A Discussion with Msgr. Robert Vitillo, Special Advisor on HIV/AIDS, Caritas Internationalis

With: Robert Vitillo

May 28, 2008

Background: Father Robert J. Vitillo is a full-time special advisor to Caritas on HIV and AIDS, directing the Caritas Internationalis response to wide-ranging aspects of the global pandemic in various parts of the world. He previously served as the executive director of the Catholic Campaign for Human Development, United States Conference of Catholic Bishops (USCCB). Prior to joining the staff of USCCB, Father Vitillo was Caritas Internationalis delegate to the United Nations in New York and to the World Bank in Washington. He became executive director of the Catholic Campaign for Human Development in January, 1997. He has served as consultant to UNICEF in Eastern and Central Europe on the development of family-centered programs to benefit children in need. Father Vitillo is president of the National Catholic AIDS Network board of directors, serves as co-convenor of the Strategy Group on HIV and AIDS for the Ecumenical Advocacy Alliance (based at the World Council of Churches), and as a member of the Boards of Directors of the National Council for Adoption, the Global Community Service Foundation, and Medicines for Humanity. In this interview, he shares how faith inspired the work mentioned above.

What path has brought you to your current position and how has it involved working with faith-based organizations and international development?

I worked at Catholic Charities in the US, as director for CC in my diocese in Paterson, New Jersey, so I had been very active in the Church’s work of charity and of social justice for some time. I had been involved in Catholic Charities even before I was ordained, and continued to be involved throughout my training. After ordination to the priesthood, I was asked to pursue graduate studies in social work (with majors both in psychotherapy and in management). I also was assigned to many different jobs in this multi-function social service agency before being appointed to the directorship.

In 1986, I was asked to serve on the staff of General Secretariat of Caritas Internationalis, based in Vatican City. Serving at Caritas Internationalis between 1986 and 1995, I first assumed the responsibility of Chief of Service for Europe and North American and later was appointed Director of Programs. I then returned to the US to assume responsibilities as the Executive Director of the Catholic Campaign for Human Development at the United States Conference of Catholic Bishops in Washington, D.C. In 2005, Caritas Internationalis requested that I return to their staff, this time as the Special Advisor on HIV and AIDS and to be based in Geneva, Switzerland. All these assignments were approved by my diocesan bishop.

In Geneva, I have made progress in strengthening the relationships among Caritas Internationalis and UNAIDS, the World Health Organization, and the Global Fund to Fight AIDS, TB, and Malaria. Since my arrival, I have been asked to assume responsibilities for directing the Caritas delegation to the UN in Geneva and thus supervise two other staff members who are active in advocacy on other priority issues for Caritas, including migration, human trafficking, the right to education, children's issues, and human rights. Recently, we have been joined by another staff person, who is coordinating Caritas' work on climate change. Finally, our delegation in Geneva has joined the Caritas delegations in New York and Rome to follow the unfolding food crisis.

On HIV and AIDS, our work is active and diverse. Much of our work concentrates on advocacy with UNAIDS (Caritas established a Memorandum of Understanding and Cooperation with UNAIDS in 1999) and the World Health Organization (Caritas entered into a “Working Agreement” with WHO in 2007). In this work, we try to represent the concerns and needs of Caritas and other Church-related organizations that serve the most poor and vulnerable both in developing countries and in higher-income countries. We also participate in international conferences such as the International AIDS Conference, to be held in Mexico City, in August 2008, and the UN High Level Session on AIDS, to be held in early June, in New York. In such gatherings, we often collaborate with ecumenical and interfaith groups in order to present the perspectives and experiences of people of faith engaged in the global response to AIDS.

How has faith been part of the vision and evolution of your institution?

Faith lies at the very heart of the Caritas mission. We trace our roots to the charitable and justice work that is reflected in the Jewish Scriptures and then in the Christian Scriptures especially in the words and example of Jesus. Caritas work is not restricted to benefitting Catholics or Christians, we serve all without concern for their race, ethnic origin, socio-economic status, or membership in a faith community. However, we give service because we are Catholic and, as Catholics, cannot ignore the needs of our sisters and brothers in the human family. We are conscious of the fact that our faith connections may disqualify us for consideration of funding by some organizations that do not understand the actual tenets of our faith tradition. Such prejudice is neither warranted or justified. We hope that the increasing openness of some UN and other international organizations to recognize the invaluable contribution of faith-based organizations to the fields of humanitarian assistance, health, and development, will encourage others to lower their prejudices and to collaborate with organizations such as Caritas and thus, in this way, be able to reach many more people in need.

