As a health journalist from Egypt, I took part in a programme entitled 'HIV/AIDS: prevention and treatment' that was organised by the US Department of State as part of an International Visitor programme to shed light on the efforts that had been exerted in the past and current practices to put an end to the HIV epidemic that spiked in the eighties and nineties before it declined, and presented many worldwide challenges.
The programme took me to four states in the United States (Maryland, Colorado, California, and Washington) as well as the capital, Washington, DC. My primary thought was that we would just witness American expertise in tackling the broad spectrum of different infection rates through conventional methods: provision of diagnosis, top notch drugs, and care in medical facilities.
It wasn’t long before I figured out how wrong I was. American methods to contain the HIV problem involved a more comprehensive approach and took into consideration many social aspects, something I feel is important to shed light on when considering Egypt’s relationship to HIV.
Although in Egypt we take pride in the low prevalence of infection (currently at 0.02%); this rate is actually disturbingly high among specific risk groups.
Moreover, there is no real guarantee that the rates will stay at their current level or dwindle, and the viral suppression (reaching an undetectable point of HIV in a sample blood test within the people living with the virus and taking medication) that really counts.
Secondly, the exposure I had in the US proved that in order to curb and eventually put an end to HIV in the community, you have to have perspective.
Indeed you must sometimes think conventionally to solve issues but other times you must think outside of the box, and when it comes to Egypt’s HIV issue, such an approach can be outlined in eight points:
New Port Hight School
Lets the kids do the talking
As we talked to different parties engaged in tackling the problem, we heard them speak with efficiency, whether politicians, scientists or members of NGOs. Nonetheless, none of these parties brimmed with the passion and enthusiasm that we saw at Newport high school in Seattle.
AIDS peer educators is an advanced health class, where participants learn first about HIV/AIDS, and develop presentation skills to deliver to their peers a two-day lesson telling them everything about the infection in a simple, comprehensive and exciting way.
As I watched the students talk and use different demonstration methods, it was very clear that this was the only way high school students would accept to listen and learn more.
Think: "treatment as prevention"
Raising awareness to prevent more infections is always a good approach, but more important is to treat those already infected, retain them in treatment, and monitor their adherence to drugs to suppress the virus.
This is the only way to reach true prevention as it makes it unlikely for them to transmit the infection.
Appleseed provided groundbreaking HIV recommendations
Bring in members of civil society
When initiative, diagnosis, and recommendations come from civil society bodies who work solely to improve living conditions, change really begins to take place.
In Washington DC, groups like Appleseed foundation and Hogan Lovells saw that the overwhelming issue of the 3.5 percent prevalence of HIV in the nation's capital was due to poor living conditions, hygiene practices, and lack of supportive legislation. These groups collaborated with volunteer attorneys, community experts and businesspeople to release the groundbreaking 2005 report which turned the situation around and pushed the government to issue regulations in favour of those affected by HIV.
Green ingredients cultivated with care in Project Open Hand
Food is part of the cure
Food insecurity is not just an issue in the developing world, but rather an international issue.
Through the work of NGOs like San Francisco's Project Open Hand and Maryland's Moveable Feast, an on-the-ground approach tackles the proven existing link between malnutrition and not adhering to medication or falling out of care.
Tens of thousands of those burdened by HIV, cancer and other critical illnesses receive tailored healthy meals that make them feel cared for and put them on the right track of health care.
Ryan White sculpture
candles adorn circle of names touched by HIV
Tell the stories and let the legacy live
Different countries have had to live their own stories of stigma that haunted people living with HIV and forced them to live in seclusion.
What turned the situation around was when affected people and their families told their stories, shared their agony and pushed the general population to relate to their stories in the 90s, people and families of those touched by HIV began speaking out against the stigma and the discrimination that they saw first hand, most notably the parents of Ryan White, who contracted HIV through blood transfusion and had to face discrimination along with his family even at his own school and among his neighbours. When people were forced to face their own cruelty, a change in behaviour began to occur.
Annual events like those commemorated in San Francisco's Aids Memorial Grove, ensure that these stories are known by future generations, and that those who lend a helping hand are identified and honoured.
In Egypt these stories are told only within closed circles, and rarely on mainstream media channels.
Dr Robert Gallo
Dr Thomas Campbell
Spread the word, but keep it simple, and keep the hope alive
The experience of talking to the legendary Dr Robert Gallo, who co-discovered HIV as the cause of AIDS and developed the HIV blood test in 1984 while at the National Cancer Institute, before becoming Director of the Institute of Human Virology at the University of Maryland School of Medicine , Dr King Holmes at the University of Washington’s Department of Global Health, Dr Thomas Campbell at Colorado AIDS Clinical Unit, Dr Ann Duerr at Fred Hutchinson research center and other medical experts provided overwhelming scientific information, state of the art research techniques and findings.
But what was really impressive was the ability of these top notch scientists to break complex information down into simple facts and communicate and infuse hope within the hearts of listeners.
It would be great to see scientists and medical professionals in Egypt do the same.
This connection infuses deep interest within the audience and a desire to learn more, feel the link between the society and those who are in charge of their health, understand that when it comes to wellness and diseases, different sectors of this society are always linked and correlated
Speak the same language
In the US, diversity is overwhelming, and the social and economic disparities among some of those living there is undeniable. It was understood from early on that the Latino community for example had to be addressed by its own people. A beautiful example of this was Clinica Tepeyac in Denver, where comprehensive care was offered to members of the Latino community. This was a place where they felt comfortable, welcoming psychiatrists who understood the stigma they suffered, and treatment regimen that included close follow-ups to monitor adherence to drugs until viral suppression is attained.
In Egypt, the problem of multiple ethnicities is not present as in other countries, nevertheless, it should be noted that different approaches should target different regions and address them while taking into consideration their social norms and culture.
In most communities, women also have an issue when it comes to HIV as they tend to carry the stigma in silence and fear, rarely having the courage to face the community.
The women empowerment programme in Colorado and other places lent an extra helping hand to those women who bear family responsibilities while suffering from stigma and despair.
In Egypt, many communities can relate to the same agony.
Art work by university students in Denver
Jamie Gentille, author of moving biography 'Surviving HIV'
Bring the action onto the campus
In Egypt, the universities need to be more of an active stage for students to express their ideas regarding developmental and social issues. This can happen by bringing the action into their territory, and providing a platform of art and self-expression.
An amazing photo gallery of paintings that captured the story of HIV in Denver's Tri-Institutional Campus was a great way to engage the students in ways that tell the story of HIV/AIDS in paintings.
In Baltimore, Maryland, Howard University organised a conference against the stigma, bringing the cause closer to youth territory and narrating to them stories of those who wouldn't accept to be defined as victims of HIV, but rather model survivors of writers, human advocates, politicians, and many other fields.