Summary of the impact

Research at the University of Glasgow (UoG) has helped faith-based organisations and their non-religious counterparts to develop a better understanding of the effects of Christian beliefs and practices on public health and international development goals. Our research and engagement strategies have benefitted the Catholic Agency for Overseas Development and its partners by educating staff and influencing, in particular, HIV policy. It has also led to greater understanding of religious resistance to the language of development as used in the Joint United Nations Programme on HIV/AIDS and the United Nations Population Fund, encouraging dialogue between UN staff and historically disengaged conservative religious groups.

Underpinning research

Faith communities are among the most significant agents in the promotion of public health and international development. Yet religious beliefs and practices can also undermine health and development goals, such as those relating to gender equality, reproductive health and HIV/AIDS. The impact of faith-based organisations on the United Nations Millennium Development Goals (MDGs) for maternal health and HIV/AIDS is contested because of the limited available evidence concerning the activities of faith-based organisations.

Julie Clague (Lecturer in Theology and Religious Studies, 2000 to the present) has been researching sexual and reproductive health issues since 1994. Her research on faith-based responses to HIV has been in three interrelated areas:

1. Mapping and evaluating faith community responses to the MDG targets on maternal health and HIV/AIDS. Clague researched and compiled the Joint Learning Initiative on Faith and Local Communities (JLI) database — at http://www.scribd.com/doc/118047301/HIV-and-Maternal-Health-Annex-1 — of faith-based responses to HIV and maternal health. Her key findings include:

- that faith-based organisations offer both community-based care and institutional health services;

- that services are diverse, spanning prevention, home-based care, advocacy, treatment, prevention of mother-to-child transmission and training of faith leaders and congregations;

- that the scale of initiatives ranges from multi-country programmes — eg, international networks of religious congregations, whose global membership may be as high as 40 million — to localised one-to-one activities; and,

- that there is sparse published evidence or mapping of the involvement of faith-based organisations in maternal health: far more evidence exists concerning HIV-related services.

2. Catholic approaches to HIV prevention. With HIV programmes across 114 countries, the Catholic Church is one of the world's largest providers of HIV-related services. However, Vatican teaching on HIV prevention — eg, rejecting condom use — is widely regarded as counter-productive to HIV-prevention strategies. Since 2000 Clague has been a member of the HIV/AIDS Advisory Group of CAFOD (the Catholic Agency For Overseas Development), the development arm of the Catholic Bishops' Conference of England and Wales and the HIV response coordinating body for Caritas Internationalis. Her research on Catholic moral method in relation to HIV makes her one of a handful of experts in this field in the Catholic Church. Clague's work has shown how and in what ways Catholic moral reasoning is applied to HIV prevention strategies. This has helped CAFOD articulate its HIV policy and successfully implement it among at-risk communities. To this end, Clague's article on `HIV and Catholic Theology' (2006), which appears on CAFOD's website, has been widely disseminated and cited across Catholic and faith-based communities worldwide, as indicated in section 4 below.

3. The ideological divide between the rights-based value system of secular societies and the religiously-inspired value system of conservative faith communities on issues of gender and sexuality. Clague has published three articles discussing the synergies and key differences between the rights-based values of secular society and the religiously informed moral values of conservative faith communities. The earliest (2000) discusses the ambivalence to rights discourse within Catholicism. The others (2006, 2009, 2011) examine religious antipathy to gender theory and homosexual rights. Clague's research shows why an ideological gulf exists between the rights-based approach to development, espoused by secular agencies such as the UN and donor governments, and the religiously-based premises of conservative faith communities, especially in the fields of women's reproductive health and HIV/AIDS. This research informs Clague's work with the World Council of Churches and the UN. With 84% of the world's population religiously affiliated, UN agencies cannot ignore the influence of religious ideology on public health. Clague is currently promoting dialogue on these contested issues between faith leaders and UN representatives on behalf of the Ecumenical Advocacy Alliance.

