RIATT-ESA Newsletter - April 2024

The year's first quarter is almost gone, yet it feels like the year just started. In 2024 RIATT-ESA newsletters will highlight emerging issues in the region, share partners' resources or promising practices, and create spaces for children and youth voices to be heard.
Currently, RIATT-ESA programming represents two distinct groups which are children and adolescents. This year's series of newsletters aims to feature promising interventions and programs that address the specific needs of these key demographics throughout their cycle.
Coming out in April, the next issue will focus on programs on pediatric AIDS, TB, adolescents, adherence, and access to services. Partners are invited to submit their program, related resources or research to be featured in the next newsletter through any of the RIATT-ESA communication channels.

 Click here to read the Newsletter

International World Health Day "My Health, My Right!

Around the world, the right to health of millions is increasingly coming under threat. Diseases and disasters loom large as causes of death and disability. Conflicts are devastating lives, causing death, pain, hunger and psychological distress. The burning of fossil fuels is simultaneously driving the climate crisis and taking away our right to breathe clean air, with indoor and outdoor air pollution claiming a life every 5 seconds.

This year’s theme was chosen to champion the right of everyone, everywhere to have access to quality health services, education, and information, as well as safe drinking water, clean air, good nutrition, quality housing, decent working and environmental conditions, and freedom from discrimination.

RIATT-ESA recognizes the challenges and barriers adolescent girls, children, and youths experience in accessing equitable health care in the communities. World Health Organization indicates that, as of 2020, 1,200,000 representing 67% of children living with HIV/AIDS were living in East and Southern Africa.

Although governments and partners have made tremendous progress in strengthening health systems and the quality of healthcare provision, there is still a need for concerted efforts to address the existing challenges and gaps in the healthcare sector to enhance the treatment, care, and support of children affected by and or living with HIV/AIDS.

This year’s World Health Day commemoration must remind all players in the Health sector to reaffirm their commitment in providing equitable and quality health care to everyone and everywhere without regard to any form of discrimination be it gender, sex, sex orientation, religion, ethic and racial background.

RIATT-ESA Commemorates World TB Day

Each year, we recognize World TB Day on March 24, 2024. In observance of this year’s World TB Day, RIATT-ESA joins the rest of the world in commemorating and reaffirming its commitment to ending TB through its work. World TB Day is a day to educate the public about the impact of TB around the world. This year’s World TB Day has been celebrated under the theme “Yes! We can end TB”. TB is still one of the world’s deadliest diseases and recent years have seen a worrying increase in drug-resistant TB. The World Health Organization estimates that 10.6 million people developed active TB in 2022, of whom 1.3 million were children, and 1.3 million people died from the disease. Adolescents (10 to 19 years) and those people living with HIV have the highest risk of mortality.

Following the United Nations high-level meeting in September 2023, WHO is encouraging a) Investment, b) Uptake of the latest WHO recommendations c) adoption of innovations, and d) active involvement of civil society organizations in the fight against the pandemic.

TB is distributed inequitably, with the highest burden of disease worldwide occurring in resource-limited settings where confirming TB diagnoses in children is challenging. We, therefore, join WHO in encouraging all partners and stakeholders to invest in ending TB through advancing high-impact clinical research, and technological innovations, catalyzing adequate financing and policy directions that build on localizing WHO recommendations.

Read the full story here

Cholera Outbreak Affecting children and adolescents in East and Southern African Region

The cholera epidemic that affected multiple countries in Eastern and Southern Africa in 2023 persists and continues to impact the region, placing additional strain on communities and healthcare facilities. Since 2023, 13 countries in the region have battled one of the worst cholera outbreaks to hit the region in years, and as of mid-January 2024, more than 200,000 cases, including over 3000 deaths, have been reported.  

