Health Concerns During COVID-19COVID-19 has understandably been the main focus around the world. In developed countries, many are new to health epidemics and the disruptions caused by them. But, in some parts of the world, widespread disease is not new at all and COVID-19 is not the only health concern. There are several other global health concerns during COVID-19. Some seem obvious, like malaria or HIV/AIDS. But, some have made less news, like a toxic goldmine in Ethiopia. These health crises also require assistance and aid from the international community.

HIV/AIDS in South Africa

In 2019, it was estimated that more than seven million people in South Africa were living with HIV. Roughly 200,000 of those people were newly diagnosed in 2019, and in that same year, 72,000 people died. Though 70% of people receive antiretroviral therapy (ART), the disease remains incurable. Its prevalence makes it one of the priority health concerns during COVID-19.

Though South Africa has the largest population of people living with HIV in the world, it has made a lot of progress. Data indicates that in 2018, 90% of infected individuals were aware of their status and 87% of people receiving treatment were virally suppressed, meaning they do not transfer the virus. Despite this success, rates continue to increase and it disproportionately affects women and young girls.

In 2016, South Africa made treatment for HIV free to all, where it used to be available only to those with advanced infections. This comes after South Africa made pre-exposure prophylaxis (PrEP) available to all sex workers to prevent HIV contraction in the first place. Though it did take years for South Africa to acknowledge this epidemic, the country is making progress. However, more focus and attention needs to go toward addressing HIV/AIDs in South Africa as it is a significant health crisis.

Malaria in sub-Saharan Africa

COVID-19 severely affected sub-Saharan Africa’s access to insecticide-treated nets (ITN) and malaria treatments. The World Health Organization (WHO) urged nations to resume the distribution of these things, in fear that mortality rates in 2020 would reach 769,000, which is double the rates of 2018.

Preventative treatments, which deliver antimalarial medication to asymptomatic people, aimed at school-aged children, has shown to significantly reduce the risk of contracting malaria. Health officials in sub-Saharan Africa have been urged to take heed of this, but the poverty affecting the region limits progress.

A whole 90% of global malaria deaths happen in sub-Saharan Africa, and of that figure, 78% of victims are children. Malaria is a treatable condition, but those most susceptible to it usually live in a state of poverty, unable to afford treatment. Malaria in sub-Saharan Africa is one of the most pressing global health concerns besides COVID-19.

Toxic Gold Mine in Ethiopia

Gold mining is an important industry in Ethiopia. The export of gold and similar minerals makes up 7-10% of Ethiopia’s export earnings. Hundreds of thousands of people are employed in the mines, both skilled and unskilled.

But, in Ethiopia’s most populous region, Oromia, a gold mine has released harmful contaminants that have severely affected people. Serious deficiencies in mine management have left the soil and water contaminated with dangerous levels of cyanide, arsenic and mercury. This contamination resulted in high rates of miscarriage, stillbirths and infant mortality, birth defects, the destruction of livestock and crops and locals are afflicted with debilitating illnesses. Residents say there was no warning about potential toxins,

The mine was considered so toxic that the situation was deemed a violation of human rights. After pushback from the citizens, it was temporarily shut down, but there was no accountability or treatment for those affected. There remains doubt whether the air and water are now safe and residents anticipate that the mine will be reopened. In August 2020, mineworkers were asked to attend a meeting, cementing this assumption. In collaboration, human rights organizations submitted a document to the Human Rights Committee entailing Ethiopia’s violations of rights in regard to the contaminated mine. It documents Ethiopia’s failures and necessary reparations that should be made to people.

To safeguard the well-being of the Ethiopian people and ensure that aid is provided to the affected people, it is essential for the international community to get involved.

COVID-19 and Other Global Health Concerns

The COVID-19 pandemic has upset the health of nations globally, no matter the resources a country has. But, it has also overshadowed some pressing issues. There are other major health concerns during COVID-19 that need international attention and aid as well.

