252 Human Development 33173 July 2005 Findings reports on ongoing operational, economic, and sector work carried out by the World Bank and its member governments in the Africa Region. It is published periodically by the Knowledge and Learning Center on behalf of the Region. The views expressed in Findings are those of the author/s and should not be attributed to the World Bank Group. Democratizing HIV Communication Information and communication Empowering by information are the key assets within the glo- bal knowledge economy. Economic The Biennial 15th International growth, market access, and the AIDS Conference in Thailand, 2004 ability to manage risk correlate centers, around the theme "Access directly with the rapidity and For All". "Access" is not only about breadth of information access and AIDS care, treatment and preven- the availability of appropriate com- tion services. Access for all should munication channels (Stiglitz, encompass access to information, econlib.org). It would be helpful for and access to platforms to air views economists recognizing the value and health priorities, particularly of information and genuine two- those of the most affected. Those way communication to argue for its working for an independent, criti- importance within the fight cal and responsive media on AIDS against HIV/AIDS, particularly to hopefully will adopt and rally behind donors intent on proving "bang for this slogan. buck." We know that despite the Development economists write of optimistic buzz around the poten- the "information rich" and the "in- tial of new information and com- formation poor" (Zielinski 2001). munication technologies, "the glo- The pattern of HIV distribution bal gap between haves and have- neatly echoes the distribution of nots, and know and know-nots information and communication deepens" (Human Development Re- access. It is the communities most port 1999). The same applies to disenfranchised with the informa- knowledge and communication on tion society that bear the brunt of AIDS. There remain serious di- the AIDS epidemic, including the vides and disconnects between poor, the displaced, sex-workers, those creating AIDS information young women, migrants, and oth- and agendas and those silently af- ers. The patterns of poor health, fected. Using parallels with the role and poor information opportunity of information in broader society, are often the result of more funda- this article makes a start at show- mental social and political eco- Findings ing how the media can democra- nomic inequities. "AIDS moves tize, illuminate and energize the through the fracture points of so- response to the pandemic. ciety" (Farmer 1992), consistently affecting those already disadvan- taged through inequitable gender, social, or economic relations. Me- tries have transformed the infor- tures a currency of life saving in- dia and communication can bridge mational landscape. This media formation and a monopoly on who these divides. The ability to com- information revolution increas- produces and transmits it. The municate, to create and receive ingly provides opportunities for a Bush administration's approach to information, and to share perspec- multitude of perspectives to be AIDS prevention, focusing around tives is central to advocacy, activ- aired. These changes are charac- abstinence, is a useful case in ism, and civil society participation. terized by multiple sources of in- point. To what extent did this U.S. The relationship between AIDS formation, including growing num- policy direction sublimate a domes- and information access is not en- bers of local radio stations and print tic agenda to enable southern tirely straightforward. The highly publications. These are increas- voices to emerge? How would this networked, such as business ingly privately owned in countries be read in terms of an AIDS infor- elites, politicians, and others pros- once dominated by the state me- mation economy of haves and perous within the information dia. There is television in places have-nots? Other donors, the UN economy, are often also heavily where there was none before, with and civil society are often also cul- affected by AIDS. But partly through multiple, usually commercial pable of paying insufficient atten- access to information and the right channels where once there was tion to the importance of empow- to speak out, HIV amongst these only one. The new technologies of erment of the voices of those most groups remains less prevalent, and the Internet and mobile telephony affected. less immediately associated with are also changing how people com- Donors, international NGOs, the disease and fatality. The early fight municate. In place of limited in- UN, and others in the forefront of for rights, treatment, care, and pre- formation coming from a few au- the response are unlikely to be vention of AIDS amongst the gay thoritative sources, many mes- wittingly seeking to control the dis- community in the north shows sages are now passed between course that shapes the response how communication can mitigate growing numbers of individuals to HIV/AIDS. Yet in the battle to the impact of the epidemic. and organizations in increasingly generate and disseminate AIDS networked societies. It has become messages and agendas, those Mobilizing civil society far more difficult to target informa- high-disease burdened countries tion and fewer sources are auto- and communities at the receiving A common question in health matically accepted as authorita- end are too rarely and