Poor sanitation and water treatment in Africa is a major concern especially during the rainy season where water levels start to rise. Communities are facing a shortage of safe playing areas for children, as raw sewage continues to flow into backyards and on the streets. In Zimbabwe's capital city, the issue is also further exacerbated due to the population density in certain areas, such as the Highfield Western Triangle suburb.

According to the UNICEF Director for East and Southern Africa region, “The cholera outbreak in the region is a significant concern to the health and well-being of children” In Zambia, the cholera escalation led to the postponement of the start of the school until 29 January for all schools. Approximately 4.3 million learners were affected. 

RIATT-ESA through its advocacy and Care and Support Technical Working Groups works with governments, international organizations, and Regional economic communities in advocating for child friendly and HIV sensitive programs including water, sanitation and hygiene programs that affects disproportionately the vulnerable poor and children living with and affected by HIV. Investments in strengthening systems to address the root causes of cholera and other public health emergencies, particularly on enhancing access to clean water, improved sanitation and hygiene, social behavior change, quality of case management, and care and support are imperative in dealing with the pandemic.

Read full story here

RIATT-ESA attends ICASA 2023

Efforts to end AIDS are taking a good shape globally and specifically in the ESA region. This year all researchers, experts and all working in the field of health as well as leaders, people living with HIV, and others committed to ending the AIDS epidemic around the world are meeting at The International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA)  in Zimbabwe to share the latest scientific advances, learn from one another’s expertise, and develop strategies for advancing all facets of collective efforts to end AIDS by 2030. AIDS IS NOT OVER is this year’s theme for a major bilingual international AIDS conference which takes place in Africa. RIATT-ESA is attending the conference where it will be able to showcase its work and disseminate the research findings for the articles it produced.

According to the UNAIDS Executive Director “AIDS continues to disproportionally affect the most marginalized in poor countries in Africa where some of the highest HIV burdens are found” she said. However, she was quick to point out that, all players working to end AIDS globally, have an amazing opportunity to end the AIDS epidemic by 2030 by supporting community led organizations to lead the way, and by tackling the drivers of HIV, such as inequalities and harmful laws,” added Ms Byanyima. According to UNAIDS statistics, around 66% of the 39 million people living with HIV live in Africa and some 51% of new HIV infections occurred on the continent, as did 61% of AIDS-related deaths.

End of AIDS' still possible by 2030 - UN

What you need to know:

• Botswana, Eswatini, Rwanda, Tanzania and Zimbabwe have already achieved what are called the 95-95-95 targets.

• The UN first set out in 2015 the target of ending AIDS as a public health threat by 2030

"The end of AIDS" is still possible by 2030, the United Nations insisted Thursday, but cautioned that the world's deadliest pandemic could only be halted if leaders grasped the opportunity.

"AIDS can be ended" as a public health threat, the UNAIDS agency said, as it outlined a roadmap of investment, evidence-based prevention and treatment, empowering civil society and tackling the inequalities holding back progress.

UNAIDS said ending the pandemic was, above all, a political and financial choice. 

"We are not yet on the path that ends AIDS," the agency's executive director Winnie Byanyima said, but "we can choose to get on that path". 

The UN first set out in 2015 the target of ending AIDS as a public health threat by 2030.

Byanyima said the greatest progress on HIV -- the virus that causes AIDS -- was being made in the countries and regions that have invested strongly. 

She cited eastern and southern Africa, where new HIV infections have dropped by 57 percent since 2010.

Botswana, Eswatini, Rwanda, Tanzania and Zimbabwe have already achieved what are called the 95-95-95 targets.

This means that 95 percent of those living with HIV know their status; 95 percent of those who know they have HIV are on life-saving anti-retroviral treatment; and 95 percent of people on treatment to achieve viral suppression -- and therefore highly unlikely to infect others.

At least 16 other countries are close to achieving the target.

They include eight in sub-Saharan Africa -- the region where 65 percent of HIV-positive people live -- and Denmark, Kuwait and Thailand.

