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Washington, D.C., June 9, 2020 (PAHO)—The Director of the Pan American Health Organization (PAHO), Dr Carissa F. Etienne, said preparing for winter and hurricanes is critical to mitigate the spread of COVID-19 in the Americas.

With more than 3.3 million cases of COVID-19 in the region and many areas reporting exponential rises in cases and deaths, “We are concerned by data showing the virus surging in new places that had previously seen a limited number of cases,” Etienne said in a press briefing today.

The PAHO Director noted, “In South America, our response to the pandemic will be impacted by the arrival of winter, while hurricane season will complicate our efforts in North and Central America, and especially in the Caribbean.” 

Preparing for respiratory infections during winter

Winter, now starting in South America, “fuels respiratory infections—like seasonal influenza and pneumonia—that can rapidly spread in colder climates and as more people gather indoors to stay warm,” she said. 

“This is a problem for patients because respiratory illnesses leave them at greater risk of severe COVID-19 infection. It’s also a challenge for strained health systems that will have to cope with the dual burden of a coronavirus pandemic and a spike in other respiratory illnesses. It does not help that the similar symptoms will make diagnosing COVID-19 even harder,” Dr. Etienne told journalists at the briefing.

Influenza vaccination “to prevent severe cases of flu is more critical than ever—particularly for high-risk groups like health workers, the elderly and people with chronic conditions. These same groups are also at high-risk of coronavirus infection,” she noted.

Seasonal influenza vaccination is ongoing in 14 countries, and more than 90 million people are being targeted. PAHO is helping countries buy vaccines through its Revolving Fund. “The Fund helped secure 24 million flu vaccine doses, despite the added logistical hurdles that we’re all facing in transporting essential supplies during the pandemic,” the PAHO Director explained.

Preparing for hurricane season

With hurricane season starting, PAHO’s director suggested that officials in the Caribbean, Central America, and the East coast of the USA “review national hurricane response plans and conduct simulation exercises to ensure your disaster and COVID-19 responses are aligned. We should also plan for potential disruptions to the care of critically ill patients and refine evacuation plans.”

She said PAHO is working to provide emergency response supplies throughout the region, and “to secure critical facilities like laboratories, and quarantine and isolation centers so diagnosis and treatment for COVID-19 can continue even under difficult circumstances.” 

“We must take action today to safeguard our progress and mitigate the spread of the virus during this time. That means redoubling our efforts to control the spread of COVID-19, so that we reduce the dual burden the approaching winter and hurricane seasons might bring,” Etienne added. 

Strengthening health infrastructure by hiring surge staff and expanding reserves of essential supplies and protective equipment is also important and “will help ensure the work done to prepare for COVID-19 is reinforced to address these seasonal threats, she said. 

The COVID-19 pandemic has pushed our region to the limit. Our communities and health systems are under duress, and our collective efforts are laser-focused on containing the virus, Dr. Etienne said.

“Preparing for winter and hurricane season is a critical part of this fight. We must take action today to safeguard our progress and mitigate the spread of the virus during this time. And that means redoubling our efforts to control the spread of COVID-19 so that we reduce the dual burden the approaching winter and hurricane seasons might bring.” 

LINKS

• Remarks from the Director: https://www.paho.org/en/media/weekly-press-briefing-covid-19-situation-americas
• Recording of the media briefing (original audio): https://youtu.be/apd6Fz9cYI8
• Recording of the media briefing (English): https://youtu.be/80A7B-3Z8M4
• Information about COVID-19 in the Americas: www.paho.org/coronavirus

Written by Oluatoyin Alleyne

“I am kind of scared and everybody like me, you know they scared. This is something new and, you know, we already have a compromised immune system so we all just frighten,” said a mother who has been living with HIV for a number of years.

“I want to talk about it and let people out there understand that this thing is real. People like me with HIV, we have to take extra care, we cannot take chances.”

Since being diagnosed with HIV and placed on treatment, she has been supporting mainly HIV-positive women as she believes they feel better speaking with someone who has walked their path or is walking their path.

“You see when the corona come to Guyana, I started cleaning, trying to get rid of the old stuff. I was scared to go out and the one good thing, I had my daughter, and if I want anything she would go and get it,” she said.

