As part of the Education Plus initiative, young women advocates in Senegal have met with key female figures in the region to discuss the education of girls in sub-Saharan Africa and the challenges they face.

A social work student in her second year of professional training said young women like her who are living with HIV still face stigma and economic marginalization in most spheres of life “Sometimes, the medicines are not in stock, and young women living with HIV often have to share their medication with each other while waiting for a new supply.” According to her, education guarantees a better future for young people, as it did for her in helping her to overcome the challenges she faces because of her HIV status and her difficult upbringing.

Another participant, Maah Koudia Keita (known as Lady Maah Keita), a Senegalese woman with albinism, and a musician, said that women with albinism are victims of harassment and the majority of them have experienced rape and sexual violence.

She is one of three professional female bass players in Africa and the only one in Senegal. She said, “People like me who were lucky to get an education now have to do the work of dispelling myths around women with albinism that drive the violence.” According to Ms Keita, the more educated and aware the community is, the better women and people with albinism can defend themselves.

Adama Pouye, a feminist activist and member of the Senegalese feminist collective that led the Buul Ma Risu (Don’t Mess with Me) movement, spoke at length during the meeting about raising awareness on sexual assault on public transport.

“Every day, you hear violent words and women come to believe that’s what they deserve,” she said. “You are told how far you can go by standards put in place by a patriarchal society, by men, and by religious standards, but our religious interpretations cannot be about oppressing women,” Ms Pouye said.

Young women are key advocates who the Education Plus initiative is working with to rally political leadership, development partners and communities in order to fulfil every adolescent girl’s right to education and health by enabling all girls to complete a quality secondary education in a violence-free environment.

As UNAIDS Executive Director Winnie Byanyima stressed at the meeting, “In this region of western and central Africa, the vulnerability of girls is high.”

She also said that four out of 10 young women are married before the age of 18 years, saying that children becoming brides is a gross violation and a failure to harness the full potential of girls.

“Keeping girls in a classroom, if she stays and completes secondary school, has a protective effect for girls from HIV. What we fought and won for primary school is what is needed for secondary education,” Ms Byanyima said.

Fatou Nar Mbaye Diouf, the Deputy Executive Secretary of the National AIDS Council, Senegal, could not agree more. “We know that allowing girls to complete secondary education protects them from HIV and improves many other health and development factors,” she said.

Sharing key data from Senegal, Ms Nar said the level of comprehensive knowledge about HIV increases with the level of education. “Among young women, it is 10% among those with no education and 41% among those with secondary education or higher, while among young men knowledge of HIV varies from 9% among those with no education to 51% with education,” she said. “Education is key.”

The Regional Director for West and Central Africa for UN Women, Oulimata Sarr, concluded the intergenerational dialogue by saying that girls’ education is not a threat, nor should it be seen as that. “We want to move the needle and move it together with young women,” she said.

Ms Sarr wants the next generation to be supported as they seek more space in decision-making. “We need to pass the baton to young people, who organize differently from us, create an intergenerational legacy with young people holding us to account.”

Iranilde Pereira Fonseca and Michele Almeida are two middle-aged women who come from different parts of Brazil but share a common childhood memory: they used to collect scraps of cloth to make dresses for the few dolls they had. It was a way to revive their handmade toys since their families rarely had spare money for new ones.

But it was not until the COVID-19 pandemic that they had the opportunity to reconnect with their past and use it as a source of survival and income. They are among the 35 women who participated in the Mulher Empreendedora (Women Entrepreneur) project, a social entrepreneurship project implemented by the Movimento Nacional das Cidadãs Posithivas (MNCP) Brazilian HIV nongovernmental organization as a part of the UNAIDS Solidarity Fund. Along with Ms Fonseca and Ms Almeida, they were trained in artisanal doll techniques and in entrepreneurship, so that they could sell their products and obtain resources to address the impact of COVID-19 on their household incomes.

