In DAP’s country support experience, even where adequate and sustained funding is available - for example in the context of fully funded support programmes to national drug policy or essential drugs project implementation - it may still prove difficult to mobilize sufficient commitment and human resources to implement public education programmes which are adequately researched, planned, conducted, monitored and evaluated. Reasons include lack of knowhow; the greater difficulties of conducting such programmes compared with professional education; competing priorities; opposition by vested interests (both commercial and professional); and the low priority given to community empowerment by a governing or professional elite, which may even find this threatening.

Much greater advocacy is needed at international, regional and national levels to promote the need for and rationale of public education in RUD; to create understanding of its potential public health and economic contribution to society; and to avoid simplistic, unsustainable and token approaches that contribute little to real community empowerment and understanding but simply pay lip-service to the very real information and educational needs of the community in this important area.

It should be recognized that in some countries it may only be possible for a very small scale project to be undertaken, probably by a national NGO. Such projects, even with easily recognizable constraints, are worthy of support as an opportunity to learn and to increase knowledge. Constraints may well be matched by advantages in that small scale projects can be more easily developed in partnership with the community and targeted to meet needs and perspectives identified by the community itself. Funding bodies should also be aware that education in the community and behavioural change may be a very slow and cumulative process, not always lending itself to easy measurement through rapid pre- post-intervention research methodologies (see above).