As FHI 360 marks its 50th anniversary, explore our history of solutions and future of possibilities.
As COVID-19 variants continue to emerge, the global vaccination effort is becoming more urgent. That is why FHI 360 is working hard to ensure that people around the world, including those living with HIV, have support, information and access to COVID-19 vaccines.
“The HIV epidemic — now in its 40th year — has claimed the lives of more than 36 million people, and now the COVID-19 pandemic poses an additional threat to people living with HIV,” said Tim Mastro, the chief science officer at FHI 360. “Fortunately, in contrast to HIV, we have highly effective and safe vaccines for COVID-19. They should be made available to all people — especially to those who may be at increased risk of severe COVID-19 disease due to underlying health conditions or compromised immune systems.”
The Meeting Targets and Maintaining Epidemic Control (EpiC) project, supported by the U.S. Agency for International Development, provides strategic technical assistance and direct service delivery to achieve HIV epidemic control in more than 40 countries. Since April 2020, FHI 360’s EpiC team has also worked to mitigate the impact of COVID-19 through clinical care, vaccine scale-up and technical assistance that reinforce the activities of health systems as they respond to COVID-19 in countries in Africa, the Asia Pacific region and Latin America.
The team is mobilizing people in the fight against both diseases. In Indonesia, for example, they built on the existing infrastructure for HIV programs to recruit hundreds of trained providers and helped to establish nearly 200 COVID-19 vaccination sites in train stations, mosques, temples and other community areas. And they are going the extra mile to ensure that people living with HIV get the information and support they need to be vaccinated.
Combating vaccine hesitancy
In Papua New Guinea, key populations — such as men who have sex with men, transgender people and sex workers — have a higher likelihood of both acquiring HIV and being exposed to COVID-19. They also can encounter barriers to accessing health services, such as stigma, discrimination and other social and economic factors.
Vaccine hesitancy is also a challenge. Papua New Guinea has administered nearly 436,000 doses — assuming each person needs two doses, only about 2.5 percent of the country’s population has been vaccinated. So, the EpiC team began embedding COVID-19 vaccination sensitization activities into its routine programs. They soon recognized that service providers who work with people living with HIV also needed additional support and training. In response, they created a two-day training for peer outreach workers, adherence counselors and trackers — the individuals who help the team find people with interrupted HIV treatment.
Immediately after the first training, nearly a third of the participants received their first COVID-19 vaccine dose, and the numbers continue to grow. The hope is that these service providers, who are already advocates for HIV epidemic control, will help people living with HIV feel more confident in getting the COVID-19 vaccine.
Collaborating for the greater good
Eswatini (formerly Swaziland) has the highest prevalence rate of HIV in the world — about 27 percent. EpiC’s partners run drop-in centers that provide services — including psychosocial services, screening for sexually transmitted infections, access to pre-exposure prophylaxis and antiretroviral medication — to key populations, including men who have sex with men, female sex workers, people who inject drugs and transgender people.
To combat COVID-19, Eswatini’s Ministry of Health holds vaccination clinics during the day — but not everyone is available during those hours. To ensure that more people can access COVID-19 vaccines, EpiC partnered with the Luke Commission, a local organization, to offer a vaccine drop-in center for key populations.
“It was a collaboration for the greater good,” said Laura Muzart, country representative for FHI 360. EpiC expanded the hours of operation at its drop-in center, keeping it open over the weekend and after business hours and providing vaccinations for both key populations and the general public. The team also trained health care workers to administer COVID-19 vaccines.
Locally led vaccination efforts
In India’s Telangana state, EpiC has been working through its local partner, the LEPRA Society, in five districts, focusing on organizational capacity-building for 18 civil society organizations (CSOs). Most of the CSOs have been actively involved in the COVID-19 response since the pandemic began, but by the end of August, very few of the people registered with them — people living with HIV and members of key populations — had been vaccinated.
EpiC helped the organizations prepare to promote vaccination, hosting a training that explained the importance of vaccinating people living with HIV and debunked myths and misconceptions about vaccines. After the training, the CSOs began sharing vaccination information with the populations they serve. Peer volunteers set up help desks and assisted people in using a mobile app developed by the government to register for vaccine appointments.
By continuously following up with and encouraging the CSOs, EpiC has helped to advance the COVID-19 vaccine efforts in Telangana. Over the past two months, the CSOs supported nearly 2,000 people living with HIV and members of key populations in receiving their first dose.
“FHI 360 has a 50-year history of fighting for equitable access to public health interventions,” said Hally Mahler, FHI 360’s HIV director. “HIV projects have deep roots in communities, and local partnerships can be leveraged to ensure that people living with HIV have accurate information about and access to COVID-19 vaccines. We must take advantage of the HIV program infrastructure and relationships to promote the health and human rights of people affected by both HIV and the COVID-19 pandemic.”