 39 million living with HIV 
In a report, UNAIDS said that two decades ago the AIDS pandemic seemed unstoppable, with more than 2.5 million people acquiring HIV each year and AIDS claiming two million lives annually.

But the picture is now dramatically different.

UNAIDS said that in 2022, 39 million people globally were living with HIV, of whom 29.8 million were accessing anti-retroviral therapy. Those missing out include 660,000 children.

The numbers on anti-retroviral treatment have near-quadrupled from 7.7 million in 2010.

Furthermore, 82 percent of pregnant and breastfeeding women living with HIV had access to anti-retroviral treatment in 2022, compared to 46 percent in 2010 -- which has led to a 58 percent drop in new infections in children.

Around 1.3 million people became newly infected with HIV last year -- down 59 percent from the peak in 1995.

Meanwhile 630,000 died from AIDS-related illnesses, and it is still the "number one killer" in countries including Mozambique, said Byanyima.

"Overall, numbers of AIDS-related deaths have been reduced by 69 percent since the peak in 2004," the report said.

 'Dependent on action' 
"The end of AIDS is an opportunity" for today's leaders to be remembered as "those who put a stop to the world's deadliest pandemic", said Byanyima.

"We are hopeful, but it is not the relaxed optimism that might come if all was heading as it should be. It is, instead, a hope rooted in seeing the opportunity."

Funding for HIV fell back in 2022 to $20.8 billion -- around the same level as in 2013, and well short of the $29.3 billion needed by 2025.

Laws that criminalise people from key populations, or their behaviours, remain in place in many nations, UNAIDS said, giving the example that criminalisation, and stigmatisation, of drug injectors prevents them from coming forward for treatment.

HIV continues to impact key populations more than the general population, it added.

In 2022, compared with adults aged 15-49 in the general population, HIV prevalence was 11 times higher among men who have sex with men; four times higher among sex workers; seven times higher among people who inject drugs; and 14 times higher among transgender people.

A new HIV drug is coming to Africa – it could be game-changing

Experts believe a new long-lasting version of PrEP has the potential to dramatically change the course of the HIV epidemic in Africa

Long-lasting injections to protect people from HIV are set to be rolled out across Africa, potentially revolutionising the continent’s fight against the disease.

Treatment for HIV has improved enormously over the last 30 years, with retroviral drugs able to suppress the virus in those who carry it and oral pre-exposure prophylaxis (PrEP) widely available in tablet form to prevent infection.

PrEP is already available free to high-risk groups in the UK, but its rollout in developing countries, where it is needed the most, has been hindered due to the logistics of distributing oral medicines in many countries in Africa where the infection still rages.

Experts now believe a new long-lasting version of PrEP – an injection which provides protection from the virus for up to two months – has the potential to dramatically change the course of the disease in Africa.

They say the drug, called cabotegravir (CAB-LA), will be the first HIV/Aids treatment to be rolled out in Africa ahead of the West. 

“CAB-LA offers the best chance we’ve ever had in the history of the Aids pandemic to reimagine prevention and to do it with equity and with impact,” said Mitchell Warren, Executive Director of AVAC, an international non-governmental organisation working on HIV prevention.

“It is quite possible that we will see a larger and faster market for this product in low- and middle-income countries than in wealthy countries, which would be unprecedented and incredibly impactful.”

A total of 38 million people live with HIV globally and there are 1.7 million new infections per year, most of which are in women and adolescent girls in Sub-Saharan Africa.

Studies show that CAB-LA, which is injected every two months, was nine times superior to oral PrEP in women, and six times in men, according to Deborah Waterhouse, CEO of the drug’s producer ViiV Healthcare. 

There are currently 31 planned or ongoing implementation studies for CAB-LA, 19 of which will be in Africa.

Malawi will have the biggest programme, which was approved last month and will begin next year. 

A large rollout was set to be launched in Uganda, but this has been thrown into doubt by the new anti-gay law that introduced 20 years imprisonment for the promotion of same-sex activities and the death penalty for certain same-sex acts.

