Urgent call issued for a dramatic upscaling of international support for the heroic efforts of civil society-led networks to reach people with life-saving HIV treatment 

GENEVA, 13 April 2022—The war in Ukraine has resulted in the destruction and disruption of health services and logistical supply chains that hundreds of thousands of people living with and affected by HIV depend on for survival. More than a quarter of a million Ukrainians are living with HIV, and lack of access to antiretroviral therapy and prevention services would mean a wave of deaths and risks a resurgence of Ukraine’s AIDS pandemic. The community-led networks which are vital to maintaining life-saving services need an urgent upscaling of international support.  

More than 40 health facilities that offered HIV treatment, prevention and care services before the war are now closed and there are various levels of service disruption at other sites. By 11 April, the World Health Organization (WHO) had verified more than 100 attacks on health facilities in Ukraine, while supply routes within the country have been thrown into disarray. The United Nations Children’s Fund reports that attacks on water system infrastructure and power outages have left an estimated 1.4 million people without access to water, while another 4.6 million have only limited access. Meanwhile, the World Bank has said it expects Ukraine’s economy to shrink by 45% this year, posing a dire threat to the maintenance of vital health and social programmes. 

An initial delivery of more than 18 million doses of life-saving antiretroviral medicine procured by the United States President’s Emergency Plan for AIDS Relief (PEPFAR) that arrived in Lviv last week is now being distributed in partnership with the Public Health Center of the Ministry of Health of Ukraine and 100% Life, the largest organization of people living with HIV in Ukraine. If they can be delivered to those in need, the medicines are sufficient to cover a six-month supply for all people living with HIV on first-line treatment. This first tranche is part of PEPFAR’s commitment to fund 12-month HIV treatment needs in Ukraine. UNAIDS estimates that 260 000 people were living with HIV in Ukraine before the war broke out, 152 000 of whom were taking daily medication for HIV.  

The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) is also providing emergency funding to ensure the continuity of life-saving HIV and tuberculosis services. 

Attention is now on ensuring that the life-saving HIV medicines reach all people in need in time. Civil society organizations are mounting a heroic effort to deliver vital medical supplies and HIV services to people living with and affected by HIV, including to vulnerable populations. They are reaching people in extraordinary challenging locations, despite the huge obstacles. But the civil society organizations on which this delivery and care system depends need further international support to be able to continue their work.  

“The situation for people living with HIV in Ukraine is desperate. We are trying to deliver medicines, food and other emergency assistance to people in need, but the work is dangerous and volunteers are putting their lives at risk,” said Dmytro Sherembey, Head of the 100% Life Coordination Council. “If we don’t get more help, I am not sure how much longer we can continue, especially reaching people in the front-line zones.” 

UNAIDS, which has released an initial US$ 200 000 in emergency funds to address urgent humanitarian and programme demands in seven cities that have large HIV epidemics (Chernihiv, Dnipro, Kharkiv, Kryvy Rih, Kyiv, Odesa and Poltava), has issued an urgent call to the international community for an additional US$ 2.42 million for civil society organizations providing HIV services in Ukraine and for those receiving refugees affected by HIV in other countries, as part of the wider upscaling needed.  

“Civil society organizations and communities of people living with and affected by HIV are the bedrock of the HIV response in Ukraine,” said Winnie Byanyima, Executive Director of UNAIDS. “They urgently require additional financial and logistical support to ensure the continuity of HIV treatment, care and prevention programmes. We urge all donors to be part of enabling this vital service to save lives and prevent a resurgence of the AIDS pandemic in Ukraine.”  

It is only because Ukraine’s pioneering response to HIV has been a partnership between public and community-led provision that it has been able to continue to provide for people even through the horrors of war. But the civil society networks, on whose creativity and courage the HIV services depend, require a boost in international support to ensure continued operations at the level required.  

