PANCAP supports National AIDS Programmes with digital communication for continuity of HIV services during COVID-19

To support the continuity of HIV prevention, treatment, care and support services during COVID-19, PANCAP provided five (5) National AIDS Programmes with Samsung Galaxy Internet-enabled tablets.  The National Programmes will utilize the devices for monitoring and evaluation, appointment bookings, virtual communication with clients and other activities critical to ensuring that programme implementation continues and the gains made in the HIV response are protected and maintained.

Support for the initiative was provided via the Global Fund Project – Sustainability of Services for Key Populations in the Caribbean and the Global Fund’s COVID-19 Response Mechanism (C19RM), which focuses on mitigating the effects of the pandemic on HIV programme implementation.

The beneficiary countries included Antigua and Barbuda, Belize, Guyana, Suriname and the Republic of Trinidad and Tobago. Each National Programme received two (2) tablets.

Dr Rosmond Adams, Director, PANCAP, underscored the importance of supporting National Programmes during COVID-19.  “Digital communication and virtual platforms are essential in facilitating continuity of programme implementation, especially in this time of physical distancing, minimizing in-person meetings and working from home,” stated the Director. He further pledged continued support to all National Programmes as the Region continues to navigate COVID-19.

COVID-19 Vaccines and People Living with HIV

As countries in the Region commenced the roll-out of COVID-19 vaccines, the community of People Living with HIV (PLHIV) had concerns around the safety of the vaccines. Multiple concerns were related to their HIV status and possible interactions with Antiretroviral Therapy (ART) regimens which may lead to vaccine hesitancy in this population. The concerns were related to how the COVID-19 vaccine will impact their immune status, disease progression, and whether they were at higher risk for some of the adverse events reported in the media. To address these concerns, the Pan American Health Organization (PAHO) collaborated with PANCAP to host a webinar on COVID-19 vaccines for PLHIV on 8 June 2021.

PAHO experts Dr Karen Broome and Dr Margherita Ghiselli presented to over 100 HIV clinicians, healthcare workers and PLHIV from across the Caribbean Region.

Dr Broome highlighted the significant impact of the pandemic on individuals, families, communities and nations. She underscored how the COVAX facility is supporting the availability of vaccines in the Region.

Dr Margherita Ghiselli placed the spotlight on COVID-19 vaccines for PLHIV. She emphasised that vaccines are critical for people with chronic conditions such as HIV. She also explained that the clinical trials included PLHIV, but safety data specific to this group is still limited. Her presentation also highlighted that there are no known interactions with ART medications and no adverse events associated with HIV status.

While there is no consensus on which CD4 count value should be used as a threshold (if any), people with weakened immune systems should be aware of the potential for reduced immune responses to the vaccine.

According to the WHO Strategic Advisory Groups of Experts (SAGE) for Immunisation, the groups prioritised for the COVID-19 vaccine do not include PLHIV with no aggravating risk factor that puts them at higher risk of COVID-19 infection and death. However, PLHIV with co-morbidities should be prioritised for early vaccination since their co-morbidities put them at higher risk of severe COVID-19 symptoms. These co-morbidities include COPD, asthma, diabetes, heart disease, kidney disease, liver disease, Parkinson’s disease, multiple sclerosis, motor neuron disease, severe obesity, among others.

PAHO and PANCAP will continue to highlight the efficacy and safety of COVID-19 vaccines for PLHIV through the joint webinar series.

PANCAP hosts dialogue on COVID-19 vaccines with PLHIV in Guyana and Trinidad and Tobago

Image: From left: Dr Rosmond Adams, Director, PANCAP, Dr Shanti Singh-Anthony, Coordinator, Knowledge Management, PANCAP Coordinating Unit, Dr Tariq Jagnarine, National AIDS Programme Manager, Guyana and Dr Ayanna Sebro, Technical Director, National AIDS Coordinating Committee Secretariat (NACC), Republic of Trinidad and Tobago

PANCAP facilitated a virtual discussion with People Living with HIV (PLHIV) in Guyana and the Republic of Trinidad and Tobago to foster an improved understanding of the safety and efficacy of the COVID-19 vaccines.

