By Dr. Gary Blick
More than a decade ago, I came into contact with the plight of a young HIV-positive Zimbabwean couple who tried desperately to conceive their first child. Tragically, they lost their HIV-positive firstborn who died shortly after birth. But it was more than 30 years ago when I decided to enter the field of HIV/AIDS research and treatment here in the United States. I was emotionally devastated by the amount of victims that this disease claimed in the early years of its arrival, as well as the indifference of politicians toward the most affected communities at the time.
Today, however, a different battle is being waged. Not between politicians and citizens and certainly not by an unknown disease of disputed origins. No, today we are more aware of the HIV/AIDS virus as well as the politico-social atmospheres that lend to its unfortunate and continued spread.
In the United States, just as in countries such as Zimbabwe—where my organization, World Health Clinicians, WHC, runs an entirely unique, health care provider-based HIV awareness and treatment initiative entitled BEAT AIDS Project Zimbabwe, BAPZ—we are not only witnessing a steady decline in certain numbers of HIV infection rates, but also a rapid increase of infections in demographics of youth aged 13 to 34.
Certain factors lend themselves to stigmatize different groups in each geographic location, such as men, health care workers and commercial sex workers in Zimbabwe, or individuals within the African-American, Latino and young gay or bisexual men—known as MSM—communities here in the U.S. But education is key to reducing the HIV/AIDS stigma, increasing awareness and decreasing the number of infections in any community, and that is one of the underlying goals of our outreach as we work to save the next generations here in the U.S. and abroad.
One dramatic and alarming difference in the response to HIV/AIDS in Zimbabwe compared with the U.S. has to do with those “lost to follow-up,” LTFU. In the U.S., a “developed” nation with the financial ability and structure to treat all Americans with HIV/AIDS, 1 million people have tested HIV-positive, but 50 percent of them, approximately 500,000 people, have been LTFU, with stigma being a strong contributing factor. In Victoria Falls, Zimbabwe, a town in a “developing” nation where BAPZ and the Zimbabwean Ministry of Health and Child Care, MoHCC, partner to perform HIV/AIDS outreach in the municipality and surrounding rural villages, the LTFU rate is 0.26 percent.
BEAT AIDS Project Zimbabwe is continuously helping local communities and revolutionizing the way that HIV/AIDS treatment is delivered throughout Zimbabwe, a country where 13.7 percent of the adult population—about 1.1 million people—is infected with the disease. We have even brought our popular anti-stigma and testing initiative, HIV Equal, to test and photograph local villagers. In June 2015, we opened our first state-of-the-art HIV specialty clinic in the township of Mkhosana, located in Victoria Falls, where we centralized our efforts to provide care to the nearly 22,000 people who fall within our jurisdiction.
Between 2011 and 2015, World AIDS Day had the theme “Getting to zero: Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths.” UNAIDS has set a 2030 goal of eradicating HIV around the globe via “90-90-90,” meaning by 2020, 90 percent of individuals will be getting tested for HIV, 90 percent of those who test positive will be started on HIV medications, and 90 percent of those HIV-positive individuals will have undetectable viral loads, which prevents transmission by 96 percent.
Through our continued efforts in Zimbabwe, we not only hope to stem the spread of HIV infection from mother to child, we also hope to provide the next generation with awareness, testing and linkage-to-care services that will help to reduce, if not eventually eradicate, the impact of HIV/AIDS on local communities there while also continuing our important work in the U.S.
Dr. Gary Blick is the co-founder and chief medical officer of the Norwalk, Conn.-based nonprofit humanitarian organization World Health Clinicians, whcccc.org, which provides awareness, treatment and prevention initiatives across the U.S. and Zimbabwe.