Addressing HIV and nutrition linkages: from evidence to impact

Scott DrimieInternational Food Policy Research Institute

Regional Network on AIDS, Livelihoods and Food Security

Nutrition Security, Social Protection and HIV: Operationalizing Evidence for Programs in AfricaXVIII International AIDS Conference , Vienna

18 July 2010

Objectives

• Focus on the challenge of translating this emerging evidence into large-scale action, and ultimately better impact.

• Discuss the pathways for policy influence when dealing with such complex interactions.

• Highlight some of the lessons from nine years of RENEWAL activity in eastern and southern Africa.

Science – Policy Interface

• Interface not well understood, and is often assumed.

• At least three distinctive perspectives:

– a linear and logical approach; – an iterative and incremental approach; and– an approach centered more on discourse.

Moving in the Divided Space

RENEWALImproved

Multi-Directional Dialogue

PolicyResearch

“Evidence”

Malawi MOA Capacity Strengthening

HIV and Agriculture Task Force

MOA: Ext Services

NAC: 2008Irish Aid: 2009

Strategy – based on scientific evidence Capacity limitations

RENEWAL / BundaSADC VAC training on HIV/FS

Modules for MOAFAO Funding

ScienceSam Bota RENEWAL Malawi

TB and HIV in Mbekweni, South Africa

ZAMBART Research Project

Community engagement Policy “dialogue” with NAC, DoH

RENEWAL National ForaMSc degrees, publications

Collaboration – build on strengths

Feedback Meeting:“march on the councilors”

Working as a network: lessons

• The nature of politics and political engagement:

– peculiar politics of HIV&AIDS

– labyrinthine departmental politics

– focus on sustaining relationships

Working as a network: lessons• The maintenance of integrity of interactive

research:

– adherence to principles of science whilst maintaining close relationships with those with political authority

– ensuring accountability to the communities within which the research is conducted.

– To “reach-in” to what individuals and organisations share rather than to focus on differences.

Working as a network: lessons• Selecting and nurturing ‘champions’ in government

and scientific organisations:

– senior officials regularly move to new posts

– scientists have a ‘natural’ reticence against use of their research in different forms and ways

– Need to engage in critical commentary and interpretation with different ‘non-science’ parties

New Ways of Working

• The “U-Process” in Mamelodi, South Africa:

– Urban-rural links research

• Urban epidemic• Urban informal settlements have double the HIV

prevalence of urban formal areas in South Africa• Risk factors (Weiser et al)• Mobility and spatial connections

Sickness and HIV:if the individual in Johannesburg becomes too sick to work, the majority will return back home

Support

54 %

67%

Importance of

food Burden on the household back

home.

Urban livelihood that supports

another household ‘back home’ would

be affected.

The “U-Process”: Phase 1“ Co-Sensing

Co-Presencing

Co-Realizing

Phase 1: Co-sensing “learning to see… the first schooling” –Nietzsche

Activities: foundation workshops, learning journeys.

Output: Documented shared understanding of reality.

The “U-Process”: Phase 2“

Co-Sensing

Co-Presencing

Co-Realizing

Phase 2:

Co-presencing Retreat and Reflect

Getting in touch with own relationship to the system, ‘inner knowing about it.

Activities: Innovation retreat, Wilderness solos

Output:: Clarity and commitment about what to do to create new reality

The “U-Process”: Phase 3“

Co-Sensing

Co-Presencing

Co-Realising

Phase 3: Co-realizing – bringing the new reality into existence

Activities: Implementation of innovations with potential to change the system, prototyping, piloting, learning by doing

Working as a network• The seemingly interminably slow process of

influencing policy requires a long-term perspective:

– Need to be persistent, to adopt an informed, supportive, flexible and adaptive approach.

– gradual strengthening of networks allows trust to be built while securing diverse representatives as a key source of legitimacy and, hence, influence.