CategoriesAfNHI WACI Health News

Investing in women, children, and nutrition is not optional. The world’s future depends on it

The global health financing landscape has drastically changed since the end of 2019. The emergence of Covid-19 dramatically increased the need and urgency for investment in global health and additional funds have been needed to respond to the pandemic and its direct and indirect consequences.

Overall, countries around the world are not on track to meet the World Health Organization’s Sustainable Development Goal of reducing maternal mortality. While the global maternal mortality rate fell 38% from 2000 to 2017 — a significant achievement — this is still less than half the annual rate needed to achieve the goal of less than 70 deaths per 100,000 live births by 2030.

In many countries, the lack of access to universal basic health care has hampered the pandemic response, while the pressure of Covid-19 has overwhelmed vulnerable systems, undermining the provision of maternal and child health and the administration of routine vaccination programs. These setbacks are likely to affect child and population health for years to come and reverse hard-won gains.

Source: STAT

CategoriesAfNHI WACI Health News

HIV Vaccine Awareness Day Celebration

AfNHi this year culminated the HVAD celebrations by having a VUKA Show that was targeting young people’s voices on the progress of the HIV vaccine. In public health history, it’s important to note the greatest impact in eradicating or controlling infectious diseases has successfully been achieved through vaccination. However, most of the current HIV prevention methods need regular adherence or daily use. To help end the epidemic, an HIV vaccine which provides long-lasting protection is necessary. Our panel of speakers were hosted by our very own AfNHi Youth cohort member, Ituleleng Mothlabane, and featured a Kenyan clinical researcher Dr Charlene Biwott, and a medical doctor from Nigeria, Dr Progress Agbola. Key highlights of the panel conversation included discussions around the progress the HIV Vaccine development has made to date, amidst the urgent need that would be met by having a vaccine available in the near future.

CategoriesAfNHI

The world still needs a safe, effective, affordable and accessible HIV Vaccine despite disruptions by COVID 19,

HIV Vaccine Awareness Day (HVAD) is observed today, the 18th of May to recognize the many volunteers, community members, health professionals, and scientists working to develop a safe, accessible, affordable and effective preventive HIV vaccine key to ending the HIV and AIDS epidemic. HVAD is also an opportunity to educate communities about the importance of preventive HIV vaccine research. HIV research also includes efforts to develop a vaccine for HIV treatment called a therapeutic vaccine, a safe and effective therapeutic HIV vaccine could prevent HIV from advancing to AIDS, replace daily use of HIV medicines, and eliminate HIV from the body. In public health history, it’s important to note the greatest impact in eradicating or controlling infectious diseases has successfully been achieved through vaccination. To help end the epidemic, an HIV vaccine which provides long-lasting protection is necessary to save lives.

While significant progress in reducing HIV and AIDS epidemic has been made through treatment and prevention programs, the rate of new HIV infections still remains unacceptably high. SubSaharan Africa accounts for 70% of the global infection (25.6 million people living with HIV). In addition, the continent has the highest incidence of HIV infections, especially among Adolescents, Girls and young women and young people, thus a preventive HIV vaccine is needed now more than ever before.

Over the last two years, the world has seen unparalleled innovation, investments, and collaboration. The rapid development and rollout of new COVID-19 vaccines, treatments, and tests have transformed the global fight. The transformative advances that are being achieved in the response to COVID-19 could be harnessed to establish strategic and strong collaborations for the HIV and COVID-19 scientific communities. These overlapping epidemics represent an opportunity to extend cross-disciplinary research into the integrated service delivery for HIV and COVID-19 and aim to achieve sustained benefits of prevention and treatment

Lessons learnt from the COVID 19 Vaccines: in the context of introduction and rollout of
an HIV Vaccine

The COVID-19 pandemic has led to accelerated research efforts globally and highlighted the importance of community engagement and leadership in the COVID-19 response, partnerships between science, government, and affected communities are crucial for success. Strong community engagement and empowerment facilitate a two-way communication through which concerns can be addressed. Few countries have sufficient access to these life-saving tools. Manufacturing and regulatory delays curtailed the ability of the lower and lower and middleincome countries to adequately plan and scale up vaccination campaigns as efficiently as highincome countries.

