HIV/AIDS in Africa
The HIV/AIDS epidemic remains a significant public health problem in southern Africa. In the last decade, infections have drastically dropped while awareness of HIV status and availability of treatment has increased. This progress aligns with the UNAIDS 90-90-90 goal. Meeting this goal means that at least 90% of people with HIV are aware of their status, 90% are receiving antiretroviral drug treatments and 90% are virally suppressed. Viral suppression means that the virus will not negatively affect a person and that that person will not be able to transmit it to another person. Some of the most HIV-afflicted countries in Africa have met and even exceeded the 90-90-90 goals. Eswatini has the highest HIV prevalence in the world today at 26.8%. It has reached 95% in all categories and is on its way to reducing new infections.

HIV/AIDS and Conflicts

Despite recent progress, international aid has been focusing on HIV/AIDS less and less, especially as the COVID-19 pandemic has become a more imminent global threat. Sub-Saharan Africa still has the highest rates of HIV/AIDS in the world. It is also one of the most conflict-ridden regions in the world.

HIV/AIDS has a history of destabilizing political and social institutions in countries and leaving them vulnerable to violent conflict. The International Crisis Group estimated that one in seven civil servants, including government employees, teachers and the armed forces in South Africa were HIV-positive in 1998.

How Does HIV/AIDS Affect Civil Servants in Africa?

  1. The disease affects the productivity of the military and its ability to respond to armed conflicts. In 2003, the Zimbabwe Human Development Report estimated that the Zimbabwe Defense Forces had an HIV prevalence rate of 55%. With such a high rate of illness, the military has high training and recruitment costs, as soldiers get sick and are unable to work. In addition to this, HIV can transmit through sexual contact. It disproportionately affects younger populations which typically make up the bulk of the armed forces.
  2. The HIV/AIDS epidemic breaks down political institutions by limiting their capacity to govern. According to former president Robert Mugabe in 2001, AIDS had a significant presence in his cabinet, killing three of his cabinet ministers in the span of a few years and infecting many more. The disease wipes out workers essential to the function of a state, like policymakers, police officers and judicial employees.
  3. HIV/AIDS threatens the quality and accessibility of education. A UNICEF report found that more than 30% of educators in Malawi were HIV positive. If children cannot receive a quality primary education, they are less likely to receive secondary education and start professional careers. Instead, crime may open up opportunities for security that education could not provide. With increased antiretroviral use and awareness of the disease, HIV rates and deaths among educators have likely dropped along with overall rates in the last decade.

Civil Servants

The impact of HIV/AIDS on civil servants in Africa has been immense. The disease affects vulnerable populations such as gay men, sex workers and young women disproportionately. However, it has also affected those who work as civil servants. Civil servants are integral to the functioning of governments. Without them, countries are vulnerable to conflict and violence. Furthermore, HIV/AIDS prolongs conflict in countries already experiencing it.

While there are many other causes of violent conflict, the breakdown of political and social institutions fueled by HIV/AIDS only exacerbates conflict. War can also be a vector for the further spread of the disease. According to UNHCR, both consensual and non-consensual sexual encounters happen more often during the conflict. Rape has been a weapon of war in conflicts in Rwanda, the Democratic Republic of Congo (DRC) and Liberia in recent years and has likely contributed to the spread of HIV.

Solutions

Combating HIV and AIDS is a very important step in stabilizing economic, political and social structures across Africa. USAID programs like PEPFAR have had a significant role in combating HIV and AIDS. PEPFAR has invested nearly $100 billion in the global AIDS response in various ways. Most notably, it has provided 18.96 million people with much-needed antiretroviral treatment.

PEPFAR also aids in prevention care. For example, it has supported more than 27 million voluntary medical male circumcisions as well as testing services for 63.4 million people. In 2012, there was a government campaign in Zimbabwe to promote circumcision, in which at least 10 members of parliament participated.

These campaigns and USAID programs have had tangible results. In 2013, a study by the South African National Defense Forces showed an 8.5% HIV prevalence rate among its soldiers, much lower than the 19% prevalence in the general population. Given the successes in decreasing HIV/AIDS infections across Africa, perhaps economic, political and social stability is to follow.

– Emma Tkacz
Photo: Flickr

Zoe Empowers
Former U.S. President John F. Kennedy once said that “Children are the world’s most valuable resource and its best hope for the future.” However, the circumstances of the world’s children bring to the forefront a harsh reality. UNICEF estimates that there are 356 million children enduring conditions of extreme poverty globally. With 356 million children surviving on less than $1.90 daily, children go without access to education, proper health care, housing, sanitation and nutritious meals. These circumstances are often worse for orphans who have no familial support. Regions with a high number of orphans, such as Afghanistan, commonly report rampant wars, natural disasters and epidemics. Without the care of an adult and a way to secure their basic needs, many of these children face exploitation, often becoming victims of trafficking and forced labor. Zoe Empowers is an organization that assists orphans and vulnerable children by providing resources and skills training for these children to become self-sufficient and escape the stronghold of poverty.

