HIV has a profound impact on communities around the world and the health systems that serve them. Many remote, underserved communities feel the heavy burden of the HIV epidemic and can face substantial challenges in accessing health services. New approaches, systems and technologies have the potential to strengthen these systems and provide greater access to quality healthcare in these last mile communities.
As a global health innovator, VillageReach is dedicated to identifying, testing and scaling these potential solutions, which can be leveraged to support the global fight against HIV. World AIDS Day gives us a moment to reflect on our work with partners and governments that contributes to the reduction of HIV, particularly at the last mile.
Chipatala cha pa Foni: The Impact of Information
Connecting with a healthcare professional in a rural community can often mean walking many kilometers – a trip which can be an obstacle to women seeking information to keeping their children healthy. Chipatala cha pa Foni (CCPF) is a mobile health hotline that allows these women to connect to the health information they need. Elina wanted to protect her newborn daughter from contracting HIV and was given Bactrim to do just that, but upon her return home she was unsure of the correct dosage. By calling into CCPF, she was able to speak with a nurse and give her daughter the best possible care. Her daughter tested HIV-negative six months later.
The potential for CCPF to provide essential information about HIV goes far beyond support to new mothers like Elina. As CCPF has expanded to include a wider audience, renewed attention is being given to ensure HIV is included in the available health information. VillageReach is finding ways to expand CCPF to ensure young women have access to a trusted, knowledgeable source of information on HIV. This information is available to anyone who uses the hotline, making CCPF a convenient, safe place for everyone to empower themselves with information.
The Power of Knowing
In Malawi, there are only eight laboratories equipped to process the tests used to diagnose HIV in infants. On average it takes nearly eleven days to get a dried blood sample to one of these labs and another eight weeks to return the results to the health center. This leaves mothers and their children in a state of limbo, waiting for the results.
In 2016, the first field tests of UAV prototypes for HIV test transport were conducted in Malawi. VillageReach conducted a study to understand the costs of using these UAVs to transport samples and results for early infant diagnosis. Because UAVs had never been deployed to transport health commodities, VillageReach used modeling to compare a hypothetical UAV transport system to the current system in Malawi – taking the initial step in the early stages of evaluating UAV integration in the Malawi lab logistics system. Providing evidence is an essential piece in deciding if and how this new technology can be used in health systems.
Leveraging the Private Sector
Antiretrovirals are an essential health commodity for those living with HIV. In rural communities, stockouts of ARVs can mean interrupted treatment – making patients more susceptible to opportunistic infections, reducing the adherence to medicines, and potentially creating resistance to treatments. Strengthening last mile supply chains to ensure essential medicines are available to even the most remote communities is a core component of the work of VillageReach.
Last year, VillageReach – in partnership with Médecins Sans Frontières, the Government of Mozambique, and a third party logistics provider – launched an integrated, outsourced logistics system that could help reduce stockouts of ARVs in Tete province, Mozambique. By combining HIV treatments and vaccines together and contracting a private company to deliver them to rural health centers, VillageReach began collecting data about the efficiency and effectiveness of this system. After six months of operation, improvements were seen in the availability of products – providing yet another option for governments to consider when looking to improve access to medicines and quality healthcare.
As the global community of donors, governments, communities and implementers work to address HIV, we need to continue to think outside the box to find new ways to address HIV in all communities. We can look at available evidence to identify those proven innovations that have the potential for impact, and we must work together to support communities in the fight against HIV – especially at the last mile.