Getting medical supplies and services to vulnerable groups of people remains extremely challenging and UNAIDS is working with humanitarian partners in Ukraine and internationally to advance urgent solutions to provide medical and humanitarian support to hundreds of thousands of Ukrainians.  

The Alliance for Public Health is working to provide the emergency support needed during the conflict, using minibuses to meet pressing humanitarian needs, including the evacuation of vulnerable populations and the delivery of food and medicines. Communities on the front line of the response are making exceptional efforts to reach people. For example, mobile clinics have been deployed by the Alliance for Public Health to take opioid substitution therapy to people who use drugs in areas where facilities have been forced to close. UNAIDS is also working with the Global Fund and with a UNAIDS Cosponsor, the United Nations Office on Drugs and Crime, to obtain additional supplies of opioid substitution therapy. 

The conflict has forced millions of Ukrainians to leave the country and thousands of Ukrainian women and children living with HIV are in need of support in host countries. Civil society networks supported by UNAIDS Cosponsors and partners are helping refugees access antiretroviral therapy in the Republic of Moldova and across the European Union.  

WHO has helped to broker a deal with the pharmaceutical company ViiV Healthcare to provide donations of HIV medicines to Czechia, Poland and other European Union countries receiving large numbers of Ukrainian refugees.  

UNAIDS is also urging the international community to help refugee accommodation centres strengthen their support for people facing the highest risks, by expanding psychosocial services, HIV treatment and prevention services, and services related to gender-based violence. A UNAIDS Cosponsor, UN Women, has said that reports of sexual abuse and human trafficking in Ukraine indicate a protection crisis. UNAIDS has warned of increased risks for lesbian, gay, bisexual, transgender and intersex people. 

Ms Byanyima reaffirmed the United Nation’s call for an end to the war. “The biggest need is for peace”, said Ms Byanyima. “The war in Ukraine must stop—now. Recovery requires an end to this war. And even when it ends there will be so much help needed. Ukrainians living with HIV have been put in grave danger by this war. The civil society-led responder networks for HIV services who risk their lives to save lives need every possible support.” 

HIV hotline number in Ukraine: 0800 500 451. 

More support for Ukrainian refugees living with HIV can be found on the ART Initiative for Ukrainians Abroad website, which was established in coordination with Ukraine’s Public Health Center. More precise data on the whereabouts and needs of people living with HIV in Ukraine and those forced to flee the country are being collected. 

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Yana Panfilova is Ukrainian and was born with HIV. When she was 16 years old, she created Teenergizer, a civil society organization to support adolescents and young people living with HIV in Ukraine. Since 2016, Teenergizer has been working internationally, promoting the rights of teenagers and young people in Ukraine and in seven cities in five countries across eastern Europe and central Asia. In 2019, the organization began providing peer counseling and psychological support to adolescents, and has trained more than 120 online consultants–psychologists to support young people across the region. In June 2021, she spoke at the opening of the United Nations General Assembly High-Level Meeting on AIDS. When the war in Ukraine started, she left Kyiv, Ukraine, with her family and made her way to Berlin, Germany, from where she is continuing her work to support young people living with HIV in Ukraine.

Why and how did you leave Kyiv?

Within days of the start of the Russian invasion I understood that we needed to make a life-changing decision—people with machine guns were patrolling the streets. I had to convince my mother that we needed to leave, because she was reluctant to go. We packed up our lives in less than an hour, drove to Kyiv railway station, left our car there and boarded the first train that we could find. There were so many people, mothers, children, and fathers and brothers seeing off their families, and many people were panicking. We had to stand on the train for 12 hours, with our suitcases and our cat. When our grandmother caught up with us at our first stop, we travelled together from Ukraine, along with her dog, crossed the border to Poland and went on to Berlin. The entire trip took seven days. It was the longest and most challenging trip of my life—I didn’t want to leave my beautiful Kyiv not knowing where we would end up. Now we are here in Berlin, refugees, safe and secure, but still in disbelief about what we have been through and distraught about what is happening to the people of Ukraine. But at least we are safe and together—my mother, my grandmother and her dog, and me and my cat. I was lucky that I brought enough antiretroviral therapy to last about two months.

