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The global fight against new HIV Infections

This blog post was written by Revati Chawla, Lead-Prevention Programming at the International HIV/AIDS Alliance. The International HIV/AIDS Alliance’s mission is to put communities at the centre of the  HIV/AIDS response in order to provide effective local solutions; as they work  to end AIDS through community action. They are a 2018 Global Health Council Member.

In July 2018, the 22nd International AIDS Conference in Amsterdam brought together organisations, researchers, scientists and activists from across the globe to discuss new advances and priority areas to tackle the HIV epidemic.

The global fight against new HIV infections

A week earlier, UNAIDS warned that the HIV response is off-track, with new infections in 2017 remaining stubbornly high at 1.8 million. The International HIV/AIDS Alliance is part of the Global Prevention Coalition, which supports efforts to accelerate HIV prevention and reduce the level of new infections in countries most affected by the epidemic as set out in the HIV Prevention 2020 Road Map. The Roadmap charts a course for countries to achieve the global HIV primary prevention goals. Its headline target is to reduce new HIV infections by 75% from 2010 figures, to less than 500,000 per year by 2020. However, UNAIDS’ first progress report monitoring the implementation of the Road Map, released in May, shows that progress has been slow.

Communities speak out on limited progress 

A series of shadow reports launched by the Alliance at AIDS 2018 provides an assessment of how each country is progressing against the 10-point action plan outlined in the Roadmap. Focusing on six countries – India, Malawi, Nigeria, Uganda, Ukraine and Zimbabwe – the reports paint a picture of inconsistent engagement with civil society groups and little movement on the implementation of new accountability mechanisms that include community-based monitoring tools and initiatives. There is also an urgent need to address structural barriers, such as laws that criminalise drug use, sex work and same-sex behaviour that prevent people from accessing the services they want and need. For young people, laws requiring parental consent for HIV testing or access to SRHR services further impacts their right to health. Weak engagement with community groups and slow progress to reform outdated laws risk undermining efforts towards the HIV Prevention 2020 Roadmap.

The Alliance’s shadow reports are a critical tool for communities to advocate to governments and donors to ensure HIV prevention receives adequate funding and that progress is not derailed by limited engagement with the communities most affected by the epidemic.

Addressing the funding gap

In a satellite session convened by the Alliance during the conference, representatives from governments, civil society and global health organisations, reflected on the current status of HIV prevention efforts and discussed the reports’ findings. Speaking out on the decisions made by governments and donors to prioritise finance for HIV treatment over prevention, Grace Kumwenda from PAKACHERE, a community based organisation in Malawi, said, “It’s not an either/or choice. Treatment should be funded, but prevention should also be funded equally. At the rate we are going now, we will not meet the 2020 prevention targets.”

Recommendations

The shadow reports highlight clear gaps in community involvement in the HIV response in the six countries featured. Patchy progress and weak engagement with community groups risks undermining efforts towards the HIV Prevention 2020 Roadmap

We must continue to assess progress in this area because if we are to meet global targets on prevention, governments must involve communities to develop effective responses for those most at risk of acquiring HIV and provide adequate resources to ensure their participation. 

About the Alliance

The International HIV/AIDS Alliance was founded in 1993 to support community groups in countries that were most affected by the global AIDS crisis. We offered a vision and a way of working that would put communities at the centre of the response in order to provide effective local solutions. We now work with communities in over 40 countries to take local, national and global action on HIV, health and human rights.

Learn more about the International HIV/AIDS Alliance.

Clade X: A Global Health Security Pandemic Simulation Highlights Need to Support Global Health Security Initiatives

This blog is a collaborative effort between Global Health Council, Nuclear Threat Initiative (NTI)|bio, the Johns Hopkins Center for Health Security, and PATH.

The U.S. government has been a leader and financier of international action to prevent, detect, and respond to infectious disease threats both prior to and following the 2014 launch of the Global Health Security Agenda (GHSA), a partnership of more than 60 countries, international organizations, and non-governmental stakeholders dedicated to global health security. Due to important progress made possible through the GHSA, the five-year partnership has been extended from 2019-2024.

The Johns Hopkins Center for Health Security, Global Health Council, NTI | bio, and PATH recently hosted Clade X: A Global Health Security Simulation for Congressional staff to demonstrate the need for continued support to prevent serious infectious disease threats. The simulation—an abridged, modified version of the original day-long Clade X pandemic exercise designed and hosted by the Center for Health Security—was conducted to highlight the necessity for effective preventive interventions and the importance of accountability of government agencies during global health crises. The exercise gave Congressional staff a window into the choices government leaders must make during a pandemic.

