Supporting national coordination structures and HIV community systems to address Covid-19

At the onset of the COVID-19 pandemic, ignited by the outbreak of the novel Coronaviirus, the national response to the HIV and AIDS epidemic in Malawi appeared to be on the edge due to uncertainties that followed the lockdown approach as practised by initial countries that faced the pandemic.

Covid-19 Frontline Healthcare Workers (left to right) Ephraim Chisunkha, Duncan Banda, Nyembezi Gausi, Thom Chigeda, Virginia Phiri and Chisomo Kankhwali captured at Bwaila District Hospital Lilongwe 4. Photos by Edward Kabuye, Unicef

The World Health Organization declared COVID-19 as a pandemic on 11 March 2020. This was a few months after the outbreak of the Coronal Virus in Wuhan, Hubei Province in the People’s Republic of China.

Malawi registered its first cases of COVID-19 on 2 April 2020 and a month earlier, on 20 March 2020, the country had declared COVID-19 a national disaster and started implementing measures to curb the spread of the virus.

Globally, countries instituted lockdowns leading to borders slowly shutting down, signaling that some crucial commodities, including those needed in the national response to HIV and AIDS, could be slowed down from being brought into the country.

Large gatherings were restricted; hence, some activities in the national response to the HIV and AIDS had to have restricted number of attendees and some were entirely suspended.

Stakeholders in the national response to the HIV and AIDS were quick to take action so that the gains made in reducing the impact of the HIV and AIDS were sustained. The outbreak of COVID-19 meant there was a lot to lose since focus, efforts and resources were towards this novel pandemic.

For starters, Malawi has an ambitious goal to end AIDS as a public health threat by 2030. These global agreed UNAIDS fast track targets are contained in the national HIV and AIDS Strategic Plan which is the guiding five-year implementation framework for all stakeholders nationally.

As such, any distraction in the implementation endeavor, such as the threat to be caused by the COVID-19 pandemic, means that meeting the targets would be a far-fetched dream. As such, there was an enormous need to do everything possible to safeguard the targets.

With its experience as the country’s coordinator of the HIV and AIDS epidemic, the National AIDS Commission (NAC) devised a number of interventions to ensure that its constituencies were both protected from the raging COVID-19 pandemic and continued to access the necessary HIV and AIDS services.

At this stage, NAC had observed that there were similarities between the COVID-19 pandemic and that of HIV and AIDS in its earlier stages, notably in the 1980’s and 1990’s.

There was misinformation on the mode of HIV transmission (which would in this age be classified as fake news), testing as well as treatment. This led to stigmatization of those that were actually or just perceived to be HIV positive. The engagement of community structures to come up with local solutions to the HIV pandemic proved a success.

The public health approach that was borne out of these interventions entailed scaling up social and behavioural change communication interventions and HIV testing and counselling. It further entailed enhancing the decentralized community structures as the most appropriate avenues to reaching the affected populations.

Government through NAC established Community Based Organizations (CBOs), Faith Based Organizations (FBOs), Community Care Groups and Village AIDS Committees, among others, to fast-track the emergency responses to HIV.

Given their nature of being rooted in the communities, it was very easy for these structures to be trusted. After all, the people that were driving them came from the same communities these structures served.

So, when COVID-19 pandemic struck, NAC quickly devised mechanisms of integrating the fight against the new pandemic with the national response to the HIV and AIDS. The idea was to ensure that those infected and affected by HIV continued to access services while being protection from COVID-19.

NAC, therefore, collaborated with national coordinating and implementing partners such as the Malawi Network of AIDS Services Organisation (MANASO), Malawi Network of People Living with HIV (MANET+), the National Association of People Living with HIV (NAPHAM), the Health Education Unit in the Ministry of Health as well as organizations serving people living with disabilities to conduct nationwide orientation of the decentralized HIV community structures and People Living with HIV (PLHIV) district chapters on COVID-19

The community structures were equipped to effectively disseminate both HIV and COVID-19 specific information as well as raising awareness. They were also enabled to identify suspected COVID-19 cases and refer them accordingly; as well as ensuring that all the HIV and AIDS interventions remained in motion.

The Commission further supported the community structures nationwide with a donation of 150 bicycles in total to aid mobility as well as bags and COVID-19 protective materials such as reusable cloth face masks and hand sanitizers.

NAC also targeted populations at risk of both HIV and Corona Virus with both HIV and COVID-19 prevention commodities. The donations included reusable cloth face masks hand sanitizers as well as condoms.

The targeted population included cross-border truck drivers through the Road Transport Operators Association and the Association of Truck Drivers as well as female sex workers through the Association of Female Sex Workers.

The Commission also facilitated the handover of Corona Virus prevention hygiene kits donated by UNAIDS in form of JIK detergent and Dettol soap worth K75,000,000 to MANET+. These were in turn handed over to 5,000 PLHIV in seven priority districts, thereby ensuring that they were protected from Corona Virus.

The Commission did all this in view of the fact that waging war on the COVID-19 pandemic was the only way of achieving the goal of ensuring that HIV and AIDS services continued to be accessed.

  • The author is Corporate Services and Public Relations Officer for National AIDS Commission

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