Are you settled in Berlin?

I’m still in limbo, like millions of other Ukrainian women and children who have made this journey. But everyone we have met at every step of this journey has been so kind and welcoming. We are now clarifying the legal aspects of how to stay here in Berlin for the next few weeks and how we can access local medical and social services. Even how we can rent an apartment is still not yet clear. We made an appointment online with the municipality of Berlin to clarify the details with them. They are working to provide me with medical insurance so I can get access to medical care and uninterrupted access to HIV treatment.

I am also in contact with Berliner Aids-Hilfe, one of the oldest nongovernmental HIV organizations in Europe; after the war in the former Yugoslavia, they have a lot of experience in working with migrants living with HIV. They have been amazing, ready to help with access to antiretroviral therapy as well as the other needs that Ukrainians living with HIV will have here in Berlin.

So, you're more or less safe now. How are the other young people from Teenergizer doing?

Most of our teenagers living with HIV have already left Ukraine and now they are in Estonia, Germany, Lithuania, Poland and other countries. We are in contact with most of them every day. Some of our activists chose to stay with their parents in Kyiv and other cities that are under attack. We are now clarifying the latest information and trying to monitor where everyone is, and if they are safe. But this is not a quick or easy process. Everyone is now trying just to survive and stay in contact. Our staff, peer educators and clients are now scattered across different countries, each with different laws, treatment regimens and access to the Internet. Those still in Kyiv are connected with our partners, who are still providing access to antiretroviral therapy and emergency humanitarian assistance. Most of our consultants–psychologists are still providing online assistance to those in most in need.

What are the issues you are dealing with to stay in Berlin?

The people here in Berlin and all the Germans we have met since we arrived have been incredibly kind and welcoming. We are very grateful. I know all cities across Europe are struggling to support millions of Ukrainians, but I don’t think we could have found a safer and more tolerant place to stay than Berlin.

Of course, our most urgent questions are of a legal nature related to temporary status here and, second, questions about access to medical care and antiretroviral therapy. Third is housing. I never thought housing would be so important or so nerve-wracking. Local volunteers are helping around the clock, and millions of Europeans have opened up their homes. But for the hundreds of thousands of Ukrainians still living in warehouses, shelters and other temporary accommodation, the lack of a place you can call a temporary home can crush your spirit.

What do you think is most important to keep doing now?

No matter what happens with the war, we have to continue supporting each other in the Teenergizer family. In Ukraine, we spent years fighting so that young people living with HIV could have our health and rights protected. And now it feels like so many of our hard-won gains have disappeared overnight. In the middle of this crisis, we have to keep standing up for our rights and focus on the urgent needs facing the most vulnerable members of our Teenergizer network. I am so lucky to be alive and here in the safety of Germany. But many of our friends are still in Kyiv and in other cities across Ukraine, fighting for their lives and our country. Some of them have no way out and others don’t want to leave their homes and their families. Now, more than ever, they need our support and reassurance that we will continue to do everything we can to support them when they need it most.

First, we need to help them to navigate this new crisis and continue life-saving services—HIV treatment for those who urgently need it, and prevention and testing services. Second, during this crisis, we must continue to provide young people with mental health services, especially peer counselling. In our region, HIV is more of a social problem than a health problem. Today, young Ukrainians living with HIV are facing the triple crises of their health, their safety and acute stress and depression caused by the war. Psychologists call it PTSD. This trauma is continuing for an entire generation of Ukrainians. Young people who need professional psychological support will start using drugs and some of them will contract HIV, but they will be too scared or ashamed to ask for help in the current crisis. The same applies to adolescent girls and women who cannot exercise their reproductive and sexual rights, or young people who do not use a condom during sex, or millions of Ukrainian women who are at risk of exploitation when they are alone in Europe, away from their families and friends. Today, thousands of adolescents still in Ukraine who are living with HIV are afraid to reveal their status. Many still do not know how to protect themselves from HIV and from the violence of war. Millions of Ukrainian youth are left alone to cope with their anxieties and fears, and an entire generation will be dealing with post-traumatic disorders—this needs urgent attention. I am convinced that if we provide even basic counselling and support now, young people facing multiple crises will be better able to cope with their problems for years to come.

