Designing and delivering HIV prevention services for African MSM in the UK is a multifaceted challenge, particularly for migrant populations, because they are embroiled in a network of systems aiming at achieving different and often conflicting purposes. Further, little is known about this vulnerable population notoriously hard to reach.  The situation calls for a system approach to improve the delivery of HIV prevention services with the ultimate goal of reducing the number of new HIV infections in this group.

2010 will be remembered as the year when the results of the CAPRISA trial that followed those of the Thai vaccine trial in 2009 reshaped the biomedical approach to HIV prevention. These are also the years in which HIV prevention has been both at a turning point and in turmoil with repeated assaults on populations at risk, notably in countries with high HIV prevalence and an economic crisis rewriting the funding agenda. Further trials of new prevention technologies (such as Pre-Exposure Prophylaxis) and a recognition that treatment can contribute to prevention, all happening against a background of economic recession are creating confusion and dilemmas amongst advocates, funders and beneficiaries as to what should be done next to successfully contain and quell the HIV epidemic.

The tenofovir-based microbicide tested in the CAPRISA trial is an obvious way forward but it is widely acknowledged that more trials are needed to confirm the study’s results and to ensure that the effect observed in this one trial can be confirmed in different settings and countries and to assess easier ways to use the product. If confirmed, this microbicide would be the first women-controlled HIV prevention tool.

But this is where promising clinical science has hit a snag. A number of trials have been in the planning pipeline for some time already, even before the results of the CAPRISA study were known. All have the potential to provide critical information about the product acceptability, use and effectiveness, information that is necessary to license the product. But less than 40% of the money needed (about USD 150 million) to conduct these trials has been committed or pledged by donors.

This is neither satisfactory nor acceptable. Insufficient funding could not only limit and slow down the development of the product, but it also leaves scientific decisions at the mercy of economics rather than hard scientific evidences. And haven’t we been told enough that scientific and clinical research should be evidences-based?

Whilst INGOs, donors, politicians, and philanthropists are being cajoled into supporting these much needed studies with money that is mostly ours, more than 7,000 new infections are occurring every day, a large majority of them in Sub-Saharan Africa, disproportionately affecting women whose urgent need for an HIV prevention tool they can control could be fulfilled with an efficient tenofovir-based microbicide.

In addition, the reticence towards identifying and committing funds to cover the necessary studies places scientists in a position where they have to support one study rather than another because funding is limited and investments need to be prioritised in times of global recession and a massive bank bailout. The message is clear: there is no money for HIV, only for bankers, as only they can help the economic recovery.

The irony is that a small investment in the tenofovir trials could make a huge and rapid economic difference. Many scientists, NGOs and activists (with some exceptions) have bought into the argument that there is not enough money to adequately address the HIV epidemic and are prepared to compromise on the science fearing that raising concerns or calling for more support may jeopardise the little money available.

As a scientist, activist, advocate, and an individual directly affected by the HIV epidemic, I can’t accept giving up or caving in to the general apathy, resignation and funder’s whim. The HIV epidemic can be dramatically curbed within a few years if we decide to give priority to prevention and match funding and policy accordingly. Letting ourselves be led by economic interests or twisting science’s arm will not buy us out of the epidemic.

Published on openDemocracy on 25 October 2010

SYFA works with local farmers, youths and children on environmental protection, organic agriculture and home gardening and currently coordinates the activities of 10 environmental groups at local schools, churches and the prison

The project was to create a new website for SYFA that would provide a better window into the work of Farmer Tantoh

Farmer Tantoh training students from the agricultural school in Nkambe the importance of botanical gardens in rural communities

Since its inauguration, SYFA has helped to prove numerous compounds (houses) in the Binju neighbourhood of Nkambe, as well as designing many gardens at churches, schools and administrative buildings.

“Farmer” Tantoh is from Nkambe, Cameroon. He studied at the Regional College of Agriculture, in Bambili, Cameroon, where his field of study was Agriculture and Rural Development. He specialized in spring water catchments’ protection using sustainable agro-forestry practices.

