By Paul Dillon
This year’s 19th International AIDS Conference concluded in the last week of July—amongst discussions on the exciting developments over the past year in the efficacy of new HIV prevention methods, including male circumcision, pre-exposure prophylaxis and treatment as prevention, there were also much-needed discussions on how policy makers and organisations can implement effective HIV prevention strategies and projects.
Aidsmap, an online HIV prevention resource, quoted the following from one of the sessions held at the conference: “We need to start thinking about the populations who are most at risk for targeted interventions,” Nelly Mugo of the University of Nairobi told a plenary session. “Then we will need to prioritize those interventions that work within those populations, and deliver them in combination with high coverage for us to get high impact.”
One such targeted intervention is the Lesotho Riders for Health programme, which ingeniously uses a network of health workers on motorcycles to deliver important healthcare interventions (such as delivering HIV medication or collecting samples for diagnostics) to hard-to-reach populations in the country’s extremely mountainous terrain. Eighty-one percent of Lesotho’s population lives in remote rural villages, often several hours walk over rough mountain paths from the nearest clinic. All of this makes healthcare delivery extremely challenging in this developing African country that faces a ‘double-burden of disease’, according to the World Health Organization. Almost one in four of Lesotho’s population are estimated to be living with HIV/AIDS. This high prevalence of HIV has also caused a rise in tuberculosis.
Though the Riders for Health programme began in 1991, it’s current programme was initiated in 2008 as a national programme that mobilises an estimated 130 health workers to the country’s ten districts. The health workers also work with labs in Lesotho to help in bringing reliability and speed to the diagnostics—30 “sample couriers” collectively transport over 2,800 samples and their results each week nationwide. Additionally, 62 health workers are mobilised throughout the country providing access to health care for three times the number of people and villages than before they were mobilised by the Riders programme.
This health intervention not only takes into account the particular challenges faced by a specific group, but also has come up with a simple, cost-effective way to overcome that challenge. By improving the time it takes to diagnose a person with HIV through its “sample couriers” system, individuals are diagnosed with the disease in a much shorter time frame, and this in turn helps HIV positive individuals get on ARV treatment sooner, which in turn helps to reduce the risk of transmitting and spreading the disease.
What’s particularly wonderful about this programme is how it is a true collaboration between government agencies, local NGOs and international foundations. The outreach health workers are from Lesotho’s Ministry of Health and Social Welfare (MOHSW), and other local NGOs. Financing and training for the project came from the Elton John AIDS foundation, and training and development of the transport systems for the health workers from the Clinton Health Access Initiative. All of these different groups are working together to make a real difference.
At Baird’s CMC, we’re also proud to be working on a collaborative project on HIV prevention and treatment called Mapping Pathways. Read more about this inspiring initiative here.