In this summary of their valuable study, David Shallcross and Nana Kuo of the UNAIDS China Office compare the experiences of community-based organizations (CBOs) in Sichuan and Yunnan that had either successfully registered or tried to register as an NGO. Based on interviews with these CBOs, they find that the benefits of registration are limited and urge grassroots organizations to approach registration with realistic expectations. They also advise local governments to not only make the registration process easier but also to do more to combine legal recognition with training and capacity-building support for NGOs.
During the past few years, the Chinese government has used major policy documents such as the 2006 AIDS regulations and the China Action Plan for HIV/AIDS Prevention and Control 2011-2015 to call for stronger social participation in the HIV response. As the political environment for HIV-related civil society organizations (CSOs) has improved, more and more community-based organizations (CBOs) ((In this article, we use the term CBO as it conveys a stronger sense of local groups that are made up of local populations, and actively respond to their needs, as opposed to other terms such as NGO or civil society organization)) have been able to provide essential HIV prevention, treatment and care services for people living with HIV and those most at risk of HIV infection. Indeed, the Global Fund HIV program ((The Global Fund HIV Program is managed by the Chinese government, and supports the national response.)) alone is currently funding almost 1000 HIV/AIDS CBOs in mainland China, and many CBOs have established cooperation with local branches of the Centers for Disease Control (CDC) ((The CDC system is a national network of public service institutions that provide basic health services and are administered by the Ministry of Health.)).
In order to more effectively involve social organizations in the local HIV response, the China Action Plan for HIV/AIDS Prevention and Control 2011-2015 urges local Civil Affairs Bureaus and Health Bureaus to facilitate registration. However, there has been little progress on this issue – to date, only a small fraction of HIV CBOs have legal status. Yet, as the Global Fund HIV program winds down in China, and other external sources of HIV funding dry up, the issues of HIV CBO legitimacy and long-term sustainability become ever more urgent. Where international agencies were willing to turn a blind eye to whether or not CBOs were registered, the Chinese government is not: under existing government procurement regulations, unregistered CBOs are not eligible for state funding. Unless the government devises a strategy to address this, either through large-scale registration or through some other funding mechanism, many HIV CBOs will face extinction when the Global Fund program ends.
At the same time, the Ministry of Civil Affairs has issued several announcements this year that allude to forthcoming reforms in CSO legislation. The proposed reforms are currently awaiting approval at the State Council, however, it is probable that any new legislation will comprise simplified procedures for CSOs that are seeking to register. This would fit in with current innovative models for CSO management that have been initiated at the regional-level, notably in Shenzhen and Guangdong Province.
UNAIDS China Office believes that, in view of the Global Fund HIV program’s exit from China and the proposed policy changes concerning CSOs, now would be a good moment to review measures for ensuring long-term CBO sustainability. With this in mind, UNAIDS undertook an initial study in 2011 to reflect on earlier CBO registration experiences. As an accompanying piece UNAIDS is also planning to explore the attitudes and experiences of local Civil Affairs Bureaus, CDCs, Bureaus of Health and other local government authorities with respect to the issue of CBO registration.
This article presents the main findings from our 2011 study, where we addressed the following question:“What did registered CBOs expect to get out of registration, and how satisfied are they with the reality?” Based on our findings, we argue that the benefits of registration are not as transformative as some observers appear to hope, for reasons that we set out below. Furthermore, we contend that CBOs should approach registration with a degree of caution until there are more significant changes in how registration is implemented by local governments, including improvements to the process, and the development of linkages with other forms of CBO capacity-building.
UNAIDS contacted a total of fourteen CBOs that provide HIV/AIDS-related services in Sichuan and Yunnan (7 in each province). Although HIV is considered a “sensitive” area, eleven of these CBOs had successfully registered over the period 2002-2011, meanwhile the remaining three had recently attempted the process. The reason for interviewing the latter was to better understand their motivations, as well as to deepen our understanding of the registration process as experienced by CBOs.
The CBOs that we interviewed were generally small organizations with 1-2 full-time staff members. Two were registered at the district-level, eight at the city-level and one at the provincial level. In most cases, their registration had been sponsored by the local Health department, although other sponsors were also noted e.g. Red Cross, All China Women’s Federation.
