On Tuesday 24th July at the International Aids Society Conference in Washington DC, USA, the APPG on Global Tuberculosis hosted the workshop ‘Politics of Persuasion: Empowering and Engaging Elected Representatives to Tackle TB/HIV through Research’ . The session was facilitated by Dr Richard Horton, Editor-in-chief of the Lancet, the world’s leading general medical journal on infectious diseases.
An audience of over 200 heard from guest speakers including Cathy Jamieson MP, member of the APPG on Global Tuberculosis, Pamela Nash MP, chair of the APPG on HIV/AIDS, Jirair Ratevosian, Legislative Director of the Hon Barbara Lee – co-founder of HIV/AIDS Caucus in House of Representatives, US Congress, Gavin Churchyard, CEO of the Arum institute and Jennifer Woolly, Director of Advocacy at Aeras. The panellists discussed the importance of gaining a clear understanding of how researchers can engage with parliamentarians using scientific evidence to build political support and help drive policy change at the national, regional and international level.
The session highlighted the importance of advocacy as an essential communication tool for both parliamentarians and at the community level to raise awareness of latest developments in research and better understanding their full potential and implications for combating TB and HIV. Panellists discussed and demonstrated through their presentations how researchers, advocates and parliamentarians can work in better synergy with each to address these twinned global epidemics.
In his opening remarks Dr Horton made a poignant statement:
“why don’t we take TB more seriously when talking about HIV? It is the leading killer of people living with HIV, accounting for 1 in 4 deaths, yet it does not get the attention the suffering and loss of life it causes warrants”.
Dr Horton pointed to an article in the Lancet published in 2010 called ‘The HIV-associated tuberculosis epidemic—when will we act?’, which highlighted that despite policies, strategies, and guidelines, the epidemic of HIV-associated tuberculosis continues to rage. Dr Horton stressed how important engagement with policy makers was to ensure appropriate action was taken to address HIV-TB co-infection.
How to engage and empower parliamentarians
During her presentation, Cathy Jamieson MP talked about how she became engaged with working on TB through a constituent (Dr Geoff Coxon) a TB drug researcher in the UK who demonstrated to her the number of tablets that a TB patient had to take – using a bag of sweets – to be cured of an active form of the disease compared to a normal course of anti-biotic that showed the extent of the problem and why it was so important for her to help.
In February 2011, Cathy joined a UK parliamentary delegation to Rwanda organised by RESULTS UK to learn more about the impact of TB and TB-HIV on development and the impact of health service integration and effective policy implementation. Subsequent to these interactions with researchers and advocates, Cathy brought her interest and enthusiasm to take on more parliamentary engagement on the issue of TB by becoming an active member of the APPG on Global TB in the UK Parliament, in which she continues to be an active voice in parliament on the issues of TB and TB-HIV.
Pamela Nash, Chair of the All-Party Parliamentary Group on HIV/AIDS talked about the importance of keeping messaging clear, uncomplicated and where possible to relate scientific information to the politicians constituency, as demonstrated by Cathy’s example. In her current position on the Parliamentary Office of Science and Technology (POST) Pamela noted her respect for the work of researchers and academics, but stressed that keeping information simple for parliamentarians was key, in order for them to understand and engage fully.
Jirair Ratevosian, Legislative Director at the office of Hon Barbara Lee – co-founder of HIV/AIDS Caucus in House of Representatives talked about his role as a congresswoman’s staffer and the importance of tailoring scientific and advocacy messaging depending on the audience. He highlighted a case where sending substantial amounts of information to politicians was often detrimental to taking on an issue as offices often lack the capacity to deal with the volume of correspondence they already receive through e-mails, phone calls and requests every day. A key tip Jirair shared was being direct in communication, outlining who you are, what you want to talk about and why it is should be important to the policy maker. Often correspondence that does not include these elements is difficult to follow and harder for staff to deal with appropriately.
TB/HIV integration in South Africa
Gavin Churchyard gave a clear and exciting example of how consistent engagement with the Ministry of Health in South Africa, even through several changes in Ministers during the same time period, led to an in depth understanding of the implications of adopting key interventions to combat TB-HIV with evidence from scientific research. This consistent level of advocacy to South African Ministers, eventually led to the adoption and implementation of Isoniazid Preventive Therapy (IPT) that reduces TB incidence in People living with HIV, in the health care system in South Africa.
Dr Churchyard paid tribute to the leadership of Dr Aaron Mostolid, Minister of Health for South Africa for implementing this important policy change that has had a significant impact on the lives of patients with millions of people – in the last year alone – being tested and put on treatment for both TB and HIV.
This is a brilliant example of how researchers can effectively engage with advocacy at the political level to influence decision makers and change policy.
Bridging the gap recommendations for working together
From the perspective of non-profit product PDP dedicated to the development of effective TB vaccines, Jennifer Woolley cited the example of Aeras and how they have previously and still continue to work with policy makers around the world to demonstrate the impact that new badly needed vaccines could have on the epidemic. Jennifer also talked about the TB vaccines blueprint, which gives recommendations for working with politicians.
Questions from the audience centred on how to tailor messages to elected officials appropriately and resource mobilisation to address the diseases. Panellists responded to the various questions by saying that you must ‘know your customer’, in terms of the message you put across. Knowing who to target – your local MP should always be the first point of contact – and what messages they would be responsive to for example by looking at their biography online was essential.
Parliamentarians on the panel highlighted that to build support for resource mobilisation it is important not only to highlight the human suffering and loss of life, but also to demonstrate the economic case for addressing TB/HIV, where possible, as this will resonate very strongly with policy makers.
Dr Horton concluded the meeting by repeating that engagement with policy makers is vitally important to continue progress made to date in efforts to tackle TB/HIV. He also thanked the speakers for their contributions, particularly for highlighting the do’s and don’ts of meeting with politicians and for the specific examples of advocacy and engagement that demonstrate how through research elected representatives can be empowered to take action.
Note: An All-Party Parliamentary Group is a nonpartisan cross party interest group that sit in, and is recognised b, the UK parliament. Full detail of APPG’s can be found here.