“I used to get scraps of cloth from my mother and loved to make clothes for the dolls I had, but I had not done any of that for many years,” remembered Ms Fonseca. “Now, with the MNCP project, I learned the process of making a doll completely from scratch. With the isolation imposed by COVID-19, it was important to be able to connect, even if only virtually, with women from various parts of Brazil and exchange ideas and experiences through this initiative.”

Of the initial group, 28 women are already selling their handmade dolls independently. The initiative was funded by the Solidarity Fund, launched in 2020 by UNAIDS to support entrepreneurship activities led by people living with HIV and key populations.

Ms Almeida agrees on the importance of connection and mutual support. “I really enjoyed meeting and interacting with the group of women participating in this project. In addition to reconnecting with my origins and my childhood, the techniques I learned helped me to develop a product that people enjoy. I sell my dolls to relatives and friends and through social networks,” she said.

The initiative emerged from the realization that the COVID-19 pandemic had a disproportionate impact on women. The pandemic has especially affected the service sector, such as hospitality, food, beauty and domestic services, for which the majority of the workforce is female. In 2020, the absence of jobs in those areas reduced the active participation of women in the workforce in Brazil to less than 45%.

“The project was extremely important for women living with HIV, as many of them were unable to access the job market, lived with an overload of domestic work, experienced situations of violence and had to deal with the interruption of specialized health services,” said Fabiana Oliveira, the MNCP Secretary of Communication and Technical Coordinator of Mulher Empreendedora.

Claudia Velasquez, the UNAIDS Country Director for Brazil, highlighted that the Solidarity Fund’s support to MNCP is in line with the strategic vision of putting people and communities at the centre of the HIV response while building sustainable income-generating mechanisms. “This approach is particularly important for the most vulnerable populations, such as these women living with HIV served by the MNCP, who have strongly felt the drop in income caused by the COVID-19 pandemic. Providing these women with their own access to financial resources and financial security ends up having a positive impact on their adherence and permanence in the HIV monitoring and treatment processes,” she said.

Ms Oliveira highlighted that Mulher Empreendedora had created an opportunity for participants to restructure and rewrite their personal stories. “Rag dolls have this power to stimulate imagination and creativity and even offer the equivalence of a real hug,” she said.

More than 600 000 Ukrainian refugees arrived in Germany since the war broke out. Among them many people living with HIV – mostly women.

In the beginning many needed shelter and then there were lots of requests about obtaining HIV treatment. Many refugees had left their supply behind or took the bare minimum.

Vasilisa Sutushko, who was born with HIV, arrived in Berlin at the beginning of March and had only one month of HIV medicine with her. She also had no clue navigating the German health system. A local NGO, Berliner AIDS Hilfe, one of Germany’s oldest HIV organizations, was flooded with an influx of calls for help.

“I got these pills for €10 for three months,” Ms Sutushko said, pointing at a box of HIV treatment. “When I came to Berlin, I had to understand whether I received medicine for myself here for free or for a fee,” she said.

Unlike in her native country, she explained, in Germany you need a prescription for almost all medicines.

“In Ukraine, I can get any pills I need without any problems at the pharmacy,” Ms Sutushko said.

Berliner Aids-Hilfe’s migration consultant, Sergiu Grimalschi, said when the first refugees began to arrive there were few organized structures, so they had to improvise across the country. “We had to find an urgent solution,” he said.

They helped countless refugees with medicine, paperwork, housing, and other pressing health issues.

According to Berliner AIDS Hilfe, most of the refugees living with HIV won’t be able to go back until the bombed medical facilities are rebuilt.

Ms Sutushko, founder of Teens Ukraine – an NGO that helps young people who live with HIV- and others are now trying to set up a network to further help people living with HIV. Stigma and discrimination in Ukraine regarding one’s HIV status has made many refugees hesitant about seeking help or open about living with HIV in their adopted countries. "I'm happy to see people like me here who need help, I can also be helpful," she said.