CAB-LA is available in the United States at the cost of $20,200 per year, but in developing countries, not-for-profit prices offered by ViiV Healthcare could keep the price tag as low as $250. 

ViiV has offered voluntary licences to three other manufacturers to drive costs down even further. 

Ms Waterhouse said the aim was to “reach the largest number of people as quickly as possible”.

“We want to break all the records because we knew that the oral PrEP introduction was very, very slow,” she said.

The injections replace daily pills, cutting the stigma of having to keep the medicine at home and lowering the risk of forgetting to take them.

Linda-Gail Bekker, a pioneer in PrEP programs who is leading one of the first implementation studies in South Africa, said the concept of taking a daily pill was “foreign” to many young women and girls.

‘We’re giving women liberation’

“We’ve struggled a little bit to get oral PrEP off the ground in Africa, particularly amongst young women and girls,” she said. 

“It’s very foreign – this notion that you take the pill, and it’ll prevent an infection. It’s harder to do something daily and consistently than it is to come in every two months for a shot.”

Dr Bekker said that injectable contraception is favoured in much of Sub-Saharan Africa, meaning that CAB-LA, which offer vulnerable women and young girls the discretion they often need, could be more likely to take off. 

“They have very little bargaining power in life,” said Ms Waterhouse. “We’re giving women liberation, empowerment, and the ability to protect themselves. This is why we’re excited.” 

There are risks involved. The use of CAB-LA could speed up the development of treatment-resistant strains of HIV, say experts.

The large needle used for the treatment can also leave tenderness on the site of the injection. 

Despite this, adding to the treatment options available will be revolutionary, said Mr Warren. 

“I believe that by having multiple [preventative] options, with the injectable, an oral pill and a vaginal ring, we can now offer people the chance to make better choices,” he said. “It’s an incredibly opportune moment.”

Same-day viral load test installed in Uganda, but people with HIV still received results months later

Despite having an on-site viral load testing platform that provided same-day results and reduced the wait time from a median of 51 days, most people attending a clinic in rural Uganda still chose to receive their results during their next clinic visit, which was usually at least a month away, researchers from Mbarara University Uganda report in the journal PLOS Global Public Health.

"Our results also demonstrate that without changes in existing clinic processes and patient preferences, the advantages of an on-site rapid molecular platform may be negated. As evidence of this, we observed that the vast majority of patients elected not to receive results via one of the expedited options," they say.

According to the researchers, the stigma attached to visiting ART clinics and a lack of understanding about the significance of viral load testing among both patients and healthcare providers may have contributed to participants not waiting for their results. They recommend rearranging clinic workflows so patients scheduled for viral load testing can have their blood drawn as soon as they arrive instead of waiting until the end of their visit to reduce wait time.

Viral load monitoring is crucial in HIV care as it helps detect treatment failure earlier and prompts timely initiation of second-line antiretroviral therapies (ART). In 2015, Uganda adopted viral load testing as the preferred approach for monitoring response to ART. In line with World Health Organization guidance, testing is provided six months after starting ART, with repeat tests offered annually for those who are virally suppressed. People with a viral load above 1000 copies/ml are offered viral load test after three months of intensive adherence counselling.

However, most people with HIV reside in rural areas and receive care at lower-level health clinics that lack on-site testing. Consequently, blood samples are collected from these clinics and transported via motorcycle to the nearest district hospital. From there, samples are shipped by bus to the national laboratory in the capital city, Kampala, for testing.

Unfortunately, this strategy may result in specimens being lost or spoiled during transit. Additionally, long delays between testing and receiving results could increase the risk of inaction, particularly for those whose VL results are ≥1,000 copies/ml.

The researchers, therefore, conducted a study to determine if the systems and processes for using a near point-of-care test were available at lower-level health centres in rural Uganda.

