Innovation and communities are the key to ending infectious diseases
Ngong Sub-County Hospital (Credit: STOPAIDS)
The COVID-19 pandemic put global health systems under incredible strain. The result? The response to HIV, as well as other infectious diseases, is further off-track. Yet there remains reason for optimism.
During recess, I was fortunate to visit health programmes around Nairobi, Kenya. Kenya has 1.4 million people living with HIV, with 1.1 million of these people receiving treatment which, when followed, reduces one’s viral load to the extent that HIV is undetectable in the body, and is also untransmissable. Tuberculosis and malaria also remain stubborn threats.
It will be a challenge to overcome these diseases, but thanks to new health innovations, we are able to accelerate the response and get back on track to achieving our 2030 sustainable development goals.
On a visit to Ngong Sub-County Hospital, I was able to see up close how such innovations are being used in clinical settings. A gene expert machine runs automated diagnostic tests for tuberculosis; previously the lab could manage 50 tests a day through a microscope, but now they can do nearer to 200. Parents access pediatric HIV medication for their children: a dispersible strawberry-flavoured Dolutegravir tablet, the price reduced by 75 per cent. People are screened on-site for cervical cancer (women living with HIV are at 60 per cent greater risk).
Doctors spoke about the value of community health workers – individuals trained to educate and empower the local public
There are challenges, including that the hospital has just one gynecologist who is only available on Tuesdays, but huge progress is being made. Much of this is thanks to Unitaid, the global health agency that invests in developing these health innovations and getting them to low and middle-income countries at affordable prices. It was Unitaid that negotiated the price reduction of an annual treatment of Dolutegravir from $480 to $120, for example. This is life-saving, as without treatment, 80 per cent of children born with HIV will die before the age of five.
All of this progress is underpinned by the trust created between care providers and beneficiaries. Doctors spoke about the value of community health workers – individuals trained to educate and empower the local public. For many, it is hard to get screened for health issues when at first you may not perceive yourself as sick, particularly when you need to go to work. These community health workers provide a critical service by building relationships in their communities and raising awareness about the benefits of getting tested at the integrated care facility, including encouraging mothers to be tested for HIV in order to prevent mother to child transmission.
One of the most moving moments for me was meeting a two year-old young girl whose mother had contracted HIV from her second husband before getting pregnant. It was thanks to a ‘mentor mother’ – another mother living with HIV who works in the community – that this young girl’s mum was empowered to take her HIV medication, meaning that this girl was born HIV free.
Indeed, it is these community-centered approaches that enable the effective delivery of these game-changing health tools which offer us a route forward to the end of AIDS, tuberculosis and malaria by 2030. We just require the political will and financial commitment to take that path forward.
Lord Collins, Labour peer and vice chair of the All-Party Parliamentary Group on HIV and AIDS
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