SEATTLE, Washington — In 2018, the Centers for Disease Control and Prevention (CDC) estimated an HIV prevalence of 2.6% of Côte d’Ivoire’s population and 1.5% in Nigeria. Yet, only 65% of those living with HIV in West Africa are aware of their HIV positive status, leading to the virus’s high transmission rates. Consequently, the world’s lowest proportion of children with HIV receiving treatment live in West Africa, and one out of every five global deaths from AIDS occurs in West Africa. Amid the COVID-19 pandemic, two NGOs are working to provide essential aid to HIV patients.
Limited Resources in West Africa
West Africa’s public health system was already strained before the COVID-19 pandemic. Now, due to the pandemic’s socio-economic effects, public health has significantly worsened. As of August 3, 2020, 102 of Côte d’Ivoire’s population of roughly 25 million died from COVID-19. In Nigeria, 888 of the population of roughly 196 million passed away from the virus.
In both nations, the global COVID-19 pandemic has compounded the implications of HIV. Relatively low COVID-19 case numbers in both of these African nations have been attainable as volunteers leave vulnerable regions, aid funding gets relocated to COVID-19 relief and the rural spread of the population allows for slower transmission rates. However, a lack of testing resources likely contributes to the seemingly low COVID-19 case rate.
Aiding Women with HIV in West Africa
Young women are particularly and disproportionately affected by HIV in West Africa. UNAIDS estimates that every day, 160 women in West Africa contract HIV. Systemic gender inequities, domestic and sexual violence, unprotected sex and low HIV education—less than 35% of young women are educated on HIV and prevention—contribute to the gender disparity of HIV in West Africa. In 2016, UNAIDS categorized both Côte d’Ivoire and Nigeria as nations requiring prioritized HIV mitigation resources.
The clear need for HIV treatment and prevention measures among women in West Africa is being met in part by the West Africa branch of the International Community of Women Living with HIV. Before COVID-19 hit the region, the organization consistently deployed community pharmacists across West Africa, including Côte d’Ivoire and Nigeria. The community pharmacists distributed antiretroviral therapies to HIV positive women and young girls who did not receive regular medical attention.
As the global pandemic continues to spread throughout the region, the West Africa branch of the organization spurred its efforts to meet the ongoing need for HIV care. The organization recently partnered with a Nigerian NGO, Positive Action for Treatment Access, which has an aligned mission to increase the visibility of HIV positive women in West Africa and provide necessary resources for them. In just a few months, the two advocacy organizations have mobilized 59 pharmacists throughout Côte d’Ivoire and Nigeria. Moreover, these community pharmacists are not foreign specialists. Instead, they are HIV positive women from the same underserved communities they are now reaching.
While these women do not have pharmaceutical training, medicine distribution is entirely legal according to the NGOs’ agreement with the Institute of Human Virology Nigeria. Under this agreement, the Institute of Human Virology Nigeria provides funding for antiretroviral therapy (ART) supplies to Positive Action for Treatment Access. The NGO then organizes the logistics of distribution, with the financial help of the Open Society Initiative for West Africa. The final, yet arguably most impactful step, is taken by the community pharmacists working with the West Africa branch of the International Community of Women Living with HIV. These women, empowered with the four organizations and NGOs, travel to homes to deliver essential medicine to women living with HIV in West Africa.
Taking Precautions Amid COVID-19
The 59 newly deployed community pharmacists take COVID-19 safety precautions, using face masks, social distancing with patients when possible, regularly sanitizing and isolating themselves after trips. In addition to providing HIV care for women in Côte d’Ivoire and Nigeria, the community pharmacists relay important COVID-19 updates, educate their patients on best practices for avoiding the virus and help to dispel misinformation about the global pandemic.
In Côte d’Ivoire, the volunteers access nine healthcare facilities to acquire HIV medicine and distribute them to three provinces across the country. In Nigeria, the volunteers access 26 health-care facilities to acquire the medicine and distribute them across three of the states significantly hit by the global pandemic: Lagos, Federal Capital Territory and Oyo.
NGOs like the West Africa branch of the International Community of Women Living with HIV and Positive Action for Treatment Access are setting a precedent for effective, flexible and community-based healthcare in a time of crisis. As HIV and COVID-19 continue to be significant health crises in West Africa, NGOs and government institutions’ humanitarian aid combined with altruistic, individual grass-roots efforts are more important than ever.