In addition, the health sector has had to deal with many concerns about how vaccines are developed, their potential side effects and how to assess effectiveness. While it is challenging to introduce any new vaccine, ensuring uptake of COVID-19 vaccination presented additional complexities. To be fully effective, vaccination must reach and be accepted by the intended target groups in each country while ensuring strengthening community engagement.

Our African prosperity lies in our human capital therefore critical to invest and save the lives of African people by implementing of learnings of the COVID 19 vaccines while undertaking research to give the world an effective, affordable, accessible and a safe preventive and therapeutic HIV vaccine; the governments, funders and world leaders should consider too;

HIV VACCINES:

Build strong and resilient political will to invest in the delivery of an effective, safe, affordable and accessible HIV Vaccine to end the HIV epidemic
· Efficient and effective delivery of existing and new HIV prevention tools – to curb new infections, avert more deaths and boost the economy of our nations.
· Investing at least 2% of National health budgets in Health research and development (Health R&D)
· All governments and research institutions must ensure vaccine trials are well-conducted and adhere to ethical and meaningful engagement of communities and all stakeholders
· Improve research infrastructure in Africa to promote homegrown solutions

COVID 19 VACCINES:

Vaccines for Africa must be manufactured and procured in Africa for African people to save lives
· Waive the IP protections — including patents, industrial designs, copyrights, and undisclosed information — guarded by the WTO’s agreement on Trade-Related Aspects of Intellectual Property Rights, or TRIPS, as proposed by South Africa and India.
· Sustain the level of political and financial commitment needed to control COVID-19 and end the pandemic

Correspondences Contact: AfNHi Coordinator, Ms Joyce Nganga at joyce@wacihealth.org

CategoriesAfNHI Article

COVID 19 AND LACK OF FUNDING NEGATING GAINS HIV PROGRESS

Stakeholders have warned that COVID 19 disruptions are likely to set back efforts made in curbing HIV infections back to ten years or more. According to UNAIDS’ new report released in July 2020, while securing antiretroviral therapy has been steadily improving, the progress is inequitable. In its report, Seizing the moment, the World Bank warns that if we don’t act, even the gains made will be lost. To reach the Millions still left behind, nations must double down and work with more urgency.

Unequal progress

Prevention of new HIV infections in Africa is far behind the rest of the world. Nearly two million people were newly infected with the virus, more than three times the global target. Seizing the moment report shows unequal progress, leaving behind vulnerable people and populations. For example, infected key populations such as gay men and their partners, men who have sex with men, sex workers, drug users and people in prison, accounted for 62 per cent of these new HIV infections. Women and girls from marginalised communities face barriers to accessing reproductive health services, especially contraception and HIV services. Those living with HIV/AIDS face stigma. A total of 59 per cent of all new HIV infections in Sub-Saharan Africa in 2019 were among women and girls, with 4500 girls and young women between 15 and 24 years old becoming infected every week. Thus, a growing number of young women are getting HIV infection, despite only making up 10 per cent of the population in sub-Saharan Africa.

Exclusion, stigma and discrimination

Social inequity and exclusion, stigma and discrimination have proven to be significant obstacles in curbing the new HIV infections. At least 82 countries criminalise HIV transmission, exposure, or non-disclosure, 103 criminalise sex work, and 108 criminalise the use, possession, or consumption of HIV related drugs.

Progress in targets

There is, however, a significant reduction in HIV transmission levels where comprehensive HIV services are provided. In addition, combining proactive medical practices with social and economic support for young women in Eswatini, Lesotho, and South Africa has narrowed inequality gaps and driven down the incidence of new HIV infections. Fourteen countries have achieved the 90–90–90 HIV treatment targets (90% of people living with HIV know their HIV status, of whom 90% are on antiretroviral treatment and of whom 90% are virally suppressed), including Eswatini, which has one of the highest HIV prevalence rates in the world, at 27% in 2019, and which has now surpassed the targets to achieve 95–95–95. The expansion of antiretroviral therapy has saved countless lives.