About Zoe Empowers

In 2004, Zoe Empowers first began as a “relief mission” in Africa working to help orphans during the HIV/AIDS epidemic in Zimbabwe. In fact, the organization’s origins stand as the initial inspiration for its name — Zimbabwe Orphan Endeavor. As time went by, the organization chose to adopt the Greek meaning of the word “zoe” — life. This definition is meaningful because of the organization’s mission to empower vulnerable children in “eight areas of life.” The organization’s overall goal is to create a world where orphans and vulnerable children are able to become self-sufficient, productive members of society, able to use their own skills and knowledge to escape the grips of poverty.

The Strategy

Zoe Empowers implements a three-year empowerment program. This costs a monthly amount of $7.66 per child and a total of $275.76 per child over three years. The program includes several core areas:

  1. Food Stability. To create sustainable solutions to hunger, Zoe Empowers gives the children a modest grant and training to start “a husbandry and farming project” in the first year of the program. In the second year, these animals and crops serve as funding to buy more land to expand on these income-generating agricultural projects. In the final year, the program reaches the ultimate impact: The children now have access to two or three healthy meals a day and share this food “with other vulnerable children in the community.”
  2. Stable Shelter. Within the first year of the program, children with the most urgent housing needs receive financing “through housing grants.” In the second year, “individual and group savings account funds” go toward the reparation or rebuilding of the “homes of deceased parents.” In the last year, the children can purchase land and build their own houses with the extra income from their businesses.
  3. Hygiene and Health. In the first year, staff provided training on personal hygiene and children with severe health issues received emergency medical assistance. In the second year, children gain access to “national health insurance.” Alternatively, Zoe Empowers helps children to finance “medical savings accounts.” In the last year, children earn enough from their business ventures to provide for themselves in terms of food, clothing, “access to health care” and other necessities.
  4. Establishing Education. In terms of learning, in the first year, Zoe Empowers provides children with financial assistance to enroll in school. In the second year, “individual and household businesses” finance the costs of school. During the last year, students can also fund the education of their “younger siblings” and plan for their own tertiary education.
  5. Sustainable Income. In order to generate income, in the first year, the children receive training on economic concepts and how to establish a business with small grants. In the second year, the children receive business loans, which are “paid back to the group bank account” while businesses grow. During the last year, these children lead their families, running several businesses and employing siblings and community members.
  6. Human Rights. In the first year, the organization contacts local officials to conduct training on child rights and build relationships with children so that they are more comfortable reporting abuse. During the second year, as business owners, the children are able to secure a higher social status. Therefore, the community welcomes their voices and opinions. In the last year, with a human rights background, children now know how to enforce their rights in the case of violations.
  7. Community Connections. All three years of this aspect of the program revolve around establishing a sense of belonging in the community as children serve as leaders and entrepreneurs in society.

Impact in Numbers

So far, Zoe Empowers works in seven countries: Kenya, Zimbabwe, Malawi, Rwanda, Liberia, Tanzania and India. Across these countries, the organization has provided assistance to 124,071 vulnerable children since 2007. In a 2020 survey, SAS collected data from 495 graduates of Zoe Empowers empowerment groups in Rwanda and Kenya. Among other results, SAS reports that 100% of graduates own successful, income-generating businesses, 96% can afford the costs of three daily meals and 91% of graduates can fund the cost of their education.

Zoe Empowers hopes to expand further into other regions. With its sustainable model, poverty can reduce as children receive the resources, training and support to become self-sufficient.

– Shikha Surupa
Photo: Pixabay

HIV/AIDS in Kenya
On July 14, 2021, in Nairobi, Kenya, the National AIDS Control Council (NACC) held its sixth Maisha HIV/AIDS conference, bringing together stakeholders to continue the battle against HIV/AIDS in Kenya and find impactful solutions. The NACC is the main “body responsible for coordinating the HIV response in Kenya.” The organization of the Maisha HIV/AIDS conference follows the objectives of NACC to mobilize resources, engage and collaborate with other organizations focusing on HIV/AIDS control. Since its establishment in 1999, NACC’s government-funded groundwork, analysis and implementation efforts have affirmed the right to health. With an average of 100,000 new HIV/AIDS cases in Kenya yearly, according to World Health Organization (WHO) data from 2014, NACC’s research, community-led initiatives and destigmatization efforts form a core part of the frontline response to the fight against HIV/AIDS.

HIV/AIDS in Kenya

According to Avert, in 2019, Kenya reported “1.5 million people living with HIV” and 21,000 deaths stemming from AIDS. While this mortality rate is high, “the death rate has declined steadily from 64,000 in 2010.” Young people account for a significant number of infections — in 2015, young people between the ages of 15 and 24 made up more than 50% “of all new HIV infections in Kenya.”