– Maddey Bussmann
Photo: Flickr

hiv epidemic in the philippinesThe HIV epidemic in the Philippines is the fastest-growing in the Asia and Pacific region. According to UNAIDS data, HIV prevalence in the Philippines increased by 207% from 2010 to 2019. AIDS-related deaths rose by 338% in the same period. In 2019, an estimated 97,000 people were living with HIV in the Philippines. Of those, 73% knew their status and 44% were receiving antiretroviral treatment.

Although these statistics indicate some progress, the Philippines still falls far below the 90-90-90 target set by UNAIDS. Aimed at ending the HIV epidemic by 2020, the program wanted to ensure that 90% of people living with HIV would know their HIV status. It also strove to give 90% of people with a diagnosed HIV antiretroviral therapy and induce viral suppression in 90% of those receiving treatment. Unfortunately, the world is not on track to meet these goals, and new targets are being developed for 2025.

Populations Most Affected

The prevalence rate of HIV in the Philippines among adults ages 15 to 49 was 0.2% in 2019. This national rate, however, masks alarmingly high prevalence rates among specific populations. The groups most affected by the HIV epidemic in the Philippines often face social stigma, isolation and legally sanctioned discrimination. These populations include people who inject drugs (PWID), men who have sex with men (MSM), sex workers and transgender people. However, new technologies, programs and initiatives are working to lessen the burden of disease and stigma on these populations.

People Who Inject Drugs

According to UNAIDS, the HIV prevalence rate among people who inject drugs in the Philippines is 29%. Among PWID, only 26.9% have been tested and are aware of their status. Key factors fueling the HIV epidemic in the Philippines among PWID include hostile public opinion and brutal law enforcement. These constitute major barriers to HIV testing and awareness. While official statistics released in 2018 revealed that over 4,500 drug users were victims of extrajudicial killings, civil society estimated the true toll to be as high as 20,000.

Progress in HIV testing is crucial to reduce HIV prevalence among PWID, who struggle to access services due to their criminalized status. Various alternative testing methods, such as rapid finger-prick testing, can reduce barriers to testing for PWID. In particular, self-testing kits, which allow people to test in private, have attracted a large proportion of first-time testers in Thailand and have achieved impressive success in China.

Men Who Have Sex With Men

The HIV prevalence rate among men who have sex with men is 5%, the second-highest among key affected populations. MSM who fear social stigma and discrimination often do not participate in HIV prevention programs. As a result, the participation rate for these programs is 14.6%, and the majority of MSM lack awareness about HIV. Condom use in this population is also low at 40.1%. However, condom distribution and sex education programs would benefit MSM, many of whom reported not using condoms because they were “not available.” Fighting the HIV epidemic in the Philippines means tailoring help to MSM.

Sex Workers

Female sex workers in the Asia and Pacific region are 29 times more likely to be living with HIV than other adult women of reproductive age. The HIV prevalence rate among sex workers in the Philippines is now 0.6%. This group has the highest rates among affected populations for coverage in prevention programs and condom use, which are 71.8% and 85.3%, respectively. Many important national HIV prevention programs raise awareness about HIV and encourage condom use among sex workers. These programs include the 100% Condom Use Program, the HIV Counseling and Testing Service, and programs led by the Philippine National AIDS Council.

Transgender People

Transgender people are one of the populations most affected by the HIV epidemic in the Philippines, with a prevalence rate of 3.9%. However, there is little information or research about the effects of HIV on the transgender community in the Philippines. A key problem is the lack of transgender visibility due to social exclusion and widespread stigma. This challenges efforts to obtain health data and develop targeted programs to support transgender individuals. To raise awareness about gender identities and transgender acceptance, sexual health education and gender studies programs must be more inclusive. This would help reduce the stigma and barriers to healthcare for transgender people in the Philippines and engage them in HIV prevention and treatment programs.