However, in 2019, 690 000 people died of AIDS-related illnesses in 2019, and 12.6 million of the 38 million people living with HIV did not receive life-saving treatment. Although progress has been made, it is masking the lack of progress and challenges that continue to persist, threatening the progress made during the past decade, with tragic consequences for people’s lives, economies, and health security. Again, Sub-Saharan Africa is most affected.

A case for biomedical research

Reducing new HIV infections need to be a deliberate act in Africa. It is imperative that the locally tailored, evidence- based, and community-owned programs be tailored to sustainably reduce new HIV infections.

In the just-concluded 5th  Biomedical HIV Prevention Forum (BHPF) hosted virtually in South Africa which focused on Financing of HIV Prevention Research in Africa, findings revealed that most countries did not have funding for biomedical research, and where research happened, it was mostly donor-driven.

To achieve Africa free of New HIV infections (AfNHi)’s vision of ending new HIV infections in Africa, the BHPF aims at mobilising scientific knowledge and building bridges between science and policy. In addition to mapping potential for collaborative national and regional activities within the AfNHi network, the forum looks to strengthen connections between policy and research through information exchange with HIV prevention advocates.

Reporting on the state of funding biomedical research in Africa, Dr Caleb Mulongo, in his research findings based on four countries; Kenya, Rwanda, Eswatini and Malawi noted that none of the four countries met the recommended allocation of two per cent of a country’s domestic budget to biomedical research.

While the Abuja Declaration targets that 15 per cent of the national budget be allocated to the health docket, none of the four studied countries (Kenya, Rwanda Eswatini and Malawi) met the target. The highest was Malawi with 11.5 per cent, with Kenya reporting the lowest allocation at less than seven per cent. Rwanda allocated about eight per cent while Eswatini allocated about nine per cent of their national budget to health.

When it comes to research allocation, Malawi set aside 1.06 per cent, which was the highest allocation from the studied countries. Eswatini had the least allocation, at 0.3 per cent.  Kenya allocated 0.79 per cent while Rwanda 0.27 per cent. It is evident low allocation in the health sector which is not adequate to support quality and universal coverage of health means there is very little if any funding to allocate to biomedical research.

More than underfunding

The mini-BHPF conferences held in Rwanda, Zimbabwe and Cote d’Ivoire, presented during the main BHPF forum had similar findings, that their respective countries had not prioritized biomedical research for preventing new HIV infections. More challenges beyond funding were nevertheless noted. There was a lack of expertise in writing proposals, those in charge do not know how to bind for funds to support their activities and where research was conducted, it was noted that because it was donor-driven, it did not particularly prioritise local issues, but rather ran with the donors’ agenda.

Own the process

A challenge has been thrown to African governments to invest more in biomedical research for HIV prevention funding, as well as invest in making sure systems are in place for translating findings into actions. A case of Malawi was noted, whose National Research Council of Malawi (NRCM) is domiciled in the Office of the President. This positioning is thought to be responsible for the higher allocations in the Health docket, hence elevating research as a national priority.

Other stakeholders including advocates for change, Civil Society and communities, Researchers and Front-line providers were called upon to keep the momentum for biomedical research HIV prevention funding, by pushing for better allocations of funds, elevating the discussion to the national level where policymakers sit and as well as information sharing across the countries.

 

 

 

 

CategoriesAfNHI

Biomedical HIV Prevention Forum (BHPF)

We are far behind the rest of the world when it comes to preventing new HIV infections. More than 1.7 million new cases of the virus were reported, more than three times the global target. From 2010 to today, new HIV infections have decreased by 38% in Eastern and Southern Africa. As revealed by the Seizing the Moment report, inequalities in progress have left vulnerable people behind. Sixty-two percent of new HIV infections occurred in key populations and their sexual partners, including gay men, men who have sex with men, sex workers, drug users, and prisoners.

