Public health experts have demonstrated the effectiveness of combination anti-retroviral medications (ARVs) in prolonging the lives of some 15 million people who now have access to them throughout the world, including in many of the low-income countries. Efforts at promoting global solidarity by governments, industries, and private donors, both on bi-lateral and multi-lateral levels have indeed been successful in sharing the medical resources that once were limited to the “privileged few” with more and more of our needy sisters and brothers in the human family. Even though we do not yet have an effective vaccine to prevent infection with HIV, we can be grateful for another sign of hope – namely, that early diagnosis of HIV, and early treatment with ARVs, is effective in preventing the spread of the virus through sexual relationships.
Since we first learned about this epidemic, in the early 1980s, Caritas, as well as sister Catholic-inspired organisations and religious orders, and organisations linked to other faith communities, we have been on the “front lines”, providing educational, medical, emotional, social, economic, and spiritual support and care, to those living with the virus. We also have been deeply engaged with accompaniment of those burdened with caring for sick relatives or who have been widowed or orphaned as a result of the disease. Our care is offered without any distinction with regard to race, sex, ethnic or national origin, socio-economic status, religion, or the lack of religious belief.
Perhaps lesser known, however, is the role that we have played in providing ARV treatment and additional support services to millions of people living with HIV disease. Recently, Caritas Internationalis and the Catholic HIV and AIDS Network (CHAN) completed a study of this engagement. The origin of our research can be traced to doubts and criticisms related to faith-based HIV programming that we have heard over the years, such as “you may be well-intentioned, but you just are not professional enough”; “isn’t this really a cover-up for proselytising?”; “you operate your services independently from the government and do not follow national guidelines”; “you need to learn to do M&E; where is the data to prove that you are effective and efficient?”
The data contained in our report point to significant numbers of people served; excellent rates of retention in treatment (both for HIV and, when necessary, for tuberculosis); substantial reduction of HIV viral load among those being served in faith-based treatment programmes. Here are just a few highlights:
· Catholic Relief Services, a Caritas member organisation from the United States of America coordinated the AIDS Relief Programme with several other U.S.A.-based organisations and their local partners. It was supported by PEPFAR and channeled US$740 million dollars to local and national projects in 10 countries during a 9-year period. It served more than 700,000 patients, with almost 400,000 receiving ARVs, and trained more than 30,000 staff in facility- and community-based treatment centres.
· During 2014, Cabrini Ministries, operating in rural Lubombo Lowveld of Swaziland, served more than 2000 HIV-positive clients, 96 percent were started on ARVs, as well as some 880 orphans and vulnerable children;
· Last year, the Eastern Deanery AIDS Relief Programme, operated by the Archdiocese of Nairobi and the Maryknoll Fathers and Brothers, which I have had the privilege of visiting, offered HIV counseling and testing to some 126,000 clients during 2014, and some 97 percent of those who tested HIV-positive are now receiving ARVs.
· With coordination and technical support from the Uganda Catholic Medical Bureau, 142 Catholic Church-related health facilities provide care and support for a total of 69,103 HIV positive individuals receiving ARVs, including 6,220 children.
· The Catholic HIV/AIDS Services Incorporated in Papua New Guinea (PNG) provides HIV services through its vast national network of hospitals and health centers. It operated 24 anti-retroviral treatment sites in some of the most isolated and marginalised areas of the country. It also provides ARVs for HIV-positive and pregnant women and maintains them on such treatment after delivery in order to prevent mother-to-child transmission before, during, or after birth (though breastfeeding) and to keep both mother and child healthy.
Despite these bright signs of hope, however, our study also revealed urgent concerns related to sustainability of these treatment programmes. Some traditional governmental and non-governmental funders are cutting back their support for a variety of reasons, including shifting priorities. Low- and middle-income countries are being expected to compensate for these cutbacks, but such plans have not always been implemented and at times faith- or other community-based programmes do not qualify for domestic funding. Moreover, some international funders have terminated support for social and other support services, when in fact these programmes are essential to attract people to early testing and to keep them on treatment.
On this World AIDS Day 2015, I will conclude my message by taking special note of the inspiring message sent by Pope Francis to the participants in the Opening Session of the International AIDS Society’s Eighth Conference on HIV Pathogenesis, Treatment and Prevention, held during July 2015, in Vancouver. The Pope expressed his “esteem for the work and the dedication required” of the scientists, clinicians, and members of civil society engaged in the global AIDS response. He gave thanks for the lives saved by Highly Active Anti-Retroviral Treatment (HAART) and for the use of “Treatment as Prevention” and noted that such efforts “give witness to the possibilities for beneficial outcome when all sectors of society unite in common purpose.” Finally, he assured the participants of his prayers “that all advances in pharmacology, treatment, and research will be matched by a firm commitment to promote the integral development of each person as a beloved child of God.” In union with these words of Pope Francis, those of us working in faith-based Organisations consider ourselves privileged to serve as Key Stakeholders in efforts to “End AIDS as a Public Health Threat”.
1 December 2015
Msgr Robert J Vitillo
Caritas Internationalis’ special advisor on HIV/AIDS and Health