The Effect of COVID-19

Lockdowns in the Philippines due to COVID-19 have blocked access to essential services for HIV patients, including treatment and testing. Eamonn Murphy, UNAIDS regional director for Asia and the Pacific, stressed that the Philippines needs to do more to convince those in high-risk populations to seek out HIV-related services.

Continued attention to these key affected populations is necessary to reduce HIV prevalence rates and make progress toward HIV eradication. In this way, focused programs can work toward lessening the severity of the HIV epidemic in the Philippines.

– Alice Nguyen
Photo: Flickr

HIV in southern AfricaIn 2006, the Duke of Sussex partnered with Prince Seeiso of Lesotho to form Sentebale, a charity focused on providing psychosocial support for children and young adults living with HIV in southern Africa. It partners with grassroots organizations in Botswana, Lesotho and Malawi and works to improve adherence to HIV medication programs.

Sentebale

“We teach them that this human immunodeficiency virus does not have to be a death sentence for anyone anymore, that the real enemy we are fighting is stigma and the antiquated attitudes that work against young people coming forward when wanting to take an HIV test,” said Prince Harry in a speech during a dinner for Sentebale in January 2020.

The name Sentebale was chosen by Prince Harry and Prince Seeiso. It means “forget me not” in Sesotho, which is Lesotho’s official language. Princess Diana, Prince Harry’s late mother, and Queen ‘Mamohato, Prince Seeiso’s late mother, were both previously involved in work with children who had been affected by HIV/AIDS. The mission of Sentebale is to become the leading organization for psychosocial support for young people and children with HIV in southern Africa.

The Let Youth Lead Program

In recent years, Sentebale has found that social accountability and peer-to-peer support were central tools to bolstering its mission. In March 2017, Sentebale launched the Let Youth Lead program. The program’s objectives are to eventually have all young people in southern Africa know their HIV status, provide and promote peer-to-peer support and help young people to advocate for themselves at the government level. Another goal of the program is to empower these young advocates with the tools to assist their peers and have their voices heard.

“I volunteered because I wanted to help people. I don’t see this as work, I just want to transform people’s lives,” said Pheto Kutmela, a Sentebale Let Youth Lead advocate. Kutmela has been volunteering in Ha Makunyapane, Thaba-Tseka district, where he lives.

These youth advocates have been able to facilitate community dialogues in 30 community councils, where they are able to discuss challenges they have been facing and suggest improvements for going forward. It can typically be difficult for young people to have their voices heard at the governmental level and this program helps create a platform for them to do so, by giving them the tools to engage with policy leaders and address education and health services.

HIV/AIDS Progress in Botswana

Sentebale has overseen some transformative improvements in the HIV/AIDS epidemic over the past several years. In Botswana, HIV/AIDS infected less than 500 children under the age of 14 in 2018 and more than 95% of pregnant women living with HIV were receiving treatment.

Sentabale is in the process of developing a five-year strategy for the organization. In January 2020, it hosted an “initial workshop” to hear the voices of young people and children so that it can shape the organization’s future vision around their feedback. Looking forward to 2021, with a few adaptations in light of the COVID-19 pandemic, Sentebale will continue to prioritize its commitment toward empowering youth who HIV in southern Africa has affected.

– Katherine Musgrave
Photo: Flickr

HIV/AIDS in AsiaAs of 2019, there were 5.8 million people living with HIV/AIDS in Asia. Of that 5.8 million, only 75% were aware of their status. HIV/AIDS in Asia is a growing problem for which there is no one solution. However, there is region-specific work being done to combat the crisis.

GreenShoots Foundation

GreenShoots Foundation is a London-based charity founded in 2010. For a decade now, it has been supporting people living with HIV/AIDS and working to alleviate poverty. It takes on international development with a holistic approach through three programs that are active in six countries across Asia.