UNAIDS estimates that 260 000 Ukrainians live with HIV. Up to 30 000 fled their country since the start of the war and need HIV treatment.

Interrupting treatment, even temporarily, can lead to drug resistance and increased risk of progression to AIDS.

Many life-saving health services could not operate after the breakout of the war in Ukraine.

But grass-root providers such as the Alliance for Public Health found ways to keep going. Despite roads being mined and many bridges blown up, the Mobile HIV Case-Finding project used its 16 vans to deliver food, HIV treatment and other essentials around the country. It also helped people find shelter.

Iryna, the Coordinator of the mobile clinic team in the Chernihiv region, said the war had complicated its work immensely. Chernihiv borders the Russian Federation and Belarus in northern Ukraine.

“Many people were on the move, going from one place to another,” she said. “It was very difficult to work.”

But since mid-March, the Alliance for Public Health has restored many of its services. The nongovernmental organization works mainly with people who inject drugs and their partners.

“The substantial number of new HIV cases in Ukraine are registered among injecting drug users because of unsafe injecting practices,” explains the UNAIDS Country Director for Ukraine, Raman Hailevich.

He knows that reaching drug users was a challenge before the war, and it’s an even greater challenge now. The credit, he said, goes to civil society groups.

“Community-based organizations working with this type of hard-to-reach population provide the most essential outreach to these groups. Without them, the delivery of prevention programmes among people who use drugs would not be possible,” he said.

Because of the insecurity, the Alliance for Public Health saw a drop in testing for HIV and hepatitis C. Iryna, however, is proud because, she said, the teams delivered treatment to more than 1400 people in March and April through the mail and/or personal home delivery.

The Mobile HIV Case-Finding project, founded in 2019, is implemented by the Alliance for Public Health and the Global Fund to Fight AIDS, Tuberculosis and Malaria and is funded by the CDC and PEPFAR.

Sasha wishes to have two children. Deusa wants to go to business school. Rihanna's dream is to be respected and be who she wants to be. And all Alicia wants is to fulfill her dreams. In the lead-up to the May 17 celebrations of the International Day against Homophobia, Transphobia and Biphobia (IDAHOBIT), UNAIDS echoes the voices and dreams of four transgender women. They, like many others, are in search of a dignified life, full of opportunities able to love who they wish to love, and not endure violence, stigma and discrimination.

Inspired by the Unbox Me campaign, launched by UNAIDS on the International Transgender Day of Visibility, 31 March, UNAIDS gave four Brazilian transgender women a small box with their portraits from a photo shoot session in 2021 with Sean Black, a photographer from the United States who specializes in LGBTQI+ subjects. As the portraits were revealed to the transgender women, they reflected on the importance of their bodies, of self-care, and of their right to live healthy and empowered lives.

"This insecurity comes from our experiences, and from our past. But with each passing day I had the opportunity to strengthen myself, to discover the beauty that I sometimes thought I didn't have, so I felt more confident," recalled Alicia Kalloch, when unboxing her self-portraits.

“There are so many bad things that we go through,” said another participant, Sasha Santos. “My portraits from the photo sessions gave me the certainty that I'm capable of many things like going to college, owning a house and having children,” she added.

Alicia, Sasha, Rihanna and Deusa were chosen to represent the 24 women from the transgender shelter, Casa Florescer, in São Paulo, who participated in the FRESH Project. Developed by UNAIDS in partnership with Black and Casa Florescer, the initiative included photo sessions as part of a therapeutic approach to provide positive reinforcement and stimulate behavior change. All the photos are being released virtually today in cooperation with the United Nations Educational, Scientific and Cultural Organization (UNESCO) office in Brazil, marking the IDAHOBIT celebrations.

