World AIDS Day: Importance of Local, Community-based Response
An assessment of the past 20 years of HIV/AIDS response in South Africa has shed light on critical scientific advances and the world’s most expansive Anti-Retroviral Therapy (ART) delivery system, currently serving 3.1 million people. In a country with the largest population of HIV-infected people (6.3 million, about 12% of the entire population), scaling up life-saving treatment programs is crucial. An effective ART program, however, is only part of the solution. Pervasive socio-economic, racial, and gender inequality has undermined the capacity of communities to overcome the debilitating legacy of HIV/AIDS. Why, then, do shortsighted, one-dimensional approaches dominate the discourse? Is the goal to simply add patients to a treatment regime in order to reach a milestone? Or is it to engender a sustained state of well-being which will meaningfully transform lives?
At Ubuntu Education Fund, we strive to achieve the latter.
In solidarity with the rest of the world, Ubuntu clients, staff and the rest of the community join hands and march to show support to those that have died because of AIDS and those still living with the disease.
This year, the South African National AIDS Council focused its attention on the importance of local responses in battling the fight against AIDS. Based in the heart of the townships of Port Elizabeth, South Africa, the Ubuntu Centre is a testament to the power of local initiatives. As a truly community-based institution, Ubuntu places local leaders at the center of their own development. Ninety-five percent of our staff—educators, accountants, administrators, clinicians, and counselors—are members of the community that we serve. It is their knowledge, skills, and vision that drive our work forward, which is why investing in community members and systems is vital for sustainable change. Local leaders are uniquely positioned to identify, understand, and respond to the needs of those who face the brunt of inequitable access to health and basic services. When strengthened, community systems can facilitate the management and delivery of services as well as mobilize action for improved social conditions and access.
Years of partnership-building and knowledge production at the local level have taught us valuable lessons and best practices. While South Africa has made noteworthy strides in preventing new infections and expanding treatment programs, the most vulnerable sections of the population still remain disproportionately at-risk. The AIDS epidemic has eroded family structures across South Africa; an entire generation has died, leaving behind hundreds of thousands of orphans who face insurmountable challenges. In 2014, there were 2.3 million children in South Africa who had been orphaned by HIV and AIDS. Without the protection of a family, financial security, or opportunities, orphans are at a higher risk of HIV transmission. Similarly, young women—due to poverty, lower status, and gender-based violence—face an HIV prevalence rate over four times higher than the rate for males. Given these disparities, isolated interventions to address the effects of HIV/AIDS are neither impactful nor sustainable.
HIV/AIDS is more than a public health issue. When compounded with obstacles that many of our communities face—poor education, abject poverty, gender-based violence, and high unemployment—the epidemic can impose multi-layered systems of inequality on those at risk. Thus, it is one of the most urgent development issues of our time.
With a nuanced understanding of the specific challenges that vulnerable South African families face, The Ubuntu model provides life-long care for children, from cradle to career. Ubuntu’s comprehensive HIV/TB program is all-encompassing, including testing, onsite treatment, adherence support, counseling, sexual and reproductive health services, primary and preventative care, nutritional and well-being programs, and community outreach initiatives. This program is coupled with educational, household stability, and health services, which work together to ensure 2,000 children and their families are on track towards healthy, stable futures.
The extraordinary results of our initiatives demonstrate that local responses work: we have maintained a 96% HIV drug regimen adherence rate (compared to Port Elizabeth’s 57%), and 100% of expectant HIV-positive mothers have given birth to HIV-negative babies.