Civil Society Appreciate Government Initiative on COVID-19; Want Rights-Based Approaches to inform the Response.

 
 CS – MOH, Hon. Mutahi Kagwe at a past forum

Representatives of civil society organizations, including the networks of people living with, at risk of and affected with HIV, TB and Malaria last week appreciated the efforts and actions put in place to slow down the spread of the novel coronavirus (COVID-19) in Kenya but called for the respect of the law and human rights approaches in the response. According to the CSOs representatives, anchoring the COVID-10 response solely on public health imperatives without bringing into play the human rights aspects may lead to unintended adverse effects and which, may undermine the long term impact of the response. The CSOs and community response made these assertions during a virtual meeting hosted by NEPHAK with the support of the Kenya Red Cross Society. Following the virtual call, the CSOs put in place a COVID-19 working group (WG) to help coordinate their engagement in the response. 

The need for rights-based approaches among the CSOs leadership that participated in the virtual meeting was so strong that KELIN, one of the organizations in the meeting and a CSO that works to promote rights-based approaches in the health sector immediately volunteered to draft an advisory opinion on human rights to be shared with the government response team at the earliest opportunity. Studies have confirmed that using a rights-based approach to guide public health interventions has been hailed as one of the best practices for managing the response to a multi-dimensional virus such as COVID-19. The Joint United Nations Program on HIV has made it clear that responding to an epidemic is not a question of balancing public health and human rights but rather a successful and effective response requires us to adhere to human rights principles. UNAIDS has produced a new guidance document that draws on key lessons from the response to the HIV epidemic: https://www.unaids.org/en/resources/documents/2020/human-rights-and-covid-19

Meanwhile, people living with HIV have praised the bold move by the Ministry of Health through the NASCOP and the National TB Program to put in place guidance on how to ensure the continuity of quality and comprehensive HIV and TB prevention, treatment, and care services in the wake of the COVID-19 breakout. With regard to HIV service delivery, the Ministry of Health agreed to scale up the implementation of the differentiated service delivery (DSD) models such as the multi-month dispensing that enables PLHIV on treatment to get ARVs refills that can last for 3 to 6 months. The guidance and adjustments resonate well with the needs of the PLHIV community as outlined by NEPHAK in a letter to CS-Ministry of health in mid-March: COVID – 19 GUIDANCE and Adjustment of Scheduled clinical visits for TB Patients

The Ministry of Health and partners also prioritized the community aspects of DSD where selected PLHIV leaders can lead the interaction and engagement of facilities on behalf of their colleagues. Under this arrangement, people living with HIV in a particular region or setting can with the support of the NASCOP and the county governments establish a community ART Group (CARG) and get one or two of them to be collecting their pills and Viral Load test results from a facility and sharing with the wider team. The team leads should also be in a position to interpret viral load results and advise those concerned appropriately. The strategies are aimed at minimizing crowding in health facilities and medicine collection points. These are some of the priorities identified from a needs assessment of the PLHIV Community by NEPHAK: https://mailchi.mp/9aff19741fc7/edition-12-nephak-weekly-bulletin-15th-march-2020

Since it is becoming apparent that the presence and impact of COVID-19 may last longer than earlier anticipated, NEPHAK has renewed its commitment https://nephak.or.ke/covid-19/ to gather credible information about the virus and share with its membership. The commitment will see NEPHAK join relevant government committees and task forces and also work together with like-minded civil society organizations to educate citizens and especially PLHIV on the science, prevention, and management of COVID-19. For this reason, we have gone back to the NEPHAK membership with the initial survey but with expanded questions: The new questions relate to pediatrics and children. The initial questions were mainly for adults living with HIV but we have since realized that parents and guardians living with HIV may be facing additional challenges in the wake of the COVID-19 outbreak. In the 2nd round of the survey, we have also included a question on the preference of communication medium and channel by PLHIV. 
 

AIDS2020 Goes Virtual: What is the Level of Preparedness of Communities?

 

The adverse effects of the COVID-19 have started trickling in. For the first time in history, the International AIDS Conference will be virtual. The virtual AIDS 2020 announcement was made last week by the International AIDS Society (IAS) and partners. The announcement explained that: “The health and safeguarding of our community is our highest priority. In light of the COVID-19 pandemic, the 23rd International AIDS Conference (AIDS 2020), to be held on 6-10 July 2020, will become the first virtual edition of the International AIDS Conference”, the statement added.
 
AIDS 2020: Virtual will enable delegates to access and engage with the latest HIV science, advocacy, and knowledge traditionally presented at the conference. It will be a compelling combination of virtual sessions and community networking, including exhibitions, workshops, the Global Village, satellites and pre-conferences, that will reach audiences around the world. Upon receipt of this communication, we posed one question: Are communities and people living with, at risk of and affected with HIV prepared to meaningfully engage in the AIDS 2020 virtual. Luckily, the communication has come when there is still time to plan and make arrangements for an impactful engagement at the virtual conference. 
 
The theme of this year’s conference is “Resilience” and there is no better word to describe the HIV community and the ability to come together in a shared commitment to the global HIV response. The decision to have the AIDS 2020 virtual is understandable given the outbreak of the novel coronavirus. According to the IAS, the decision was informed by advice from the World Health Organization, UNAIDS, leading global and local health authorities, and people living with HIV around the globe. In particular, the IAS and partners; “are acutely aware that there is not yet sufficient data on whether people living with HIV are more susceptible to COVID-19 or more likely to develop severe disease.” The decision is, therefore; “informed by a special obligation to reduce any potential risk to the HIV community.”
 
AIDS 2020: Virtual will continue to shine a spotlight on the host cities, San Francisco and Oakland, exploring the tale of these two cities through science, innovation and activism, while underscoring the Bay Area’s dedication to health equity in its “Ending the HIV Epidemic” initiatives. Countries, including Kenya will also share on their progress with the epidemic control. We are also aware that the COVID-19 will feature prominently at the AIDS 2020 Virtual. In the next two weeks, we shall be reaching out to the NEPHAK membership, including key populations living with HIV to assess their level of preparedness to meaningfully engage at the AIDS 2020 Virtual.