The discussion was chaired by Dr Shanti Singh-Anthony, Coordinator, Knowledge Management, PANCAP Coordinating Unit, with support from Dr Tariq Jagnarine, National AIDS Programme Manager, Guyana and Dr Ayanna Sebro, Technical Director, National AIDS Coordinating Committee Secretariat (NACC), Trinidad and Tobago.

In opening remarks, Dr Singh-Anthony highlighted that despite the large volume of information available on COVID-19, it was important for PLHIV to hear experiences from their peers who received the vaccine.  She emphasized the importance of sharing first-hand experiences to increase the acceptance of the vaccine among PLHIV.

The Knowledge Coordinator referred to data provided by the World Health Organisation (WHO) that indicated that the COVID-19 vaccines approved by regulators are safe for everyone, including PLHIV and that there is no reason why PLHIV should not take the vaccines when offered.

Dr Singh-Anthony further explained that before vaccines are licensed for scale-up, national regulators review the data and ensure they are safe. No data have emerged to cause worry that PLHIV are at any greater risk from the COVID-19 vaccines than anyone else.  She further highlighted that the Region has surveillance systems in place to ensure that rare but serious adverse events are reported to the public health authorities and the manufacturers of the vaccines.

In remarks, Dr Rosmond Adams, Director, PANCAP, emphasized the importance of dialogue on the COVID-19 vaccine within the community of People Living with and affected by HIV, especially with regard to the harmful repercussions of “fake news” and misinformation about the vaccines. He referred to the current data from WHO, which underlined the safety and efficacy of the COVID-19 vaccines and urged PLHIV to continue to promote vaccination and other COVID-19 public health precautions.

The Guyana team shared their experiences with accessing the COVID-19 vaccines; participants shared their fears and how these were overcome by seeking advice from healthcare professionals.  They also highlighted the importance of following the science and WHO guidance on the safety of the COVID-19 vaccines.

The Guyana team also highlighted that there were no severe adverse effects from the vaccine among the group of PLHIV that shared their experiences.  Mild reactions reported included minor pain around the injection site and mild fever, which the WHO has listed as expected side-effects from the COVID-19 vaccine.

Members of the Trinidad Team shared their experiences, including a detailed description of the process involved in receiving the vaccines at health centres.  Participants from Trinidad also echoed the sentiments of Dr Adams, providing first-hand accounts of being exposed to large volumes of misinformation shared on social media and instant messaging platforms.  The team reiterated the importance of seeking information on the vaccines from trusted sources, including the Ministry of Health and PAHO/WHO.

Dr Sebro concluded the discussion by underscoring the importance of continued dialogue among PLHIV on the COVID-19 vaccines. She explained that the virtual dialogue is the first of many initiatives planned by NACC to increase the uptake of the COVID-19 vaccines among PLHIV in Trinidad and Tobago.

In addition, PANCAP will host a webinar, “COVID-19 Vaccines and PLHIV”, on Friday 18 June. A video series highlighting the safety and efficacy of the vaccines among PLHIV will also premiere on all PANCAP digital platforms.

COVID-19 and the impact on Vulnerable Populations

The coronavirus disease (COVID-19) pandemic is a global health emergency. With the indiscriminate spread of COVID-19 globally, many vulnerable populations are experiencing negative consequences such as job loss, food insecurity, and the inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative gear. Some of the most disadvantaged in the COVID-19 era are People Living with HIV (PLHIV) and other high-risk groups.