insuffi- policy circles is "how can we mobi- tive. ciently empowered to speak out on lize civil society?" Too often the Just as within broader economic this issue (Scalway 2003). Where answer centers only on pushing terms, businesses, governments those most affected can use me- out information. The more appro- and other institutions depend not dia and other communication priate question for health only upon hearing but also on be- channels to demand better ser- policymakers would be "how do we ing heard for their success vices, life-saving drugs, and basic enable civil society to mobilize us?" (Branscomb 1994), so too do those rights in relation to health, re- This is particularly true in coun- within the information economy markable successes can follow. tries with weak infrastructure, around HIV/AIDS. Placing HIV The work of the Treatment Access poor governance, stifled media, and within an information economy Campaign in South Africa is a no- meager resources. And part of the allows us to draw upon and lever- table example. answer to this question is to sup- age the resources of economic dis- port media capacity, growth, and course. More importantly, it lays Creating networks freedom to engage with AIDS out within a simple, apolitical, logic (Carrington 2002). Networking the AIDS community the importance of bottom-up com- In countries facing, or about to involves creating connections munication, as well as top-down face, the brunt of the AIDS pan- across some of the political, social, information dissemination. This demic, the media is changing fast. and gender inequalities that fuel information economy features Privatization, globalization, and the epidemic (Panos/UNFPA 2001). haves and have-nots, the empow- deregulation of the media indus- There is potential for the changes ered and the disempowered. It fea- in the contemporary media envi- faith-based community networks, Press, 1992. ronments to make this happen innovations such as neighborhood Human Development Re- through greater pluralism, access health committees (Zambia Inte- port. New Technologies and to information, and democratiza- grated Health Project 2004), and in- The Global Race for Knowl- tion. But these changes also bring creasing access to broadcast me- edge, 1999. about a highly advertising-driven dia, the majority of those currently Panos/UNFPA. Communica- and commercial media, often prone living with HIV may never have the tion for Development to sensationalism. There has been means to meaningfully air their Roundtable Report, 2001, an explosion of radio stations in views to their publics and to their www.panos.org.uk many developing countries and an policymakers. Scalway, T. Missing the associated upsurge in talk radio. The "Access for All" theme needs Message? 20 Years of Discussion programs, phone-ins to be seized upon by those working Learning from HIV/AIDS. and other talk-based formats are with AIDS and communication. Panos Institute, 2003, increasingly popular and provide Access to information, access to www.panos.org.uk some of the most powerful ex- public debate, and access to a me- Stiglitz, Joseph E. The amples of development program- dia that can speak for, to and across Concise Encyclopedia of ming. This format brings greater communities are all good rallying Economics: The Library of equity to the production of knowl- calls. All of us working with or for Economics and Liberty, edge and understanding about HIV/ the media could usefully apply this www.econlib.org/library/ AIDS. Stories told by HIV positive slogan to bringing the communi- enc/information.html people, sympathetically treated on ties most affected by HIV/AIDS into Zambia Integrated Health a radio program, can arguably have the discourses that determine the Projects: Presentation, far more effect than more conven- response. UNICEF Communication tional communication messages, for Social Change Meet- and there are many examples of This article is a reproduction of the ing, April 2004 this happening (see Soul City ex- article by Thomas Scalway pub- Zielinski, C. The Changing ample on www.comminit.com). lished in Development Outreach, July Role of Information in Devel- Community media, particularly 2004, World Bank Institute. Thomas opment, Health Information community radio and the Scalway is Director of the London for Development Project, telecenter movement, offer useful Panos Institute AIDS Program. For 2001, http://www.iwsp.org entry points for this horizontal or more information, please email bottom-up communication, but still hivaids@panoslondon.org.uk receive little support within the context of HIV/AIDS. Partly be- References cause of ease of start-up, and ease of access, online communities of- Branscomb, A.W. The Economics of fer a range of horizontal commu- Information. Public and Private nication models amongst special Domains of Information: Defining interest groups, yet they are only the Legal Boundaries,1994, starting to connect those who were www.asis.org hitherto out of touch. Africa only Carrington, T. and Mark Nelson. accounts for one percent of "Media in Transitien: The Internet usage for example. Em- Hegemeny of Economics," in powering more marginalized groups The Right to Tell: The Role of living with HIV, particularly the Mass Media in Economic Develop- rural poor, to enter into private dia- ment, World Bank, 2002. logue or public debate about the Farmer, P. AIDS and Accusation. response remains an imposing Haiti and the Geography of challenge. Despite traditional and Blame, University Of California