The Biomedical HIV Prevention Forum aims to build links between science and policy, mobilise scientific knowledge and end new HIV infections in Africa according to Africa free of New HIV Infections (AfNHi). The forum will enhance the linkage between policy and research by training researchers on research ethics, facilitating collaboration between national and regional activities within the AfNHi network.

As a pre-conference to ICASA (International Conference on AIDS and STIs in Africa), this forum is held twice each year. As a follow-up to the events in 2013, 2015, and 2017, the BHPF in 2021 will be the fifth one to take place.

Getting scientific (research) and evidence-based decision-making policy together is the purpose of the meeting.

Specific objectives are:

  • HIV and COVID-19 Vaccine Impact in Africa
  • Biomedical HIV prevention landscape: where are we and what is in the pipeline
  • Investments for HIV prevention research (Domestic Resources Mobilization)

The expected outcomes

  • Integrating HIV prevention research with policy-making: Engage local and regional authorities in promoting evidence-based decision-making.
  • Stronger AfNHi network: A strategy for exchanging experiences and establishing solid working relationships in the future.
  • The capacity of BHPV tools to be advocated, applied, contextualised, and improved will be increased.
  • A set of recommendations for consideration is packaged into briefs and action statements addressing various stakeholder groups so that the BHPV and research are promoted in a conducive environment.

You can register on the AfNHi website.

CategoriesAfNHI Article GFAN Africa

Domestic Resource Mobilization as a Pathway to Achieving Sustainable Health and HIV Financing in Africa

On 4 December 2019, on the sidelines of ICASA, WACI Health in partnership with GFAN Africa and civil society partners organized a meeting at the Marriott Hotel, in Kigali, Rwanda to discuss sustainable health financing in Africa. The meeting was opened by Honorable Dr Nyemazi Jean Pierre the Permanent Secretary, Ministry of Health in Rwanda who welcomed participants to the meeting on behalf of Dr Diane Gashumba, the Minister for Health. Dr Nyemazi emphasized Rwanda’s commitment to health, noting that Rwanda’s UHC coverage is at 95% as he urged other countries in Africa to invest more domestic resources so that the continent achieves the desired health outcomes.

blog

In his remarks, Hon Yoweri Ssebekali, a Member of Parliament in Uganda & Member of Uganda TB Caucus emphasized the need for Governments to take ownership of the health of their citizens. By investing more domestic resources, and allocating these resources where there will be the biggest impact. He stressed the need for a strong focus in primary healthcare.

Shu-Shu Tekle Haimanot of the Global Fund Secretariat, Maurine Murenga of the Lean on Me Foundation and Dr. Marrie Goretti in their remarks underscored that domestic resources for health are key to ensuring everyone has access to effective, efficient and affordable healthcare whenever they need it.

Civil society then presented a statement to Dr Nyemazi, articulating the need to make further progress to defeat HIV and to sustain the gains made to date. “African Governments particularly, must urgently address HIV within the context of health and even more broadly in the framework of the Sustainable Development Goals (SDGs), to ensure the health and wellbeing for all. Broadly in the sense that Governments must address health in the context of non – health dynamics which affect health such as education and climate change. For example, globally, almost 60% of new HIV infections among 15-24 year olds were contracted by adolescent girls and young women. Investing in the education of girls, and keeping them in school will significantly keep them healthy”. Read the statement.

Further, civil society noted that “we are at a point in time when donor funding for health in Africa is shrinking. In the absence of adequate funding for health, citizens in African countries have to pay for healthcare services from their pockets. In some countries, citizens are spending up to 40% of their household budgets to pay for healthcare.” The statement emphasized the need for Governments to put every possible effort in allocating adequate domestic resources for health, which will contribute to achieving UHC.