The study

The open-label pilot study was conducted in 2020 and 2021 at the Bugoye Level III Health Center in the rural highlands of western Uganda, which sees about 500 people living with HIV per week. Adult HIV prevalence in the region is 5.7%, similar to the national estimate (6.2%), but rates of viral suppression in the region are modestly lower than the national average as well as that observed in urban areas.

The investigators installed an on-site GeneXpert platform. Study participants underwent parallel VL testing at both the central laboratory (standard of care) and on-site using the GeneXpert HIV-1 assay. GeneXpert provides results in 90 minutes and is able to measure viral load down to 40 copies/ml, whereas the standard of care test using dried blood spot samples measures down to 840 copies/ml.

Everyone aged 18 and above receiving care for HIV at the ART clinic was eligible to participate. A total of 242 participants with a median age of 37 years were enrolled in the study. The majority (72%) were women, 66% were married, and had been on ART for about five years. Most participants had experienced at least one ART regimen switch.

A two-day practical training programme for study staff and laboratory technicians from the health centre was also conducted. The primary outcome was the number of VL tests successfully performed each clinic day. Secondary outcomes included the time it took for the test results to return to the clinic, and the participant's preferences for receiving their results, either by waiting at the clinic or receiving a phone call.

Results

A total of 111 tests were done throughout the study period: During phase one, which took place during strict COVID-19 lockdowns when only dried blood spot testing was available, 24 tests were conducted and sent to the central lab. In phase two, when the Xpert assay was available on-site, the clinic conducted 87 parallel tests.

During both study phases, it took a median of 51 days from when the sample was collected and sent to the central lab to when the health centre received the test results.

Of the 87 samples sent to the central lab in phase two, 80 were returned to the facility. However, seven samples were yet to be returned by the end of the study, with five outstanding for over 120 days. In contrast, most results (78%) from the Xpert assay were available on the same day.

When participants were asked how they would like to receive their results, most (87%) elected to have them at the next visit. The median time-to-patient was, therefore, similar between the central lab and the Xpert assay, at just under three months.

Only eight participants chose to remain at the clinic for their results, and three elected to receive results by phone. All those who elected to wait received their results the same day, while those who requested a phone call received results within 24 hours.

"A number of participants in our study… expressed an aversion to remaining at the clinic to receive their VL results,” the researchers comment. “While not stated overtly, this sentiment may reflect longstanding stigma at being seen at the ART clinic. It may also represent low knowledge among participants—as well as the providers—regarding the importance of VL testing."

Qualitative data

Because knowledge and perceptions of viral load testing are critical in achieving improved treatment outcomes, including viral suppression, a separate qualitative study by researchers from Makerere University College of Health Sciences in Uganda explored the meaning that people living with HIV attach to viral load testing.

They conducted in-depth interviews with 32 people attending eight high-volume health facilities across Uganda.

The participants were between the ages of 24 and 50, with 53% female and 56% married. They had been on ART for an average of 6.5 years and were mostly subsistence farmers. All participants were on dolutegravir-based first-line regimens and had records indicating they were virally suppressed.

"One relatively simple intervention may be rearranging clinic workflows."

The descriptions of viral load testing used by the participants nearly matched the medical meaning, and many people living with HIV understood what viral load testing was.

For example, in the central region where Luganda is the most widely spoken language, participants described viral load as 'Obungi bw'akawuka mu musaayi' (the amount of HIV in the blood). The Acholi speakers of Northern Uganda described it as 'Pimo dwong onyo nok pa kwidi twojonyo iremo' (the number of viruses in the blood). The Eastern region Ateso speakers' say 'Etiai lo ekurut kotoma akuwan' (the amount of the virus in the body).

Perceived benefits of viral load testing were the ability to show the amount of HIV in the body, how the people living with HIV take their drugs, whether the drugs are working, and also guide the next treatment steps for the patients.