“And then the calls start coming, persons start calling and asking for aid and they were also afraid to go out and get their treatment. It was really frightening, and you know I had to direct them on how to go and get treatment, calling the health centres to help them.

“And then, you know, we see the news with them talking about HIV persons and how our immune systems was compromised and advising people who not on treatment to get on treatment because their immune system could weaken, that was frightening.

“So now I had to call up people and tell them to keep up their immune systems, tell them to drink a lot of vitamins and take their medication and not to miss taking it. It was then some of them started finding out about hampers and I decided to call NAPS [National AIDS Programme Secretariat] and I was told that you had to reach certain criteria to get a hamper.

“So if you not sick and you not working, you cannot get the hamper and I felt really bad because here we telling people stay home be safe, some of them would get a one day work here and there but now they frighten to go out. They frighten to go out, but they can’t get a hamper. We not asking for every month but at least one time. They felt really bad when I told them about the criteria, and I had to turn to my church and ask for help and some of them would get hampers.

“People always talking about criteria. It is like you have to be really sick to get a hamper. You have to carry yourself really down. Your immune system have to very low for you to get a hamper.

“They are people who not working and can’t support their children. They have HIV. Why can’t they get a hamper?” she questioned.

“I think also they need to train people with HIV about the corona so that we can really talk to others, because persons living with HIV will more listen to other positive persons and they need to get the information.

“Some of them call and even come looking for me because they want information and help. They would not want to talk to the people at the treatment centres they would prefer to talk to someone who understand what they are going through. It is a really frightening situation, especially for people who are working. And even those who are not working, they are afraid to go out,” the woman said.

“You know I am very brave but even I don’t want to go out. I don’t go out nowhere. Them children frighten for me more than I afraid [for] myself.

“It is sad to know that people living with HIV and they are in need and they have to go out there and compromise themselves and could get themselves and their children sick. It is a sad thing for single parents, especially. I stand a chance because I have me children and they would make sure I eat and that I alright.

“Depression is now getting a lot them. Even me I does feel so bored because before I am always out and about, and it can get difficult for me. It is something really sad. They don’t have nobody to talk to. The group we had ain’t really functioning right now. Because of the COVID, we can’t even meet. But some would call.

“A lady call me from the East Coast. Somebody give she my name for help. I submit she name, and I hope to get help from my church. She have six grandchildren and they mother die from HIV and she does have to work and mind them. She must be try all over and somebody must be just give her the number and she call. Is a good thing I does say give them me number and if I could help I would help.

“Persons are saying they want them doing a shutdown of the country but what will happen to persons who are working? They are not putting anything in place. I am scared but I don’t think we could afford a lockdown. Too much poor people will suffer,” she continued.

In a direct appeal to HIV-positive persons, the woman urged that they stay on treatment.

“If you on treatment, stay on the treatment, adhere to it. Keep your surroundings sanitized, keep it clean. And if you not on medication contact your nearest health centre. It is serious, don’t make joke, you already living with a compromised immune system and it is important that you adhere to the Ministry of Health guidelines,” she warned.

If there are HIV positive sisters out there who need support, please call 693-2817 and the positive sister who answers will do her best to assist or at least direct you where you can get some assistance.

Only recently a call was made for persons living with HIV in Guyana to take extra measures to protect themselves from contracting COVID-19.

NAPS Director Dr Rhonda Moore pointed out that persons living with HIV are at an increased risk of developing the most severe form of the virus or even dying if they are to contract the virus. She noted that this may be the case for persons who are not on treatment or those who are not virally suppressed.

Moore had explained that the HIV attacks the immune system, making it difficult for those living with it to fight off any infection which includes COVID-19 and, therefore, contracting the virus may lead to persons needing hospital care and in most cases intensive care. She also mentioned that persons who are virally suppressed are those persons who have been using their treatment and as a result the virus is under control, which means that their immune systems can fight other infections.

Dr Moore urged persons living with HIV to stay at home unless it is absolutely necessary for them to venture outside, to practice COVID-19 precautionary measures put in place by the health authorities and to ensure they eat as healthy as possible. She had also informed that the NAPS food bank is prepared to work with the treatment facilities to provide those who need additional support with hampers.