And also no matter what, we have to push politicians to listen to young people and allow them to influence the decision-making process about their own health and future. The voices of young people, especially young women, should be heard to stop the war and rebuild Ukraine.

How do you see the future of Teenergizer now?

Today, me, my family and my country are facing the greatest crisis of our lives. So if I am not sure about tomorrow, it is difficult to see what the future holds. Over the years, we built a real family, teams of young Teenergizer leaders in different cities in eastern Europe and central Asia—in Kazakhstan, Kyrgyzstan, Tajikistan, Ukraine, even in Russia. But now we are divided. After the Second World War, Winston Churchill said that there would be a wall. And I think that a new wall is appearing now.

What would you say today if you were again on the podium of the United Nations General Assembly?

This is a war between the old world and the new world.

We are young people who want to live in a new world, where there are no wars, where pandemics such as HIV, tuberculosis and COVID-19 are ended, where poverty and climate change are solved. In this new world, all people, no matter who they are or who they love, whatever language they speak or what passport they hold, can enjoy freedom and live their life with dignity, and travel and move across open borders, between peaceful countries. We learned how important and precious this was in recent years when Ukrainians could travel. We could see how peace-loving people lived in other parts of the world, and it made us appreciate the beauty and freedom we have in Ukraine. Today, more than ever, we only understand what we want to rebuild in our own country when we compare it to the values we find in other countries.

And it is this old world that is financing and sustaining this war. This is a road to nowhere.

With the billions spent on this senseless war, the world could find a cure for HIV, end poverty and solve other humanitarian crises.

The new world is about development, not destruction. It is about being able to improve yourself, improve the quality of your life and really support others to do the same.

Everything has an end. And the war will eventually end. What will you do on the first day after the end of the war?

I'll start to read Leo Tolstoy’s book War and peace.

Ten days after the start of the Russian invasion of Ukraine, UNAIDS spoke to Oleksii Kvytkovskyi, the head of the Volna Donbas Resource Center of the All-Ukrainian Association of People with Drug Addiction, a nongovernmental organization working with people who inject drugs in Ukraine.

How are you feeling Oleksii?

I am tired of fear and fleeing. I have decided I will carry on doing what I have been doing for the past 14 years—defending the rights of key communities, notably people who inject drugs and people in need.

This is not your first encounter with war?

Eight years ago, I was there when the Russian Federation attacked the eastern part of Ukraine—as you know, they are now self-proclaimed republics. I have three children and two were born during that conflict, one in 2014 and the other in 2019.

I still work in four cities in the Luhansk oblast (region), which are controlled by the Ukrainian Government, located almost on the front line: Severodonetsk, Lysychansk, Rubizhne and Kreminna.

What are you currently doing in your job?

We at the nongovernmental organization receive and then deliver opioid substitution therapy (OST) and food and water to those who need it. We only have enough OST until the month’s end. That’s about 28 days, and then I don’t know what we will do.

Access to antiretroviral therapy is also problematic in some cities. Basically, we look at who lacks what and if there are risks of interruption.

Have a lot of people left your area?

Very few people can leave because they don’t have enough funds to do so. Until now they have been evacuating women, small children and the elderly as a priority.

Our nongovernmental organization turned to international organizations and we received assistance from the Eurasian Harm Reduction Network, the Eurasian Network of People who Use Drugs and Volna, and that has really helped to provide urgent assistance.

