Happy World AIDS Day 2015…

By Brynn Kolada and Maiden Mahowe

Hmm…“Happy” doesn’t really feel like the right word there. How about: the World has made some amazing progress in fighting AIDS, but on this Day in 2015 there’s still so much more work to be done! That feels more accurate.

There have been remarkable achievements in combating HIV/AIDS in the past 15 years — the Millennium Development Goal (MDG) 6 to enroll 15 million people on life-saving HIV treatment by the end of 2015 was met nine months ahead of the deadline, new HIV infections have fallen by 35%, and AIDS-related deaths globally have fallen by 41%. However, last year alone approximately two million people became newly infected with HIV, and 1.2 million people died from HIV-related causes globally.

And in Malawi, it is estimated that in 2014, 34,000 new HIV infections occurred, including 7,400 amongst children less than 14 years old. Preventing these childhood infections and eliminating mother-to-child transmission (EMTCT) of HIV is critical to creating an AIDS-free generation, but in Malawi and other low-resource settings, it will require redoubled efforts and creative solutions to access the most hard-to-reach populations. Additionally, progress to ensure that all HIV-positive children are accessing care and treatment has lagged behind EMTCT achievements, so identifying children living with HIV is an urgent priority.

Through our year-long Global Health Corps fellowship, we are working with mothers2mothers (m2m) Malawi, an organization that trains, employs, and empowers mothers living with HIV to serve as Mentor Mothers working in health facilities and communities nationwide. Mentor Mothers provide essential health education and psychosocial support to new mothers and pregnant women, helping them to access life-saving medical care to protect their babies from HIV infection.

Photograph courtesy of mothers2mothers.

In the few short months we have been working with m2m, we have seen changes in programming that reflect the shifting nature of the HIV response in Malawi. Two distinct examples of this are m2m Malawi’s community program, as well as the pediatric program that will be rolled out in early 2016.

Through the community program, Community Mentor Mothers (CMMs) work in their own communities to improve uptake of antiretroviral therapy by providing tailored support to ensure women are getting tested for HIV, accessing care, and remaining adherent to treatment. Rather than working in health facilities that women have to travel to, CMMs conduct home visits for one-on-one sessions, and facilitate support groups and health education talks in community gathering places. This model will help m2m identify clients who otherwise may not be educated about HIV treatment or may be reluctant to get tested. Achieving elimination of mother-to-child transmission of HIV requires that all women know their status and can make informed decisions to remain healthy and ensure their babies are HIV-negative, and CMMs offer locally-specific support and encouragement to promote healthy behaviors.

Additionally, in 2016, m2m will begin implementing a focused pediatric program that works in both facilities and communities to ensure clients are getting their entire family tested and linked to care if necessary. Currently, 53% of adults living with HIV in Malawi are on ART, while only 31% of children living with HIV are accessing treatment. m2m’s pediatric program will harness their existing presence and trusted Mentor Mothers to increase identification of HIV-positive children, and provide support and education to children and caregivers at every step of the process from testing, through treatment initiation, and adherence and retention in care.

According to UNAIDS, the most significant barrier to early treatment initiation in Malawi is that there is still a large number of people who do not know their HIV status. m2m’s community and pediatric initiatives are working toward correcting this gap and identifying HIV-positive women and children in hard-to-reach areas that may have been missed by other services.

As Global Health Corps fellows, we have been fortunate to be able to contribute to these programs, creating tools and guides that help the Mentor Mothers properly deliver their services, and helping with data collection and analysis to ensure that our programs are accomplishing their objectives. As the package of m2m Malawi programming shifts and expands, our fellowship exposes us to new technical content, builds our professional skills, and challenges us to keep up with the ambition of our programs and our Mentor Mothers.

2016 holds a lot of promise for all of us.

It marks the beginning of the Sustainable Development Goals, which will build on the 15 years of work toward the MDGs and work to ensure good health and well-being for all people.

It marks the 15th anniversary of mothers2mothers, and while celebrations are in order, m2m will also be continuing to innovate and expand programming to reach as many women as possible with support to eliminate mother-to-child transmission of HIV and to ensure healthy lives for themselves and their families.

And with 2016 comes new Global Health Corps fellows at m2m Malawi, who will no doubt continue to strive for health equity through support for m2m’s Mentor Mothers and their clients.

While much has been done and there’s lots more work to do, we can’t wait to see what the world looks like on World AIDS Day 2016!

Brynn Kolada and Maiden Mahowe are 2015–2016 Global Health Corps fellows at mothers2mothers in Malawi. All GHC fellows, partners and supporters are united in a common belief: health is a human right. There is a role for everyone in the movement for health equity. Join the movement today.

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