Tantoh has worked with local youths and low-income farmers, introducing lawn creation and flower gardening and also organic farming techniques adaptable to the tropics thereby protecting the local environment.

Achievement: The SYFA website is up and running since mid-June 2007.

This is the narrative I wrote when nominated for the 2006 UN Online Volunteer of the Year Award. I did not get the award but another volunteer from Nabuur was one of the 10 volunteers to receive the award.
In 2005 I decided to take a break from the hectic London life and to move to Thailand for a year. I arrived in Bangkok in February 2006 and after a couple of months holidaying around, I decided to devote some of my free time to voluntary work.

I have often been involved in voluntary work. I believe volunteering is a civic duty which origin goes far back in time when small communities were helping each other in difficult times or hostile surroundings. With nation building, social progress and technological developments, helping each other has become less of a necessity in people’s mind; society is here to provide. But everyday life shows us that this is not the case and that we still need to help each other on a voluntary basis.

Whilst in London I was volunteering for The Food Chain, a registered charity whose mission is to improve the health and well being of London’s population living with HIV by alleviating hunger and malnutrition. I started as a navigator, helping a driver delivering meal on Sunday. I quickly became involved in the management of the organisation. Between 2004 and 2006 I chaired the Fundraising Subcommittee contributing to the organisation of fundraising events and managing other volunteers. Previously I volunteered as a tutor helping young French student in difficulty at school and was also a supporter of Survival International.

In Thailand, because English is not the first language, online volunteering was the best option for me. I can do it from home and have no problem contributing everyday if needed. After much research on the internet, I found the United Nations Online Volunteering website and my attention was caught by a Nabuur advert seeking online community facilitators. I checked the organisation website and decided it was something I could contribute to and joined in April 2006.

Nabuur is the first online organisation I volunteer with. Its mission is to give communities in developing countries access to their global Neighbours via the Internet and through these neighbours to the huge reservoir of resources (knowledge, solutions, energy, creativity) that is available elsewhere. I choose this organisation for several reasons.

Nabuur is an online community and Nabuur’s assignments involve communicating with other volunteers. Our activities as volunteers are not performed in isolation (such as other volunteering opportunities of translation or researching information). This fundamental feature of the organisation allows for a lot of interactivity between volunteers and makes volunteering very attractive and motivating.

Nabuur offers a direct contact between the people who help and those who are helped. There is no red tape and working for Nabuur is working directly with the people in need. There is an ongoing dialogue between the online community and the real community.

Nabuur works from bottom to top. It is the real community that comes with a problem that the online volunteers will try to solve, not the volunteers that tell the community what it needs. In all project, the community leads.

Nabuur offers work opportunities related to all kind of issues such as community development (agriculture, education, income generation…), health (Water sanitation, HIV/AIDS, nutrition…) and social issues (Gender, Youth…). The volunteers join a particular “village” because they feel close to its location or because they have a strong feeling for the issue at stake. As a volunteer I am both facilitator in one village and members of other villages, increasing the possibility for me to expand the field of my knowledge.

Nabuur presents the community it helps with professional solutions not just quick fixes. It is important to provide communities with real solutions otherwise they would be disappointed by the organisation and the volunteers too would be frustrated. If the project is successful, it will translate into a working solution that can be implemented by the local community. The volunteer get the satisfaction to see their project taking shape with regular update, stories and pictures from the community and witness the direct results of their work and involvement.

After joining the organization, I chose the assignment of creating an awareness and training campaign on safe use of drinking water for a community in Uganda. This project offers me the possibility to use my professional skills of coordinator in the role of online facilitator and it also contribute to my personal development as I knew little about water sanitation and Uganda before that.

As a Nabuur volunteer I contribute in four different areas of the Nabuur organization: administrating my village, contributing to other villages, supporting and training other facilitators, and contributing to the development of the organization.