Telephone interviews with the CBOs principally covered the following: (i) what were your original motives for seeking registration? (ii) what was the registration process like? (iii) what have been the main benefits of registration, and how well do they compare with your original expectations?
Motives for registration
The interviews revealed that the government was often an important agent in the decision to obtain legal status. Although there were no cases where government representatives explicitly suggested that the CBO should register, government partners were often consulted before the CBO took the decision to go through with the process. In some cases, the government immediately offered its assistance, which was instrumental in persuading the CBO to launch its application. For example, one CBO in Sichuan Province was encouraged with the words, “You should have done this a long time ago”, while all four registered CBOs in Yunnan described getting offers of government or GONGO support as soon as they raised their plans.
On the theme of government-civil society relations, all CBOs interviewed during the study perceived registration as a way of improving their relations with the government, and yet their reasons for seeking this improvement were disparate. Some CBOs in the study had been set up with the support of government agencies, typically the local Center for Disease Control or CDC. These CBOs appeared to view registration as a way of facilitating their service-provision. For example, one group stated that by having a formal legal identity, it would be easier to gain the trust of sex-workers – one of the targets of their HIV prevention work. Similarly, there were even some CBOs that were set up without government support that expressed a strong wish to complement the official AIDS response – in the words of a CBO leader in Liangshan, the aim of his organization was to “help the government out, and not cause any trouble”.
Yet there were also groups that described their initial motivation behind registration as a desire to gain a platform for advocacy work. They argued, a legal identity would make it easier for them to draw the government’s attention to neglected local issues. Two CBOs from Sichuan that both registered in 2005 stated advocacy as their sole reason for registering, and did not mention any other factors that had influenced their application.
In fact, few of the eleven registered CBOs mentioned more than three factors that had led them to seek legal status. The most commonly cited reason was funding access, but government relations and legitimacy also featured prominently. Other reasons that were mentioned less frequently include community relations, public image, advocacy and long-term development. One CBO in Sichuan that registered in 2003 stated a single reason – at the time they had been selected for participation in a DFID program, and one of the conditions that DFID had laid down was that the CBO should have legal status.
Hence, what the conversations revealed is that registration represented different things to different CBOs. Although it was generally associated with improvements in areas such as funding, government relations and CBO legitimacy, there were also other perceived benefits. Furthermore, it was sometimes used as a tool for reaching specific ends, rather than as a worthwhile end in itself. Finally, nearly all CBOs believed that registration would improve their relationship with the government, even though their initial relationship with the government, and the direction they wanted the relationship to move in, were very different.
Barriers to registration
The CBOs’ descriptions of the registration experience revealed barriers in three main areas: accurate knowledge of the registration process; registration requirements; and government attitudes. Examples of all three were commonly cited, although the evidence suggests that government attitudes had the most influence on the length and difficulty of the registration process.
In terms of knowledge gaps, the most striking cases occurred among the three CBOs that were unsuccessful in their attempts to register. For example, one group still believed that the local community office (街道办事处) was capable of acting as a sponsoring agency, while another group believed that, in their province, only the Health Bureau was able to act as the sponsor for HIV/AIDS CBOs – the study itself included recent examples from the same province that easily disproved this theory. Among the eleven registered CBOs, we also noted that very few had conducted any research into the process before beginning inquiries with the government. In some cases, this was because the government itself had proposed that the CBO seek legal status, however, in other cases this was not so. As a result, few CBOs had exercised choice over their legal identity (社团 or 民非), or even the level of government at which they had registered. In the majority of cases the local government had discreetly decided these for them.
CBOs also mentioned difficulties in meeting the official registration requirements. For example, it was sometimes difficult to find a suitable office space, or raise sufficient capital. Various strategies had been adopted to deal with this. In one case, a CBO had managed to borrow money from AIDS Care China, a much larger domestic HIV/AIDS CBO that is active across several provinces.