Since the rise of HIV/AIDS in the 1990s, many sub-Saharan countries still grapple to control the spread of the virus. However, today, Kenya stands as “one of sub-Saharan Africa’s HIV prevention success stories.” In 2019, yearly new HIV infections stood at “less than a third of what they were at the peak of the country’s epidemic in 1993.”

The efforts of the NACC and several local and international organizations are responsible for these successes. In 2013, the NACC began the Prevention Revolution Roadmap to End New HIV Infections by 2030, a strategy for combating HIV/AIDs in Kenya.

The Kenyan government distributes condoms each year as an HIV prevention method. In 2013, the government distributed “180 million free condoms.” Furthermore, the government mandates the inclusion of HIV education in school curriculums to ensure citizens are well-educated on the HIV epidemic and specific guidelines for prevention and treatment. Kenya also utilizes events and the media to raise awareness of HIV/AIDs, which has proven successful. One particular community mobilizer with Lodwar Vocational Training Centre (LVTC) in Kenya distributes 5,000 condoms per day to communities while disseminating information on the current HIV/AIDS epidemic in Kenya and testing processes.

The Maisha Reporting Tool

Kenya’s Government Ministries, Counties, Departments and Agencies (MDAs) use the NACC’s Maisha Reporting Tool to monitor HIV/AIDS in Kenya. This allows MDAs to become effective AIDS control units. Policy-makers inform their intervention using localized data pulled from the tool. The Maisha Reporting tool ultimately aims to encourage the active engagement of MDAs “in developing and implementing policies to tackle the prevention and management of HIV and AIDS in Kenya.”

MDAs’ participation in the certification system involves documenting and tracking their efforts to reduce new cases of HIV/AIDS in Kenya. These recorded undertakings on the part of MDAs include efforts for counseling and testing, distribution of condoms and baseline surveys to help control the spread of the disease.

MDAs strive to manage HIV/AIDS in Kenya, and with the help of the NACC and government funding, MDAs are shifting the narrative of implementation. Through targeted outreach, conferencing, programming and advocacy, Kenya is able to make strides in the battle against HIV/AIDS. The NACC’s Maisha Reporting Tool aims to equip all government agencies with a platform that facilitates understanding and encourages action in order to one day establish an HIV-free Kenya.

– Joy Maina
Photo: Flickr

HIV/AIDS in Ukraine
Ukraine has one of the highest rates of HIV/AIDS in the world, with an estimated 260,000 people living with the disease. Odessa, the third-most populous city in Ukraine, has “the highest concentration of HIV/AIDS of anywhere in Europe.” Poverty exacerbates HIV/AIDS in Ukraine and primarily has links with injected drug use, threats to government funding, lack of access to antiretroviral treatment and social discrimination.

Poverty and HIV/AIDS in Ukraine

Ukraine is second to Moldova as the two poorest countries in Europe. The poverty rate in Ukraine increased during the COVID-19 pandemic, from 42.4% in 2020 to 50% as of February 2021. There is a strong connection between poverty and the spread of diseases; it could be both a cause and a result of poverty.

HIV/AIDS causes conditions of poverty when working adults become ill and can no longer support their families. The disease becomes a result of poverty when the conditions of poverty put people at greater risk of contracting it. As an example, women and girls who live in poverty are more vulnerable to sexual exploitation. They are more likely to resort to working in the sex trade. That could put them at dangerous risk for contracting HIV.

HIV/AIDS in Ukraine’s Women and Girls

UNAIDS estimates that out of all people with HIV/AIDS in Ukraine, 120,000 are women over the age of 15 and 2,900 are children aged 14 or younger. Gender inequality, poverty and violence against women and girls are significant factors in the spread of HIV. Women and girls who live in fear of violence may be reluctant to advocate for safe sex, receive testing or seek treatment for HIV and other diseases.

Gender inequality inhibits women’s access to resources for sexual and reproductive health. In rural Ukraine, where the poverty rate is highest, 36% of women do not participate in community or family decision-making. Only 46% are competent with a computer or the internet. Almost 48% do not have access to medical services.

The Lack of Access to Antiretrovirals

As Sky News reported, access to antiretrovirals is a major problem for many people living with HIV/AIDS in Ukraine. Although a law stipulates that antiretroviral therapy should be free to all citizens, limited national resources have resulted in restricted access.

Antiretrovirals are crucial for preventing the spread of HIV to children. The use of antiretrovirals during pregnancy and administered to an infant for four to six weeks after birth can result in a transmission rate of 1% or less. According to U.N. Women, the majority of women living with HIV/AIDS in Ukraine were between 18 and 45 years old. Out of these women, 39% discovered that they were HIV-positive during pregnancy.