There were numerous complaints about the time spent waiting at health facilities to take a test and the delayed or lost results, as this participant shared:

“They delay bringing our results and, in most cases, it comes late, and other times the results get lost from the lab for good [and never to be traced], and there is a patient I know who has been complaining that they usually draw her blood to test for her VL and that she has never received the test results. And I also encourage her to ask about it during their clinic visits.”

Conclusion

“There is need to improve results turnaround time for viral load test results by scaling up remote VL results printing in health facilities, increase health workers and motivate them well and also scale up community based VL services,” says the researchers.

In the first study, the researchers also suggest rearranging clinical workflows to solve the long wait times at the facility.

"One relatively simple intervention may be rearranging clinic workflows, which currently relegate phlebotomy and laboratory testing as the final step before discharge. With prior review of scheduled attendees, patients due for VL testing could have blood drawn on arrival, thereby reducing potential wait times," they conclude.

References

Boyce MR et al. It takes more than a machine: A pilot feasibility study of point-of-care HIV-1 viral load testing at a lower-level health center in rural western Uganda. PLOS Global Public Health 3: e0001678, 2023 (open access).

DOI: https://doi.org/10.1371/journal.pgph.0001678

Nanyeenya N et al. Hopes, joys and fears: Meaning and perceptions of viral load testing and low-level viraemia among people on antiretroviral therapy in Uganda: A qualitative study. PLOS Global Public Health 3: e0001797, 2023 (open access).

DOI: https://doi.org/10.1371/journal.pgph.0001797

How a mix of incentives and youth-staffed services increased HIV testing among young people

Newly published results from the two-year Yathu Yathu trial show a considerable increase in HIV testing. The trial, which was co-designed by adolescents and young people (ages 15-24), set up community hubs staffed by youth peers and offered incentives for adolescents and young people to attend them.

What is the research about?

Two areas of Lusaka, Zambia were split into 20 zones. In half, sexual and reproductive health (SRH) hubs for young people were set up and staffed by peer support workers, a nurse and supervisor. The hubs provided comprehensive sexuality education, HIV testing and contraceptives. They also referred young people to local clinics for SRH services, such as PrEP and voluntary male medical circumcision (VMMC).

Young people in all zones were given a Yathu Yathu card. This allowed them to earn points for accessing SRH services. They could swap points for rewards, including soap, toothbrushes, toothpaste, nail polish, menstrual pads and haircuts.

In the intervention zones, young people earned points from getting SRH services from a hub. In the control zones, young people earned points from getting SRH services from a standard health facility.

In 2021, around 100 young people per zone (around 2,000) were surveyed to assess Yathu Yathu’s impact.

Why is this research important?

In sub-Saharan Africa, young people have a high risk of HIV, sexually transmitted infections and unintended pregnancies. Despite this, young people struggle to access the HIV and SRH services they need.

What did they find out?

Around 75% of young people surveyed were sexually active.

In the intervention areas, 73% of young people were aware of their HIV status (either by testing for HIV in the past 12 months or self-reporting as having HIV). This was higher than the control areas, where 48% of young people knew their HIV status.

The greatest effect was among adolescent boys (ages 15-19). In the intervention areas, 62% of adolescent boys knew their HIV status compared to 30% in the control areas.

The community hubs did not increase uptake of other SRH services. Overall, 60% of young people who did not want a baby used some form of contraception the last time they had sex (40% used condoms). There was no difference between intervention and control areas.

Around 38% of young people in intervention areas had heard of PrEP, compared to 29% in control areas. But PrEP use was low in both groups. Around 5% of young people overall had been offered PrEP and only 0.4% had taken it. This may be linked to the fact that the hubs did not provide PrEP directly.

There was no difference between areas in uptake of VMMC.

In terms of HIV prevalence, 3.8% of young women and 1.5% of young men had HIV. Most (94%) were on treatment. This suggests existing HIV treatment services were working well.

What does this mean for HIV services?