However, the most significant barriers related to government attitudes, which frustrated the registration process at multiple stages. Firstly, Civil Affairs officials did not always ensure that CBOs possessed accurate information – this is clear from the experiences of CBOs that applied unsuccessfully. Secondly, the Civil Affairs Bureau could be arbitrary with respect to the application materials. Several CBOs described being told to change apparently small details in their forms without any kind of explanation. This process was repeated several times with each new trip to the Civil Affairs office resulting in a new refusal based on yet another newly discovered “fault”. In some cases, this cycle was only broken when another government agency interceded – in two cases, CBOs successfully asked their sponsors to step in.
Finally, as earlier research on registration has demonstrated, the most notable difficulty was finding a willing government sponsor ((The technical term is “professional supervising unit” (业务主管单位).)). This problem was not only the most frequently mentioned; it also appeared to have the largest impact in terms of length of application process: when a sponsor was available, the entire process took as little as two months, whereas in cases where a sponsor could not be found, it took as long as one year.
Yet, the study also revealed that the government could be exceptionally supportive when it wished. In fact, CBOs that had previously cooperated closely with government agencies (typically local CDC) in HIV service provision were not only encouraged in their application, but also benefited from other forms of support. For example, one CBO in Yunnan described how its application materials, and the entire application process, were completed in three months thanks to its board of directors (which comprised local CDC officials); another CBO in Sichuan described how the local government helped it to locate an office space, thereby ensuring that it could meet the necessary material requirements. These examples suggest that government support is not only a motivating factor for CBO registration, but also an enabling factor, and that the availability of government support is influenced by the strength of earlier CBO-government cooperation.
Satisfaction levels among registered CBOs differed considerably as seen in two contrasting testimonies from CBOs that both registered in 2008: on the one hand, a CBO leader in Yunnan eagerly listed all the benefits that had accrued to her organization since registration, citing improvements in legitimacy, community trust, staff well-being, long-term development and funding access; while on the other, a CBO leader in Sichuan exploded with anger and resentment when asked to talk about the process and the benefits it had brought to his organization. In his words, he felt “humiliated” by his treatment at the hands of the government, and claimed that it had increased the burden on his organization without offering any compensating benefits.
Overall, we observed that most of the registered CBOs reported improvements in networking ability, government relations and public image, however, there was little evidence for improvements in funding, especially with respect to purchase of services by the local government. Tax benefits – which are often mentioned as one of the main advantages of CSO registration – were also not alluded to, suggesting that they were either absent or negligible. Indeed, one CBO leader in Sichuan whose organization registered in 2003 commented darkly that if she were given the choice now she would choose not to register. In her words, the Global Fund had enabled unregistered CBOs to easily access funding; meanwhile, her registered organization routinely failed to receive government funding, and yet had to maintain offices and fulfill annual reporting requirements.
At first glance, the range of responses appears confusing. However, it makes sense if we recall that CBOs had different expectations from registration in the first place, and that the registration process itself was far from uniform. If CBOs had a clearer idea of what they could hope for, it is likely that there would be less divergence in their subsequent reactions.
UNAIDS undertook this study because we wanted to understand what HIV/AIDS CBOs hope to achieve via registration and whether CBOs that had obtained legal status felt these expectations had been met. This is important in the context of understanding whether registration is something that should be promoted in its current format, and also has consequences for how we analyze predicted reforms in this area, since many observers hope that these reforms will contribute to a better legal and social environment for civil society in China.
From the study, we can see that CBOs generally perceive registration as a means for strengthening dialogue and cooperation with the government. However, what they expect to gain from this process depends on how they view their own role. Among groups active in Sichuan and Yunnan during the period 2002-2011, some civil society actors registered primarily in order to strengthen their ability to carry out local advocacy. These groups appeared to view registration as something transformative, providing them with a legitimate platform for working on local issues. Even CBOs that focused on service-provision sometimes shared this transformative aspiration, especially if their earlier cooperation with the government had been limited.
At the same time, other civil society actors pursued legal status for a mixture of reasons that included improving government relations, community relations, access to funding etc. Many of the CBOs in this group had been established with the help of local government agencies, and still cooperated closely with the government in areas such as planning, management, target setting etc. For these CBOs, registration was not perceived as something transformative, or an opportunity to re-set the existing government-CBO dynamic, rather, it was perceived as “more of the same”. From this, we conclude that registration is perceived as enhancing CBO-government relations, but that different conceptions of the CBO’s role affect expectations about the nature of this improvement.