Persons who are not using any treatment for HIV are urged to call NAPS hotline (Guyana) at 227-8683 extension 215 to be directed to treatment sites in their areas.

Photo by NEOSiAM 2020

Submitted by Enrique Romero, Executive Director, National AIDS Commission (NAC) – Belize and Anellie Paredes, Communications and Programs Officer, NAC – Belize

As part of its “Continuity of HIV Services during COVID-19 Action Plan”, the National AIDS Commission (NAC) – Belize conducted a Needs Assessment of People Living with HIV (PLHIV). The exercise was conducted through the various existing layers of support to PLHIV including social workers and adherence counsellors from the Ministry of Health (Belize), Peer Navigators, NAC District Committees and Civil Society Organizations (CSOs).

The assessment revealed that many PLHIV are desperately in need of food items to remain adherent to their medication. The NAC provided the Ministry of Human Development, Social Transformation and Poverty Alleviation (Belize) with a list of 100 persons to facilitate and expedite assistance to these individuals through the Government of Belize’s “Food Assistance Programme”. The NAC is currently in discussions with two private companies and other agencies to facilitate the donation of food items to PLHIV.

To further contribute to Belize’s COVID-19 response, the NAC has utilised its Facebook page to empower persons by promoting healthy lifestyles, social distancing and good hygiene. The NAC’s public education and awareness messages continue to focus on respect for Human Rights, condemnation of acts of violence and abuse against vulnerable groups, including persons from the LGBT community, women and children. The NAC also issued a call to action urging persons to refrain from cyberbullying, stigma and discrimination which have increased during COVID-19.

The NAC continues to work with its social partners and communities to provide care, treatment and support services to persons living with and affected by HIV and AIDS.

Contributor: Valerie Wilson, Director, Caribbean Med Labs Foundation (CMLF)

COVID-19 has undoubtedly changed the world; laboratories are not immune to this change.

The COVID-19 (Coronavirus) pandemic has laid bare the critical importance of accurate, reliable and timely laboratory testing for diagnosis, patient care and management.

It took COVID-19 to teach us, perhaps, one of the most striking lessons of the pandemic: the urgent need for scaling up testing to identify those infected, to prevent further spread and reduce harm.

Through online training, the Caribbean Med Labs Foundation (CMLF) assisted countries in ensuring quality management systems for accurate and reliable COVID-19 results.

As early as March, CMLF had pinpointed the crucial role of laboratories (article here).  As it has done for more than a decade of its work on strengthening laboratory services in the Caribbean, the Foundation provided vital information for Ministries of Health, laboratories and health care providers to help guide their decisions.  This guidance addressed options for, and benefits of COVID-19 testing to identify persons infected who require treatment and for surveillance of those who may have been infected and recovered.

CMLF also emphasised that COVID-19 illustrated the urgent need for regional governments to adopt national laboratory policies, enact legislation to improve quality and resourcing of public laboratories and monitor the quality of private laboratories to ensure readiness to address public health threats.

CMLF has assisted the Organisation of Eastern Caribbean States (OECS) to identify COVID-19 laboratory tests and supplies.  To ensure that other critical regional health interventions continue in light of severe supply chain disruptions globally, CMLF continues to collect and share data with partners on regional HIV and Sexually transmitted infections (STIs) reagent stocks.  The goal is to ensure that HIV and STI diagnostic, treatment and care services continue during the COVID-19 pandemic.

The International AIDS Society (IAS) is hosting a series of webinars on COVID-19 and HIV to discuss the pandemic and its impact on People Living with HIV (PLHIV).

Please see details below.

The IAS is pleased to invite you to the final webinar of this series brought to you by the IAS Educational Fund under the theme, COVID-19 and HIV: Adapting community-based HIV services during a pandemic, which will take place on 28 May 2020. This webinar will share and discuss how community-led HIV organizations pivoted their services to benefit their communities and the key and vulnerable groups that they support, highlighting practical actions implemented since the beginning of the COVID-19 pandemic.

Please register to confirm your participation before 27 May.