The Education Loans & Social Entrepreneurship program aims to support children’s education in India. In the Philippines and Cambodia, the Food, Agriculture & Social Entrepreneurship program is bolstering rural economies by promoting sustainable farming as well as sustainable business practices. The Medical Assistance & Medical Education (MAME) program, which is active in Kyrgyzstan, Vietnam and Myanmar, is improving the lives of those with HIV/AIDS.

Medical Assistance & Medical Education (MAME)

The objective of the MAME program is to fight HIV/AIDS and other diseases that pose a threat to public health. It helps by providing greater access to treatment plans and equipping local healthcare workers with the knowledge they need to help people living with HIV/AIDS.

In Kyrgyzstan, the HIV infection rate has risen 21% since 2010. GreenShoots Foundation is working with the Kyrgyz National Infection Control Centre to provide local organizations with medical knowledge about HIV/AIDS through workshops and internships. It is also making efforts to change public opinion so that people living with HIV/AIDS in Kyrgyzstan are not stigmatized and know what resources are available to them. It has already trained 45 medical staff and 130 students, as well as impacted 350 patients directly.

What began as a health concern for sex workers and drug users in Vietnam has since grown to become a nationwide issue. While deaths related to HIV/AIDS have dropped 45% since 2010, there were still nearly 5,000 Vietnamese people who passed away from the disease in 2018. So while much is being done to address the epidemic, there is still room for improvement.

GreenShoots Foundation has been focusing on the province of Hoa Binh, where the government has taken steps to improve HIV/AIDS treatment, but the level of medical knowledge still needs to be improved. Through workshops, visits to hospitals and the media distribution of medical information, GreenShoots Foundation has been able to improve upon what changes the Vietnamese government has made. It hopes to host more workshops with a broader reach in the future.

Medical Action Myanmar has also been collaborating with GreenShoots Foundation. Similar to approaches used in Kyrgyzstan and Vietnam, the organizations have been focusing on workshops to provide medical workers with better knowledge as well as working with people living with HIV/AIDS on microfinance. Additionally, GreenShoots Foundation has sent 13 doctors and nurses to Yangon to support people living with HIV/AIDS. It has also dedicated nearly 7,000 hours toward mentoring medical staff.

Further Impact

Through its various workshops across Asia, GreenShoots Foundation has trained over 3,000 doctors and more than 1,000 medical students in HIV education. Through this, it has been able to contribute to the fight against HIV/AIDS in Asia and make for a healthier world.

– Evan Driscoll
Photo: Flickr 

AIDS in South Africa
South Africa has the world’s largest HIV/AIDS epidemic with 7.5 million people currently living with the virus. One of the main reasons why it has not been contained is a lack of testing. Less than 25% of the population has been tested in South Africa, where it is estimated that around 13% of people have AIDS. The lack of testing is caused by the negative stigma which still surrounds the virus, as well as the lack of access to reasonable testing and treatment methods. Now, cell phones are providing a new way for people with AIDS in South Africa to get tested and seek treatment. This is a massive step that may save millions of lives in the future.

Project Masiluleke

Project Masiluleke is an NGO providing these essential services in South Africa. It has developed multiple different steps to reduce the number of those affected by HIV/AIDS in South Africa. One of the main services is a program called SocialTxt which encourages people to get tested as well as refers them to medical guidance via text message. Texting is a valuable mode of communication because it is able to reach approximately 90% of the South African population. Since the implementation of this project, the number of daily calls to the National AIDS Helpline has tripled. Being able to easily access HIV/AIDS support services via cell phone has encouraged more and more people to seek help.

However, many South Africans still refuse to get tested because there is such a negative stigma around HIV/AIDS. This is a large part of why cases have continued to spread in South Africa. To help overcome this barrier, Project Masiluleke also provides users with self-testing kits. This way, people sign up for a kit via text message and then are able to take the test in total privacy. This method lets people feel more secure during the entire process and has encouraged many more people to get tested and seek treatment.

