HIV isn’t a death sentence – even in Africa’s conflict hotspots

Wednesday, December 6, 2017 — As ICASA2017, Africa’s largest annual HIV conference, takes place in Abidjan, Cote d’Ivoire, this week (5 - 9 December), Doctors Without Borders (MSF) is drawing attention to the struggle millions of people in West and Central Africa (WCA) face in getting lifesaving HIV treatment – especially those in areas of conflict and war. At the conference, MSF staff will present 8 abstracts as well as medical & operational research findings from HIV and AIDS projects across Africa.

In WCA, 4 million people are still undiagnosed and untreated for HIV. In an era of ARVs and ‘test and treat all’, in this region, people are dying of AIDS.

In countries like Central African Republic (CAR) and South Sudan, war and political instability make accessing treatment even more complex.

CAR

  • In CAR, a country plagued with inter-communal violence, displacement and political instability, the leading cause of death among adults is not violence but HIV.
  • There were 7,800 HIV-related deaths in 2015 alone in the small country of just 4.5 million people. The 120,000 people living with HIV and AIDS in CAR face persistent anti-retroviral therapy (ART) stock-outs and low quality of care in the few facilities that do treat HIV (only 25% of PLWHA are estimated to be on ART). Many must also contend with daily instability due to the enduring crisis.
  • Although stable treatment is nearly impossible to find, MSF’s HIV projects in Carnot and Paoua adapted approaches which have helped keep people on treatment. Weak health systems and instability should not prevent other actors from responding.

South Sudan

  • In remote parts of South Sudan, HIV testing and ART can be nearly impossible to obtain. War has forced many people to flee to isolated locations, and staying on treatment while moving between villages is extremely difficult.
  • In Yambio County in the southwest, HIV prevalence is estimated at 3.4% - the country’s highest. There, MSF provides mobile and same day testing and treatment, with the aim of improving the lives of people with HIV.
  • The ‘Test and Treat’ project includes 3-month starter packs for HIV patients and long refills provided by travelling community health workers. Two mobile teams run six centres where people are tested and receive treatment in the surrounding countryside. When conflict forced people to flee their homes, the project continued, with promising results. Between June 2015 - November 2017, 14 804 people were tested for HIV, and 401 were enrolled in the programme.

“While this concept is new to this region, the ‘Test and Treat’ approach has been tried in other parts of Africa and was first introduced by the WHO. The big difference with this project is that Yambio is in a conflict setting. From time to time violence flares, leaving populations cut off from the outside world,” says Farhan Adan, MSF project coordinator in Yambio. 

“Rather than making patients come to a distant dispensary, our service calls into rural communities at set times. A patient could be tested and have the results in a day. Treatment can start immediately. Counsellors are on hand to explain how HIV will impact patient´s lives.”

Today, we have the following available at request:

  • Interviews with staff from CAR and South Sudan
  • Video and B-roll (South Sudan) Link
  • A selection of photographs from the Test and Treat pilot programme in Yambio
  • Abstracts (presented by MSF staff at ICASA2017 conference)

BACKGROUND

Doctors Without Borders (MSF) currently supports over 230,000 people living with HIV in 19 countries throughout Africa, Asia and Eastern and treat approaches, improved adherence support and differentiated models of care.

In West & Central Africa, MSF runs HIV programme in Central African Republic, South Sudan, Democratic Republic of Congo and Guinea.

FOR MORE INFORMATION

Rukudzo

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About MSF

Doctors Without Borders/MSF is an independent international medical humanitarian organisation working to bring emergency medical care to people caught in conflict, crises and disasters in more than 65 countries around the world including South Africa. We rely on the regular generous donations from individual donors to support our work.

To support MSF’s work:

•             SMS “JOIN” to 41486 to donate R15 per month

•             Visit www.msf.org.za/donate

HIV | Test and treat in Yambio, South Sudan

MSF field staff load an MSF car with working materials for the field in Yambio.
An MSF counselor has a consultation meeting with an HIV patient at an MSF mobile clinic in Bodo, a village just outside Yambio, in Gbudwe State, South Sudan.
CAG meeting
Christine Joseph - Community mobilizer<br/>I go to work in the mornings, and mobilize the community for Test and Treat, and I encourage them, so that they can get treatment if they have HIV. I tell them that MSF has brought this close to the community, and it is to their benefit, so they should come for testing. If you ask the community, they will say they know MSF, since the emergency response, so now they come for Test and Treat. They come because we go to them, Yambio city is far for them to go for testing, it helps them because MSF is close to them for testing, they are happy about it.