"When I saw my picture, I saw an empowered woman,” said Rihanna Borges, who currently works with other transgender women to provide counseling and peer support. “I think the role I play today is incredible, working with other sisters, talking to them about the importance of self-care and HIV combination prevention." Their plea is to have society see transgender people for who they are. “I want us to feel empowered and say, ‘Today I am somebody’ and leave this invisibility behind,” she added.   

Inequalities, stigma, and discrimination disproportionately affect populations in situations of greater vulnerability, such as transgender women. A report by the Brazilian National Association of Transsexuals and Transgender People (ANTRA) shows that 140 transgender people were murdered in 2021 in the country, 99% of whom were transgender women. HIV prevalence among transgender women in Brazil is above 30%, whereas for the general population prevalence is at 0.4%.

Most of the transgender women at Casa Florescer were forced to leave their homes against their will and many ended up using drugs or suffering various types of violence.

"At the shelter we seek to work with people in a cycle of self-discovery and empowerment so that they can overcome past vulnerabilities,” explained Beto Silva, Coordinator of Casa Florescer. “Photographic art, which was an important part of the FRESH Project, was an efficient way to mobilize and engage them.”

"Participating in the photo shoot not only served to show the internal and external beauty of this group of transgender women, it was also an important step to help them gain control over their bodies and their lives," said Claudia Velasquez, Director and Representative of UNAIDS in Brazil. Deusa de Souza could not agree more.  As a participant in the photography workshop, she said, she felt recognized as a beautiful transgender woman. “It was important for me to see myself in these photos and how they reflect my empowerment and my own personality and beauty.”

A new report by UN Women and CARE International highlights the urgent need to provide health-care services to women in Ukraine and sets out why the international community needs to support a gendered response to Ukraine’s humanitarian crisis.

The report also emphasizes the need for an intersectional approach to the crisis that addresses the exacerbated risks for marginalized communities—lesbian, gay, bisexual, transgender and intersex (LGBTI) people, Roma people, people living with disabilities and people living with chronic diseases—who face immense hardship and have particular needs with regard to their health and safety.

“This powerful report illustrates why and how humanitarian responses need always to be gendered and need also to address the particular needs of marginalized communities,” said Winnie Byanyima, the Executive Director of UNAIDS. “The courage and commitment of women leaders who continue to serve their communities, even in the face of war, in Ukraine and across the world is an inspiration.”

The report’s analysis, which was based on surveys and interviews with people in Ukraine, was conducted in April and details some of the gender dynamics of the crisis and sets out practical and actionable recommendations for the international humanitarian response.

Women and girls interviewed for the report highlighted challenges in access to health-care services, especially for survivors of gender-based violence and pregnant women and new mothers, as well as rising fears of gender-based violence and lack of food, especially for those in conflict areas.

Many respondents referred to the health risks, including the spread of COVID-19, linked to unsanitary shelters.

The war has also impacted access to sexual and reproductive health, including family planning and maternal, newborn and child health. Many media reports have noted that conditions as a result of the war have increased the risk of premature birth.

Transgender people also require regular access to medicines, but many have had to stop hormone therapy due to supply shortages. Several LGBTI organizations are providing access to medicines to members of the transgender community, but their help does not cover all the needs.

“The Rapid Gender Analysis allows us to consult directly with affected populations in order to accurately identify what specific needs different groups of people have, and how to best meet them,” said Sofia Sprechmann Sineiro, the Secretary General of CARE International. “What we are hearing from the people of Ukraine is that certain groups—such as those with disabilities, Roma and other ethnic minorities, single mothers and unaccompanied children—are each in need of different forms of protection and assistance. To keep our response effective and relevant, such groups must be consulted and prioritized across the aid ecosystem as this truly devastating situation continues to evolve.”

The report calls for support for women-led and women’s rights organizations that provide financial resources and for their voices to be amplified at national and international platforms.

Gaps in services to respond to gender-based violence need to be filled, according to the report, while sexual and reproductive health, including the clinical care of survivors of sexual assault, and maternal, newborn and child health care, including access to contraception, should be made a priority.

