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6 Words of Wisdom: Working with the Media and Nongovernmental Organizations RELATIONSHIPS WITH THE MEDIA One of the participants raised the issue of engaging the public and the media, not only to help raise awareness about the prevalence of vio- lence, but also to participate in interventions in their respective communi- ties. Mr. John Donnelly’s presentation addressed the issue of engaging the media. As reporter for the Boston Globe who focuses on global health, Mr. Donnelly stated that building relationships and having regular dia- logue with reporters is critical to attracting the attention of journalists and obtaining “a good media outcome.” He made five suggestions for improving relationships with the media. The first was to have a thorough understanding of their materials to make a strong presentation to the jour- nalist, providing “good and bad” examples to illustrate trends and what is currently being done to address the problem. He remarked on the amaz- ing evidentiary content of the World Health Organisation (WHO, 2002a) World Report on Violence and Health and that it was a fresh perspective for him to learn that so many types of violence could be addressed with the same public health approach for prevention, but that “it was all over the place.” Cultivating a relationship with a reporter using new research findings that have not yet been published is also a possibility. Secondly, he suggested that the example provided should be grounded in “real life” and that advocates should take the time to show the reporter why the focal issue is compelling. As an example, he recounted an experience when he traveled to India, at the recommendation of a WHO researcher, to learn about road traffic safety. In his conversation with a hospital adminis- 

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7 WORDS OF WISDOM: WORKING WITH THE MEDIA AND NGOs trator in Delhi, Donnelley still did not see the issue as compelling until the hospital administrator led him by the hand to a street near the hospital, where he saw tractor-trailer trucks, rickshaws, people running across the street, ox-drawn carts, motorcycles, passenger cars, and Metrorail above the street. In that chaotic activity, the hospital administrator was able to point to a spot on the road where one of his nurses was killed two weeks prior as she tried to cross. The available pedestrian crossings were each a half mile away, in opposite directions, from the hospital. This became a compelling example of the problem of road traffic safety. His third suggestion was for participants to keep in mind that the media landscape is undergoing incredible transformation, especially in the United States. Economic survival has required many budgets to be reduced, which results in fewer domestic and international staff. These reductions have caused the traditional outlets that people are courting for media cover- age to look internally and, as a result, to cover local issues more intensely. The fourth important suggestion is to develop relationships with various reporters. He readily admitted that this is not an easy task and it takes a long time—perhaps years of talking—and will not always result in a story. It’s a conversation about national and international issues that permits you not only to become better acquainted with that journalist, but also to build trust. He even suggested that people could learn from each other by approaching colleagues to ask them about both positive and negative experiences with journalists. His last suggestion might help increase the likelihood of getting an article in the press that one would actually be happy about in terms of accuracy in data and context. Here, the trusting relationship is very impor- tant, but other things that facilitate this include checking with the reporter for the accuracy of quotes while the article is being written, making oneself available to the reporter for clarification, helping him or her obtain addi- tional information for the story or fact checking, and answering questions. This also extends to reporters working in countries where you are trying to change policies or invoke leadership to address issues—partnerships with reporters in those countries are essential. Donnelly cautiously ventured that people can also be a part of the media via “blogs” or publishing photo- graphs or videos online. This attracts attention not only on the Internet, but also of reporters in the area since there is local interest in covering what is happening locally. Questions from the Audience Donnelly addressed a few questions from the audience with an empha- sis on specific opportunities for advocates and researchers to capture the media’s attention and engage them to discuss or explore the root causes

