“Progress is being made, but more must be done.”
I can’t count how many times I’ve heard these words, or a variation on them, at global health conferences, multilateral meetings, breakfasts, receptions, and workshops.
In the context of HIV/AIDS, around the world nearly 37 million people are living with HIV. And while new infections are decelerating, 1.8 million people were infected with the virus last year. In Sub-Saharan Africa, the burden of HIV/AIDS is so huge that more people die from AIDS each year than in all of North America, Latin America, Europe, the Middle East, and the Caribbean combined.
At the core of this inequity is a clear fact: the standard of HIV/AIDS prevention, treatment, and care remains woefully uneven because we simply have not invested enough in the people who serve on the front lines of communities hardest hit by, and most vulnerable to, HIV/AIDS.
Across the HIV care continuum, health workers play essential roles in educating, treating, and supporting patients as they seek to prevent or address HIV infection. We know that community health workers in African countries play key roles in service delivery for both prevention and treatment, yet community health worker programs for HIV lack adequate, long-term resources.
There’s good evidence that training, supervision, mentorship, and adequate compensation help retain health workers in their communities. Retention, in turn, increases the quality of coordinated care as well as health outcomes for people who are HIV-positive. Expanding the roles of nurses and midwives in pediatric HIV care can dramatically decrease mother-to-child transmission of HIV and reduce deaths among children.
So what more can be done? We must invest where we have not fully ever done so before: in health workers on the front lines of HIV. We should:
Invest in their training. Strengthening the skills of nurses and midwives will help advance the fight against HIV by elevating the standard of HIV care across health systems, even in the face of persistent health worker shortages.
Invest in their mentorship. In addition to classroom and clinical training, mentorship can offer needed support to providers, improve the quality of care they deliver, and ultimately strengthen prevention and survival for key populations.
Invest in their well-being. Fear of infection, stress, and burnout causes providers to leave active service in their communities. Investing in the resilience and well-being of health professionals and community health workers will increase retention and effectiveness as they battle this epidemic.
Invest in retaining them in hard-to-reach places. The availability of health workers in the least-resourced and most remote areas, such as central Uganda, is essential to closing gaps in service delivery.
On the eve of the 30th anniversary of World AIDS Day, as we look at what’s been done and what remains, we know we cannot create the single technology or find the single scientific advancement that will eliminate HIV/AIDS before the next World AIDS Day. What we can do is invest where it matters for so many people, every single day: in the people providing care to those who need it the most. By doing that we not only create an opportunity for equity and progress, but also a path towards greater empathy, understanding, and compassion as better-equipped providers offer stronger, more confident care to the people in their communities.
Vanessa Kerry, M.D., is the CEO and cofounder of Seed Global Health.