There is great concern about the impact of COVID-19 among the nearly 40 million PLHIV worldwide. HIV treatment centers and care delivery systems have been adversely impacted in several countries during the pandemic. But this has created an opportunity to apply alternative strategies like multi-month prescription, decentralizing HIV care in low-resource settings and introducing telemedicine in high-resource settings.  Other alternative methods include retention in care programmes and direct observation of treatment critical in mitigating shocks to healthcare systems in the future.

Like HIV and AIDS, COVID-19 has a more significant impact on people who are already marginalized. As a result, there is concern over the continued spread of COVID-19 in poorer countries and those with higher HIV rates. According to the Centres for Disease Control and Prevention (CDC), 16.7% of COVID-19 patients in intensive care are immunocompromised with underlying health conditions and their chances of recovery are much lower.

GROUPS MOST AT RISK

For COVID-19, failure to adhere to physical distancing or handwashing recommendations constitute behaviours that increase the risk for contracting COVID-19. People who are older or have pre-existing conditions such as chronic respiratory disease, cardiovascular disease, hypertension, cancer and diabetes are at greater risk of being infected with COVID-19. It is well established that HIV disproportionately affects groups already marginalized, including racial/ethnic and sexual or gender minorities and those living in poverty. It is quickly being recognized that COVID-19 also disproportionately affects minority groups, which is not surprising given existing health disparities and economic instability.

HEALTH DISPARITIES

As with HIV, the COVID-19 pandemic reveals the systemic inadequacies that produce health disparities. There is a disproportionate burden on already vulnerable populations experiencing poverty and other systemic stressors. The United Nations 2020’ report has indicated that increases in food costs and market stockpiling have had the most harmful impact on vulnerable communities, particularly those in low-income nations. Although vulnerable populations vary across countries, those with stigmatized or marginalized intersecting identities often experience the highest burden, including Men who have sex with Men (MSM), transgender women, people who inject drugs, commercial sex workers, young women, and youth (15–24), who account for a third of all new HIV infections. Furthermore, immigrants are at increased risk of infectious diseases, including both HIV and COVID-19, as are other people who are displaced.

Additionally, PLHIV in rural areas may experience additional barriers that inhibit access to care, such as the lack of adequate technology to support telemedicine, lack of finances for transportation to attend clinics, and other barriers to accessing care during the current pandemic.

BIOLOGICAL IMPACT OF COVID-19 ON HIV TREATMENT

PLHIV, whose disease is not well managed and whose condition is not virally suppressed, are placed at an increased risk for contracting and experiencing complications related to COVID-19, in addition to complications associated with HIV disease progression. Given the lifelong prognosis of HIV, it is imperative for PLHIV to visit their healthcare providers regularly and adhere to treatment.  PLHIV are also more likely to contract opportunistic infections such as pneumonia, Tuberculosis, Toxoplasmosis, etc., than those without compromised immune systems. They may experience delayed treatment due to COVID-19. This can occur due to overcrowding in an already taxed healthcare system. PLHIV who seek out urgent care may face an increased risk of contracting COVID-19 among other illnesses while in healthcare settings.

COVID-19 has taken a dramatic toll on HIV health care services. Lockdowns and associated changes have hampered the ability to deliver standard health care services, including testing, treatment, care, and dispensing of antiretroviral drugs (ARVs). Those associated changes include closing clinics, community health workers’ inability to visit PLHIV, the inability of support groups to meet, and the shortage of personal protective equipment (PPE) for health providers. Evidence already shows an overall decline in persons coming to facilities for HIV testing and clinical care and treatment.

PSYCHOLOGICAL IMPACT OF COVID-19 ON HIV TREATMENT

Given the unprecedented nature of COVID-19, an increase in anxiety has been prevalent worldwide. Furthermore, the CDC has noted that individuals with chronic health conditions, such as HIV, may develop a stronger stress response than the rest of the population. This strong stress response is due to an increased risk of contracting COVID-19 due to a compromised immune system. The compounded stigma associated with an HIV-positive status and COVID-19 may lead to an array of mental health issues and psychological disorders such as depression, sleep disorder, substance abuse, anxiety, schizophrenia, and personality disorders, which may trigger somatoform disorders which may lead to failure to seek care.

