How community-based innovations are leading the HIV/AIDS fight

Community Health Workers during a presentation of a report on the fight against HIV/AIDS at Mayange Health Centre yesterday. Photo: Craish Bahizi.

The global health community needs to scale-up innovative interventions and collaborations with product development partnerships to bring life-saving solutions in the battle to end HIV/AIDS.

That is a case that many health activists have been making.

Yet few parts of the world, especially in Africa still have limited access to the new innovations, despite having high levels of HIV infections.

The World Health Organisation (WHO) indicates that there were an estimated 1.7 million new HIV infections around the world last year, and nearly 65 per cent of those were in Africa.

Moreover, experts point out that there are tens of potentially transformative innovations in the pipeline that need to be taken to the next level.

Dr Ade Fakoya, a Senior Disease Coordinator at the Global Fund, says innovations driving the war against HIV are not necessarily complex science innovations, but small community-driven services.

“There are a lot of innovations in science but often people forget about those innovations in services delivery, like engaging key population groups. Those differentiated services are making real impact,” he says.

The Global Fund recently concluded its second round of mobilising funds in which $14 billion was raised from donors.

Fakoya says such funds will be directed towards innovative community solutions, highlighting an example of supporting efforts aimed at rolling out HIV self-testing kits to rural communities and marginalised groups.

Here are some innovations different players and countries have adopted to fight against HIV/AIDS.

Government-led innovations

In Rwanda, the Government has taken the lead to work with different partners to distribute health services to different people.

Jules Mugabo, the WHO National Professional Officer in Rwanda, says his organisation works with the Ministry of Health to ensure that HIV testing services are rolled out at different levels.

“Currently, HIV testing services are available in all public and private health facilities and we do provide services in the community outreach programmes,” he notes, adding that Rwanda also adopted ‘Index Testing’ as one of the strategies to create awareness about the epidemic.

Perhaps that is why the country has been able to achieve significant progress in fighting HIV/AIDS.

Today, over 90 per cent of all people living with HIV in Rwanda know their status and almost all of them are on life-saving treatment. Of those, 90 per cent have achieved viral suppression.

The country has also adopted other strategic interventions that have enabled 91 per cent of the citizens get covered by health insurance, while 99 per cent of pregnant women are tested for HIV.

On the other hand, 95 per cent of the kids in the country are fully vaccinated.

Index case testing is when an HIV positive person (index case) is asked to contact family members (children, spouse, sexual partners, siblings, and parents) to establish their HIV status.

It is becoming one of the common approaches countries are adopting to help people know their status.

Dr Aliyu Gambo, the Director General at the National Agency for the Control of AIDS in Nigeria highlights index testing as one of the approaches his country is taking to increase the level of awareness among citizens.

That is in addition to the political leadership his country has taken to support different population groups championing the HIV fight efforts and putting in place various prevention initiatives.

“Recently, 10,000 primary healthcare centres were renovated, equipped and provided with human resources to provide basic healthcare for all including HIV testing for pregnant women,” he reveals.

His government is also supporting annual treatment of people living with HIV, strengthening data reporting of prevention activities, and integrated nutrition services into HIV services.

Indeed, Winnie Byanyima, the Executive Director at UNAIDS, argues that governments have every reason to invest in HIV fight, saying that there is a prevention crisis and the world is not doing enough.

“We are not doing enough, we are losing the battle and this can’t be right. Governments must put resources, donors must put resources to the people in need. There is a crisis of resourcing,” she notes.

To put her argument in context, the world had set out to achieve 500,000 new HIV infections a year by next year, but today there are 1.7 million infections.

Countries had also targeted to achieve less than 500,000 HIV deaths per year, but the number is currently at more than 700,000 deaths annually.

Byanyima’s call to action to governments and donors is quite the same message that civil society organisations (CSO) and other foundations are spreading to halt the AIDS epidemic.

The role of Foundations

Christine Stegling, the Executive Director at Frontline Aids – largest global CSO working on AIDS – insists that “We should remind the world that we are in a crisis mode.”

The organisation unveiled its global plan of action 2020-2025, highlighting 10 actions to prioritise to help the world secure a future free of AIDS.

The plan, which was launched on Tuesday at the International Conference on AIDS and STIs in Africa (ICASA), sets out the charity’s commitment to focusing resources and expertise towards the most marginalised people.

Stegling says her organization already works with marginalized communities in countries like Kenya, Zimbabwe, Uganda, Cote d’Ivoire and Senegal, providing HIV prevention services.

“We are doing education and outreach in communities. We have learnt that those that are hardest to reach are best reached by their own communities,” she notes.

The organisation is currently bringing testing services and information around HIV and vulnerability issues of infections to communities using local that the masses understand.

“We are also providing condoms and lubricants to marginalized communities. Communities really have to be an integral part of a bigger health system,” she says.

Marginalized communities like gay people, sex workers or women who are in abusive relationships, Stegling argues that they are often not reached by government services.

“We are providing those services that are bridging those bridges between communities and government services.”

The UNAIDS indicates that the majority of global infections in 2018 were among key populations and their sexual partners, with 54 per cent of newly infections coming from marginalized societies.

Reverend Johannes Petrus insists that if nothing is done to have engagements with those people, the world is going nowhere, a role which he says religion, in some parts, has taken upon themselves.

“We should preach that all human beings have equal value. That’s a religious statement,” he notes.

Kali Lindsey at John AIDS Foundation also shares similar sentiments, indicating that there is a need to drive resources to the people.

“We provide (financial) resources to sex workers organisations and other communities that are disproportionately affected with HIV. It is something we believe other foundations can replicate,” he notes.

editor@newtimesrwanda.com

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