The exercise highlighted the need for the U.S. to play a leadership role in the global health security community and for countries to work together to develop a robust pipeline of countermeasures to mitigate the impacts of outbreaks; create transparent international action plans that measure progress; and support sustained global health security funding that advances health security preparedness in low- and middle-income counties. Overall, participants emphasized the need for the Administration and Congress to work together to develop and support a comprehensive U.S. strategy for pandemic preparedness.

During the simulation, Dr. Tom Inglesby, Director of the Center for Health Security, played the role of National Security Advisor to the President, with co-facilitation by Carolyn Reynolds, Vice President of Advocacy and Policy at PATH, and Dr. Beth Cameron, Vice President for Global Biological Policy and Programs at NTI. While the scenario was fictional, it gave participants a realistic perspective into what it is like to face multiple reports of disease outbreaks occurring simultaneously in Venezuela and Germany.

(Left to Right): Dr. Tom Inglesby, Carolyn Reynolds, Dr. Beth Cameron, and Dr. Jennifer Nuzzo.

As part of the fictional scenario, Congressional staff were tasked with providing recommendations to the President about whether to, and how the U.S. should respond to the scenario. Among the most significant challenges were: requests for global aid amid an impending national crisis; requests for U.S. military and public health intervention in various geopolitical environments; and processing information about the severity and longevity of the outbreak in the context of a constrained national budget. An additional challenge throughout the exercise was the lack of timely and specific information, mimicking the lack of reliable data that exists to inform leaders during a real global health crisis.

As a result, participants grappled with providing timely resources to affected countries. Delays in aiding highlighted that if previous investments in disease detection and reporting systems had been made, more information would have been available to inform response decisions, and ultimately, fewer people would have died.

In the second half of the simulation, participants discussed the impact of a reported outbreak of Clade X in Niger, as well as a new outbreak in a small college town in the United States. During this session, the conversation focused on the impact of the outbreak on U.S. domestic and foreign policy. Thorny issues also arose regarding the need to protect Americans and military personnel abroad while at the same time contributing to an international response effort.

Following the simulation, the non-governmental sponsors led the group through a “hot wash” discussion about Congressional roles in preparing for and responding to outbreaks, including deployed public health personnel to help with disease  prevention; providing for robust disease-detection data; and identifying channels for coordination and communication across the executive and legislative branches.

The simulation painted a realistic picture of global health security risks in action—the lack of emergency preparedness and planning, absence of clear authorities, and poor communication with the public—and was a reminder that viruses know no borders. Today, more than two-thirds of countries are still not properly prepared to address pandemic threats. A severe infectious disease pandemic could cost more than 1 million U.S. lives and up to $6 trillion to contain*. Although a growing number of countries are taking steps to prepare for the increasing risks of emerging infectious diseases, sustained political commitment, financial support, technical assistance, and partnerships are needed to strengthen the capacity of every country to prevent, detect, and respond to global health threats.

Regarding the original Clade X, from the Johns Hopkins Center for Health Security website:

The original Clade X was a day-long pandemic tabletop exercise hosted by the Johns Hopkins Center for Health Security that simulated a series of National Security Council-convened meetings of 10 U.S. government leaders, played by individuals prominent in the fields of national security or epidemic response. The exercise illustrated high-level strategic decisions and policies needed to prevent a severe pandemic or diminish its consequences should prevention fail.

At the conclusion of the exercise on May 15, 2018, the Center for Health Security presented 6 strategic policy goals needing commitment from the United States to prevent or reduce the worst possible outcomes in future pandemics. Those recommendations are:

  1. Develop capability to produce new vaccines and drugs for novel pathogens within months not years.
  2. Pioneer a strong and sustainable global health security system.
  3. Build a robust, highly capable national public health system that can manage the challenges of pandemic response.
  4. Develop a national plan to effectively harness all US healthcare assets in a catastrophic pandemic.
  5. Implement an international strategy for addressing research that increases pandemic risks.
  6. Ensure the national security community is well prepared to prevent, detect, and respond to infectious disease emergencies.

To learn more about Clade X and access an extensive repository of materials from the exercise, please click here.

References:

*Gostin, L.O., Mundaca-Shah, C.C., & Kelley, P.W. (2016). Neglected Dimensions of Global Security: The Global Health Risk Framework Commission. JAMA, 315(14), 1451-1452

Pushing Boundaries in Global Health Storytelling: A Webinar with Creative Activist Lisa Russell

View the full PowerPoint presentation and YouTube recording.

Image courtesy: Lisa Russell

As an advocacy organization, Global Health Council (GHC) can attest to how much impact we can create through our stories. Stories have the ability to compel people to act and support our asks, which include sustained global health funding from the U.S. government and bipartisan support of global health programs.