What about you?

I begged my wife to take the children and leave for Lviv. I even found a place for them to live but she said that she wouldn't leave me, and so she stayed.

But I am afraid. I am anxious about my children and my beloved wife.

What keeps you going?

I go to work every day. People ask me if I fear for my life. My answer to this is, “When you solve someone’s problems, you unknowingly forget about fear and war. Then solving the problem of a person from the community becomes the key objective for you, so you set out to help in any way.”

UNAIDS is deeply saddened at the death of Paul Farmer

GENEVA, 11 March 2022—UNAIDS is deeply saddened at the death of Paul Farmer, anthropologist, doctor and global health champion. He was Kolokotrones University Professor and Chair of the Department of Global Health and Social Medicine at Harvard Medical School, Chief of the Division of Global Health Equity at Brigham and Women’s Hospital in Boston and co-founder of Partners in Health.

“Paul Farmer fought for social justice and human rights and passionately believed in the right to health for all,” said Winnie Byanyima, the Executive Director of UNAIDS. “His work saved millions and showed us the way to reach health care with dignity.”

Partners in Health, a social justice organization founded more than three decades ago, establishes long-term relationships with sister organizations based in settings of poverty. Its main goal is to bring the benefits of modern medical science to those most in need.

In 2000, Mr Farmer and colleagues proved that community-based approaches to HIV treatment in poor settings worked. In 2000, an estimated 4.7 to 8.9 million African children aged 0–17 years had lost one or both parents due to AIDS and HIV had become the world’s leading infectious cause of death among adults with more than 90% of those deaths occurring in low- and middle-income countries. Many had argued that the high cost of antiretroviral medicines (more than US$ 10 000 annually) and the lack of health infrastructure would mean that progress against AIDS would be impossible, but Mr Farmer and his team proved them wrong. His pilot HIV treatment programme in a poor community in rural Haiti that relied on an existing tuberculosis-control infrastructure showed that positive results could be made among people with advanced HIV. 

Mr Farmer also advocated that HIV treatment could reinvigorate HIV prevention programmes and argued that, from his experience in Haiti and Rwanda, the rollout of effective antiretroviral therapy lessened HIV-related stigma and discrimination. 

In 2012, Mr Farmer and his team celebrated the fact that almost 10 million people living in low- and middle-income countries were on antiretroviral therapy. Later, he focused on people dying of hepatitis C, like HIV a treatable and preventable disease, and regretted that at the time of his death nearly 10 million people living with HIV still did not have access to treatment.  

In late November 2021, Mr Farmer joined a virtual UNAIDS panel ahead of World AIDS Day. He stressed that all human lives have the same value and that everyone has the inalienable right to be healthy and to fulfil their potential. Drawing parallels between COVID-19 and HIV, he said, “Inequality is a major driver of pandemics in general. As with AIDS as with structural racism, gender inequality and various forms of social marginalization, active processes continue to structure risk for COVID-19 and also for the fruits of science that have been marshalled to fight it.”

UNAIDS is saddened by the death of Prof Paul Farmer, a passionate advocate for HIV treatment, who showed the world that AIDS-related deaths can be reversed with access, rights & compassion. The global health community has lost a pioneering leader, but his work will continue on. pic.twitter.com/UVS7JP8xuj

— UNAIDS (@UNAIDS) February 21, 2022

He added, “We are now living in a time of vaccine apartheid ... were we to have had a vaccine for HIV, it would be a similar challenge. So, it is, in fact, not two different pandemics posing two discreet sets of challenges but two colliding pandemics.”

As Mr Farmer repeated over and over again during his life, it is our collective duty to take the steps needed to tackle inequalities. UNAIDS, in its 2021 World AIDS Day report, Unequal, unprepared, under threat: why bold action against inequalities is needed to end AIDS, stop COVID-19 and prepare for future pandemics, warned that if the transformative measures needed to end AIDS are not taken, the world will also stay trapped in the COVID-19 crisis and remain dangerously unprepared for the pandemics to come.