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 VIOLENCE PREVENTION IN LOW- AND MIDDLE-INCOME COUNTRIES of violence and not the action that may be overshadowing the headlines. Timing, he suggested, is critical, along with the recognition that you may be contacted by a reporter or need to contact a reporter with whom a rela- tionship has been developed with only a few hours’ notice. He suggested that political reporters may also be interested, especially during presidential campaigns, not only in exploring the candidates’ track records on violence prevention, but also in learning what they might do about the issue if they are elected. When asked why the media was reluctant to cover suicide, given that it accounts for more than 50 percent of violence-related deaths, Donnelley remarked that the media provides little coverage because of the shame and stigma often attached to suicide for families and communities. He added that journalists do not want to be accused of privacy violations. New research in suicide prevention may help increase coverage of the issue, and personal experiences of journalists with the topic may also encourage increased willingness to cover it. He also noted that training sessions for reporters on various health-related topics can be a useful tool in improving the way the media reports an issue. RELATIONSHIPS WITH NONGOVERNMENTAL ORGANIzATIONS During the course of the workshop presentations and question-and- answer periods, there were multiple references to collaborating with other organizations that are engaged in research, programming, and advocacy for health issues that might intersect with violence or be impacted by violence. David Gartner spoke about the work of the Global AIDS Alliance and shared lessons learned from its advocacy for policies, resources, and programming to address the HIV/AIDS pandemic. In the course of his organization’s work, it, along with other implementers, has come to realize that violence prevention must be an integral part of the global response to HIV/AIDS. His four-point recommendation for moving violence prevention forward was preceded by a brief overview of U.S.-based advocacy that has contributed to the success of the global response to HIV/AIDS, which includes a tenfold increase in the provision of antiretroviral treatment in Africa. Gartner noted that new multilateral institutions such as the Global Fund to Fight AIDS, Malaria, and Tuberculosis (Global Fund) and its operational structure that include equity in developing country membership and civil society as a full governance partner has also contributed to the rapidity of the response and successful resource mobilization. U.S. policy changes have enabled the use of low-priced generic drugs around the world. Gartner agreed with Donnelley’s earlier call for marshaling evidence to make the case for policy development and resource mobilization for a cause, but also stated that accurate costing data grounded in what is actually needed for programmatic success are critical to helping multisectoral organizations coalesce around

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 WORDS OF WISDOM: WORKING WITH THE MEDIA AND NGOs a common message and vision to work toward resource mobilization. The broad HIV/AIDS coalition was also able to generate bipartisan congressional support. He quoted Tip O’Neill as saying that “all politics is local,” which Gartner thinks is particularly true for funding issues. All of these activities, combined with a political commitment from the Group of 8 (G8) to work toward universal treatment and access to AIDS services, has facilitated some progress toward this goal. He mentioned that at the same 2005 G8 Summit in Gleneagles, Scotland, summit where this commitment to universal access and treatment was announced, President Bush announced a new Women’s Justice and Empowerment in Africa initiative to combat sexual violence and abuse against women. By Gartner’s query to the audience, few had heard of the initiative—which, in his opinion, should have been a watershed moment for the violence prevention community—and his organization has had dif- ficulty finding out the results of this initiative. Mr. Gartner’s first point for developing a strategy to put violence pre- vention on the U.S. policy agenda and mobilizing real resources is to ask for what is really needed, not what is “reasonable,” which in Washington, D.C., is defined as “lacking ambition.” Asking for what is needed and what a unified coalition of researchers, advocates, and organizations truly wants increases the likelihood that it will become a reality. Earlier, he mentioned the costing estimates from the Joint United Nations Programme on HIV/ AIDS (UNAIDS) that helped create the unified voice that asked for multiple billions in funding. In the next several weeks after this workshop, and for the first time, these estimates will include costing for what is needed to internationally address violence prevention in the context of HIV/AIDS— which is only a first step to begin to address the global problem of violence. Mr. Gartner suggested that the entire community working on violence prevention would be able to rally around those costing estimates and build on the momentum for future funding and resource requests. To advocate for the domestic availability of these funds while expanding international funding for other initiatives, he contended that enormous pressure should be put on the congressional appropriators. With that said, billion-dollar initiatives do not come from Congress; so ideally, if the violence prevention community wants a new presidential initiative or linkage to an existing one, explicit language for major funding is needed that will go toward violence prevention and a structure for accountability. He echoed Donnelley’s sug- gestion that the community should devote a lot of attention to this issue with the presidential candidates. The second point acknowledged the importance of establishing link- ages with other issues and movements, which has been responsible for the success for advocates working on other health issues. Even linkages outside of the health sector, with education for example, may be helpful to educate people and political candidates on the impact of violence. If