Using community hubs staffed by young peers, and incentivising young people to go to them, can increase HIV testing among young people.

Crucially, the Yathu Yathu trial was co-designed by young people. This is likely to have helped create a scheme that young people wanted to engage with. The incentives would have been chosen based on the kinds of products that young people actually want. The presence of peer workers in easily accessible hubs also made it easier for young people to get tested. This shows that listening to young people’s views is the way to design services and support that works for them.

The fact that the intervention did not improve take-up of broader SRH services beyond HIV testing suggests more work is needed to understand what young people want and need in these areas. This can only be done by ensuring young people play a significant role in designing and delivering interventions.

African ministers of finance join forces to highlight the importance of financial sustainability in the response to HIV

Although great strides have been made in tackling HIV in recent years, Africa remains the continent most affected by HIV and progress towards ending AIDS is stalling. The COVID-19 pandemic, global inflation, growing debt levels, and a retreat from overseas development assistance by some donors are hampering Africa’s efforts to ramp up national HIV responses and are jeopardizing broader outcomes for health, social development and economic growth.

UNAIDS estimates that globally, low and middle-income countries will need investments of US$ 29 billion annually to meet targets of ending AIDS as a public health threat by 2030. In 2021, only US$ 21.4 billion was spent on HIV responses low and middle-income countries. 

In order to advance urgent and collaborative action to keep HIV high on political agendas and re-prioritize funding for health and HIV, African ministers of finance joined international partners on the sidelines of the World Bank / International Monetary Fund Spring meetings in Washington DC to explore ways to ensure financial sustainability of domestic HIV responses.

During the event, Ministers of Finance and senior representatives from Angola, Burundi, Democratic Republic of the Congo, Eswatini, Kenya, Lesotho, Nigeria, Mozambique, Rwanda, South Sudan, Tanzania and Uganda, and the Minister of Health of Côte d’Ivoire came together with global partners, including PEPFAR, the US Department of the Treasury, UNAIDS and the Global Fund to Fight AIDS, TB and Malaria.

Participants explored co-creating country-led paths towards the sustainability of the HIV response within broader health financing challenges. In the dialogue with Ministers of Finance, several issues were explored, among those, the need to overcome financing bottlenecks for HIV, expand local production of medicines and health technologies, or strengthen health systems and pandemics preparedness, while considering the relevance of developing joint HIV financial sustainability road-maps. 

The event, ‘Investing in Sustainable HIV Responses for Broader Health Security and Economic Resilience in Africa’, was moderated by Donald Kaberuka, Chair of the Board of the Global Fund to Fight AIDS, Tuberculosis, and Malaria and the African Union’s High Representative for Financing, the Peace Fund and COVID-19 response. The event included remarks by;

• Alexia Latortue, Assistant Secretary for International Trade and Development, US Department of the Treasury,

• Dr. John N. Nkengasong, US Global AIDS Coordinator and Special Representative for Global Health Diplomacy, PEPFAR, US Department of State,

• Winnie Byanyima, Executive Director, UNAIDS, and  

• Symerre Grey Johnson, Head of Regional Integration Infrastructure and Trade, New Partnership for Africa's Development (AU/NEPAD)

Participants also reflected on the finding of the recently released report by the Economist Impact, supported by UNAIDS, titled A Triple Dividend: The health, social and economic gains from financing the HIV response in Africa. The report provided evidence showing that fully financing the HIV response to get back on track to achieve the 2030 goals will produce substantial health, social and economic gains in 13 countries in sub-Saharan Africa. 

This meeting was the first in-person discussion among ministers of finance and international partners around the sustainability of the HIV response held since COVID-19 travel restrictions were lifted. The meeting will be followed by a series of regional and in-country engagements to advance the financial, political and programmatic sustainability of the HIV response in preparation for the African Union’s Assembly of Heads of State Extraordinary Session on Ending AIDS by 2030.