The role of ICASO

An interesting discussion has emerged on the HealthGap and ITPC lists over the past day or two. It concerns the role of ICASO in ‘managing’ the nomination of civil society participants in various global HIV/AIDS policy arenas and processes. I think it touches on some deeper issues that go way beyond ICASO.

This was all happening in the space of a few hours on different lists – it was beginning to feel like an episode of 24! – with Richard Stern (see left) playing the Keifer Sutherland role.

Richard asked a fairly innocuous question about one of the UNGASS-related working groups, to which Mary Ann Torres (ICASO) replied:

Dear Richard:

Communication about the Civil Society Coalition on UNGASS HIV/AIDS has been posted in all listserves since the end of January. Explanation about the aims of the Coalition, as well as the structure has been amply disseminated. Working Group 2 is one of three working groups created to implement the strategies of the Coalition. It currently has +100 members (from all regions).

Thanks for your interest

Mary Ann

Then Richard came back with:

Thanks Mary Ann

I am not sure that it is a good idea that ICASO is "managing" the nomination of so many important positions on a world wide level, with the result being that these are the people who have access to decision makers in various forums and meetings. ICASO is very big, isn't it? I hope that this type of discussion is not offensive to you...its just a reality that ICASO seems to have become a kind of "mega-AIDS Corporation."

At the moment I don't have any suggestions for an alternative plan, but I think diversity in decision making is very important, and that alternatives should also be sought.

On the one hand this could be positive in some ways, on the other hand, is it really good for civil society world-wide to have so many events, nominations, etc. "managed" by ICASO? Please feel free to let me know your thoughts.

sincerely,

Richard

To which a fairly defensive Tim Thomas (ICASO consultant) responded:

First, a disclaimer: I have been working with ICASO for over 5 years as a part-time independent consultant.

I've never met Richard Stern, but I've marveled at his audacity over the years. More often than not, his activism is well placed because it's well informed. Unfortunately, his (and others) ongoing criticism of ICASO is based on hearsay and speculation - not the facts. Given that ICASO has forged new ground as one of the world's most prolific and strategic advocates on behalf of the community sector, it's strange that forceful and frequent critics like Stern choose to remain so uninformed about ICASO'sstructure.

ICASO is not a 'mega-AIDS corporation.' A simple review of their annualreport shows the breadth and scope of their work, including their financial state. At last count, their Toronto office consists of fewer than 10 full-time employees, and their Regional Secretariats (APCASO, AfriCASO,LACCASO, NACASO, and EEPO) are struggling to accomplish an ambitious work-plan with one or two full-time employees in each office. These people come from the communities they serve, just like most of the activists and advocates on this list.

The reason that ICASO facilitates nominations and appointments of communitysector representatives to so many forums, committees and boards is simple: no one else is doing it. Time and time again, ICASO sends emails as broadly as possible requesting nominations and suggestions for others to do what it does, and time and time again no one replies. There are ample opportunitiesto get involved in ICASO's advocacy and networking - Stern needs only to commit his time and energy and then he , too, will be well placed to influence policy and those who make it. Complaining that ICASO is running the show is a waste of time. If you want to change how community-based advocacy is organized, then stop whining and get involved.

Tim Thomas

And Richard came back to him with….

Hey Tim,

If ICASO has only ten full time employees then how can you possibly do a good job in terms of handling all the responsibility for the nominations for these very important posts, when this is combined with all the other tasks that you undertake??? This is a critical question. Some times its good to say "no, we just can't handle that,lets see if someone else can do it better than us." All of ICASO's public work in this area is "high profile," in the sense of contact with "decision makers" or facilitating who gets contact on the various Boards, working groups etc. I have my doubts about whether you can do an adequate job at effectively and democratically serving the world wide community of PLWA and those who support them with only ten staff members given all the other responsibilities that ICASO apparently has. Sorry but that's how I see it.