Social Discrimination Against People Living With HIV/AIDS

According to WHO, discrimination against people who use drugs and people living with HIV presents a serious challenge to identifying those who need treatment. Harsh drug laws, fear of HIV/AIDS and systematic police abuse undermine efforts to provide HIV information and services such as testing and safe needle exchanges. In addition, the law requires drug treatment centers in Ukraine to register drug users and share the information with law enforcement. This protocol keeps people who use drugs from seeking medical help, which subsequently prevents them from testing and receiving treatment for HIV/AIDS.

The War in Donbas

The war in Donbas has made it difficult for people to receive treatment in a region that previously had one of the highest rates of HIV/AIDS in the country and was home to nearly one-quarter of all antiretroviral recipients. When the war began in March 2014, it displaced 1.7 million people. To compound this, unsafe sex has resulted in an increase of HIV/AIDS within the military. Combined with ongoing military conflict and a shortage of antiretrovirals, Ukraine is experiencing a crisis: the government has failed to keep up with infection rates.

Solutions

In July 2021, Ukraine received a grant of $35.8 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. According to the Ukrainian government, it would use the funds to purchase personal protective equipment (PPE), reduce risks associated with COVID-19 and strengthen the health care system.

Ukraine is collaborating with the Centers for Disease Control (CDC), USAID and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The country wants to implement prevention campaigns, increase access to antiretroviral treatment and target key risk groups, such as people who inject drugs, sex workers and men who have sex with men.

On September 1, 2021, President Biden announced that the United States would provide more than $45 million in additional assistance for Ukraine. The aid would help people the COVID-19 pandemic and the war in Donbas affected. The U.S. is working with USAID-supported programs to provide supplies for Ukrainian health care centers, training for health care workers and psychosocial support for the most vulnerable populations.

– Jenny Rice
Photo: Unsplash

Diseases in Nigeria
Nigeria ranked 142 out of 195 countries in a 2018 global health access study. However, although Nigeria has a challenging health care system, the country has improved the infrastructure that has helped it fight diseases such as polio, measles and Ebola. Nigeria now has centralized offices called Emergency Operation Centers (EOCs) that serve as a base for government health workers and aid agencies to coordinate immunization programs and collect data. While there is progress, many diseases still plague Nigeria.

Cholera

Cholera is a water-borne disease that results in a quick onset of diarrhea and other symptoms such as nausea, vomiting and weakness. It is one of the many diseases impacting Nigeria in 2021. If people with cholera do not receive treatment, the disease may kill them due to dehydration. A simple oral rehydration solution (ORS) can help most infected people replace electrolytes and fluids. The ORS is available as a powder to mix into hot or cold water. However, without rehydration treatment, about half of those infected with cholera will die, but if treated, the number of deaths decreases to less than 1%.

In August 2021, Nigeria began to see a rise in cholera cases, especially in the north, where the country’s health care systems are the least prepared. The state epidemiologist and deputy director of public health for Kano State, Dr. Bashir Lawan Muhammad, said the rise in cases is due to the rainy season. It is also because authorities have been dealing with Islamist militants in the north. In Nigeria, 22 of the 36 states have suspected cholera cases, which can kill in hours if untreated. According to the Nigeria Center for Disease Control, 186 people from Kano have died of cholera since March 2021, making up most of the country’s 653 deaths.

Malaria

Malaria is another one of the diseases affecting Nigeria. Through the bites of female Anopheles mosquitos, parasites cause malaria and transmit it to humans. Globally, there were 229 million malaria cases in 2019, with 409,000 deaths. Children under the age of 5 years old are the most susceptible group, and in 2019, they accounted for 274,000 or 67% of worldwide malaria deaths. That same year, 94% of malaria cases and deaths occurred in the WHO African Region. Although the disease is preventable and curable, the most prevalent malaria-carrying parasite in Africa, P. Falciparum, can lead to severe illness and death within 24 hours.

The President’s Malaria Initiative (PMI), which USAID and the CDC lead, works with other organizations to help more than 41 million Nigerians. Despite the difficulties that COVID-19 presented in 2020, the PMI was able to assist Nigeria to distribute 14.7 million treatment doses for malaria, 8.2 million of which went to pregnant women and children. Besides that, the “PMI also distributed 7.1 million insecticide-treated mosquito nets (ITNs), provided 7.2 million rapid test kits, and trained 9,300 health workers to diagnose and treat patients” of malaria. Before the PMI, only 23% of Nigerian households had bed nets, but since 2010, that number has risen to 43%. The PMI also aims to improve health systems and the skill of health workers to administer malaria-related services.

HIV

HIV (human immunodeficiency virus) attacks the immune system, leading to AIDS (acquired immunodeficiency syndrome). One can control the virus with proper medical care, but there is no cure. The disease is prevalent in Africa because it originated in chimpanzees in Central Africa. The virus likely spread to humans when the animals’ infected blood came into contact with hunters. Over the years, HIV spread across Africa and other parts of the world, becoming one of the diseases impacting Nigeria today.