CategoriesAfNHI Article WACI Health News

Effects Of Covid-19 On Sexual Effects Of Covid-19 On Sexual Reproductive Health And Rights (Srhr) Among Young People In Africa Health And Rights (Srhr) Among Young People In Africa

Mid-April, I was privileged to join the Live webcast on discussions around the Effects of COVID-19 on Sexual Reproductive Health and Rights (SRHR) among young people in Africa. The panelists included experts in the medical, advocacy, and policy fields: Dr. Charlene Biwott (KEMRI, Kenya), Millicent Sethaile (Her Voice Ambassador, Botswana), and Levi Singh (Youth SRHR Strategy Officer, South Africa). The moderator was Evelyne Odhiambo (AfNHi Youth Cohort, Kenya). Important to note were conversations around the vulnerability of young people during this pandemic where the younger populations have so far been the least vulnerable to complications and death from COVID-19 and yet play a very key role in flattening the COVID-19 curve by minimizing transmissions to the vulnerable populations in our society that include the immune-compromised and the elderly.

Currently, there has been a great shift of focus in Africa to cater to the COVID-19 pandemic thereby impacting negatively in other areas including SRHR. Some of the effects on SRHR include:

  • Reduced access to family planning services which in turn impairs the women’s ability to exercise choice and control over their fertility. This may lead to unplanned pregnancies, abortions, gender inequalities by reducing women’s opportunities in education, employment, and full participation in society.
  • Increase in Gender-based Violence (GBV) where this pandemic puts the young people at risk especially girls and young women by cutting them off from the essential protection services and social networks. This could be in the form of rape, intimate partner violence (IPV), defilement, early and forced marriages.
  • Economic stress leading to transactional sex and exploitation, social vulnerability may lead to increased incidences of HIV infections, STIs, and social stigma.
  • Increased risks of mental health issues including and not limited to depression, suicidal rates, and psychosocial trauma.
  • Global lock-downs and movement restrictions create barriers for young to access health services like youth-friendly clinics, comprehensive care clinics (CCC), and access to pre-exposure prophylaxis (PrEP).
  • Social stigma may lead to difficulties in obtaining documentation for instance P3 forms to prove any incidences of social violations. The process of seeking justice has slowed down as well during this period.
  • Higher rates of maternal and perinatal mortality due to the reduced access to friendly SRH services like safe abortion services, antenatal care, and skilled attendance during delivery.

There have been negative experiences by young people seeking SRHR in Botswana with their current lockdown as described by Ms. Sethaile where young people who had long term contraceptive methods are finding it difficult to access health care for the management of the side effects since movement is restricted and monitored, there is lack of access to essential medications like ARVs, 7 days into the lockdown there were over 28 reported rape cases and nowhere to report. Lastly, their law enforcement currently not taking up GBV cases as more efforts goes to COVID-19.

Interesting conversations also arose around the intersectionality of COVID-19 and SRHR and these included: First, countries to ensure access to SRHR services. Secondly, the need for political support in availability, accessibility, and security of SRHR commodities. Thirdly, we have existing policies and commitments like the MAPUTO plan of action which guides the African Union States on SRHR policy framework that ensures universal access to comprehensive sexual reproductive health services, Also, there is the recent United Nations summit on International Conference on Population and Development (ICPD 25). These policies and commitments foster the need to hold the member states accountable on matters SRHR. Lastly, it is important to engage the youth so as to understand and have their voices presented so as to effectively meet their needs.

From the above conversations, the COVID-19 pandemic has laid bare the readiness and preparedness of a global epidemic, different systemic and structural gaps exist which include but not limited to lack of or inadequate shelters that can accommodate women who are abused, inadequate human and capital resources on SRHR and mental health all of which will have a massive impact on the rights and access to health care. Countries need to ensure that there is proper balancing of resources and priorities so that not all human and capital resources are geared towards COVID-19 effort at the expense of other health service provisions.