“It’s critical that the humanitarian response in Ukraine takes into account and addresses the different needs of women and girls, men and boys, including those that are furthest left behind,” said Sima Bahous, the Executive Director of UN Women. “This timely analysis provides the evidence of those needs, and their urgency. Women have been playing vital roles in their communities’ humanitarian response. They must also be meaningfully involved in the planning and decision-making processes to make sure that their specific needs are met, especially those related to health, safety and access to livelihoods.”

Angola faces a considerable challenge of new HIV infections among young people. In 2020, there were 7000 new HIV infections among young people aged 15–24 years. One of the barriers to reducing new HIV infections among young people and ensuring treatment are restrictions on their ability to get tested to learn whether they have HIV.

As in several countries, young people under the age of 18 years cannot be tested for HIV without first asking their parents to consent to it. As young people often fear discussing HIV testing with parents, many decide instead to not seek testing, and so remain unaware of their HIV status, putting them at grave risk and negatively impacting public health efforts.

As part of efforts to remove these barriers, Angola received support from the Technical Support Mechanism, a UNAIDS managed, country-driven mechanism, funded by USAID, which supports countries to overcome HIV policy and programmatic challenges.

A review carried out by the Technical Support Mechanism assessed the alignment of Angolan laws, regulations and policies regarding age of consent to HIV testing and counselling with public health and human rights norms and standards and the extent to which they create barriers to access to services.

The review produced evidence that informed a recommendation for Angola to remove the legal barriers preventing young people, including young members of key populations, from accessing HIV and tuberculosis testing services. This would allow young people aged 14 years, and those below 14 years if they are sufficiently mature, to seek and access HIV testing and counselling without requiring them to ask their parents first. This will help to establish an enabling legal environment for early diagnosis of HIV. In turn, access to information and HIV services would reduce the likelihood of HIV transmission and contribute to a decrease in new HIV infections and AIDS-related deaths.

By enabling more young people to access HIV testing services, Angola will also be able to leverage resources from the Global Fund to Fight AIDS, Tuberculosis and Malaria to reach young members of key populations—a priority for achieving national HIV targets. Strategic learning from this experience could also provide valuable insight for similar technical support in eastern and southern Africa and in other regions.

“Ensuring that young people know their HIV status is vital. Rules that effectively bar many young people from accessing HIV testing by requiring parental consent delays them from knowing their HIV status and holds them back from accessing life-saving HIV services. The laws imposing an age of consent for HIV testing need to be removed in the interests of everyone’s health. This will save lives and help Angola end AIDS,” said Michel Kouakou, the UNAIDS Country Director for Angola.

Ahead of the International Day Against Homophobia, Biphobia, Interphobia and Transphobia (IDAHoBiT) held annually on 17 May, UNAIDS talks to Evelyne Paradis, Executive Director of ILGA-Europe, the Europe-based Lesbian, Gay, Bisexual, Trans and Intersex Association about protecting the rights of LGBTI people in humanitarian crises. 

How do humanitarian crises particularly affect LGBTI people?  

Humanitarian crises affect everybody, however, some communities sometimes need a targeted response because of pre-existing vulnerabilities. These particular vulnerabilities make people feel unsafe when dealing with humanitarian organisations providing safe shelter, basic necessities food and medical aid. Not knowing if they will be treated without discrimination, simply welcomed and be taken care of, is a barrier for people in accessing humanitarian support.

ILGA-Europe is heavily involved in the Ukraine crisis.  What are the main challenges facing LGBTI people affected by the war? 

In the Ukraine crisis, what we are seeing is that LGBTI people are not de facto integrated in first aid supply chains. Transition-related and intersex-specific medication, such as hormone replacement therapy, and to a certain extent medicines for people living with HIV, are not ensured in humanitarian packages at the moment. On top of this, a significant portion of the LGBTI community cannot meet their basic needs, due to pre-existing socioeconomic inequalities.

