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Community-Led Efforts Successfully Combat AIDS In Sub-Saharan Africa, Report Shows



Enos Mumfwa zips around the streets of Lusaka, Zambia like a man on a life-saving mission. His Suzuki motorcycle easily handles the hairpin turns and pothole-ridden dirt roads that lead to the Mtendere Mission Hospital. Strapped to the back of his motorcycle is a small gray cooler containing blood samples that will soon be tested for viruses like HIV and Covid-19.

If you consider the most important tools to fight preventable diseases, you probably think about medicine before motorcycles. And that’s exactly why community-led health solutions are so important.

In many countries across sub-Saharan Africa, access to life-saving diagnostics is outrageously sparse, and acquiring quality blood specimens is only half the battle. Motorcycles are one of the most effective and efficient ways to get samples from hospitals to testing centers. And thanks to a recent grant, local laboratories like the one at Churches Health Association of Zambia have purchased more bikes to close the figurative and literal gaps in global health, one mile at a time.

Local leadership is essential to fighting preventable diseases—especially AIDS. On December 1, World AIDS Day, UNAIDS released a new report, “Let Communities Lead,” detailing how community-driven, bottom-up solutions are transforming global health. Here are some of the key takeaways.

Community-Led Health Solutions Are Saving Lives

We’ve made extraordinary progress in the AIDS fight over the past two decades. AIDS-related deaths have decreased nearly 70% since their peak in 2004 and the cost of antiretroviral drugs has never been cheaper. Whether in life, business, or global health, success is rarely accidental. While there’s no denying the valuable role life science companies have played in advancing the AIDS fight, many of these wins would never have happened if it weren’t for local innovation and community-led solutions.

In 2018, Circle of Hope, a Lusaka-based nonprofit that combats AIDS, was facing a dire problem: not enough people were testing for HIV. Many Zambian testing centers were located too far apart and too far away from urban centers where people congregate. Their solution was to create community health outposts near busy places like markets and churches, putting testing centers within 10 minutes of key at-risk populations. By staffing the outposts with local physicians, counselors, and analysts, they established trust in the community. They started conducting more tests, which led to a 1,200% increase in the number of people being diagnosed with HIV and knowing their status.

“We have found that our community-led approach has helped overcome the stigma that often deters people from learning their HIV status or seeking the services they need,” said Gibstar Makangila, Circle of Hope’s executive director.

These encouraging results aren’t limited to Zambia. Nigeria has seen a nearly two-thirds increase in HIV treatment access in rural areas thanks to efforts from community-based organizations. Some Kenyan communities experienced a four-fold increase in consistent condom use after local community programs were introduced. Efforts like these are both saving lives and lowering the overall cost of testing, treatment, and care.

The history of antiretroviral medicine in the AIDS fight is long and dark. First introduced in the late 1980s, this life-saving medicine was quickly available in the United States and other wealthy countries. But if you lived in middle and low-income countries, access was scarce and the cost was exorbitant, which caused millions of people to needlessly die.

The new UNAIDS report details how global, country and regional community-led advocacy campaigns have helped pressure governments and companies to allow more generics, lower prices, and ultimately increase access to critical interventions. Just last year, Colombian advocates successfully made dolutegravir, a coveted antiretroviral drug, a medicine of public interest, which led to the creation of more generics and lower prices. Today, life-saving HIV/AIDS medication costs as little as 12 cents per day, a steep decline from $27 per day in 2000.

Community-Led Initiatives Need More Support

There’s lots of evidence showing how community-driven approaches to global health are efficient and effective. However, in today’s fractured society, these types of initiatives are increasingly under fire. According to the report, global funding channeled through communities has decreased in the past decade from 31% in 2012 to 20% in 2021.

Community-led efforts also face long-term sustainability challenges. Even when community-driven programs are effective, short-term grants create instability, and many organizations lack the proper systems to continue these projects after the grants expire. Allocating more money to boost community systems for the long haul is critical to addressing this problem.

According to UNAIDS, one of the best ways to strengthen community-led solutions is for governments to support more social contracting or government funding for community-led health initiatives. Countries across the world from Niger to Vietnam have successfully empowered community-led responses around operating local health centers and providing testing and treatment services. Yet just 63 of 93 reporting countries have these types of social contracting mechanisms in place.

Why It Matters

While it may not dominate headlines, AIDS is still a crisis in many corners of the world. Every minute someone dies of AIDS-related causes. Over 9.2 million people living with HIV lacked access to treatment in 2022, and 660,000 of them were children.

We’ll only ever end this injustice by targeting life-saving resources to marginalized communities. Few know how to lead these efforts better than the communities themselves.

“Too often, decision-makers treat communities as problems to be managed rather than as leaders to be recognized and supported,” UNAIDS Executive Director Winnie Byanyima said in a press release earlier this month. “Communities are not in the way—they light the way to the end of AIDS.”

Source : Forbes

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