References to the research

Details of the impact

Clague employs research methods and evidence to demonstrate both the positive and negative impacts of faith responses to health and development. This demonstration is crucial to advancing the dialogue between faith service providers and the international agencies responsible for overseeing the achievement of key development targets such as the Millennium Development Goals (MDGs). In 2000 the MDGs were established and agreed to by 189 member states in the UN. Two of these universally recognised objectives for addressing specific global needs have not been met: MDG 5 (improving maternal health) and MDG 6 (combating HIV/AIDS, malaria and other diseases). Clague's research has been used to:

1. bridge the secular/faith-based divide in the international HIV/AIDS response through activities within the following organisations.

- Joint Learning Initiative (JLI). Religious drivers of the HIV/AIDS pandemic have undermined the positive contributions to tackling HIV made by faith communities, meaning that these contributions have been overlooked, under-researched, and as a consequence under-funded. To address this research deficit, the UN is working with representatives from faith-based organisations and relevant researchers including Clague, through the JLI, to map the nature and extent of faith community responses, in order to develop a reliable evidence base of the role and impact of faith-based interventions in relation to HIV and maternal health. Clague is co-chair of the HIV/AIDS and Maternal Health learning hub of the JLI, and was instrumental in driving the data-gathering and evidence-based research to examine the link between faith, maternal health and HIV/AIDS development work. The JLI and the evidence base it continues to compile, through the learning hub co-chaired by Clague, is an important channel for faith-based organisations to communicate their impact more effectively to those overseeing the global HIV and maternal health response. The United Nations Population Fund (UNFPA) published the JLI report on maternal health and HIV while JLI research findings have been disseminated to the major donor agencies USAID (the United States Agency for International Development) and DFID (the UK Department for International Development).

There have been a number of meetings between DFID's Civil Society team, USAID and the JLI project team, in which the agencies expressed an interest in JLI findings concerning the role of faith-based organisations in global health, since this information is unavailable elsewhere. USAID and DFID have shown their recognition of the value of the emerging evidence base established by JLI in a number of ways. For example, USAID proposed that another JLI learning hub be established, focusing on maternal and child health; and Clague has been invited to deliver two seminars at DFID in London and East Kilbride to promote faith literacy among staff, including senior civil servants and ministers (although these are scheduled to take place in November 2013, outwith the eligible timeframe).

A Senior Advisor for the UNFPA writes:
Faith beliefs and practices — such as those concerning sensitive issues such as gender equality, sexual and reproductive health and HIV — continue to shape critical behaviours that have a profound impact upon health. Clague's engagement in this field is helping to promote dialogue within the Catholic Church on such difficult topics. It is also helping non-religious and global inter-governmental bodies, such as UNFPA: (i) better understand the diversity of approaches that exist within Catholicism; and, (ii) identify the synergies and key differences between Catholic values and teachings, as well as the human rights that underpin much of UN policy on these issues.

- Ecumenical Advocacy Alliance. In November 2011 Clague was consultant to the Ecumenical Advocacy Alliance of the World Council of Churches during their `closed-door' workshop discussions on Theology, Human Rights and the HIV Response. Clague's input was described by the HIV and AIDS Campaign Coordinator as `a vital part' of this ongoing Ecumenical Advocacy Alliance project. Religious leaders, representatives from UNFPA and UNAIDS (the Joint United Nations Programme on HIV/AIDS), and people living with HIV met in Geneva to promote debate and research into the (often sensitive) human rights issues relating to HIV, with a view to overcoming ideological barriers and facilitating dialogue between faith communities and non-religious agencies. This event, along with the next session to be held in Manila (November 2013), will lead to a forthcoming World Council of Churches publication on human rights and HIV. The Alliance's work on which Clague is advising is focused on Christian approaches to gender and to sexual and reproductive health rights, aiming to identify areas of agreement and contention in the run up to ICPD Beyond 2014 (the official UN review of successes and failures in the 20 years since the first International Conference on Population and Development). The aim of the publication is to better understand and address Christian ambivalence concerning international rights norms.

In May 2011 Clague was approached by the Partnerships Advisor at UNAIDS to provide advisory input for the drafting of the plenary speech delivered by Michel Sidibé (Head of UNAIDS) to the Vatican AIDS Conference, ensuring that details in the speech were accurate and its language appropriate to its audience.

