With three million people dying each year, the economic and social costs of HIV/AIDS are escalating, particularly in Africa. In many places this is reversing progress towards the Millennium Development Goals. HIV/AIDS is also having an immense impact on the internal organisation of civil society organisations (CSOs) as staff themselves become both infected and affected. The loss of staff time due to sickness, family care and funerals, depressed morale, combined with the rising medical, recruitment and training costs mean that many CSOs are struggling with increasing overheads and declining output. As the director of a CSO in Malawi explains:
'One of my most experienced fieldworkers has asked me to let her work mornings only. Having endured the trauma of watching her three young children die in the last four years, her husband is now critically sick in hospital and she needs to look after him. Our terms and conditions limit compassionate leave to five days, but she will need to care for him much longer than that. But if I give her more the organisation will suffer and it will set a precedent … How would you respond?'

There is a desperate need to build not just individual, but organisational resilience to HIV/AIDS. This can be developed through a combination of interventions – the most common ones being staff awareness programmes and creating HIV/AIDS organisational policies. But CSOs need to go further and analyse the long-term human resource implications, ensuring that the costs of responding to the organisational impacts are built into their financial budgeting, planning, monitoring and evaluation processes. Responding effectively also requires CSOs to address wider issues such as the organisational culture, how decisions are made, gender roles and organisational boundaries with employees’ private lives.

Capacity building providers have a vital role to play in ensuring that organisational resilience to HIV/AIDS is brought onto their clients’ agendas. This is especially important because many CSOs may feel overwhelmed by the possible impacts of HIV/AIDS on their own organisation. Capacity builders need to be aware of the issues and have the competencies to support clients in addressing HIV/AIDS mainstreaming in their external programmes and relationships, as well as in their internal organisation. It will require HIV/AIDS specialists to develop organisational development (OD) skills, and OD practitioners to acquire knowledge and skills to deal with HIV/AIDS. Capacity building practitioners will need to adapt both the content of their services and methods of delivery.
While some international NGOs and donors have been at the forefront in assisting partners to see and respond to the challenges of HIV/AIDS, others have lagged behind. To remain relevant and effective, donors need to decide how they can help raise their partners’ awareness of the issues, how they can help them access capacity building support; what extra funding this will require; and how they can adjust their partnership strategies to assist CSOs to adapt to an HIV-infected world.
While policies are helpful, it has to be remembered that no amount of preparation, and no policy can insulate us from the painful realities of HIV/AIDS. As one member of staff of the Community Development Resource Network (CDRN) in Uganda has reflected on being robbed of Dorothy, a valued colleague and friend:
'Dorothy’s experience showed us both the value and limitations of having a health policy covering HIV/AIDS. The policy was a necessary, but not sufficient, response, and implementation proved traumatic. Our feminine caring culture came to the fore at a time of internal crisis. Because Dorothy was a friend and colleague, not just a human resource, we went far beyond our stated policy to help her. We felt we had to live out our stated values of standing with the poor and marginalised – an HIV+ woman abandoned by her partner with three children to support. If we had followed the policy to the letter, we would have compromised the core values that made CDRN what it was.'

Clearly there are no easy ways to build organisational resilience to HIV/AIDS, but there is an urgent need to find practical ways forward. INTRAC’s Praxis programme is therefore prioritising learning in this field, and is supporting the documentation of experiences and discussion of appropriate responses. The following documents can be downloaded from the INTRAC website:

• Praxis Paper 4 , Building Organisational Resilience to HIV/AIDS, Rick James, March 2005.
• Praxis Note 10 , The Crushing Impact of HIV/AIDS on Leadership in Malawi, Rick James, April 2005.
• Praxis Note 11 , Capacity Building in an AIDS-Affected Health Care Institution, Hans Rode, April 2005.
• Praxis Note 12 , Robbed of Dorothy, Betsy Mboizi (CDRN) with Rick James, June 2005.
• Praxis Note 13 , Building Capacity to Mainstream HIV/AIDS Internally, Rick James and CABUNGO, July 2005