REGISTER NOW

Date: Thursday, 28 May 2020
Time: 13:00 – 14:30 (CEST)

Use this tool to see the time of the webinar at your location.

Topics and speakers:

• Mitigating the impact of COVID-19 for key populations
Dr Chris Akolo, Technical Director of LINKAGES Project, Family Health International 360 – USA

• Adapting sex worker services during the COVID-19 pandemic
Surang Janyam, Founder and Director of Service Workers IN Group (SWING) Foundation – Thailand

• Maintaining harm reduction services during the COVID-19 pandemic
Anton Basenko, Country Focal Point: PITCH, Alliance for Public Health – Ukraine

• Ensuring access to HIV treatment in lockdown
Prof Mehdi Karkouri, President of Association de Lutte Contre le SIDA and Board Member of Coalition Plus – Morocco

• Taking HIV and related youth services virtual
Mather Mawodzeke, Head of Programmes, Africaid Zvandiri – Zimbabwe

• Integrated Sexual and Reproductive Health and Rights services during the COVID-19 pandemic
Nisha Jagdish, Director of Gender and Rights Program, Family Planning Association – India

Moderator: Kate Thomson, Head of Community, Rights and Gender and Civil Society Hub, The Global Fund to fight AIDS, Tuberculosis and Malaria

A recording of this webinar will be made available on the IAS website.

After registering, you will receive a confirmation email with instructions for joining the webinar. Please send us your questions in advance of this webinar to coronaquestions@iasociety.org.

The webinar series is recommended to HIV professionals, government representatives working in the field of HIV, public health specialists, programme managers, service providers, civil society representatives and members of organizations supporting key and vulnerable populations.

We look forward to your joining us! Please help us inform others by promoting and disseminating this invitation within your networks.

The IAS Educational Fund is aimed at providing and investing in educational opportunities that support the frontline HIV workforce by making scientific fora more accessible to our members and their communities.

For inquiries or further information, please contact iasedu@iasociety.org.

GENEVA, 18 May 2020—A cornerstone of the response to HIV, community-led health service delivery has become even more critical in the context of COVID-19, as the needs of marginalized community members and the burden on the health sector are increasing, making it vital that continued provision of HIV, Tuberculosis and other health services is secured.  Community-led organizations are providing a lifeline to underserved, marginalized and hard-to-reach populations around the world.

Physical distancing restrictions have created significant challenges for those needing to access essential services, creating an increased burden on community organizations, which are at the centre of service delivery.

UNAIDS recognizes that community organizations have an unparalleled depth of experience in creating and delivering responses to health and human rights crises within their communities. The many community-led networks and groups that emerged to respond to HIV possess immense practical experience, organizational strength and unparalleled community access for facilitating the delivery of life-saving support, and for influencing people’s real-life practices to better protect their health.

Community-led networks and organizations have also developed important working relationships and roles within health and community systems, including in coordination and task-shifting functions. As evidenced in many countries, these capacities can, with proper support, be deployed to facilitate the provision of COVID-19 information, prevention, testing and linkages to care. Yet without formal recognition of the essential nature of their work, they face significant barriers to continuing to provide services. It is the view of UNAIDS that it is critical to the COVID-19 response and to mitigating broader health impacts of the pandemic that community-led organizations be supported to continue to provide essential services and have the protective equipment and safe policy environment necessary to do so.

The role of community-led organizations must be appropriately recognized and supported in the context of COVID-19. They must be factored into all aspects of planning, design and implementation of interventions to combat both COVID-19 and the efforts required to mitigate the impact of COVID-19 on other health areas, including HIV and tuberculosis. In particular, and as first steps in this effort, UNAIDS urges COVID-19 crisis committees at the national and district levels to:

• Include the workforce of community-led health care services into the lists of essential service providers and treat them as equivalent to health-care providers.
• Design physical distancing restrictions and policies in ways that allow community-led services to continue operating safely. Essential services include, but are not limited to, the physical provision of HIV, tuberculosis and COVID-19 and other health services that include prevention commodities, including condoms, lubricants, clean needles and opioid substitution therapy, contraceptives, hygiene kits, test kits, medication, triage and linkage to care, adherence support, packages of food and other essentials, the provision of legal services and protection for survivors of gender-based violence and other forms of violence and discrimination. Particular attention needs to be paid to people with physical disabilities.
• Provide special authorization to relevant community-led service providers to move freely, with appropriate personal protective equipment, to deliver the services when and where needed.
• Ensure that community-led organizations, networks and groups be provided with personal protective equipment and training in order to protect themselves and their clients in the course of service delivery.
• Take urgent measures to ensure the security, and expansion, of existing funding for community-led organizations, so that those organizations can continue to provide services.
• Ensure inclusive and transparent governance of COVID-19 responses, with decision-making bodies that include representatives of community-led organizations, including those focused on gender, equity and human rights, to ensure that COVID-19 policies are designed to support the range of service providers and activities necessary for an effective and equitable response.

GENEVA – The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria embraced a swift and effective response to the COVID-19 pandemic in order to protect progress against HIV, TB, malaria and to strengthen systems for health to save lives.

The Board, concluding its 43^rd meeting and the first one held virtually, agreed on the imperative to leave no one behind, stressing the critical role of communities in keeping people safe, especially when facing a new wave of challenges. Recognizing the severe danger posed by COVID-19 to progress made against HIV, TB and malaria, the Board asserted a strong commitment to striving for equitable access and protecting the most vulnerable.

Advancing global health security and strengthening systems for health is central to protecting the Global Fund’s core mission and to fight new and emerging diseases like COVID-19. The Board discussed measures to make sure that mitigation and response strategies will protect people, by leveraging the power of multi-stakeholder engagement and partnerships including civil society, communities, government and private sector partners.

“This is one and the same fight,” said Peter Sands, Executive Director of the Global Fund. “It’s not just a battle against one particular virus, it’s a commitment to make everyone safe. It’s about finishing the fights we haven’t yet won, and winning the new fight against COVID-19, as well as preparing ourselves for fights against pathogens as yet unseen.”

“A concept of global health security that only focuses on threats to people living in rich countries won’t work,” Sands added. “We need global health security that protects everyone, from new threats and old, that is grounded in rights and that simultaneously recognizes the role of science and the equally important role of communities. We must unite to fight.”

Board members expressed strong support for enhancing guidance, monitoring and risk management in the rapidly evolving context. Effective monitoring mechanisms, strong analysis and tracking of the evolving epidemiological, social and economic impact all need to be reflected in the Global Fund’s risk assessment and mitigation measures.

Beginning in March 2020, the Global Fund launched new measures to respond swiftly and effectively to COVID-19 in close collaboration with other partners, making up to US$1 billion available to help countries fight COVID-19, mitigate the impacts on lifesaving HIV, TB and malaria programs, and prevent fragile health systems from being overwhelmed.

The Global Fund is also a founding partner of the Access to COVID-19 Tools (ACT) Accelerator, a global collaboration of organizations and governments working to accelerate the development, production and equitable access to new COVID-19 technologies. The Global Fund also co-leads the WHO Diagnostics Consortium along with UNICEF to negotiate pricing and procure molecular diagnostic tests for COVID-19 responses.

At its meeting, the Board also discussed the development of the next Global Fund Strategy and the need to adapt to the new challenges posed by COVID-19 and by climate change, with a fresh imperative, as one Board member put it, “for engaging our strengths in delivery of our purpose.”

“Development of our new strategy will be driven by evidence through an inclusive process,” said Donald Kaberuka, Chairman of the Board of the Global Fund.

The Board has consistently underscored the removal of human rights and gender barriers to health care as a critically important element, recognizing that COVID-19 is disproportionately affecting the poorest, the most marginalized and the most vulnerable, in the same way as HIV, TB and malaria.

The Global Fund raises and invests more than US$4 billion a year to support programs to fight AIDS, TB and malaria in more than 100 countries. The infrastructure and capabilities to defeat diseases like AIDS, TB and malaria – medical supply chains, laboratories, community health workers, disease surveillance – are also needed to fight COVID-19.

Under WHO guidance, the Global Fund strongly encourages countries to take prompt action to mitigate the potential negative consequences of COVID-19 on existing programs supported by Global Fund grants.