2. inform the Catholic response to HIV/AIDS by advising policy-makers in key decision-making contexts. Since 2000 Clague has been a member of the HIV/AIDS Advisory Group of CAFOD. In this capacity she has helped to drive the discussion of Catholic approaches to HIV prevention within the Church. The Director of CAFOD describes Clague's contribution to dialogue on this subject in the wider Catholic faith community as `tremendous'. On 25 July 2010 Clague co-organised an international seminar on HIV with Gillian Paterson (Co-founder and Coordinator at HARC, The HIV, AIDS and Religion Collaborative). This brought together 75 Catholic ethicists in Trento, Italy to foster international collaboration on HIV-related research, and resulted in the formation of a Catholic HIV Network under the auspices of Catholic Theological Ethics in the World Church.

As well as empowering Catholic responses to HIV on the ground, Clague's expertise is influencing approaches at episcopal level. Through the Caritas in Veritate Foundation Clague offers advice on Catholic social teaching to the Holy See in Geneva for its interventions at the UN Human Rights Council. The Foundation is one of the official channels by which the Catholic Church engages with the UN. On 27 June 2011 Clague was invited to speak at a Directors' Meeting of CIDSE, an international alliance of Catholic development agencies, on tackling sensitive issues in Catholic identity and international development. The current president of CIDSE has noted their appreciation of Clague's contribution, which helped the alliance
redefine our understanding of gender and reproductive health ethics at a CIDSE Directors' Meeting in Ghent in 2011 [....] [Clague's] approach, research and expertise — and engagement through CAFOD, CIDSE and the JLI — clearly in my opinion has influenced the wider Catholic and FBO world, improving its understanding and effectiveness.

Clague delivered a lecture on `HIV and the theology of sin' to 90 London-based Christian HIV practitioners at the AIDS: A Sign of the Times conference, sponsored by CAFOD and Progressio (14 November 2009). She has also delivered in-service training on HIV prevention to clergy and practitioners for CAFOD (attended by local and overseas partners). These included the following workshops: A rights-based approach: compatible with and challenging to Catholic Social Teaching? (29 May 2009; 53 attending); Faith and HIV: how Catholic theology might better serve the needs of the Church and its faith-based organisations in tackling the pandemic (21 June 2010; 62 attending); Pope Benedict's Comments on HIV Prevention (10 December 2010; 87 attending); and, Working with Contentious Key Populations affected by HIV (22 July 2011; 50 attending. Clague delivered a similar in-service day for 30 Scottish Catholic International Aid Fund staff on `Catholic social teaching and HIV' on 28 September 2011.

Sources to corroborate the impact

Bridging the secular/faith-based divide:

- Partnerships Advisor at UNAIDS [email confirming assistance with UNAIDS (Sidibé) speech) available from HEI].

- Senior Advisor, UNFPA [testimonial available from HEI].

- Michel Sidibé (UNAIDS), speech to Vatican Conference on AIDS (30 May 2011), reported at: [UNAIDS link or available from HEI]

- Joint Learning Initiative on Faith and Local Communities (JLI) report, `HIV and maternal health: faith groups' activities, contributions and impact', August 2013. [Link or available from HEI.]

Informing Catholic response to HIV/AIDS:

- Director of Caritas In Veritate Foundation [contact details available from HEI].

- HIV and AIDS Campaign Coordinator, Ecumenical Advocacy Alliance [contact details available from HEI].

- CEO of the Catholic Agency For Overseas Development (CAFOD) [testimonial available from HEI].

- Clague's `Living positively with Roman Catholic teaching' on the Catholic Agency for Overseas Development (CAFOD) website: [see `Catholic Social Teaching' in the Prayer Resources pull-down menu].

- Jaap Breetvelt, `Theological responses to the HIV and AIDS pandemic', Kerk in Actie [Church in Action, The Netherlands] (2009). [PDF link] [See pg28; cites Clague's `Living positively with Roman Catholic teaching'.]