Cell-Life

Cell-Life is an NGO based in Cape Town, South Africa that seeks to help those affected by HIV by developing new technologies. They have developed several different texting services that send daily medication reminders. This organization also focuses on treatment literacy, which seeks to make people more aware of the resources they have to combat the virus. One of the most important things in the fight against AIDS is making sure people know they have support structures and can communicate with providers as well as other members of their community.

Moving Forward

Project Masiluleke and Cell-Life are great examples of new technologies bringing solutions to ongoing issues. NGOs taking advantage of widespread cell phone use to tackle the AIDS epidemic in South Africa are setting an example for other organizations and countries. Moving forward, these organizations and others must continue to use new technologies to increase access to resources and testing. Hopefully, with the help of cell phones, the spread of AIDS in South Africa will slow.

Jackson Bramhall
Photo: Flickr

What You Need to Know About the Masai Village HIV:AIDS CrisisHIV/AIDS affects the majority of African countries. Masai villages are located in Kenya, where approximately one in five adults is currently infected with HIV/AIDS. The Masai Village HIV/AIDS crisis continues to affect many, and, as a result, humanitarian organizations are working to alleviate the increasingly high infection rates.

What Does the Masai Village HIV/AIDS Crisis Look like?

HIV/AIDS infection rates are increasingly high and treatment rates are increasingly low. Of the affected 38 African countries, Kenya, the home of Masai villages, is the fifth most affected country in the world. Masai culture is greatly patriarchal, traditional and resistant toward common health practices. Marriage practices, a fundamental aspect of the Masai culture, gravely impact the Masai village members’ health. Prior to marital relationships, most girls will have sexual relations with young warriors and such relations will continue after the girls are properly married. Immediately after reaching puberty, girls are married to older men with the goal of preventing childbirth out of wedlock.

Even after marriage, most women fear seeking testing or treatment, as husbands will abandon their wives if they are infected with HIV/AIDS. Because men provide financial support, housing and food, women, understandably, do not seek appropriate treatment.

In Kenya, more than 30% of newborns are infected with HIV/AIDS and approximately half of those children die before they are 2 years old. The alarmingly high death rate is largely due to the fact that both the babies and their mothers do not seek proper diagnoses, let alone treatment. The United States Agency for International Development (USAID) found that since the onset of the global HIV/AIDS crisis in 1981, 17 million children lost at least one parent from HIV/AIDS. Of those 17 million children, 91% live in Sub-Saharan African countries such as Kenya.

Obstacles in Alleviating HIV/AIDS Rates

According to Doctors Without Borders, a fundamental obstacle posed by the Masai Village HIV/AIDS crisis is the unavailability of health clinics. Because Masai villages are independent of the country’s government rule, little progress can be made from African or Kenyan government forces. Masai villages are primarily controlled by a Laibon, a de facto leader of the village, who makes decisions regarding marriages, cattle, spiritual practices and health. Laibons primarily practice alternative medicine, leaving the communities with no access to HIV/AIDS treatment.

Even if there is a clinic close by, they are unlikely to have treatment. In addition to stigmas around testing, clinics do not have the antiretroviral treatments that are available in the United States. In implementing antiretroviral treatments within the United States, mortality rates have been reduced by more than 80%. But, such treatments can cost more than $9,000, which Masai village members and clinics cannot afford. Furthermore, there are numerous legal barriers preventing the production and importation of antiretroviral treatment to Kenya, specifically the rural areas of the Masai villages.

Progress for the Masai Village HIV/AIDS Crisis

The Masai village HIV/AIDS crisis has extreme implications. HIV/AIDS most commonly affects the younger, more sexually-active members of the village. Because the younger population is more physically able to partake in laborious work, the strenuous tasks that keep the villages operating cannot be completed if they are sick. Therefore, high infection rates lead to a decrease in social contribution. Without the help of younger Masai members, the villages become vulnerable to instability. For both health reasons and the function of their villages, Masai members will not be able to survive if Kenya’s infection rate remains above 4%.

