More than a decade ago I came into contact with the plight of a young HIV-positive Zimbabwean couple who tried desperately to conceive their first child; tragically, they lost their HIV-positive firstborn who died shortly after birth. But it was more than 30 years ago when I decided to enter the field of HIV and AIDS research and treatment here in the United States. I was emotionally devastated by the amount of people that this disease claimed in the early days of its arrival, as well as by the political indifference towards the most affected communities at the time.
Today, however, a different battle is being waged. Not between politicians and citizens and certainly not by an unknown disease of disputed origins. No, today we are more aware of HIV as well as of the politico-social atmospheres that lend to its unfortunate and continued spread. In the United States, just as in countries such as Zimbabwe, where my organization, World Health Clinicians, runs an entirely unique, healthcare provider-based HIV awareness and treatment initiative entitled BEAT AIDS Project Zimbabwe (BAPZ), we are witnessing a steady decline in certain numbers of HIV infection rates — but a rapid increase of infections in demographics of youth aged 13-34.
Certain factors lend themselves to stigmatize different groups in each geographic location, such as men, healthcare workers and commercial sex workers in Zimbabwe or, here in the U.S., African-Americans, Latinos, and young gay and bisexual men. But education is key to both reducing HIV stigma, increasing awareness and decreasing the number of infections in any community, and that is one of the underlying goals of our outreach as we work to save the next generations here in the U.S. and abroad.
One dramatic and alarming difference in the response to HIV and AIDS in Zimbabwe compared with the U.S. has to do with those labelled "LOST TO FOLLOW-UP (LTFU).” In the U.S., a so-called developed nation that clearly has the financial ability and structure to treat all Americans with HIV, one million people have tested HIV-positive, but 50 percent of them — approximately 500,000 people — have been LTFU, stigma being a strong contributing factor.
In Victoria Falls, a “developing” nation where BAPZ and the Ministry of Health and Child Care (MoHCC) partner to do HIV and AIDS Outreach in the city and the surrounding rural villages, the LTFU rate is 0.26 percent. And that is despite HIV stigma and the limited ability of the MoHCC to care for its people without much assistance from Non-Governmental Organizations (NGOs) like BAPZ and over $90M annually from the President’s Emergency Program for AIDS Relief (PEPFAR).
Zimbabwe is a gorgeous and diverse country with some of the warmest and friendliest people I have met in this world. It has also been one of a handful of African nations to enjoy international support for education, awareness, and development. Recently, however, it has endured several setbacks related to its HIV and AIDS initiatives, as well as to its education sector. Literacy rates were once over 90 percent, the highest on the African continent, but have dropped dramatically.
Through BAPZ, we are not only working with the full support and assistance of the MoHCC and local partnerships, collaborations, and offices to provide testing and outreach to end the stigma and spread of HIV, we are also working to ensure that local schoolchildren who fall within our jurisdiction receive the funding required to pay for their uniforms and school books and to provide them with the basic necessities of electricity and clean running water. UNICEF and Britain’s Department for International Development (DFID) pulled funding last year from the Basic Education Assistance Module (BEAM), which funded Zimbabwe’s education program. But the country is slowly gaining support from international organizations like BAPZ, along with NGOs and foreign governments as it continuously appeals for financial assistance for education. BAPZ’s Guardian Angel Programme is ensuring that more than 300 students in the Victoria Falls municipality are returning to school. Through grants from WHC and from private donations, school-aged children are receiving funding for school fees, books, and uniforms.
BEAT AIDS Project Zimbabwe is continuously helping local communities and revolutionizing the way that HIV treatment is delivered throughout Zimbabwe, a country where 13.7 percent of the adult population — about 1.1 million people — is HIV-positive.
We have even brought our popular anti-stigma and testing initiative, HIV Equal, to test and photograph local villagers. In June, 2015, we opened our first state-of-the-art HIV specialty clinic in the township of Mkhosana, located in Victoria Falls, where we centralized our efforts to provide care to the nearly 22,000 people who fall within our jurisdiction.
Between 2011 and 2015, the World AIDS Day theme has been: "Getting to zero: Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths." UNAIDS has set a 2030 goal of eradicating the epidemic around the globe via “90-90-90,” which means that by by 2030, 90 percent of individuals will be tested for HIV, 90 percent of those who test positive will be started on HIV medications, and 90 percent of those HIV-positive individuals will have undetectable viral loads (which prevents transmission by 96 to 99 percent).
Through our continued efforts in Zimbabwe, we not only hope to stem the spread of HIV infection from mother-to-child, we also hope to provide the next generation with awareness, testing, and linkage-to-care services that will help to reduce, if not eventually eradicate, the impact of HIV and AIDS on local communities there while also continuing our important work in the U.S.
Dr. Gary Blick is the co-founder and Chief Medical Officer of the Connecticut-based non-profit humanitarian organization World Health Clinicians, which provides awareness, treatment and prevention initiatives across the U.S. and Zimbabwe. He is also Medical & Research Director of CIRCLE CARE Center, and CEO of BEAT AIDS Project Zimbabwe, both of which are WHC initiatives. He is a doctor of Internal Medicine and an HIV Specialist certified by the American Academy of HIV Medicine. His organization also founded the popular social media anti-stigma and testing initiatives: HIV Equal (in the U.S.) and in Zimbabwe.