The CDC works with the Federal Ministry of Health (FMOH) and other organizations to create and sustain HIV response programs in Nigeria. The CDC’s “data-driven approach” and prevention strategies and treatment strengthen the collaborative system in Nigeria. These include HIV treatment, HIV testing, counseling, services to help prevent mother-to-child transmissions and integrated tuberculosis (TB) and HIV services. TB is the leading cause of death among people living with HIV.

From October 2019 to September 2020, nearly 200,000 Nigerians tested positive for HIV and began treatment. During the same period, over 1 million HIV-positive people tested for TB. More than 5,000 of those individuals tested positive and began treatment for TB. By the end of September 2020, nearly 25,000 orphans and other vulnerable children received HIV/TB services through the CDC. Not only that, but all facilities in Nigeria that the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) supports now use TB BASICS, which is a program that “prevents healthcare-associated TB infection.”

In 2021, Nigeria will face many diseases. On the other hand, great strides are occurring to educate the Nigerian population on diseases like HIV, malaria and cholera. Despite efforts, there is still much more necessary work to reduce illness in Nigeria.

– Trystin Baker
Photo: Flickr

HIV/AIDS in Mexico
To better understand the HIV/AIDS crisis in Mexico, looking at the numbers alone is only half the equation. In 2020, UNAIDS reported 340,000 people living with HIV, a 55% increase from 2018’s report of 230,000. The stigma surrounding positive HIV status plays a significant role in discouraging HIV testing and treatment. However, several programs in Mexico aim to make treatment more accessible and address the underlying issues relating to HIV/AIDS in Mexico.

HIV/AIDS in Mexico

HIV prevalence in Mexico is notably high among gay men, prisoners, transgender people and sex workers. Men who have sex with men (MSM) account for the highest number of infected people, with approximately 1.2 million men affected in this category. Despite this fact, only about 40% of these individuals go for HIV testing and know their HIV/AIDS status. Homophobia and a machismo culture mean that “sex between men is highly stigmatized.” Therefore, individuals within this category are hesitant to access HIV testing. Regular HIV testing is significantly higher in the transgender and sex workers communities at 62% and 66% respectively. The stigma surrounding HIV leaves many unaware of their status and exposed to potential transmission.

“PrEParing” for a Better Future

The fight against HIV/AIDS in Mexico starts with the United Nations PrEP program. On September 13, 2018, the U.N. launched its pilot PrEP program with the goal of targeting high-risk HIV-negative individuals. PrEP or (pre-exposure prophylaxis), is a preventive treatment for HIV-negative people who have an increased likelihood of coming into contact with the virus, such as sex workers and individuals whose partners have HIV.

The program received $26 million in HIV treatment funding to assist “7,500 at-risk people in Mexico, Brazil and Peru” until 2020. In Mexico, the PrEP program was open to assist up to 3,000 people with free treatments across four Mexican cities including Puerto Vallarta, Mexico City, Merida and Guadalajara. Additionally, patients received STD testing, counseling and condoms free of charge.

In a 2018 press release, Dr. Ariel Campos of Jalisco’s State Council for AIDS Prevention (COESIDA) said that in Puerto Vallarta, 300 people would receive a one-month supply of Truvada through the program. After the first month, the plan was to re-test patients for HIV and other STDs and then put them on a “three-month schedule” of Truvada. Studies show that PrEP is 99% successful at preventing HIV infection “when taken as prescribed.”

Protecting Prisoners

The Mexican Movement for Positive Citizenship (MMPC) helps combat HIV/AIDS in Mexico by helping those “invisible to society.” Many living with HIV in Mexico’s prisons often lack basic medical treatment, including prisoners in the advanced stages of the AIDS illness. People living with HIV in prison have personally affected each woman working with the MMPC.

For 30 years, Georgina Gutiérrez, a human rights activist and representative for the MMPC, has worked with Mexicans living with HIV. Her partner faced eight years of imprisonment in the Santa Martha Acatitla Penitentiary where the reality of the prison system opened her eyes. MMPC is one of 30 UNAIDS initiatives encouraging community-based HIV work. MMPC “received an award of $5,000” to carry out its work. To date, the MMPC has helped 180 HIV-positive prisoners at the Santa Martha Acatitla Penitentiary, providing both COVID-19 PPE and HIV/AIDS training. An additional 1,000 prisoners and staff have “benefited from the project.”

The efforts in the fight against HIV/AIDS in Mexico continues to grow with help from everyday citizens, commitments from organizations and advancements in medicine. If support continues to grow, the stigma behind HIV/AIDS in Mexico will soon be a thing of the past and Mexico will have its HIV/AIDS crisis well under control.

