As the world looks to 2015 and beyond, MSH organized a panel and reception at ICASA 2013 highlighting how the global health community can best work together to achieve an AIDS-free generation with zero new infections among adults and children, zero deaths due to AIDS, and zero HIV-related discrimination. The event, entitled “Targeting Zero Together: What will it take?,” brought together experts and audience members from NGOs, civil society organizations, governments, donor organizations, and more, to discuss the steps it will take to meet the current Millennium Development Goals and propose ideas for a post-2015 agenda.
MSH South Africa Country Representative Bada Pharasi shared a brief introduction of
MSH’s work in South Africa as he welcomed everyone to the event and introduced moderator and MSH Global Technical Lead for HIV and AIDS Scott Kellerman.
Kellerman then opened the session, prompting panelist Lois Chingandu, executive director of SAfAIDS, with the question “How do you define vulnerable populations?” This led to a rich hour and a half long discussion between the three panelists about how we can best reach zero, both in vulnerable populations and overall.
Chingandu’s response was simple: follow the evidence, and the evidence says that the youth, ages 11-19, women of all ages, and men who have sex with men are the most vulnerable to contracting HIV. Panelist Steven Smith, health attaché and regional representative for Southern Africa with the US Department of Health and Human Services, continued the discussion, emphasizing the role of evidence in shaping HIV prevention and treatment. Agreeing with her fellow panelists, Director for Health Impact Assessment with the Western Cape Department of Health Tracey Naledi explained how building upon evidence and increasing the use of geographic targeting has helped South Africa target those who need services the most.
Building upon the importance of evidence-based approaches, the panelists discussed the role of health systems in shaping prevention and treatment interventions. Smith emphasized the management piece of health systems, stating that we must strengthen the capacity of each country’s health system to respond to something new. Relying on past methods and a treatment-side approach no longer works – we must go into the community and promote a prevention-focused approach.
The conversation easily transitioned into the importance of breaking social and cultural barriers to better reach vulnerable populations and reduce stigma. Chingandu explained that only once these barriers are broken and individuals from key populations, such as sex workers, feel comfortable enough to come forward for treatment without fear of stigmatization, only then will we see progress towards reaching zero new infections. She continued, stating that we can no longer have a moral umbrella around HIV – we need to promote the idea that every sexual act you have must be protected, regardless of the act and who you have it with.
As the event opened up to audience questions, the theme continued to focus on the role of change in our fight to reach zero. One audience member posited the question of how best to implement behavior change communication in HIV interventions. Naledi responded with an example from her work with the Western Cape Department of Health to reduce inter-generational sex. After working with other disciplines, such as communications and marketing professionals, to review posters discouraging inter-generational sex, she and her colleagues found that the department’s posters were conveying a conflicting message and were instead encouraging young women to engage in relationships with much older men. Naledi explained that to best incite behavior change, the global health community needs to work with other disciplines, like the department of health did, to create stronger communications materials and build a stronger message.
Wrapping up the panel portion of the evening’s event, one audience member asked “What
really works? What drives people to seek treatment?” Chingandu’s responded back with, “Why is it that every morning we wear underwear?” She continued, saying, that once we can determine why that is natural to all of us – why we all engage in wearing underwear every morning without thinking twice – then we will know what drives people to change their behaviors and seek treatment.
Click here to listen to the full panel and learn more about how we can work together to target zero new infections in a post-2015 world.