CBOs reported mixed satisfaction-levels with respect to the registration process and its long-term impacts on their development. This divergence is understandable in the context of their differing expectations, however, it also reflects genuine inconsistencies in how the registration process was implemented at the local level. The latter is attributable to local government attitudes which varied from supportive to opaque and obstructive. It is harder to assess the long-term impact of registration on CBO development, partly because the testimony was subjective, and partly because it is not possible to know which of the impacts described (e.g. increased local funding, improved community relations) were truly attributable to registration, and which would have happened anyway. Nevertheless, to take local funding as an example, we noticed that CBOs that had previously worked on local government projects and received government funds prior to registration reported modest increases, while CBOs that had not previously worked with the government generally did not. Overall, CBOs that assumed registration would bring about significant changes in their organization were often disappointed, while those that saw registration as a natural progression built on a pre-existing relationship with the government were more satisfied.
What does this mean for CBOs in China that are considering registration under existing legislation? First, the testimony collected in this study makes it difficult to evaluate whether or not registration is something that should be promoted as beneficial to CBOs. Most of the interviewees were mildly positive about the experience, but there were a few that expressed bitterness or even anger. Hence any CBO that is thinking about registration would do well to research local conditions, and understand whether or not it is realistic and in their own interests to go down the registration route. Secondly, government attitudes do play a critical role in the process, which means that CBOs with existing relationships not only have a smoother path, but may also benefit more in the long-term. Therefore, for CBOs that decide that registration truly is in their organizational interests, it is worth building up government relations substantially before embarking on obtaining legal status. Finally, this study provides little evidence to support the idea that registration is transformative for CBO development, and rather supports the notion that registration acts as a way of affirming an existing CBO-government relationship, or otherwise conferring privilege. Hence, from the CBO perspective, registration remains something that should be approached with limited expectations if it is approached at all.
This study also has implications for policy-makers who are working on registration reforms to make it easier for CBOs to gain legal status. UNAIDS welcomes this trend, as well as other initiatives that create a more favorable environment for civil society, since international experience demonstrates that CBO engagement is essential for an effective AIDS response. Moreover, in countries such as China, the role of CBOs in reaching marginalized populations with high HIV prevalence, such as sex-workers, injecting drug users (IDU) and men-who-have-sex-with-men (MSM) cannot be underestimated.
However, we are concerned that simply lowering the registration barriers, for example, by removing the requirement to find a professional supervising unit, will not be sufficient to create the conditions for meaningful civil society engagement. Firstly, as this study makes clear, legal status alone is not a guarantee of CBO development, and needs to be supported by capacity-building in other areas, including funding, public credibility, networking and learning opportunities etc. Hence, if the government wishes to use these reforms to strengthen CBO’s role in society, it needs to integrate legal recognition with other, more practical, forms of support. Secondly, many CBOs wish to inform themselves about the registration process but are unable to obtain accurate information from the local Civil Affairs bureaucracy. If the government is serious about promoting registration among CBOs, it needs to address this issue, since otherwise it risks losing applicants before they have even taken their first step towards gaining a legal identity. Finally, we urge the government to address inequalities in the process itself, which include striking inconsistencies in the application period and the amount of feedback CBOs receive. We believe that until CBOs feel that their application will be treated fairly, it will be hard to promote registration on a larger scale, hence we recommend that the government establish clear standards in areas such as the maximum application period, the amount of feedback CBOs can expect, and opportunities and mechanisms for appealing the decision.
The UNAIDS China Office considers that, by combining the measures outlined above, the government would stimulate demand for registration among HIV CBOs. This would not only contribute to the achievement of objectives described in the China Action Plan for HIV/AIDS Prevention and Control 2011-2015, but would also facilitate expanded government purchase of CBO services in the coming years. We stand willing to work closely with the government on exploring this and other solutions, and to this end, we intend to complement this preliminary study with further investigation of the attitudes and experiences of local government agencies that cooperate with HIV CBOs. We hope that by analyzing the needs of both sides, it will be possible to define measures that ensure a smooth transition for HIV CBOS after the Global Fund leaves China, so that they can make a long-term, sustainable contribution to the HIV response.