Trans women with a male gender marker on their documents can be obliged to join the army or cannot leave the country along with other women, which puts them in a potentially very harmful situation.

Having access to safe shelter is also an issue. In Ukraine, many LGBTI people don’t feel safe to be ‘out’ in regular shelter, while some who are displaced in the country are reporting facing discrimination when trying to rent an apartment. As a result many of the LGBTI groups have set up shelters to support their communities. Some of those who are staying and are visible have been physically attacked, as LGBTIphobia was already an issue in Ukraine before the war.

This is all happening while LGBTI people face the same struggles everyone else is facing; money, food, caring for loved ones, and so much more.

What are organizations like ILGA-Europe doing to help? 

We are sending direct financial support to groups who are staying in Ukraine and are providing direct support to their communities, as well as to LGBTI groups in hosting countries. We’re also actively working to mobilise resources for all the LGBTI groups working in support of LGBTI people in Ukraine and abroad. We’re working with large humanitarian groups and organisations like UNAIDS and connecting them to the needs on the ground, while advocating with European institutions and governments to take action both in support of LGBTI communities in Ukraine and for LGBTI people who have left the country.

What can be done to better address the unique needs of LGBTIQ+ people in humanitarian crises?  

What we are seeing is that an LGBTI perspective is really not integrated into humanitarian work and the development of protection measures, such as protection from gender-based violence or access to medicines. In many ways we have had to start from zero, including having to establish contacts with actors in the humanitarian sector.

While it is still early in this particular crisis to have specific recommendations, there will be no doubt be a lot of learning to be done from the work currently happening, so that we make sure that in future LGBTI perspectives and needs are integrated in the way humanitarian actors respond from the start.

Many civil society and community organizations are supporting LGBTI people affected by the war in Ukraine.  What challenges do they face in carrying out this important work?  

Most LGBTI organisations are not set up to be doing humanitarian work, and yet they are supporting basic needs in addition to the work they continue to do for their communities. But they cannot do it all. If they become the first point of support and assistance, there’s a lot of other work, like advocating for rights, that will not be done. This is true in Ukraine as well as in hosting countries.

Inequalities, stigma, discrimination and human rights violations against are continuing to prevent LGBTI people from being able to access the HIV and health services they need. How can we achieve positive political, legal and social change?  

The work that has started with the humanitarian sector shows there’s a need, but it’s also an opportunity. If the humanitarian sector incorporates an LGBTI perspective and LGBTI people in their work from the start, this can mean a positive change for these communities, especially in times of crisis.

Evelyne Paradis will be one of the speakers at an IDAHOBIT event held on the 17 May focusing on how to better protect the rights of LGBTIQ+ people, particularly in the context of the war in Ukraine, and how to ensure equal rights for all. More information

The start of the Ukrainian war fifty days ago surprised many people including Berliner Aids-Hilfe’s migration consultant. Sergiu Grimalschi, along with his colleagues, has been thrust at the forefront of helping thousands of Ukrainian refugees coming to Germany, primarily those living with HIV.

Mr Grimalschi, a professional interpreter, came to Berlin from Romania in the early 1990s. For the past twenty-five years, he has been working on the HIV response primarily with migrants and is currently employed by Germany’s oldest HIV organization. From 2006 to 2012 he helped countries in Eastern Europe and Central Asia (EECA) develop HIV health services and worked in Ukraine, Belarus, Russia, and Poland.

UNAIDS spoke with Mr Grimalschi about the challenges Ukrainian refugees living with HIV face in Berlin.

Question: Sergiu, many refugees living with HIV in Germany are now coming to you directly. Were you able to prepare for this ahead of time?