Partners in Health has organized an online memorial service at 10:00–12:00 Eastern Time (16:00–18:00 Central European Time) on 12 March 2022 to honour his work.

By Tabita Ntuli, UNAIDS Community Support Adviser, South Africa

If one word could define Leonora Nontokozo Mathe, AIDS activist and champion of key population rights, it is ubuntu—an African word with deep meaning that describes the character of people who recognize their shared humanity and humility. Born with HIV, Ms Mathe died this week after a long struggle with pneumonia.

Born and raised in Bulawayo, Zimbabwe, Ms Mathe was a phoenix who rose from the ashes after losing both of her parents at the tender age of 12 years. Ms Mathe was no ordinary person; she was an unforgettable icon who challenged HIV for the 31 years of her life. A quiet revolutionary, like still waters running deep, she was shy in her mannerisms, yet her advocacy spoke volumes. She knew how to listen attentively and was even better at speaking and expressing her mind in a way that advocated for the rights of people living with HIV.

Ms Mathe was a mother, sister and friend, a devoted advocate and champion of key population rights who was so softly spoken, loving and supportive. To know her personally meant you were exposed to her cheer and comical nature, for she was always cracking jokes and no one could hold back from laughing at some of the things she would say. She had the ability to make everything seem manageable, no matter how big or seemingly scary it was, and she spoke so candidly about her journey with HIV.

Ms Mathe travelled the world with her advocacy, visiting Namibia, Uganda, Rwanda, Morocco, Spain, the United Arab Emirates, Qatar, the Netherlands and Belgium, to name just a few of the countries she travelled to. A visionary and a leader who was starting her own organization, Hashtag InSolidarity, with the purpose of being more instrumental to key populations, she had partnered with a 14-year-old to help raise 100 000 crayons for needy kindergartens through a project called the Crayon Craze.

She wanted so much to empower women and girls through her organization and was in the implementation stages when her health became more challenging.

For the past three years, Ms Mathe was in and out of hospital, battling with pneumonia, yet she spoke which such lightness and understanding. She would say things like, “You know this body of mine has been through so many challenges due to being born with HIV, nothing shocks me any more about it, I just have to keep on fighting for my kids and my dreams to manifest before I die.”

Her dreams are as valid today as they were when she was alive. She experienced so many challenges with establishing her organization and trying to source funding and wanted to work with women living with HIV who are passionate about helping other women.

“Leonora Nontokozo Mathe was a tireless and passionate activist and leader who dedicated her life to championing the rights of people living with HIV and key populations and the empowerment of women and girls,” said Eva Kiwango, UNAIDS Country Director for South Africa. “We share in the sadness and offer condolences to her family and all who knew and loved her. She will be sadly missed.”

Ms Mathe was exceptional, phenomenal, wonderful, gifted and talented. A fiery soul whose light burned so brightly, particularly on key population matters, on which she unapologetically spoke about issues that needed urgent attention and addressing.

A light that burned so beautifully shall never be forgotten—her legacy lives on.

The Trinidad and Tobago transgender activist and community leader Brandy Rodriguez has died.

Ms Rodriguez was a stalwart of national and regional efforts to advance the rights of lesbian, gay, bisexual and transgender people. She was the President of the Trinidad and Tobago Transgender Coalition (TTTC). Through her collaboration with the United Caribbean Trans Network (UCTRANS) and the Latin American and Caribbean Network of Transgender People, she contributed to the movement for increased visibility, advocacy and community organization around gender identity issues. She also contributed to policymaking and workplace engagement efforts, including as a member of the Pan Caribbean Partnership against HIV and AIDS.

But her impact went even deeper. As a peer navigator for many years at the Family Planning Association of Trinidad and Tobago (FPATT), Ms Rodriguez provided direct support to members of the transgender community, including street-based sex workers.

