Society has made incredible progress in the HIV response. Today, effective and well tolerated treatments make it possible to keep the virus under control for people living with HIV (meaning their viral load is ‘undetectable’) and prevent transmission. Despite this, nearly 40 million people are living with HIV globally today, and there are nearly 2 million new infections each year. Clearly, more needs to be done to meet the goal of ending the AIDS epidemic as a public health threat by 20302.
COVID-19 is jeopardising the progress made in tackling HIV
HIV places enormous burden on the communities that are most affected, a reality that has been compounded further by the global COVID-19 pandemic, which now jeopardises the progress achieved so far towards ending the HIV epidemic. Efforts to manage patients infected with COVID-19, and also to contain its spread, have pushed healthcare systems to breaking point. In the face of resource constraints, it may have felt necessary to deprioritise certain areas of healthcare, so that available resources could be used to respond to the COVID pandemic. This could result in a reduction or even discontinuation of certain healthcare services, including in relation to HIV.
A lot of what we have learnt in the last year with COVID-19 applies equally to HIV. Governments and policymakers must join forces to respond and address the problems and inequities that allow diseases to thrive in other parts of the world. To be effective, the response must be truly global.
Part of the reason HIV has remained a challenge for over 40 years is that the global community has struggled to unite and address some of the root problems that drive continued new infections: poverty, lack of access to healthcare and education, and the marginalisation of the people and communities most at risk of HIV. These issues can be addressed most swiftly and effectively through partnership, and by meaningfully engaging with the communities most affected by HIV, particularly people living with HIV, to shape and deliver that response.
People living with HIV, and the communities they belong to, understand what it takes to deliver a successful response to HIV. The knowledge and strength of their communities, their doubts and sensitivities, and the persisting stigma so many still face. By recognising the crucial role these communities play and putting them at the centre of the global HIV response, governments can accelerate their progress in addressing HIV and bringing this epidemic to an end.
Ending HIV for everyone, everywhere: Gilead’s ongoing commitment through partnerships
For more than 30 years, Gilead Sciences has endorsed and promoted the idea of community-led partnerships to address the HIV epidemic. Gilead has supported strategic programmes that help to address HIV in key communities across the world.
Gilead continues to invest in and expand these valuable partnerships; partnerships that have a tangible impact on the communities they serve; partnership that are built with the HIV community, to address the needs of those most affected by the virus.
Community organisations and government officials meeting with Gilead and the Elton John AIDS Foundation in RADIAN Model City Almaty, Kazakhstan.
RADIAN: addressing HIV related challenges in Eastern Europe and Central Asia
The RADIAN partnership, launched by Gilead and the Elton John AIDS Foundation in 2019, offers support for initiatives in the hard-hit Eastern Europe and Central Asia region (EECA). Unlike other regions, rates of HIV in EECA have increased, with infections up by 72 per cent, and AIDS-related deaths up by 24 per cent since 20103. RADIAN focuses on the groups most affected by HIV in EECA: gay men, transgender people, sex workers, and people who use drugs.
This community partnership model recognises that people living with and affected by HIV are experts in their local epidemic. RADIAN’s Unmet Need Fund provides these communities with the funding and resources they need to tackle HIV, trusting their leadership to ensure resources are allocated where they will be best used.
Through the RADIAN Model Cities programme, these community organisations work in partnership with city and local governments to improve and strengthen access to HIV prevention, testing, and care, and reduce the stigma that otherwise discourages people living with HIV and people at risk from engaging with the healthcare system.
DREAMS: a global public-private partnership to support girls and young women in sub-Saharan Africa
In a region where HIV disproportionately affects adolescent girls and young women, the barriers to effective HIV prevention and care are complex. In sub-Saharan Africa, six in seven new HIV infections among adolescents aged 15–19 years are among girls. Girls and young women aged 15–24 years are twice as likely to be living with HIV than young men. In sub-Saharan Africa, women and girls accounted for 63% of all new HIV infections in 20214. Women and girls are particularly vulnerable to HIV due to structural factors like gender-based violence, exclusion from economic growth opportunities, and a lack of access to secondary education.
To address these challenges, Gilead was one of the founding organizations of the DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) Initiative in 2014, a global public-private partnership dedicated to supporting girls and young women in sub-Saharan Africa.
Led by PEPFAR, DREAMS has had considerable impact as the program has helped reduce number of new HIV diagnosis across multiple countries, 96 percent of which have had a decline of greater than 25 percent, and nearly two-thirds (62 percent) of which have declined by greater than 40 percent5.
DREAMS has supported communities to deliver frontline services like HIV education, self-testing, PrEP and treatment, and – crucially – to address the gendered barriers to autonomy for women and girls. Effecting this change would not be possible without the action and leadership of the affected communities.
Acting together, to create possible
To achieve the common goal of ending the HIV epidemic, it is crucial that policymakers, HIV communities and private-sector entities understand how to play together in this feat. Access to global networks of public health experts, government funding, and innovative solutions in HIV must be built and implemented in partnership with communities most affected by HIV.
Having the community and community partnerships at the core of the HIV response is crucial, regardless of country or region. With the support of government and policymakers, community-led partnerships can help the goal of ending the HIV epidemic become a reality.