RECOMMENDATIONS

HIV services must continue to be made available for people living with and at risk of HIV. This includes ensuring the availability of condoms, lubricants, ARVs, sterile needles and syringes, harm reduction, pre-exposure prophylaxis (PrEP) and HIV testing.

To prevent persons not having an adequate supply of medicine and to reduce the need to access the health system, countries should move to the full implementation of multi-month dispensing of three months or more of HIV treatment.  This can be further enhanced with telemedicine, virtual support groups, food hamper delivery and increased mobile testing. There must be access to COVID-19 services for vulnerable people, including a targeted approach to reach those most left behind and removing financial barriers.

ADVICE FOR PEOPLE LIVING WITH HIV

  • People with a CD4 count of over 200 who are taking HIV treatment and have an undetectable viral load are considered at no greater risk than the general population. They should follow general advice to observe the curfew hours and maintain social distancing.
  • People with a CD4 count below 200, or who are not taking HIV treatment, or who have a detectable viral load may be at higher risk of severe illness. Nonetheless, they should still follow the same general advice.
  • People with a very low CD4 count below 50 or who have had an opportunistic illness in the last six months should follow the Ministry of Health guidelines – wear a mask, wash hands regularly and avoid crowded spaces with social distancing practices.

COVID-19 is serious, and PLHIV should take all recommended preventive measures to minimize exposure and prevent infection. As in the general population, older people living with HIV or PLHIV with heart or lung problems may be at a higher risk of becoming infected with the virus and suffering more severe symptoms.

All PLHIV should reach out to their healthcare providers to ensure that they have adequate supplies of essential medicine. Until more is known, PLHIV —especially those with advanced or poorly controlled HIV disease — should be cautious and pay attention to the prevention measures and recommendations by the Ministry of health.

National AIDS Programme (Guyana) and CRN+ discuss Alternative Models of Interventions for PLHIV

To address HIV service provision gaps and barriers to prevention, care and treatment due to COVID-19, the National AIDS Programme Secretariat (NAPS) Guyana, with support from the Caribbean Regional Network of People Living with HIV (CRN+), facilitated a government and civil society stakeholder forum on 30 March 2021.

The Forum focused on innovative ways through which civil society organisations (CSOs) in Guyana can meet these urgent needs. With thirteen (13) representatives from government and civil society, the session provided an opportunity for the NAPS to explore alternative models of interventions for supporting People Living with HIV (PLHIV) during COVID-19. Participants described specific information on structuring monthly support groups in smaller numbers, piloting a reservation platform for PLHIV to make appointments and seeking ways to connect PLHIV with social protection schemes.

The facilitator, Dr Minerva Pinelo of Right Insights, shared examples of alternative models of interventions rolled out in Belize and drew from case studies from Zambia and New Guinea. The session’s format was instructional, allowing participants to learn more about alternative models such as adherence clubs, community antiretroviral therapy distribution points, community antiretroviral therapy groups, appointment spacing and fast-tracking for antiretroviral therapy refills.

The session allowed for discussion on various specific examples of interventions that have supported PLHIV’s adherence and quality of life. Questions, queries, and comments shared indicated a mutual interest in addressing the prevalence of HIV in Guyana and the commitment to scaling up alternative models of interventions for PLHIV to address service provision gaps exacerbated by the pandemic.

CSOs reported innovative ways to garner support for PLHIV and overcome present challenges. For example, Ms Desiree Edghill, Executive Director of Artiste In Direct Support (AIDS), reported that their peer support group was reduced to two persons to comply with COVID-19 safety recommendations for avoiding large groups. In addition, the CSO, along with another organisation, piloted the use of “Quick Res” for booking appointments for consultations or accessing sexual health services. By booking appointments, PLHIV are less exposed to waiting in crowded lobbies for HIV testing services, STI testing services, medication refills or other sexual reproductive health services.