– Sal Huizar
Photo: Flickr

Reduce HIV/AIDS in Zambia
HIV (human immunodeficiency virus) is an infection that can transfer through sex. It attacks cells in the human body that fight diseases, thus making it a dangerous infection. With about 38 million people in the world suffering from HIV, it has become a prominent issue, especially since there is no definite cure for the infection. As a result, in many African countries like Zambia, the number of HIV cases is significant. Through the exploration of HIV in impoverished countries, research has shown that there is a correlation between poverty and a lack of education with the numbers of HIV cases. Here is some information about HIV in Zambia including efforts to reduce HIV/AIDS in Zambia.

About HIV/AIDS in Zambia

Evidence shows that Zambia is among the first 10 countries with the most cases of HIV. An estimated 1.5 million inhabitants of Zambia had HIV/AIDS as of 2020, with an adult prevalence of 11.1%. Additionally, Zambia has experienced a total of 24,000 deaths due to HIV/AIDS.

HIV/AIDS is quite prevalent among adults from ages 15 to 59 in Zambia, with a greater prevalence among females than males. Additionally, HIV is most prevalent among older adults, with 73.5% of infected women and 73% of infected men being 45 to 59 years of age. This demonstrates that approximately 980,000 people between the ages of 45 and 59 in Zambia suffer from HIV/AIDS.

The Link Between Poverty and HIV/AIDS

Research has found a strong connection between poverty and HIV cases; those living under the poverty line are more likely to obtain a sexually transmitted infection, such as HIV. Studies have found that those who are in circumstances of poverty in Zambia are often likely to resort to illegal means of work, such as sex trafficking or prostitution. The U.S. Department of State’s annual reports state that sex traffickers often exploit women in Zambia with money or food, placing Zambia on a severe Tier 2 ranking for sex trafficking. Additionally, the loss of jobs from COVID-19 resulted in an increase in the poverty rate in Zambia, going from 11.19% in 2019 to 12.17% in 2020. This shows that vulnerable young women below the poverty rate became desperate for money, thus resorting to the sex trafficking industry, where the circumstances led to the transmission of HIV.

Children’s Risk for HIV/AIDS in Zambia

Zambia’s population of children with HIV is a prominent issue; infections among children between the ages of 0 and 15 border at approximately 6,000 a year. In 2018, 79% of the children with HIV received antiretroviral therapy (ART), which is an effective means of treating HIV/AIDS. Of the children in Zambia who did not receive ART, 50% of them died before their second birthday. Additionally, the U.N. estimates that there is a total of 1 million children in Zambia who are either orphans or vulnerable to bribery, resulting in them being frequent targets of the sex trafficking business.

Potential Solutions to Reduce HIV/AIDS in Zambia

An example of an NGO (non-government organizations) in Zambia that focuses on preventing HIV in Zambia is the Kara Counseling and Training Trust (KCTT). This organization began in 1989 with the purpose of counseling people in Zambia who suffer from HIV/AIDS. Additionally, UNICEF’s HIV program in Zambia provides preventative resources for Zambian citizens in order to prevent the spread of HIV/AIDS. It has initiated several new programs, such as the National Paediatric and Adolescent Prevention, Treatment and Care Implementation Plan of 2017. Though there is currently a prevalence of HIV cases in Zambia, NGOs like the KCTT and UNICEF can be of great aid to people in need and can provide hope for resolving this issue.

Though the issue of HIV has been prevalent in Zambia for a long time, recent developments from different organizations have provided hope for the issue to reduce. By spreading awareness of the danger of HIV/AIDS and its causes, along with the distribution of preventative resources in Zambia, there is a high chance that the rates of HIV/AIDS in Zambia will reduce over the next few years.

– Andra Fofuca
Photo: Wikipedia Commons


The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is working to end HIV/AIDS. Since PEPFAR’s launch in 2003, the U.S. government has made an investment of more than $85 billion to combat the HIV/AIDS epidemic. This investment has saved more than 20 million lives and has brought the HIV/AIDS epidemic under control in more than 50 countries through HIV infection prevention.

The Joint United Nations Programme on HIV/AIDS set 95-95-95 targets to reduce and control HIV infection by 2030. These include making sure that 95% of people with HIV infection are aware of their HIV status, ensuring that 95% of HIV-positive people receive antiretroviral treatment and calling for viral load testing and suppression among 95% of HIV-positive people. The limited availability of resources during COVID-19 challenges the effort to meet these targets. However, both the CDC and PEPFAR have shown their commitment to ending HIV/AIDS despite countries grappling with the COVID-19 pandemic. 

Limited Resource Availability  

Lockdown restrictions and travel restrictions to battle the COVID-19 pandemic have affected the availability of essential HIV services around the world, making it difficult for PEPFAR to end HIV/AIDS. In the early stages of the COVID-19 pandemic, health professionals dedicated to combatting HIV/AIDS diverted their efforts to the COVID-19 response. Viral load testing platform manufacturers started developing molecular diagnostic capability for COVID-19 using the same equipment that people used for viral load testing for HIV previously. All this decreased the availability of antiretroviral services. It also restricted the ability of healthcare professionals to follow with treatment outcomes associated with viral load testing.  