How did you get so deeply involved in HIV and AIDS work?

In 1987, when Caritas Internationalis identified HIV/AIDS as one of its program priorities, I was assigned to staff this work! I had not been involved in AIDS before. However, I was trained in psychiatric social work so the field was not entirely new to me.

How is Caritas Internationalis organized generally?

Caritas Internationalis is the global confederation of national Catholic humanitarian assistance, social service, and development organizations. The confederation has 165 national members operating in more than 200 countries of the world. Some Caritas organizations cover several countries (e.g., the Pacific and Caribbean). Each is independent, and the General Secretariat in Vatican City has no direct authority over them. Usually, the national Caritas organization is sponsored by the Bishops' Conference in the respective country. From the United States, the Caritas member organizations are Catholic Relief Services, Catholic Charities USA, and the Catholic Campaign for Human Development. The Caritas General Secretariat has a mandate of coordination, especially of humanitarian work and in disasters, of representation at the United Nations and other inter-governmental organizations, and of education and capacity building with member organizations.

Every four years there is a Caritas General Assembly, which discusses and designates priority areas. The last was in June, 2007, last summer, so the next will be in the summer of 2011. The last Assembly reaffirmed the priority of HIV/AIDS, but put this work in the broader context of development, especially including health. Climate change was underscored as a new priority. Other priority areas are peacebuilding, migration, and empowerment of women.

Caritas has a secretariat for Europe that is based in Brussels; it works with the European Union as well as the Council of Europe. The European Caritas members have identified special focus areas for this continent, notably extreme poverty and migration. There is a special task force on HIV/AIDS (I am a consultant for it), that focuses on central and eastern Europe. There is a huge expansion in European work, as the countries have expanded from 21 in the late 1980s to 49 today.

The various national Caritas offices work to build and maintain bilateral relations. This involves both support and dialogue. The Caritas organizations in high-income countries often partner with those in lower-income countries in order to assure funding for various programs, including that in response to HIV and AIDS. It is important that the traditional “donor” organizations listen to the needs and priorities of their partners. For that reason, Caritas Internationalis has developed Partnership Principles for such bi- and multi-lateral relationships.

Good relationships have been established in several countries with AIDS ambassadors, for example Holland, Sweden, Norway; all seem more open to partnering with faith organizations, though it takes some explaining why the Catholic Church takes certain positions. The key is broadening the discussion to the many other areas relevant for development, where the Church has so many activities.

Can you tell me more about your own work and that of the Geneva office? How do you apportion your time among so many activities?

The bulk of my time goes to health and HIV and AIDS. Caritas has been deeply engaged in this area (as have I) since the 1987 CARITAS General Assembly, which chose HIV/AIDS as a priority. The heavy impact of HIV and AIDS was already apparent in East and Central Africa, and Caritas members realized that there was a need for training and capacity building. A major need emerging then, and continuing today, is that of capacity building of Caritas and other Catholic organizations, as well as of religious leaders, through seminars, regional and national, and training.

You commented that United Nations agencies are becoming more interested in the work of faith-based organizations. What are you seeing and how do you explain this new interest?

The main recognition is an increasing understanding of how much that actually is being done in the field by faith-based organizations (FBOs). The World Health Organization was much influenced by the Religious Health Assets Program (RHAP) study done last year. WHO itself has announced and underscored the results: that 40 to 70 percent of health services in several countries is provided by religious organizations, and that this is especially important among poor and marginalized communities. Thus, after noting the results of the latter and similar studies, the UN agencies and other bi-lateral and multi-lateral organizations seem more open to partnering with FBOs. WHO also is marking the 30th anniversary of the Alma Ata meeting that stressed the importance of primary health case. Many FBOs have been and are involved in examining primary health care challenges. The Alma Ata discussions have made WHO much more conscious of these issues. For example, in January 2008, the WHO Stop TB Department and Caritas Internationalis sponsored a Joint Mission to Swaziland in order to encourage greater collaboration between the government and faith-based organizations in responding to HIV/TB co-infection in that country. At the present time, much of the tuberculosis control and treatment there is centralized, while it needs to be community-based. The mission made contact with FBOs, brought government officials out to the field, then organized a conference together with FBOs and government officials in Manzini. They worked together on a framework. This could serve as a model for other places. WHO also has contacted Caritas and the Holy See Mission in Geneva about pandemic influenza and has proposed to the joint development of educational materials and preparedness plans that could be implemented by religious structures in the eventual outbreak of this pandemic.