There was significant enthusiasm from Dr Tariq Jagnarine, National AIDS Programme Manager – Guyana and at least two CSOs that reported opportunities for scaling up existing alternative models of interventions as a country. It was clear that while challenges such as stigma and discrimination and socio-economic hardships have deterred PLHIV from remaining adherent during the pandemic, CSOs must continue to address service provision gaps.

Participants were receptive to drawing from best practices and emerging trends presented during the Forum, including integrating technology, where possible to achieve a wider reach of PLHIV throughout all regions in Guyana.

New Jamaican web drama series to tackle youth sexual and reproductive health

The Ashe Company, a civil society partner of Jamaica AIDS Support for Life (JASL), launched a web drama series, “CHILL”, which aims to foster increased awareness of sexual and reproductive health among the Region’s youth.

“CHILL” focuses on a group of Jamaican millennials as they navigate sex, love and relationships. The realities of the HIV epidemic intrude on their lives and force the characters to face fears and uncomfortable truths in this fast-paced drama. In “CHILL”, reproductive and sexual health messages are interwoven into the storylines as the characters follow their passions and ambitions.

The 13-episode production was developed by The Ashe Company, which has a strong history of edutainment interventions. Ashe uses innovative and creative techniques to impart behaviour change strategies around social issues. These proven techniques are used to reach specific cohorts and populations of people with targeted messaging. The production aims to provide empowering and inspiring stories of courage from everyday people in communities affected by HIV.

The series premiered on The Ashe Company’s YouTube page (@theashecompany) in March, with new episodes uploaded each week at 6:00 PM Jamaica Time.

Watch the trailer for “CHILL” here.

Anira Foundation adapts operations to ensure continuity of sexual and reproductive health education for young people during COVID-19

Image – Mrs Sandra Granger, Founder and Chair, Anira Foundation presenting a certificate to a participant of the peer educators training at the Foundation’s office

The Anira Foundation, launched in 2017 by Former First Lady of the Cooperative Republic of Guyana and PANCAP Champion for Change, Mrs Sandra Granger, adjusted its focus and modus operandi due to the COVID-19 pandemic in early 2020.

The Foundation had planned three Robotics Camps for children during the year in collaboration with STEMGuyana.  It conducted one camp at the Lusignan/Good Hope Learning Centre in January. The declaration of the pandemic and the institution of COVID-19 Guidelines commencing in March caused the scheduling of the other camps to be put on hold until the restrictions are lifted.

Implementation of the Anira Foundation-SCLAN-Gilead Science Project to improve the sexual and reproductive health of young people, including avoidance of HIV and sexually transmitted infections, was also slowed by the pandemic. The Project Coordinator and Staff then focused attention on what they could achieve.

They met virtually, liaised with relevant partners and engaged in several intervention activities, including the recruitment of consultants and staff; developing an updated data collection plan; initiating contact with community leaders; identifying peer educators and trainers to be trained; and developing indicators for teen mothers to be assimilated into school or skills training.

While consideration was given to conducting training and interviews virtually, it was discovered that this might not yield optimal results due to problems related to connectivity and cultural biases.  Hence, under strict adherence to the COVID-19 Guidelines, training of peer educators was conducted in November 2020 at the Foundation’s office.  Ten young women were trained for Phase I of the project, which is scheduled to focus on Sophia, a large community on the outskirts of the capital Georgetown (Region 4- Demerara/Mahaica).

The decision was also taken to initiate contact with community leaders in Region 9 – Upper Essequibo/Upper Takutu and Region 1- Barima/Waini so that work could begin on these Phases of the Project.  This would help make up for time lost.

The Foundation recognized the heavy economic burden caused by the pandemic and, through the kindness of donors, provided clothing and toiletries to teen mothers,  distributed COVID-19 relief to teen mothers through “Women Across Differences” and a few single mothers and shut-ins. This was done through the monthly provision of gift certificates redeemable at any Bounty Supermarket.