Because limited progress can be made from within the Masai villages, many global aid organizations such as Adapt-A-Doctor and Kenya AIDS Intervention are paying physicians to practice in struggling countries. Additionally, Doctors Without Borders is increasing their time in hotspot countries, such as Kenya, where they provide free counseling and testing to Masai village members.

Through the efforts of external organizations and health associations, awareness of the HIV/AIDS epidemic in Masai villages is increasing. The help of such organizations in collaboration with Masai villages will lead its members to live healthier, safer and longer lives.

– Maya Sulkin

Photo: Flickr

India's AIDS EpidemicIndia is the most populous country on the planet and one of the most densely populated countries. With over 1.38 billion densely packed people, diseases spread quickly and HIV/AIDS is no exception. Although only 0.2% of adults have HIV/AIDS, this equates to roughly 2.4 million people, a total far higher than any other country in Asia. For this reason, many new programs have started. Although their tactics differ, each program works to fight India’s AIDS epidemic.

Causes of the Epidemic

The causes of India’s HIV Epidemic stem from multiple, diverse issues. Two primary causes include the practice of unprotected sex between sex workers and the injection of drugs using infected needles. These two practices are most common among vulnerable populations such as low-income communities. Thus, India’s AIDS epidemic is centered in select regions; although only a small percentage of the total population has HIV, this number is high in certain regions, and extra precautions are necessary for prevention in these areas.

Despite these overwhelming statistical figures, recent research has provided optimistic results. The number of HIV infections per year decreased by 57% between 2000 and 2011, and the annual deaths from AIDS decreased by 29% from 2007 to 2011. Bold government programs inspired by independent research instilled this change within the Indian population. The programs’ success stems from a variety of HIV treatments and from education, challenging the stigma and misconceptions about the disease.

Methods of Success

One of India’s renowned HIV treatment methods is the Antiretroviral Therapy program, known as ART. ART is the provision of supplements and antiviral drugs for citizens infected with HIV. In 2004, the Indian government sponsored the program, striving to place 100,000 infected Indians on the program by 2007. This program likely played a major role in the steep decline in HIV-related deaths from 2007-2011.

Noticing the success of the ART initiative, the Indian government took a further step in 2017 by initiating the World Health Organization’s Treat All policy; this policy focuses on making the ART program accessible to all disadvantaged Indians. The Treat All policy increased the number of new monthly joiners by several hundred.

Along with these programs, the Indian government has sponsored adolescent education programs centered on preventing the spread of HIV; they aim to end the negative stigma towards the disease and those infected. These programs also provide basic sex education. Studies on these programs have shown extraordinary results; samples of students understand essential facts about the disease such as how it spreads and the current lack of a cure. Although direct government intervention is vital, ending India’s AIDS epidemic starts with educating the youth.

Plans for the Future

With such a large number of people carrying the disease, managing HIV in India is no small task. Although the aforementioned methods have shown optimistic results, the involvement of local communities, governments, and NGOs is essential to maintaining the trend. When discussing diseases such as HIV, the intervention of international bodies cannot maintain the health of individual citizens; ending India’s AIDS epidemic is ultimately the responsibility of Indians, and these new programs enable them to do so.

Joe Clark
Photo: Flickr

HIV/AIDS in JamaicaAs of 2018, 32,000 people were living with a positive HIV diagnosis in Jamaica, with 44% of this population receiving treatment. This has been attributed to the stigmatization of HIV/AIDS, which can make those who live with it unwilling to pursue help. In response, Jamaican activists have campaigned and advocated for the destigmatization of HIV/AIDS because they believe it is the first step to completely eradicating the disease in Jamaica.