We recognize the importance of hearing from the people on the frontlines of health programs – putting them at the center and in charge of their narratives. GHC has supported patient advocates to tell their stories at the 71st World Health Assembly (WHA71) and, more recently, at the just concluded interactive civil society hearing in preparation for the High Level Meeting (HLM) on noncommunicable diseases (NCDs) at the United Nations General Assembly (UNGA) this September. However, we find ourselves asking, how can we better elevate the voices of the people for whom we advocate?

Cue our webinar co-host, Lisa Russell, an award winning filmmaker and creative activist. Lisa was kind enough to share her experiences with and expertise in storytelling, specifically why it is essential, and more importantly, why it is critical to practice it correctly and responsibly.


A few key highlights from Lisa’s presentation:

Storytelling is a very important element of global health advocacy but we need to invest as a community in making sure the stories we tell are accurate, respectful and responsible.  That comes with investing time in teaching/learning and growing the craft.  It’s a relatively new trend in the global health community but it needs to be based on true storytelling for it to be high quality and sustainable.
Lisa Russell, MPH.

1.Telling stories is critical because the act forms an emotional connection between the storyteller and the audience. There are several types of storytellers including, but not limited, to filmmakers, poets, photographers, musicians, writers, and even beatboxers. However, storytelling is not marketing, journalism, advertising, communications, or campaign slogans. While complimentary aspects of communication, they require a different skill-set from storytelling.

2.Perhaps most important to note is that stories have a structure. They have key elements, which, when built, create a memorable and impactful story. These elements include character, setting, plot, conflict, and resolution. Lisa refers to her short film, Heroines of Health, to illustrate how each of these key elements play a role in creating a highly acclaimed and impactful story.

 

Common pitfalls in storytelling in global health are usually around telling a flat linear story, often chronologically (…and then…and then…). With such storytelling, there is no character development, no real conflict or climax, and often the story is unmemorable. Also, many people will start with text to share the context of the story, which detracts from the purpose of the story. You want the story to move people, to be a journey and an experience that they are invested in.

 

Why pursue responsible storytelling?

If done well, global health storytelling can enable the global health community to elevate stories of struggle and resilience in a way that reaches a larger audience and has greater impact on funding and legislation. If done poorly, it can perpetuate “poverty porn” and a storytelling trend end that is not effective, respected or sustainable.
Lisa Russell, MPH

So how does one begin to create impactful stories?

First, consider partnering with storytellers: musicians, artists, and filmmakers-. They are bold and emotional, have a large following, and have the ability to break down information in a more relatable manner. You can create strong and sustainable partnerships with these storytellers by inviting them to sit “at the table”, invest in their understanding of your organization and the issues you focus on, and invite them to host professional development workshops for staff and/or patient advocates.

You can use different devices to create an impactful story. You can use your story to break down stereotypes; create characters as people first, before their professions; underscore universal or cross-cutting themes that most audiences can relate to; and, of course, use the the story structure to make your story more memorable.

Even with these tools in mind, it is critical to invest time to develop the craft of storytelling, so that the final product is a true reflection of the stories we seek to tell, and are respectful of the people who have let us into their lives. These stories do have the highest chance of connecting with our final audience, and getting them to act on the asks we make of them.

Stay tuned for future webinar on this topic and others!

Sign-up for Lisa’s newsletter to learn more about the craft of storytelling and upcoming events.

NCD Advocacy Resources for Youth by Youth

As a follow-up to the Call to Action: Youth, NCDs, & 2018, NCD Child is sharing 2 new resources developed by youth advocates to help promote the inclusion of young people in policy-making and policy targets.  Over the past 6 months, young advocates have continued to be vocal about the need for policy makers, civil society, and others to walk the talk with regards to youth inclusion in the global NCD agenda. To maintain momentum and hold our governments accountable, youth champions encourage their colleagues, networks, and peers to reach out to their Ministers over the next several months in the lead-up to the 3rd UN High-Level Meeting on NCDs.

1) Template letters to government:  This letter was developed to be sent from young people to government officials and making our key asks – proposing intergenerational collaboration for NCD policies as well as include a young person in their official country delegation to the UN High Level Meeting on NCDs. We suggest that the letter be sent much in advance of the High-Level Meeting, since being included in the preparatory work for the meeting could offer great opportunities to learn and influence.

2) Talking points on NCDs & young people:  The talking points highlight key messages related to the prevention, treatment, and management of NCDs in young people.  The information can be used in a variety of platforms, including but not limited to, social media, advocacy at high-level meetings, outreach to government, and collaborations with important civil society partners.  We hope you incorporate the messages into your advocacy efforts in the lead-up to the UN High Level Meeting on NCDs and beyond.  