GENEVA, 14 MAY 2020—More than 140 world leaders and experts, including the President of South Africa and Chair of the African Union, Cyril Ramaphosa, the Prime Minister of Pakistan, Imran Khan, the President of the Republic of Senegal, Macky Sall and the President of the Republic of Ghana, Nana Addo Dankwa Akufo-Addo have signed an open letter calling on all governments to unite behind a people’s vaccine against COVID-19. The call was made just days before health ministers meet virtually for the World Health Assembly on 18 May.

The letter, which marks the most ambitious position yet set out by world leaders on a COVID-19 vaccine, demands that all vaccines, treatments and tests be patent-free, mass-produced, distributed fairly and made available to all people, in all countries, free of charge.

Other signatories include the former President of Liberia, Ellen Johnson Sirleaf, the former Prime Minister of the United Kingdom, Gordon Brown, the former President of Mexico, Ernesto Zedillo, the former United Nations Development Programme Administrator and former Prime Minister of New Zealand, Helen Clark.

They join notable economists, health advocates and others, from the Chair of the Elders and the former President of Ireland, Mary Robinson, Nobel Laureate, Joseph Stiglitz, to Moussa Faki, Chairperson of the African Union Commission, Dr John Nkengasong, Director of African Centres for Disease Control and Prevention, and Dainius Puras, the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

“Billions of people today await a vaccine that is our best hope of ending this pandemic,” said Cyril Ramaphosa, President of South Africa. “As the countries of Africa, we are resolute that the COVID-19 vaccine must be patent-free, rapidly made and distributed, and free for all. All the science must be shared between governments. Nobody should be pushed to the back of the vaccine queue because of where they live or what they earn.”

“We must work together to beat this virus. We must pool all the knowledge, experience and resources at our disposal for the good of all humanity,” said Imran Khan, Prime Minister of Pakistan. “No leader can rest easy until every individual in every nation is able to rapidly access a vaccine free of charge.”

The letter, coordinated by UNAIDS and Oxfam, warns that the world cannot afford monopolies and competition to stand in the way of the universal need to save lives.

“This is an unprecedented crisis and it requires an unprecedented response,” said former President of Liberia, Ellen Johnson Sirleaf. “Learning the lessons from the fight against Ebola, governments must remove all the barriers to the development and rapid roll-out of vaccines and treatments. No interest is more important than the universal need to save lives”

The leaders recognize that progress is being made and that many countries and international organizations are cooperating multilaterally on research and development, funding and access, including the welcome US$ 8 billion pledged on 4 May at the European Union’s international pledging marathon.

However, as many countries and companies are proceeding with unprecedented speed to develop an effective vaccine, the leaders are calling for concrete commitments to ensure that it is made affordable and available to all in the quickest possible time. These include:

• A mandatory worldwide pooling of patents and sharing of all COVID-19-related knowledge, data and technologies in order to ensure that any nation can produce or buy affordable doses of vaccines, treatments and tests.
• The rapid establishment of an equitable global manufacturing and distribution plan for all vaccines, treatments and tests that is fully funded by rich nations and which guarantees transparent “at true cost prices” and supplies in accordance with need rather than the ability to pay.
  • This would include urgent action to massively increase manufacturing capacity to produce the vaccines in sufficient quantities and train and recruit millions of health workers to distribute them.
• A guarantee that COVID-19 vaccines, treatments and tests are provided free of charge to everyone, everywhere, with priority given to frontline workers, vulnerable people and poor countries with the least capacity to save lives.

“Faced with this crisis, we cannot carry on business as usual. The health of each of us depends on the health of all of us,” said Helen Clark, former Prime Minister of New Zealand. “The COVID-19 vaccine must not belong to anyone and must be free for everyone. Diplomatic platitudes are not enough—we need legal guarantees, and we need them now.”

“Market solutions are not optimal to fight a pandemic,” said Nelson Barbosa, former Finance Minister of Brazil. “A public health care system, including free vaccination and treatment when that becomes available, is essential to deal with the problem, as shown by the Brazilian experience with compulsory licensing of antiretroviral drugs in the case of HIV.”

Uniting behind a people’s vaccine against COVID-19—open letter and full list of signatories