USAID’s Health Policy Project

International initiatives, such as the Health Policy Project, have been an important resource for activists because it focuses on training and educating. This project is a part of USAID’s mission to counter HIV/AIDS around the world and USAID is its chief source of funding. Within the Health Policy Project, HIV positive individuals have been invited to larger conferences where they are able to learn more about how to counter stigmatization and how to mobilize others. Because these individuals are Jamaican and their stories are personal, their message tends to be more positively received by audiences. This has allowed for a greater discussion of HIV/AIDS because it gives faces to those who are being discriminated against.

Governmental Initiatives for Anti-Discrimination

On a legislative level, the Jamaican Government has pushed multiple initiatives and studies to better the living conditions and access to care for those living with HIV. For example, healthcare discrimination is countered through the Client Complaint Mechanism and the Jamaica Anti-Discrimination System by educating the population, monitoring minority communities and training healthcare workers. In addition to that, these organizations collect reports of discrimination from around the country and help to investigate and correct them. These bodies are also working to provide free HIV treatment across the country and hope to accomplish this in the coming years.

Jamaica AIDS Support

Jamaica AIDS Support is the largest non-governmental organization working to counter and destigmatize HIV/AIDS in the country. Besides the promotion of education and treatment, the organization also provides access to mental health treatment for those who are HIV positive. This has allowed for a larger discourse about mental health and how it relates to this disease as well as a greater social acknowledgment of how stigmatization hurts others. In 2016, Jamaica AIDS Support began the Greater Treasure Beach Area pilot project, which aims to educate young people on HIV/AIDS so that in the coming generations there will be more tolerance and acceptance of those living with HIV.

Eve for Life

Local organizations, such as Eve for Life, have also been instrumental in the fight against HIV/AIDS discrimination by approaching the issue through empowerment. Eve for Life specifically works to empower women living with HIV through multiple education initiatives as well as smaller groups meant to support these women. One such group, Mentor Moms, works to help young mothers living with HIV to secure treatment and it provides smaller meeting groups where these similar women can find community. So far, it seems these initiatives have been overwhelmingly successful as more female activists have become involved in the fight against HIV/AIDS, which has led to greater social consciousness about the disease.

Conquering Stigma and Countering HIV/AIDS

Destigmatization initiatives in Jamaica are the key to countering HIV/AIDS and the country is off to a promising start. By utilizing personal narrative and education, activists hope to secure a world that is more welcoming for their children than it was for them. In the words of UNAIDS country director, Manoela Manova, “The more we do to ensure that people feel safe and respected, the closer the country will come to ending AIDS.”

– Mary Buffaloe
Photo: Flickr

PEPFAROne of the most effective programs in the fight against AIDS is the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR. The program was first authorized by Congress in May 2003. It initially started as a way to help the people of Africa, where the AIDS epidemic was most concentrated. Now, PEPFAR has international and domestic programs that fight AIDS in over 50 countries.

Poverty and HIV

The prevalence of HIV/AIDS is widely recognized to correlate with impoverished rural and urban areas. Poverty is not a necessary condition for contracting HIV. However, it can be related to risky sexual behaviors, such as participation in sex at a young age and prostitution. Poverty can also lead to inadequate sexual education or resources that would assist in preventing AIDS.

The underlying factors in poor areas that increase the risk of AIDS —  violence, social mobility, economic strain and access to education — need to be addressed. Tackling risk factors as a method of prevention has already proven to be largely successful in fighting AIDS internationally. Further, that approach has helped families simultaneously fight sources of intergenerational poverty.

PEPFAR

When President George W. Bush announced PEPFAR at the State of the Union, he said of the program: “seldom has history offered a greater opportunity to do so much for so many… And to meet a severe and urgent crisis abroad, tonight I propose the Emergency Plan for AIDS Relief, a work of mercy beyond all current international efforts to help the people of Africa. This comprehensive plan will prevent seven million new AIDS infections, treat at least two million people with life-extending drugs and provide humane care for millions of people suffering from AIDS and for children orphaned by AIDS.”