By the way, I also set limits for how much I can do effectively. We in Agua Buena focus on treatment access issues in several countries but we often say no to invitations, and we don't take on responsibilities that we can't handle effectively. That, however, does not take away my right to have an opinion and share it, in fact more opinions would be better. I am not sure why you are so defensive.

The core of advocacy is criticism and large Agencies that are so involved in issues related "access to decision makers" should be willing to accept criticism, and at least consider reevaluating their policies...

Tim, I am not criticizing all of what ICASO does, I have seen many, many good things that ICASO does, and I have great respect for the work of LACCASO, your counterpart in Latin America, which has been a leading advocate on so many issues for many years.

But that doesn't mean that I agree with everything that ICASO does, and my position on the issue we have been discussing here has been clear for two years. In my opinion, there is a significant and un-met need for a greater "balance of power" when it comes to determining the representatives of the various constituents of PLWA on the Global Fund Board, working groups, invitations to meetings, etc. etc. etc. As well as the management of the application process where ICASO does not make the final decisions about who is chosen.

My 'audacity' in terms of hopefully constructive criticism (not only of ICASO, but of the Global Fund, the UN Agencies, and many, many other key
actors) that you refer to has certainly closed some doors to me in terms of opportunities and invitations for higher level participation, but I will stick with my approach--- given the number of lives that are at stake. Tim, At this moment we have 4,000 deaths a day from AIDS and probably going up, so you can surely agree that improvement is needed somewhere, right?

If this kind of holocaust were happening in Europe and the U.S., there would be demonstrations in the street every day, until things changed, and I would probably be a moderate compared to what others would be doing and saying.

sincerely,
Richard

I have to say I totally share your [Richard] concerns about the need for a broader and more inclusive mechanism for civil society nominations to global and other bodies, and for a more effective system and division of labour to be set up. I doubt there is anyone who could possibly doubt the importance and benefit if it were established. Where I differ is on whether the problem lies with ICASO. Sure they are small, and sure they have limited capacity (I was in their Toronto offices in February and met I think 6-7 people, so fewer than 10 full-time staff really is just that), but I think our collective inability or reluctance to address this and to demand more of this kind of process is the real shame. So well said and thank you for getting this thread going.

Besides the size of any potential facilitator, there are at least two other key issues that need to be raised here.....

Co-option for one. Without intending to point fingers, we have to acknowledge the good and the bad of ICASO's very close relationship with some of the bodies we seek to collectively influence through advocacy. This HAS to put them in a difficult position from time to time - i.e., when civil society 'interests' and those of the global bodies like UNAIDS or the Global Fund get blurred, and things end up being less transparent than we might naively hope. Let's look at an example of what I mean and you can make up your own minds what is driving this kind of process.

When the Universal Access Global Steering Committee (GSC) was set up last November, an email was sent out by UNAIDS giving THREE WORKING DAYS for civil society nominations to be made. It transpired that at the time UNAIDS also 'invited' ICASO to fill some kind of 'facilitating' role in support of civil society engagement with the UA Initiative. As it turned out, the pressing need for convening the committee so quickly (its first meeting) evaporated, and we could actually have taken about two months if needed.

Apparently (according to UNAIDS) about 20 people were nominated during those three days as potential civil society representatives to that body. We were told (again by UNAIDS) that the current reps were selected from those 20. We also now know that a representative of one of the ICASO regional secretariats is one of the current 10 reps, and one person from ICASO's Toronto office has observer status at the GSC meetings that relates somehow to ICASO's/his facilitating role.

We made an explicit appeal (to UNAIDS) for information in three areas:

1. Who was on the list of 20 nominees for the Universal Access panel;

2. Something about how UNAIDS went from those 20 nominees to the selected people. ("Even if you 'hand-picked' them from the list, tell us that");

3. What information can/should be more widely shared about the Global Steering Committee reps (i.e., what can we expect them to share?).

We never received this information. To my knowledge the role of ICASO has never been explained and the information above has never been revealed (by UNAIDS or ICASO).

