Community empowerment and public health: shaping the future
Community involvement is essential to all aspects of a comprehensive approach to HIV/AIDS: prevention, treatment, care, support – and research (see Chapter 5). In the expansion of treatment up to and beyond the targets of the 3 by 5 initiative, civil society must raise performance demands on the public, private and nongovernmental sectors. Scale-up cannot happen without government commitment, but civil society advocacy can support this commitment.
The success of this effort in HIV/AIDS control will have important implications for the wider public health agenda. The necessity of community involvement in treatment roll-out represents an opportunity to build skills and catalyse collaboration between communities, health care providers and public health planners that can carry over into other areas of public health work, and help strengthen health systems across the board. Communities educated and mobilized around HIV/AIDS control, provision of services and support will be better able to take part in health promotion, disease control and treatment efforts that tackle other health problems. These include tuberculosis and malaria, maternal and child health, and chronic adult diseases in low-income and middle-income countries. Recognizing and building up these capacities is part of the process of strengthening health systems. Success in accelerating this process could be a lasting contribution of the 3 by 5 initiative to global health improvement.