Answer: No. No one was prepared and, to be honest, the war was a complete surprise for us, and for me personally. Eastern Europe has been a priority for my organization since 2010. We all speak eastern European languages and have stayed informed about the situation in the region. So, when the war started, I did a simple thing that turned out to be decisive. I wrote one mass email to an EECA group saying that anyone living with HIV fleeing from the war to Germany could contact me or my colleague by phone. First, I got called by colleagues from Moldova, with whom I worked closely during the COVID-19 pandemic when we provided medicines to people stuck in Europe. Then various Ukrainian organizations started contacting me. They continued to share my email and within a week the Berliner Aids-Hilfe numbers were on all social networks and on all Telegram channels.

Question: Many refugees living with HIV fled to Europe, in particular Germany, because they believed that everyone here has access to HIV treatment and services. True or false?

Answer: Yes, everyone has access except migrants without health insurance. That has changed only recently.

In Berlin, for example, every person, including undocumented and uninsured migrants could access treatment but only since the end of 2018.

All this was due to the fact that people without health insurance in Germany cannot be treated, and the law does not take into account people without insurance. And, as you know, if you cannot be treated, you die. Since 2000, we focused on all possible ways to provide all people living with HIV without insurance with access to medicines and qualified medical treatment.

Addressing this issue was the most difficult and the most important task for us in many years, but we managed to solve it. And that is thanks to many years of advocacy work that we did.

Question: So tell us how you deal with influx of refugees in Germany?

Answer: It is still not so simple. Firstly, the situation is very different in different states (landers) of Germany.

Secondly, when the first refugees began to arrive, there were no really organized structures, so we had to improvise with colleagues across the country. One bad thing was for example that Ukrainian people fleeing their homes were advised to leave medicines for those who stayed in Ukraine. In the first days of the war, medicines were collected throughout Germany in order to send them to Ukraine or Poland. But after one week, a lot of people living with HIV from Ukraine were in Berlin. A few women came to me saying, ‘I have only 2 or 3 pills because I gave everything to my husband.’

We had to find an urgent solution.

We went to doctors in Berlin and found stockpiles of HIV treatment but then we ran out. Doctors wrote out prescriptions, but it was not clear how they would be covered or paid for. Only Dolutegravir, for example, which is a part of the treatment that a majority of Ukrainians living with HIV take, costs more than 700 euros here. But everyone made extra efforts– doctors, social workers, other people living with HIV – they said, 'There is a war going on.’ And eventually the German health authorities began gradually to cover treatment costs.

Many people who arrive from Ukraine still do not understand how one gets treatment in Germany. There are no big specialized centers that dispense medicine here. I explain to people: ‘we help you to get an HIV-specialized doctor in your region who gives you a prescription and then you can go to the pharmacy and get your medicine.’

In recent weeks, onlly some of the 16 German regions have been treating people without insurance, without registration, based only on the person’s passport. For the past two weeks in Berlin, doctors have been authorized to treat Ukrainian refugees just by providing photocopies of their passport and sending it to the social services to get reimbursed. A real show of human solidarity.

Question: How many people are currently receiving antiretroviral therapy in Berlin?

Answer: At the moment, about 600 Ukrainians living with HIV are in contact with me throughout Germany and 150 in Berlin. Overall, I would say about 2,000 people total but not everyone has asked for help yet because they have enough medicine.

Question: Sergiu, tell us how the war started for you?

Answer: When my mother called me from Romania on the morning of February 24 and said, ‘the war has begun,’ I asked her, ‘Mom, did you sleep badly? Stop!’ I thought she had a bad dream. I never thought that Russia would go ahead with the invasion of Ukraine.

Personally, I am very connected to Eastern Europe. My grandmother left Russia in 1918, my grandfather was from Chernivtsi, which means that theoretically, he could have been Ukrainian if he had not left in 1940. I have a lot of very good friends, relatives, and colleagues with whom I worked there so this is terribly painful for me.

Question: Sergiu, as I understand it, you not only help refugees with treatment but also help out with housing and other things?