Stay in the know on future resources made by youth advocates for youth advocates by joining the NCD Child Youth Voices Connect group on Facebook

Advancing Synergy: Laying the Foundation for Impactful Partnerships

This blog post was written by Dr Arti Patel Varanasi, Founder, President and CEO, and Dr Mychelle Farmer, Chief Medical Officer at Advancing Synergy. Advancing Synergy’s mission is to develop innovations that empower individuals and impact communities to achieve better health. They are a 2018 Global Health Council Member and actively engaged with the Noncommunicable Diseases (NCD) Roundtable.

At Advancing Synergy, we believe in the ability of diverse individuals and sectors coming together to leverage innovations that empower individuals to effect positive change and impact communities by making them healthier and stronger. Achieving health equity is central to our work and our mission. Our team believes in engaging all stakeholders, especially the end-users and youth leaders to ensure that the resulting technology-enabled solution will be useful to and accepted by the target audience. As a result, our initial efforts on addressing health disparities among cancer patients through technology-based interventions has extended to developing new partnerships to raise awareness about the needs of people worldwide for the prevention and control of noncommunicable diseases (NCDs).

Our partnerships have stemmed from our initial work in developing and evaluating our innovative digital health solution, POiNT℠ (point of need together℠) among low-income breast cancer patients. Through this project, we identified the importance of task-shifting and task-sharing as vehicles to promote adherence to NCDs care and treatment. Advancing Synergy set out to explore task-sharing through the use of digital health platforms and presented the work at the 2018 USAID Mini University and the 2018 Global Health and Innovation Conference. Additionally, recognizing the importance of developing solutions for diverse resources settings, Dr. Arti Varanasi, President & CEO of Advancing Synergy, was an invited speaker at the Chatham House research event on Harnessing New Technologies for Global Health Security in March 2018.

The NCD Child Workshop Group at the Global Health Practitioner Conference 2018. Image Courtesy: CORE Group DC

Advancing Synergy is now exploring new partnerships with civil society, academia, and the private and public sectors. Arti believes such partnerships allow each group to focus on their strengths and result in collective action to promote NCDs prevention and control. She is working closely with the CORE Group and was recently appointed the Chair of CORE Group’s NCDs Interest Group. Through careful consultation with members of CORE Group’s NCDs Interest Group, Advancing Synergy collaborated with NCD Child and CORE Group to conduct a half-day workshop on NCDs. This workshop, held in Bethesda, Maryland in June 2018, was attended by over 50 participants from diverse segments of civil society. Following the workshop, Advancing Synergy was also part of a Youth Delegation, organized under the leadership of Dr. Mychelle Farmer, Chief Medical Officer at Advancing Synergy and Chair of NCD Child, to visit UN Mission to share advocacy messaging around NCDs. Advancing Synergy will continue to collaborate with NCD Child and CORE Group, and the dialogue will continue through the NCDs Interest Group to find answers to difficult health challenges.

Focusing on the diverse health needs of poor and marginalized people, Advancing Synergy is laying a foundation for practical, low-cost solutions to practical problems related to NCDs that will help to answers questions, like: How can we learn from the experiences of others as we integrate NCDs into existing community health platforms? How can we transfer digital technology to low resource settings, so we can address complex health issues like NCDs? Central to finding answers to these questions is harnessing the talent, energy, and insight of young persons and empowering them as advocates for themselves and their communities. Dr. Mychelle Farmer brings her expertise in global health at the intersection of child and adolescent health, youth leadership, and noncommunicable diseases to lead Advancing Synergy’s youth advocacy initiatives.

Dr. Arti Varanasi presenting the GHC-NCD Roundtable joint statement at the Interactive Civil Society Hearing on NCDs. Image: American Academy of Pediatrics.

Advancing Synergy will take the message of task shifting and youth advocacy to a diverse population in need. As a representative of the Global Health Council and the NCD Roundtable at the United Nations Interactive Hearing on NCDs, Dr. Varanasi addressed the health needs of youth and the elderly. Digital solutions can link families including young and older family members struggling with NCDs, so they can identify local, age-appropriate solutions to the prevention and control of NCDs.

Advancing Synergy’s desire to extend cost-effective solutions to all in need will be supported by new partnerships. Informed by Advancing Synergy’s role as a member of NCD Roundtable’s steering committee, Dr. Varanasi’s leadership within CORE Group’s NCDs Interest Group, and through active participation in global health forums like the NCD Alliance and the Global NCD Forum, Advancing Synergy will spread the message of health for all, using practical, novel solutions to the world’s biggest health threat.