 1 = RMB 6.2

1 Ministry of Health of the People’s Republic of China. (2012). 2012 China AIDS Response Progress Report.

1 China Daily, Wen Jiabao, speech at the HIV/AIDS work meeting on 20 November 2012

1 HIV Expenditure from Domestic Public Sources: Asia and the Pacific. Latest Available Data slide 7 of HIV and AIDS Data Hub for Asia-Pacific Review in Slides: ‘HIV Expenditure’. Retrieved from: www.slideboom.com/presentations/856026/HIV-expenditure