Every minute, a life is lost to AIDS. Every week, 4000 girls and young women become infected with the infectious disease, and out of the 39 million people living with HIV, 9.2 million do not have access to lifesaving treatment across the countries, a new report released by the Joint United Nations Programme on human immunodeficiency virus (HIV) / AIDS (UNAIDS) has painted a gloomy picture.
However, on the brighter side, the report , as suggested by its title ‘Let Communities Lead’ says that there’s hope to end the deadly disease by 2030 if communities on the frontlines get the full support they need from governments and donors.
“Communities across the world have shown that they are ready, willing and able to lead the way. But they need the barriers obstructing their work to be pulled down, and they need to be properly resourced,” said Winnie Byanyima, Executive Director of UNAIDS as the world observe World AIDS Day on Friday.
“Too often, communities are treated by decision-makers as problems to be managed, instead of being recognised and supported as leaders. Communities are not in the way, they light the way to the end of AIDS.”
The report notes that community advocacy from the streets to the courtrooms to parliaments has secured groundbreaking changes in policy. Communities’ campaigning helped open up access to generic HIV medicines, leading to sharp, sustained reductions in the cost of treatment from US$ 25 000 per person per year in 1995 to less than US$ 70 in many countries most affected by HIV today, it said.
“Investing in community-led HIV programmes delivers transformational benefits,” it assers while citing several instances to drive home the point. For example, it says programmes delivered by community-based organizations in Nigeria were associated with a 64% increase in access to HIV treatment, a doubling of the likelihood of HIV prevention service utilization, and a four-fold increase in consistent condom use among people at risk of HIV.
Talking about community initiatives in India, it said that “a community-led initiative by the Transgender Welfare Equity and Empowerment Trust (TWEET) in India supports the socioeconomic inclusion of the transgender community by increasing awareness of the business sector regarding transgender issues and by helping connect community members to well-paid jobs.”
As per reports, the number of People Living with HIV (PLHIV) are estimated at around 24 lakhs. Southern States have the largest number of PLHIV viz. Maharashtra, Andhra Pradesh and Karnataka being the top three. Annual New Infection (ANI) are estimated at 62.97 thousand in 2021 in India.
The UNAIDS report says, among sex workers reached by a package of peer-based services in the United Republic of Tanzania, the HIV incidence rate was reduced to below half (5% vs 10.4%).
The report also highlights how communities are at the forefront of innovation. For instance, in Nambia’s Windhoek, a self-funded project by the Youth Empowerment Group is using e-bikes to deliver HIV medicines, food and adherence support to young people who often cannot attend clinics due to their schooling hours. In China, community organizations developed smartphone apps that link people to self-testing which contributed to a more than four-fold increase in HIV tests across the country from 2009 to 2020.
The report reveals how communities are also holding service providers to account. In South Africa five community networks of people living with HIV inspected 400 sites across 29 districts and conducted more than 33 000 interviews with people living with HIV. In the Free State province, these findings led provincial health officials to implement new appointment protocols to reduce clinic wait times and three- and six-month dispensing of antiretroviral medicines.
“At this time, community-led action is the most important countermeasure in the AIDS response,” said Solange Baptiste, Executive Director of the International Treatment Preparedness Coalition. “Yet, shockingly, it isn’t a cornerstone of global plans, agendas, strategies, or financing mechanisms for improving pandemic preparedness and health for all. It is time to change that,” the report says quoting Baptiste.