Initially I joined Nabuur as a village facilitator which is a role similar to that of project manager. In this position I am at the junction between the online volunteers and the representative of a local community in Uganda which has asked Nabuur for help. My role is to ensure that the project is on track, that tasks are assigned to volunteers and that regular progresses are made. I also act as a filter between the online virtual community and the local representative of the community. It is important to protect the local representative from to many questions as (s)he and the communities already have enough on their plate. As a facilitator I am also a forum moderator, seeing that the online discussions are focused on solving the problem, and a web host, welcoming new volunteer, introducing them to each other and to the issue and developing a “homy feeling”. I also report regularly on the progresses of the project to the online volunteer and to the local representative.

Soon after I joined two other online villages dealing with a similar issue. This facilitates and enhances the cooperation between villages tackling the same problems and avoid redundancy of work. It also offers an opportunity to share our resources easily.

We quickly found out that the problem of our community in Uganda was going beyond awareness of safe use of drinking water but that the community was lacking of clean water and did not have the skills or knowledge to produce it. But after only a few months, the 25 volunteers of my villages have achieved quite a lot. We have identifying several methods of water sanitation, we have surveyed the skills and assets of the community, and we have surveyed the various sources of water available as well as the general quality of the water. We are now in the process of selecting the best and most relevant water sanitation methods for the community and we also started work on the awareness campaign.

Besides working for real communities in need, I also contribute to the online community by providing other facilitators with management and coordination skills and help training them. As a professional coordinator, I share my experience with other facilitators who may come from very different way of life. Recently I ran a technical tutorial on producing newsletters, an essential tool for the communication between the facilitator and its volunteers but also to share the achievements of the project with the online community and the local representative. I will soon run another tutorial on using a Wiki tool for collaborative writing and project management. I also provided other facilitators with sample letters for inviting new volunteers and welcoming new members and I have designed an online survey for improving the contribution of the volunteers.

Finally, I am contributing to the future development of the Nabuur concept and of the Nabuur project. As members we are welcome to contribute to the organisation of Nabuur and I have made several suggestions and proposals to improve the management of the volunteers and the administration of the organisation.

Because I am involved in several aspects of Nabuur, I spend a fair amount of time volunteering online. Most days, I spend two hour online but it does happen that I spend a full day working online. It is a well invested time as I have met some very interesting people who I hope will become long time friends.

I believe that overall I am a driving force for Nabuur. By sharing my knowledge and helping with the training of other facilitators I believe I contribute to improve the performance of the organisations. I am not directly involved in solving all the problems of the 100 and more communities supported by Nabuur but I provide tools, methods, and strategies that will help achieving results. I also hope to be a motivating force for those facilitators who have sometimes to deal with low level of contribution in their village. Most importantly I would like to believe that I am contributing to the creation of a community spirit between all the Nabuur volunteers. Such spirit is fundamental for the success of the various projects currently in progress.

In return, Nabuur helped me realize that the Internet can be a helpful and powerful tool for solving people’s problem. Except for its role as a knowledge base and information source, I used to think that the Internet was a big waste of time and space where people were endlessly arguing on meaningless issue in futile forum. But the Nabuur concept demonstrates that it is possible to organise constructive actions when people of good will are brought together. I am lucky to be in a position where I can give a lot of time to online volunteering but in return, I am learning a lot, discovering new opportunities and broadening my horizon. It probably sounds a bit cliché, but despite living in a global village, bad or poor communication is still the main obstacle to peace and prosperity. Volunteering online gave me a little bit more hope that one day we will be able to really and sincerely help each another, even if we come from different backgrounds and have very different stories because all these differences are invisible online and therefore are not an obstacle to working together.

In conclusion, to someone thinking about volunteering online I would say that it is a very rewarding experience but that (s)he must be prepared to be committed. Unlike conventional volunteering, the Internet does put a bigger virtual distance between the people who need help and those who can provide it. But this does not mean that the needs of far away people are not as important as those of your next door neighbours. Organizations working online are particularly dependent on their volunteers and on their commitment. So join an organization, get involved at your level, give a reasonable amount of your time, it will pay back.

Note: I ended my collaboration with Nabuur in 2007. I remain a strong believer in the Nabuur concept as defined by Siegfried Woldhek, but believe that, as an organisation, Nabuur has not chosen a path that cannot deliver suitable and relevant assistance to communities where it is needed and in a timely fashion.