While all this was going on, I also wrote a mail on behalf of the UNGASS Civil Society Steering Committee that clearly stated:

"While we appreciate the nomination process UNAIDS is trying to follow, we have some serious reservations ... both in principle, but also in light of the very limited time available for a more open consultation and nomination process to be organised."

A general response came back from UNAIDS that included:

"Clearly the selection 'process' could be much improved and the civil society partnerships unit is looking to standardise a protocol for any future similar processes we take forward at UNAIDS - with closer involvement of the PCB NGOs, for example, as a possible way in helping determine outcomes. We have already had useful conversations with ICASO and other organizations about developing a protocol and will ask widely for inputs into this piece of work in early 2006."

So what was going on here? For certain we know that there was an inadequate civil society nomination process, and that it was controlled heavily by one of the very UN agencies that needs to be MORE accountable, not less; that transparency about how nominees were put forward (by who?) and finally selected was non-existent; we also know that ICASO was closely involved in the process behind the scenes, including to some extent 'advising' UNAIDS on how it should be conducted in the future - nevertheless there was zero transparency.

This was a terrible process and a collective failure to nominate participants effectively. It was probably no better that similar processes intended to help engage civil society in the Three Ones and Global Task Team processes, also 'facilitated' by ICASO if I recall correctly.

My personal interpretation is that a small group of people, some from UNAIDS, some from ICASO, and probably a small number of others, got together to do their best to make the process work under great pressure - how else does anything ever get DONE? Despite sincerity and genuine intentions in this instance, by simply going along with the situation of pressure created by UNAIDS, they perpetuated all that is the worst about these fake nomination processes. Of course, the total lack of transparency also leaves room for suspicion and doubts to creep in about motivation, and I for one have questioned whether balancing between maintaining their close relationship with UNAIDS (etc) and authentic transparency on behalf of civil society is even possible for ICASO or anyone else.

So that's the now. The other burning question is what should/could take the place of the mechanisms ICASO currently provides?

I can't help thinking that given investments already made the current systems should provide at least part of the answer. I would encourage ICASO and others to develop further in this direction - much further - possibly to do nothing else? But it has to be done with a much greater commitment to transparency, agreement to let their own HIV/AIDS advocacy agendas go for the sake of neutrality and objectivity, and demonstrate a clear loyalty to the civil society side of the relationships they are trying to help foster. I am not sure if ICASO can or is willing to do those things.

Let's unpack this a little further to see what the 'ideal' facilitator profile would have to look like. I suggest there are at least four essential enabling factors to making such facilitation work effectively:

• A unique type of credibility: Gaining a reputation for providing correct, complete and timely information, even when it may reflect badly on oneself or close partners.
• Sources of funding and other support that are INDEPENDENT of vested interests and political pressures.
• The general backing and support of the communities and organisations that broadly form HIV/AIDS civil society (whatever we each think that means).

And in case they are not difficult enough to find, the fourth is even more difficult to pin down:

• An ability to take up a stance of genuine reflection and responsibility - or the ability to put your own ideas aside.

Much of what we see in potential facilitators - including I am afraid ICASO - is typical of the way some NGOs behave: Blaming others for their political intrigue and failure to speak out, and then doing the same themselves.

The question is: If an organisation put forward a coherent plan to do this, and appeared to posess the characteristics above, how many of us would support it?

ICASO does not have that profile at present, but might want it (and could develop it) through its future actions. Who else? I am compelled to mention the 'new' World AIDS Campaign (WAC) and the fact that in some ways WAC and ICASO are trying to do similar things when it comes to facilitation. WAC is new and does not have any other agendas, other than to throw off the old UNAIDS 'baggage' that comes with the name and previous funding support. They are also in their start-up phase and still defining their role clearly - but do appear to have some refreshing approaches in mind.

These two organisations might provide the kind of alternative options/division of labour Richard is seeking. Do they have a plan to do so?