The right to health, including the right to care, treatment and support, is a basic human right. Government inaction, the high costs of medicines and diagnostics (including anti-retrovirals), under-resourced health systems, stigma and discrimination, all act to undermine the rights of people with HIV to treatment, care, support and prevention.

Community Mobilization For Improved Access To Care, Support and Treatment
 
Background
•  In August 2004, John Snow International (JSI) Europe and the Southern African AIDS Trust (SAT) co-hosted
   a regional lessons sharing workshop on Community Preparedness for Improved Access to Treatment.
• The feedback from representatives of several Eastern and Southern African countries was unanimous:
   treatment will not succeed without a comprehensive care and support system at the community level.
• Some of the lessons shared at the workshop contributed to the development of a Training Manual on
  Community Mobilisation and Empowerment for Improved Access to Care, Support and Treatment (CMEIACST).
• The Training Manual aims to mobilise communities to identify existing resources that can be utilized to
  undertake linkages and partnerships to expand the knowledge, skills and resources available to them to
  undertake work in this intervention.

Training Manual
•  Some of the lessons shared at the workshop contributed to the development of a Training Manual on
   Community Mobilisation and Empowerment for Improved Access to Care, Support and
   Treatment (CMEIACST). 
•  The Training Manual aims to mobilise communities to identify existing resources that can be utilized to
   undertake linkages and partnerships to expand the knowledge, skills and resources available to them
   to undertake work in this intervention.

The Training Manual covers a full range of complementary issues necessary for the delivery of treatment services, including:
•  Undertaking a needs assessment and analysis within the community
•  Linking care and prevention
•  Basic treatment literacy on opportunistic infections and anti-retrovirals
•  Strategies for expanded, accessible nutrition and food security
•  Stigma reduction and meaningful involvement of people infected and affected
•  Increasing the involvement of men and young people
•  Providing psychosocial support
•  Ethics and equity for care, support and treatment
•  Resource mobilisation
•  Developing action plans for CMEIACST

Training Of Trainers 
•  JSI Europe supported the Zimbabwe AIDS Network (ZAN) to host a national Training-of-Trainers (TOT)
   workshop. 
•  The TOT included seven ZAN Provincial Level Coordinators (PLCs) and 23 representatives from other ASOs.
•  The trainers later facilitated provincial-level workshops attended by civil society organisations and service
    providers.

Provincial Workshops
•  To date, 10 provincial-level workshops have been held, with a total of 120 organisations having received
    training. 
•  A consultant was hired to co-facilitate all the provincial CMEIACST workshops with the ZAN PLCs and other
   ASO representatives.
•  The purpose of including the consultant was to ensure that the provincial workshops met the standard that
   had been agreed and to build the PLCs facilitation skills.

Lessons Learned
•  Resource limited communities can substantially increase their access to care, support and treatment if given 
   the appropriate technical and financial support.
•  Participants with varied backgrounds can discuss common issues especially if they focus on what exists and
   happens on the ground. 
• The sharing of information on common regional issues like access to treatment is important for building a
   regional treatment advocacy coalition. 
• The creation of linkages between community representatives, ASOs and local service providers strengthened
   partnerships for prevention and treatment of illness.
•  Topical issues of care, support and treatment should be linked to prevention in order to pass comprehensive
   information to communities.

Recommendations
•  There is need to compliment the government ARV roll out programme by providing communities with information
    that allows them  to fully benefit from the roll out programme and to seek ways to prolong health, in order to
    avoid going on ARVs. 
•  Providing correct information on care, support and treatment will assist in strengthening national monitoring and
   evaluation systems for the uptake of treatment in terms of adherence, resistance and side effects.
•  Topical issues of care support and treatment should be linked to prevention in order to pass comprehensive
    information to communities.
•  The ZAN/JSI spearheaded workshops have been held at national and provincial levels and there is need to put
    more resources into this program so that it can be cascaded further to district and community levels.
•  Organizations that provide resources for treatment should focus on supporting civil society to mobilize and 
    empower communities to address their own problems related to the accessibility and availability of
    comprehensive care, support and treatment.