Answer: Yes, of course, we help with the refugee registration and access to social aid services, health insurance, psychological support in their language and everything that they need. We also advise people against going to the countryside. It is better for people living with HIV or who need substitution therapy to stay in Berlin or other big cities, because there are better health facilities.

I and my colleagues and friends try to help people with accommodation and clothing. I have a friend, a Romanian doctor, whose house was empty. I asked her if she wanted to help. Now six Ukrainian families live in her house. Another German friend gave 2,500 euros to women from Ukraine for urgent needs. Of course, I am accountable for all this money, but this is a personal, private initiative. One of my friends, a lawyer, bought iPads for many refugee children. He says children need to study so now they can go online.

Question: Amazing work Sergiu... What keeps you going?

Answer: I am impressed by all this human solidarity and I hope that all this horror will end shortly...This is a big test for all of us.

COVID-19 is having a devastating impact on the Jamaican economy. In 2020, the economy declined by more than 5%. According to the World Bank, the poverty rate increased from 19% in 2018 and 2019 to about 23% in 2020. Working women have been among the most affected by the crisis, accounting for approximately 78% of health-care and humanitarian employees and 55% of staff in industries that are highly susceptible to COVID-19, including commerce and tourism. Jamaica’s tourism industry, for example, which reached 4.2 million visitors in 2019, plummeted in 2020 and 2021 as a result of the global travel restrictions related to the pandemic.

In response, the Jamaican Government has implemented a series of recovery strategies, including a reduction in taxes. It also launched the COVID-19 Allocation of Resources for Employees (CARE) programme, aimed at assisting workers and businesses during these difficult times.

People living with and affected by HIV have also felt the impact. The strains caused by COVID-19 on health-care workers and facilities, compounded by loss of income and movement restrictions, have generated disruptions in access to HIV and other health-related services.

In response, Jamaica’s National Family Planning Board and UNAIDS, in partnership with key stakeholders in the design and implementation of the country’s social protection strategy, including the Ministry of Labour and Social Security, the Planning Institute of Jamaica, the Ministry of Local Government and Rural Development and civil society organizations, collaborated to produce an assessment of national social protection and HIV. The assessment provided a mapping of social protection services in the country, identified gaps in outreach and opportunities to respond to the specific needs of people living with and affected by HIV, such as increasing awareness on the existence of and application requirements to benefit from these programmes, and provided recommendations for the improvement of social protection.

Of the more than 100 people questioned, a considerable number were not aware of the existence of social protection programmes, despite several programmes being offered in the country. There was also an apparent lack of clarity on who is eligible to participate in the programmes. In general, people living with HIV, specifically mothers less than 25 years old who are living with HIV, are among the populations facing the most barriers in accessing HIV and social protection programmes in Jamaica, particularly the Programme of Advancement Through Health and Education (PATH). For example, to apply for PATH, a family score is assessed, which includes all members of the family. Where the family is deemed not poor, it would not qualify for PATH, including the young mother.

“Social protection schemes are critical for ending the AIDS epidemic because they address socioeconomic inequalities, which fuel HIV risk and vulnerability, including stigma and discrimination and other human rights abuses, by breaking down barriers to accessing HIV services,” said Richard Amenyah, the UNAIDS Country Director for Jamaica.

Among its recommendations, the assessment stressed the importance of raising awareness of existing social protection programmes, revising the selection criteria for social assistance, digitalizing enrolment and transfer payments, enhancing local coordination and consolidating labour market programmes.

“Social protection programmes play an important role in cushioning society’s most vulnerable from the harsh social and economic realities brought about by circumstance such as the COVID-19 pandemic. As such, the recommendations of this assessment can only enhance existing social protection programmes and strengthen multisectoral collaboration in this area for the benefit of those most affected, including persons living with HIV,” said Lovette Byfield, the Principal Director of the National Family Planning Board.