The Impact of COVID-19 on Viral Load Testing 

PEPFAR conducted a review to examine the global impact of the pandemic on viral load testing for HIV. The review showed that the coverage of viral load testing for all countries supported by PEPFAR was at a stable 78% between September and December 2019, but that coverage dropped to 71% between January and March 2020 due to the limited accessibility to laboratory and medical services amid the pandemic. Between April and June 2020, when routine services restarted, viral load testing coverage jumped by 75%. 

Additionally, 91% of the patients on antiretroviral treatment who did receive the viral load testing between October 2019 and March 2020 remained stable in terms of viral suppression. That continued at 92% between April and June 2020. This stable suppression of viral load indicates that even though fewer patients received antiretroviral treatment and testing during the COVID-19 pandemic, those who did receive the viral load testing had access to and complied with the antiretroviral treatment regimen. Despite poor odds, PEPFAR’s effort to end HIV/AIDS was right on its track during the first year of COVID-19. 

Innovative Initiatives  

To fulfill the HIV/AIDS targets by 2030, PEPFAR must develop newer strategies that countries can implement during the ongoing COVID-19 pandemic. One innovative approach PEPFAR has adopted includes point-of-care technology for those patients who are in need of expedited testing. These include patients failing the antiretroviral treatment, pregnant and breastfeeding women and children with low rates of viral suppression.

To support the impoverished communities in the sub-Saharan Africa region who the COVID-19 pandemic hit especially hard, PEPFAR has begun to dispense antiretrovirals for several months at once. It also has implemented task shifting and healthcare worker sharing. Third, it has encouraged the use of telemedicine while canceling most of the in-person activities to reduce the transmission risk. Fourth, PEPFAR has allowed flexibility in reporting requirements, funding reallocation and staffing. All these strategies combined have helped PEPFAR to keep on track with its agenda to end HIV/AIDS despite COVID-19.  

The COVID-19 pandemic has significantly affected the resource availability required for delivering the services for HIV infection control. However, PEPFAR is continuing to meet targets for 2030 by applying innovative strategies.

– Jared Faircloth
Photo: Flickr

An Insider’s Look: HIV/AIDS Clinics in South AfricaAccording to the Joint United Nations Program on HIV/AIDS (UNAIDS), roughly 7.8 million adults and children are currently HIV positive in South Africa. HIV is a life-threatening immunodeficiency virus transmitted through bodily fluids. Upon infection, the virus causes acquired immunodeficiency syndrome (AIDS) which cannot be reversed or cured. As a result, people living with HIV/AIDS have weak immune systems and cannot fight off common diseases.

Considering the seriousness of HIV/AIDS, affected communities in South Africa require immediate attention and assistance. Below are 3 facts about a non-governmental organization called Child Family Health International (CFHI) that sends healthcare students to work in HIV/AIDS Clinics in South Africa. Afterward, a CFHI healthcare student recalls his experience working at an HIV/AIDS clinic in Durban, South Africa.

3 Facts about Child Family Health International (CFHI)

Firstly, CFHI offers health education programs around the world. Every year, the organization sends undergraduate students and faculty members abroad to experience healthcare systems in different countries. To date, the organization offers programs in Argentina, Bolivia, Costa Rica, Ecuador, Mexico, Ghana, India, the Philippines, Uganda and South Africa. For the South Africa program, participants have an opportunity to work in a tertiary public hospital, a Parochial Hospital, a hospice center or an HIV/AIDS clinic.

Secondly, CFHI partners with HIV/AIDS clinics in South Africa. To help mitigate the rising number of HIV-positive cases in Durban, South Africa, CFHI sends students and staff to a local HIV/AIDS clinic called the “Blue Roof Clinic.” Originally, the Blue Roof building housed a local nightclub renowned for drug and alcohol abuse. However, in 2006 the non-profit organization Keep a Child Alive (KCA)‘s cofounder, professional singer Alicia Keys, helped to buy the building. After years of renovations, it became a local HIV/AIDS clinic dedicated to providing free medication and treatment to South Africans testing positive for HIV.

Thirdly, CFHI helps to combat poverty in South Africa. By sending students to the Blue Roof Clinic, the organization assists thousands of HIV-positive patients every month. This type of assistance includes giving patients anti-retroviral medicine, psychological support, legal advice, nutrition guides and HIV prevention tips. Best of all, HIV/AIDS treatments are free of charge and offered to everyone in need. The only cost to patients includes transportation to and from the clinic. Overall, CFHI continues enrolling thousands of students from over 35 different countries to help people around the world.

3 Interview Questions with a CFHI alumnus

To learn more about CFHI, The Borgen Project interviewed Christian Warner, a CFHI healthcare alumnus.