In relation to UNAIDS, Caritas is involved in a special working group that brings people from various UN agencies, together with faith-based representatives, with the objective of building a framework on how to partner better. They are now finalizing the framework document resulting from this work. This meeting took place in early April 2008 and provided a good interchange.

The ILO is indeed fairly unique among UN agencies in terms of the long duration and depth of its partnerships with faith organization; the new Counsellor for Socio-Religious Affairs (who succeeded Dominique Peccoud) is Father Pierre Martino Lagarde. ILO tends to show a special appreciation for the religious as well as social side of issues, and seems open to building even stronger relationships with the faith sector.

On issues of migration, UNHCR has always had strong field partnerships with faith organizations, but its headquarters staff seems more interested in working with our Caritas delegation to plan special invitations of church-based field workers to international meetings and consultations.

You also referred to peacebuilding work. What is its nature? How does it relate to the Catholic Peacebuilding Network that is active in the US?

Peacebuilding work has grown over the last eight years. Since that time, Caritas Internationalis assembled a group of experts who produced an excellent set of training materials and organized regional training sessions on this topic in each region of the world. Caritas Internationalis also has collaborated with the US-based Catholic Peacebuilding Network.

As you look at the Berkley Luce FBO project and June 24 ISS Hague consultation, what are priority issues that emerge and topics you would most like to see addressed?

A major issue is capacity building. There is a large need for this work among FBOs, in large part to help them access the expanded funding mechanisms that are now available, for example the Global Fund and the World Bank. In the past, FBOs have concentrated on serving people at local level and mainly through church-based support. There is increasing recognition, however, that through traditional and existing means, they cannot generate enough resources to sufficient scale-up in order to deal with the huge global problems that face us today, including those of the major pandemics.

The area of monitoring and evaluation is also critically important. Accountability is an important issue. Many FBOs are very accountable, but they often do not frame it in the same way as secular development organizations. Monitoring and evaluation must be integrated into the daily activities of faith-based organizations. It simply is not acceptable to claim “we are serving people and do not have time for bureaucracy.”

Another challenge is trying to promote mutual dialogue, trust, planning, and collaboration among various faith-based organizations themselves. Such approaches enable them to present a unified front or face, while they still are able to maintain their unique mission, identity, integrity, and adherence to the doctrines of their respective faith traditions. Little by little this is starting to happen. Interfaith networks are emerging to work with the Global Fund are emerging in several countries. Within the Catholic Church, the many religious orders have worked together to set up an HIV and AIDS committee, which started with a mapping exercise. There was a meeting in Rome in early May (Georgetown University helped with the exercise and was part of the meeting). There is a strong commitment to promote greater collaboration in this field.

Advocacy to influence the way some funds are distributed presents a major challenge. Many of the large organizations have a prejudice to work with governmental structures, even when we know the latter very often do not work well. The main target of such advocacy is the Global Fund but there are others, the World Bank included.

The Global Fund organized a meeting with FBOs at the end of April 2008 in Dar Es Salaam. One issue was to get a clearer idea of what funding is actually going to FBOs. The initial estimate was very small, around 2 percent, but the Global Fund argued that this involved only principle recipients, and if secondary financing was taken into account the amount would be much larger. When they did such a review with consultants, the amount was still small, around 5.8 percent. While Global Fund leadership and staff often convey a message that many FBOs are not very involved, in fact they are, working with most of the Country Coordination Mechanisms (CCMs). Then there is the argument that FBOs do not apply, or do not apply properly. During the Dar es Salaam meeting, there were open and frank discussions of these questions. In my opinion, however, progress must be made to influence governments to be more open to partnerships with FBOs and to pass on needed funding to these organizations.

I believe that the Global Fund needs to issue guidelines to governments in order to strongly encourage that funds must be allocated to those organizations that actually are providing the services to people living with and affected by the three pandemics being addressed by the Fund. The Global Fund issues guidelines on lots of things, so why not an advisory on allocating funds to civil society actors, including FBOs? With the help of such an advisory, FBOs could seek to hold governments more accountable.

Can you give an example of a successful country case?

Zambia is very often cited as an example. The Christian Health Association of Zambia (CHAZ) is responsible for much of the Global Fund monies and is seen as very successful.

How do you work with the Ecumenical Advocacy Alliance (EAA)?

We work closely together. There is above all much work on advocating full funding, many meetings to prepare, and joint studies. Caritas has assisted the Alliance to develop a special campaign to promote access to pediatric anti-retroviral medications. I serve as the co-convenor of the Alliance's HIV Strategy Group.

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