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70 VIOLENCE PREVENTION IN LOW- AND MIDDLE-INCOME COUNTRIES they understand the dangers of exposure to HIV and sexual assault for many girls in schools without latrines or in walking to school, this could be an entry point for violence prevention dialogue. He stated that it will be nearly impossible for groups to obtain long-term funding in the hundreds of millions or more without these linkages. He offered concrete examples of funding for tuberculosis and services for orphans and other vulnerable children that effectively and synergistically linked to HIV/AIDS policy in recent years. With the relationship between HIV transmission and violence, there may be opportunities for leveraging real AIDS funding for violence preven- tion. To date, the U.S. Congress has only asked for reports on AIDS and violence and issued a generic request for funds to train police and military to address gender violence where appropriate. This type of request and any similar to it, he cautioned, will not yield the results that are needed to scale up the kinds of programs that will work in violence prevention. It is an important part of the response to violence, but a more significant way to address gender-based violence and equity would be to implement broader empowerment interventions. These could include providing access to a safe education for all girls, which may come from abolishing school fees, as well as linkages to economic empowerment strategies that contain violence prevention messages, such as microcredit financing programs illus- trated by the Intervention with Microfinance for AIDS and Gender Equity (IMAGE) study. Education and economic empowerment are clearly linked to decreasing the vulnerability of women and young girls and may play a role in addressing risk factors for young girls especially—because they often marry older men for economic security but are subsequently exposed to HIV and intimate partner violence. In Gartner’s messages about linkages, he stated he was not suggest- ing that violence prevention would become subsumed by other issues but rather that concurrent activities could take place. He clarified that his suggestion was to advocate for a presidential initiative and congressional legislation for violence prevention while linking with existing programs of key implementers for public violence prevention education and intervention integration. He noted that these collaborations might even educate many foundations and increase the funding they make available for violence prevention initiatives. Accountability for funds requested and appropriated was his third point. Any violence prevention initiative should have clear and measurable performance targets that become a part of the reporting process, as well as an entity with oversight for the initiative and the power to deliver program- matic management to reach the performance targets. This would be similar to the Office of the Global AIDS Coordinator, which has real authority and reports directly to the Secretary of State and the White House.

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7 WORDS OF WISDOM: WORKING WITH THE MEDIA AND NGOs His final point was that multilateral organizations are essential to real success. While most of his comments have focused on the U.S. response to HIV/AIDS, it is important to recognize that every U.S. dollar contributed to the Global Fund leverages an additional $2 for most other European donors. In addition, multilateral aid is not subject to what he termed “the beltway tax” or the high overhead rates that prevent important money from reaching the ground where it is most needed. He identified a small multilateral vehicle that has been addressing the prevention of violence against women for the last decade—the United Nations Development Fund for Women (UNIFEM). The United States has increased its contributions to $1.8 million of the $1 billion UNIFEM budget. He did articulate sup- port for the recommendation to create an agency for women as part of the United Nations, which Stephen Lewis mentioned as a possibility for an appropriate multilateral mechanism. If this recommended agency does not evolve, he suggested that people should support the UNIFEM to become a major multilateral mechanism that can leverage money from the rest of the world. Questions from the Audience In response to questions from the audience, Gartner pointed out that addressing violence, like other issues in global health, is not only an issue of compassion, but also clearly one of national security. India, Russia, and China—all countries with rising HIV rates and climbing rates of vio- lence—are nuclear powers. He stated that we are risking state failure in many countries of sub-Saharan Africa, with the possibilities of future civil conflicts and the alarming and escalating numbers of children who will be orphaned in many southern African nations. Recent events have shown that drug-resistant tuberculosis can cross borders quickly. All of these examples and many others point to the health dimensions that link violence to issues directly related to the security of the United States. When asked about the usefulness and impact of reports from the Insti- tute of Medicine (IOM) for influencing Congress and the administration, he identified the IOM’s recently released report PEPFAR Implementation: Progress and Promise (IOM, 2007; available at http://www.nap.edu/) as being enormously helpful in the HIV/AIDS community’s efforts to remove budgetary allocations from the U.S. Global AIDS Initiative’s legislation that are affecting the effectiveness of U.S. prevention policy in the program. He also stated that he thought an IOM report (a consensus study) would be helpful in catalyzing the operational and policy definitions for what could constitute scientifically sound violence prevention interventions, as well as linking together the issues that need to be addressed.