Today, PEPFAR has far exceeded its once lofty goals. The program has provided over 18 million people with HIV treatments and helpful services, like cervical screenings and education programs. To celebrate its incredible success, PEPFAR launched a new website in July 2020. It provides a timeline of scientific discoveries, legislation and social outreaches pivotal in the worldwide fight against AIDS.

Starting in 1981, the timeline explores the first known cases of AIDS in the U.S. and Africa. It moves on to facts about school education about AIDS and global programs like the World Health Organization’s Global Program on Aids (1987). A few tabs later, it relates the explosion of Congressional funding and legislation for PEPFAR and allied programs circa 2006 all the way to present day, 2020.

Additionally noted are milestones, such as PEPFAR’s 10th anniversary marking one million HIV-free babies born due to PEPFAR programs. This corresponds to the increased financial investment by the U.S., which proves the initiative’s substantial success.

Continued Efforts

PEPFAR is not satisfied with resting on its existing laurels, however. The same month PEPFAR released its celebratory website, PEPFAR also announced its latest report and upcoming budget. The new budget doubles funding for its HIV program that helps adolescent girls and young women to $400 million.

The program has so far helped over 1.5 million women and girls in only six months in 2019 and decreased HIV cases in that demographic by 25% since 2014. The new budget additionally increases PEPFAR’s cervical screening program, Go Further, by 70%. Together these effective programs are only a small piece of PEPFAR’s astonishing $85 billion total investment over the past 17 years of its existence.

Elizabeth Broderick
Photo: Flickr

sexuality EducationThe age group of 15 to 24 accounts for 16% of the global population but represents 34% of people in the age group of 15 to 49 that acquire HIV each year. Young people remain disproportionately affected by the HIV epidemic and comprehensive sexuality education is a strategy for addressing this issue.

Comprehensive Sexuality Education (CSE)

In the 2016-2021 Strategy of UNAIDS, one of the eight sub-strategies includes “quality comprehensive sexuality education accessed by all adolescents and young people.” Many other organizations believe comprehensive sexual education is essential for young people to protect themselves from HIV and other sexually transmitted infections.

Comprehensive Sexuality Education (CSE) is a curriculum-based program taught in school or out of school and over several years. The purpose of CSE is to “provide age-appropriate information about human rights, human sexuality, gender equality, puberty, relationships and sexuality and reproductive health.”

Digital Sexual Education

In places where there are ineffective or insufficient schools, digital sexuality education may be a substitute. Over 70% of 15 to 24-year-olds are online so sexuality education and information are increasingly being delivered through a digital format. Although millions have access to online sexuality education, research is limited regarding its impact. Although digital education is effective in reaching large groups of young people, some fear that cyberbullying and unsafe online research could hinder the success of online tools.

CSE Initiatives

The HIV epidemic impacts many regions, but sub-Saharan Africa remains the most affected. With support from the United Nations, the Southern African Development Community (SADC) and the East African Community (EAC) joined together to provide sexual education in the region. In 20 Eastern and Southern African countries, adolescents can access comprehensive sexuality education.

In support of comprehensive sex education, UNESCO alongside five other organizations published the International Technical Guidance on Sexuality Education. The document outlines key topics for curriculums specific to different regions.

In 2002, The UNAIDS Inter-Agency Task Team (IATT) on Education and School Health was created to improve HIV education. The IATT aims to increase leadership support and resource allocation for HIV and health education. IATT members believe that education is essential for successful HIV programs.

The Impact of CSE

CSE provides more than information. It aims to help young people establish positive values regarding their sexual health through discussions about relationships, gender roles and sexual abuse.

In a study focused on measuring the impact of curriculum-based sex and HIV education programs on adolescents or young adults between 9 and 24 years old, 65% of the programs had a significantly positive impact on behavior.

With more focus on education as a tool for prevention, it is hopeful that the global HIV epidemic will be positively impacted.

– Rachel Durling
Photo: Flickr