She also supported transgender people living with HIV to access testing, treatment and care services. Among Caribbean countries that have reported on HIV prevalence for transgender people, the median HIV prevalence is more than 27%, far higher than that among any other key population group. Ms Rodriguez worked to ensure that members of this community not only started treatment but stayed the course.

From the base of the TTTC in Tunapuna, Trinidad and Tobago, Ms Rodriguez worked to ensure that the most marginalized people in her community had access to food, health care and mental health support. During the COVID-19 pandemic, her organization coordinated relief for transgender people who had lost their means of generating income.

This May she was recognized by Queen Elizabeth II for her advocacy and service when she received the 180th Commonwealth Point of Light award.

“Brandy fought fearlessly against discrimination. And in this fight, she didn’t just ask for recognition or plead for equal access to quality health care, but she made the point that it was a right that must come without conditions. She was determined to settle for nothing less,” a release from FPATT said.

In 2018, she addressed journalists at a regional media sensitization hosted by the UNAIDS Caribbean Sub-Regional Office and the Caribbean Vulnerable Communities Coalition. For most of the reporters it was their first time speaking to a transgender person and hearing how stereotypes and prejudice in their reporting were harmful to the community.

“For 22 years it has been an uphill battle, especially in the Caribbean. My conviction to not be silenced and to help vulnerable people keeps me committed to my goal of a better, more inclusive future for all,” Ms Rodriguez said.

The Director of the UNAIDS Caribbean Sub-Regional Office, James Guwani, recognized Ms Rodriguez for her work as a voice for the voiceless.

“She shows why it is imperative that we support community organizations with the ability to connect to those who are hardest to reach. At a time that the global HIV response is focusing on ending inequalities and supporting community-led interventions, we draw inspiration from Ms Rodriguez’s life and work,” he noted.

“The mother of the LGBTI community of Trinidad and Tobago has gained her wings,” said Alexus D’Marco, UCTRANS’ Executive Director. “The work of Brandy Rodriguez will not be forgotten and we must ensure that it continues.”

The Bangkok Metropolitan Administration (BMA) in Thailand has been awarded the inaugural Circle of Excellence Award at the Fast-Track cities 2021 conference, held recently in Lisbon, Portugal. The Circle of Excellence Award showcases outstanding work in fast-tracking the HIV response and advancing innovative programming to end the AIDS epidemic in cities by 2030.

“To receive the Circle of Excellence Award for Bangkok is a great honour. It demonstrates not only the past achievements but, moreover, the future commitment to accelerate the HIV response and towards ending AIDS in Bangkok. We are proud that innovations have produced remarkable results, particularly same-day antiretroviral therapy and key population-led health services, such as specialized and holistic services for transgender people and the scale-up of pre-exposure prophylaxis (PrEP) programmes. These innovations are not only applied in Bangkok but have become models for the region,” said Parnrudee Manomaipiboon, the Director-General of the Department of Health, BMA, during the award ceremony.

Organized by the International Association of Providers of AIDS Care, in collaboration with UNAIDS, the Fast-Track Cities Institute and other partners, the Fast-Track cities conference highlighted successes achieved across the Fast-Track cities network, addressed cross-cutting challenges faced by local stakeholders and shared best practices in accelerating urban HIV, tuberculosis and hepatitis B and C responses.

“Bangkok has put in place a 14-year strategic plan for ending AIDS from 2017 to 2030, which is under the leadership of the Bangkok Fast-Track Committee,” said Pavinee Rungthonkij, the Deputy Director-General, Health Department, BMA. “During COVID-19, BMA and partners have introduced innovations such as multimonth antiretroviral therapy, an express delivery of antiretroviral therapy service, sexually transmitted infection self-sampling and PrEP,” she added. Among other achievements, Bangkok has expanded its PrEP services to 16 municipal public health centres and eight city hospitals and implemented citywide awareness campaigns. PrEP in the City was the first citywide PrEP campaign focusing on transgender people in Asia.