The Foundation looks forward to the easing of restrictions so that it can continue its work and fulfil its mission of educating and empowering vulnerable citizens of Guyana

My COVID-19 vaccination experience and what lies ahead for us

(Georgetown, Guyana via Kaieteur News)  This past week gave me renewed hope of us getting ahead of this pandemic. I never thought I would be getting vaccinated against COVID-19 so early. It’s been less than a year since the World Health Organization declared this pandemic, and we already have access to vaccines against it in Guyana. I am grateful to the authorities, and I am also optimistic for my fellow Guyanese as the government has declared that there should be sufficient vaccines for all Guyanese in 2021. This has obviously provided us with an opportunity to exit the pandemic, and we need to grasp the opportunity to get vaccinated with both hands. Today, I will share my vaccination experience with you and present facts that will hopefully encourage you to get vaccinated as soon as your turn comes.

How I felt after getting vaccinated?

I was given my first dose of the AstraZeneca vaccine late last week, and it was a surreal experience. As a health worker that routinely deals with COVID-19 patients, it felt like I was being given a dose of freedom as I wouldn’t have to put my life in jeopardy every time I have to see a patient. The nurse who administered my vaccine was as nice as they come, and I didn’t feel much when the vaccine was given to me. I then went back to work as per usual and had a productive workday. As it progressed into the evening, my arm got a bit sore, and I had a mild headache. As the night progressed and early the next day, I had some body aches and felt a little fatigued. I am currently firing on all cylinders and I’m feeling much more optimistic than before I was vaccinated.

Is it bad to get symptoms after being vaccinated?

While many see some post-vaccination symptoms and side effects as bad, I was very happy to have the body aches and fatigue. Knowing what I knew, I realised that my symptoms were a sign that my body was mounting an immune response to the vaccine, and therefore, I am developing immunity against COVID-19. If I didn’t get any symptoms after the vaccine, I would have been worried that I may not have mounted an immune response. While most look at the following symptoms as side effects of the vaccine, I look at them as our immune response to the vaccine:  sore arm, headache, chills, tiredness, feeling sick, fever, dizziness, weakness and aching muscles.

Of course, there may be a few persons with allergic reactions to the vaccine, but that is extremely rare. Most of the time, these persons would have had a history of being allergic to other vaccines. Please note that vaccines are different from injections that are given for pain and routine infections. If you were allergic to a pain or antibiotic injection, it doesn’t mean that you are allergic to vaccines. If you never had allergic reactions to vaccines, then it’s likely that you will not be allergic to the COVID-19 vaccine.

What lies ahead for me?

Now that I would have gotten my first dose, I will have to get a follow-up booster shot in three months. This booster shot basically seals the deal and strengthens my immune response even further, so that my body is more prepared to combat COVID-19. Currently, my immune system is developing antibodies against the SarsCov2 virus (Coronavirus) and it will take about a couple of weeks for sufficient antibodies to form. While there should be a decent amount of antibodies in about a month from now, the booster shot in three months will ramp those antibodies level further up so that I have an extremely strong defence system that is prepared and ready to overwhelm the coronavirus if I get in contact with it.

Can I finally move around without masks?

No, I cannot! As you just read, my body will take time to prepare a proper immune response against the Coronavirus. During this time, I can still get infected and be affected by COVID-19. In addition, there is a small percentage of people who the vaccine does not work as well as it does in most others. While I am optimistic that the vaccine is efficacious in me because of my symptoms after being vaccinated, I will not leave anything to chance. Therefore, I will still practise social distancing, wear my mask, and practice proper hygiene until enough of us are vaccinated and we can exit the pandemic.

What lies ahead for Guyana?