  1. Tell me about yourself and why you participated in the South Africa CFHI program. “My name is Christian Warner and I studied public health at Oregon State University (OSU). I had an internship in South Africa through CFHI my senior year of school. I chose CFHI’s program in South Africa because students have an opportunity to work in local HIV clinics and help local populations living with HIV/AIDS and tuberculosis. Overall, I wanted to gain healthcare experience working in a foreign environment.”
  2. What does an average day working in HIV/AIDS Clinics in South Africa look like? “I spent time working at an HIV/AIDS clinic called Blue Roof Clinic. Each morning, I arrived at the clinic to make sure we had adequate supplies. Typical supplies included sanitation gloves, cleaning supplies and antiretroviral treatments for patients. A couple hours later, patients would start showing up. During the day, I shadowed retired nurse practitioners working in the clinic. The nurses would ask patients a variety of medical history questions before administering treatment. They also asked whether patients had trouble getting to the clinic transportation-wise. Our mission is to ensure everyone can access the clinic and its resources.”
  3. How do HIV/AIDS Clinics in South Africa ensure treatment is available to all, regardless of socioeconomic status? “The Blue Roof Clinic offers free walk-in appointments and HIV treatments for everyone in need. This allows people to seek medical assistance without visiting the hospital or acquiring insurance. The clinic also makes people feel comfortable because their medical and visitation history is 100% confidential.”

Ending the HIV/AIDS Pandemic

The U.N. pledged to end the HIV/AIDS pandemic by 2030. To accomplish this goal, 90% of people living with HIV must know that they carry the disease and have access to treatment. Therefore, governments and non-governmental organizations worldwide are donating billions of dollars to provide affected communities with antiretroviral medicines and other treatments. However, governments must also monitor antiretroviral medicine supply chains and stockpiles to ensure economic ramifications caused by the COVID-19 pandemic do not disrupt people’s access to treatment.

– Chloe Young
Photo: Flickr

HIV/AIDS In Zimbabwe
HIV/AIDS in Zimbabwe has become prevalent, mainly due to unprotected sexual transmission. The U.S. Embassy in Zimbabwe reported that in 2020 there were “approximately 1.23 million adults in Zimbabwe living with HIV.” Zimbabwe has the sixth-highest HIV/AIDS rate in the world, considering that the nation has roughly 31,000 new infections annually. However, despite the common misconception, the high rate of HIV/AIDS does not stem only from sexual activity. High case rates have become common among children as infected mothers pass HIV/AIDS on to their kids during childbirth. Organizations are working to reduce the prevalence of HIV/AIDS in Zimbabwe.

What is HIV/AIDS?

The human immunodeficiency virus (HIV) “is a virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases.” When an HIV/infected person goes without treatment, the condition can develop into acquired immunodeficiency syndrome (AIDS), a “late stage of HIV infection that occurs when the body’s immune system is badly damaged because of the virus.” There is no cure for HIV/AIDS to this day, despite extensive research since the virus was initially identified in 1981. However, by taking antiretroviral drugs, people “can live long and healthy lives and prevent transmitting HIV to their sexual partners” and children.

Action to Address HIV/AIDs in Zimbabwe

The Centers for Disease Prevention and Control (CDC) supports an HIV/AIDs program in Zimbabwe that began in 2004. In 2019, the program achieved a milestone, extending the reach of antiretroviral treatment coverage to 82% coverage for infected men and 88% coverage for women. In 2017, a UNICEF-led HIV program helped achieve the target of “ensuring that 80% of pregnant women, new-born, children and adolescents have equitable access to cost-effective and quality health interventions and practice.” With the support of organizations, overall, Zimbabwe has had success in “expanding access to HIV testing and treatment, including prevention of mother-to-child transmission (PMTCT) and lowering HIV prevalence.”

Data from the Zimbabwe Population-based HIV Impact Assessment survey (ZIMPHIA 2020) shows the nation’s progress. The survey indicates that almost 87% of HIV-infected adults knew their status. In addition, of the population “aware of their status,” 97% were receiving antiretroviral treatment. Finally, “among those on treatment, 90.3% achieved viral load suppression,” meaning they are now unable to transmit the disease to other people. With this progress, Zimbabwe is on its way to achieving the UNAIDS target of eradicating AIDS by 2030.

Looking Ahead

Although HIV/AIDS has been a significant public health crisis in Zimbabwe for quite some time, the government is taking the necessary steps to reduce its prevalence. Increasing diagnosis rates have set off a chain reaction in Zimbabwe as people seek the necessary treatments and educate themselves on the condition and preventative measures to protect themselves and others. There is still much work that needs to occur, however, the country is doing its part to safeguard the lives of its citizens through early detection measures and access to treatment.

– Sara Jordan Ruttert
Photo: Flickr