“Significant progress has been made in the HIV response since Bangkok joined the Paris Declaration to end the AIDS epidemic in cities in 2014. It shows that mutual commitments and a strengthened partnership between stakeholders at all levels are key to an effective HIV response. Bangkok will continue to leverage support, scale up innovations and Fast-Track solutions to achieve the 2025 targets and end AIDS by 2030,” said Patchara Benjarattanaporn, the UNAIDS Country Director for Thailand.

In the response to the colliding COVID-19 and HIV pandemics, communities continue to demonstrate resilience, agility and innovation. To empower, train and protect communities, UNAIDS, in collaboration with the Namibian Ministry of Health and Social Services and the Africa Centres for Disease Control and Prevention, is supporting civil society organizations to implement the Partnership to Accelerate COVID-19 Testing (PACT) initiative in Namibia. In addition, community sensitization activities to reduce the spread of COVID-19, and the associated stigma and discrimination, and to minimize its effects on people living with HIV, are being implemented.

In May 2021, Namibia experienced an exponential increase in community transmission of COVID-19 cases owing to the emergence of the delta variant, which derailed the country’s containment efforts and severely stretched its health system. The nation rose to the challenge with strong political leadership and commitment. Evidence-informed and high-impact interventions led to a marked decline in cases, positivity rates and deaths.

Through the PACT initiative, four civil society organizations with experience in working with vulnerable communities and networks of people living with HIV in informal settlements were supported by the Ministry of Health and Social Services and UNAIDS to implement the PACT project. The project focuses on COVID-19 prevention and contact tracing, mitigating the impact of COVID-19 on the HIV response and facilitating access to quality health care in all 14 regions of the country and will ultimately deploy 270 community health workers.

UNAIDS is partnering with three of the four civil society organizations, working in the three regions with the highest burden of HIV and COVID-19, Oshana, Erongo and Khomas, which account for 36% of people living with HIV, 52% of COVID-19 cases and 42% of COVID-19-related deaths nationally. These civil society organizations have done remarkable work to address the needs of key populations, adolescent girls and young women, and people living with HIV using existing HIV infrastructure and systems.

“Ending the two pandemics requires greater data-driven involvement of communities, partnerships, integration of COVID-19 and HIV services and reaching underserved and vulnerable communities. This is the approach that the PACT initiative has taken in Namibia to mitigate the spread of COVID-19,” said Alti Zwandor, UNAIDS Country Director for Namibia.

To adapt, harmonize and sustain the training of community health workers, UNAIDS has been working with the National Health Training Centre, which has adapted the Africa Centres for Disease Control and Prevention training curriculum on COVID-19 to include information on vaccines, HIV and sexual and reproductive health and rights. Forty senior trainers from the training centre were trained to deliver multiple trainings across the country. A further 250 community health workers and 25 supervisors were subsequently trained and deployed to implement community outreach activities. In addition to the house visits and community sensitization activities, one of the nongovernmental organizations, the Tonata people living with HIV network, has incorporated bulk text messages with COVID-19 information in local languages to support groups for people living with HIV, thus spreading awareness of the PACT initiative to a much larger audience.

“The community health-care workers in the field experienced situations where community members were aggressive when given information on COVID-19. In some hotspots, the population also complained of hunger and indicated that they would only engage with community health-care workers once provided with some food hampers so they could concentrate,” said Agatha Kuthedze, Director of the Namibia Planned Parenthood Association (NAPPA). She added that the organization had referred people in need of social welfare to the authorities for further help. 

The initiative will continue to build on the successes and integrate critical HIV and sexual and reproductive health and rights programming while continuously exploring innovations for a sustained and comprehensive HIV response. The partner nongovernmental organizations involved are Tonata, the Walvis Bay Corridor Group, NAPPA and Project Hope.