I am optimistic for us as a country especially after the government announced that it should have sufficient vaccines for all Guyanese in 2021. We need to vaccinate around 75-80 percent of our population before we can begin to safely move around freely and without masks. If we take too long to do this and the virus continues to spread, then the virus is likely to mutate even more and the current vaccines may become ineffective. We are racing against the virus and these vaccines are the boosters that we have to win this race before the virus mutates too much and we can never catch up with it.

I urge you to get vaccinated as soon as your turn arrives and encourage everyone you know to do the same. We are in this together and can only get out if we all play our part and get vaccinated. If more than 25 percent of us choose not to get vaccinated, then we are stuck in this pandemic and we will all continue to suffer for years to come.

National AIDS Coordinating Committee collaborated with NGOs for Continuity of HIV Services during COVID-19

In managing the national response to HIV and AIDS in the Republic of Trinidad and Tobago, the National AIDS Coordinating Committee Secretariat (NACC) recognizes that conditions arising from natural disasters and other threatening events have the potential to disrupt service delivery in the continuum of care.

At the onset of COVID-19, the NACC, through its Secretariat, met with agencies to assess how service delivery was being impacted and identify the needs for further support. Information was provided to NGOs to mitigate the impact of restrictions that affected access to care. The most vulnerable, including People Living with HIV (PLHIV) were identified and the NACC worked with NGOs to facilitate the distribution of hundreds of relief food hampers, “baby bags”, hand sanitizers and face masks to those in need.

This relief effort was also augmented by networking with UN Agencies and other NGOs and agencies to provide a sustained flow of social intervention. The national response to HIV and AIDS during COVID-19 could not have happened without networking and collaboration by all stakeholders.

“Communities must take an active role in response to public health threats like HIV and COVID-19” – World AIDS Day 2020 Message – Dr Nikkiah Forbes

World AIDS Day is commemorated on 1 December every year since its initial observance in 1988.  It is an opportunity for global unity to show support for People Living with and affected by HIV, to raise awareness about HIV and AIDS and to remember those who lost their lives to AIDS.

This year introduced us to a new virus called COVID-19 that emerged and caused a pandemic. We saw firsthand how pandemics affect health, lives and our way of life. COVID-19 highlighted the relationship between health, socialization and the economy. We saw how a pandemic could threaten access to healthcare, especially to vulnerable communities and those facing inequalities. We saw how global supply chains bringing medications and lifesaving commodities could be disrupted with shutdowns in global trade and travel. COVID-19 showed us and reminded us that we must be resilient, united and work together to see an effective response.  With this in mind, this year’s World AIDS Day theme is “Global solidarity, shared responsibility”.

Global solidarity, shared responsibility speaks to the importance of all communities actively taking a role in response to public health threats like HIV, AIDS and COVID-19.

We have learned valuable lessons over time in our work in HIV and AIDS. These lessons include working together to offer people-centred services, leaving no one behind and reaching persons where they are.  We have learned that we must fight stigma and discrimination and address health inequalities to achieve the best outcomes and best lives for People Living with HIV (PLHIV).  Those lessons and services centred around such fundamentals allowed resiliency and ongoing HIV care in the face of COVID-19.  These are some of the best practices that are the cornerstone of work in the Bahamas National HIV/AIDS Centre and Programme that have resulted in overall declines in new HIV infections and AIDS-related deaths.

Indeed our work in HIV and AIDS is a lesson in what we can do and accomplish when we all work together. For us to continue to make strides in our response, there needs to be a unified global response. The health response, including HIV and AIDS, must be fully funded and financed. All aspects must be strengthened, including the supply chain of antiretroviral therapy and access to innovative testing modalities. Health care workers providing care must be supported. Health systems require strengthening. Access to medicines and vaccines must be equitable and assured. Human rights for all must be respected. This requires committed and dedicated leadership. Every one of us plays a role as well.  Shared responsibility reminds us of the fact that what we all do matters and that we must make a collective effort along with the efforts of governments, civil society and others for the best response and the best possible outcomes.