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Celebrating Women Who Fight for What Counts

By The Global Fund

March 7^th, 2022

When the Global Fund was created 20 years ago, HIV, tuberculosis (TB) and malaria seemed unbeatable. But – with science, increased investments and effective collaboration spanning the private and public sectors, civil society and people affected by the diseases – HIV, TB and malaria were forced into retreat.

The Global Fund partnership has saved 44 million lives and cut the combined death rate from the three diseases by 40%. Much of this success is due to the tireless efforts of women.

Around the world, the work of the Global Fund is mainly led by women – they are on the front lines identifying and fighting disease outbreaks, providing vital health services, ensuring essential supplies reach those most in need, advocating for equal access to health care and ensuring communities are prepared for future health threats.

On International Women’s Day, we celebrate some of the women who are part of the Global Fund partnership – women who fight for what counts.

Anjalee Weerasooriya: Ensuring people pushed to the margins access testing and counseling services

Sri Lanka

Celebrating Women Who Fight for What Counts

Anjalee was the first counsellor to join the community center and health clinic in Slave Island, a suburb of Sri Lanka’s capital city, Colombo.

The free clinic provides HIV, syphilis, hepatitis B and COVID-19 testing and counseling services. Most clients are referred to the clinic through a community outreach worker and many of them use drugs.

“When clients get a positive result on their sexually transmitted infection (STI) or HIV test, they get very emotional and do not know what to do. Some fall apart after hearing the news. I am here to talk to them and try to help them overcome their emotions to stay strong,” she says.

Anjalee explains that many people who use drugs face discrimination and are a particularly vulnerable group who often struggle to access health care.

“Many of them have financial issues because of drug use, and don’t have the money to pay for treatment or counseling. We do that for free here. Most of our clients come to us and talk to us like we are family,” she says.

The Global Fund works in partnership with the Ministry Health and others in Sri Lanka, including the Family Planning Association, to end HIV. The Slave Island community center and clinic is one of a number of successful programs targeting key populations – people who are most likely to be exposed to HIV and whose participation in fighting the disease is vital in ending the epidemic.

In 2020 alone, and despite the COVID-19 pandemic, Global Fund-supported HIV prevention programs reached nearly 15,000 people from key populations in Sri Lanka, a 20% increase from the previous year.

Carolyne Wasonga – Fighting HIV and gender-based violence

Kenya

Carolyne Wasonga doesn’t just have one job in her community – she has four.

She works as a community adolescent treatment supporter – providing assistance to young women with HIV, including on adhering to antiretroviral (ARV) treatment. She is a paralegal trained to identify and address cases of gender-based violence. As a "know your rights" facilitator, she organizes youth groups on understanding their rights and how to protect them. And she is a mentor, providing support and advice on a one-on-one basis.

Carolyne is also HIV positive. “I remember my first time at the hospital. No one could understand me, no one could talk to me. So I know if we talk to another HIV-positive person he or she will understand.”

COVID-19 created a number of new challenges for Carolyne and her colleagues, but the peer educator network was able to adapt quickly to continue to provide essential services. This included door-to-door client visits where Carolyne would deliver ARVs to young people facing challenges with their treatment or who were unable to get to the health facility, provide support, counseling and check-in visits, and respond to suspected cases of violence.

“What I love about my job is that I'm able to change lives. I can't change all of them, but there are a few individuals that I can change,” she says.

Carolyne is one of 400 peer educators who are part of a Global Fund-supported program aimed at reaching adolescent girls and young women with HIV prevention, treatment and care.

Maia Kintsurashvili - Supporting TB patients throughout their treatment

Georgia

Nurse Maia Kintsurashvili works at the Tskaltubo Hospital in western Georgia, where she provides care and support to people with TB. She has been working with TB patients for five years and has been a nurse since 2000.

“I consider the nursing profession to be one of the most humane, noble and honorable professions,” she says. “Every person who recovers brings great happiness to me.”

Maia’s work includes supporting patients through the Adhere mobile application – a video-supported treatment (VST) application which allows patients to take their medication at home, record the process and upload videos that Maia later reviews.

Providing this remote support can drastically improve the quality of life of Maia’s patients, especially those with drug-resistant TB. Treating drug-resistant TB is grueling. Patients take daily medications that can have severe side effects for up to two years. Many are hospitalized for months at a time and are required to make daily trips to a health clinic to ensure their treatment is supported and monitored closely.

By providing remote support with treatment adherence, Maia’s patients can live a life as normal as possible.

“It gives [patients] more time because they do not have to come to the clinic every day and can take the medication at any convenient time of day,” says Maia. “It also helps in the reality of the COVID-19 pandemic. Being in a risk group for COVID [because they have TB], they do not have to visit the clinic [frequently] and meet people who might be infected.”

Maia also explains that because her patients do not have to visit the clinic on a daily basis, some have started jobs, while others have been able to keep their jobs throughout treatment.

Global Fund investments now support VST applications such as AdhereTB in several countries across the Eastern Europe and Central Asia region, including in Armenia, Azerbaijan, Belarus, Kazakhstan, Moldova and Ukraine.

Isha* - Ensuring the smooth and timely delivery of vital health supplies

South Africa

As the inbound and inventory supervisor at a large warehouse in South Africa, Isha plays a critical role in getting COVID-19 tests to people who need them most across her country.

Isha is responsible for controlling what comes into the warehouse and ensuring products are stored correctly before they are shipped out. She says that she and her colleagues had to adapt the way they worked when COVID-19 tests arrived.

“It is a very sensitive product. If you mix a batch and send it out incorrectly, there is going to be an issue. We take a lot longer than we (usually do with other products) simply because we give that extra attention. We know the sensitivity around the product,” she says.

Isha is one of the many logistical experts whose role is often behind the scenes but is crucial in ensuring the smooth functioning of the supply chain that underpins any pandemic response, whether for COVID-19, HIV, TB or malaria.

“There are a lot of ups and downs. You have to make sure your stock is accurate, because if it is not – you’re going to have a problem. So that’s the most stressful part of my job. And making sure the vehicles are on time so we can receive it. But I love my job, I absolutely love it,” she says.

Through the COVID-19 Response Mechanism, the Global Fund is now the primary source of grant support to low- and middle-income countries for all COVID-19 tools except vaccines – this includes personal protective equipment for health care workers, medical oxygen and diagnostic tests.

*Name changed.

Dr. Jayanthi Shastri – Providing high quality diagnostics to everyone

India

Dr. Jayanthi Shastri leads a team of 53 doctors, paramedics and support staff at the Nair Hospital microbiology unit in Mumbai, India. She has been on the front line fighting infectious disease for 37 years.

Like many health care workers, Dr. Shastri and her team have been under an incredible amount of pressure because of the COVID-19 pandemic.

“We work long hours. There were times when many people on the team didn’t have transport to get to work, they struggled with homeschooling their children, and some had financial problems because their spouses lost their jobs,” she says.

While fighting COVID-19, Dr. Shastri’s and her team are also continuing to fight TB.

Determined to protect the gains made against TB, India has integrated TB and COVID-19 screening programs and laboratory services. In Mumbai, a new diagnostic tool developed and manufactured in India allows hospitals to do rapid, onsite co-testing for both diseases. Dr. Shastri says co-testing has been a game changer.

She also says that working at a public hospital gives her the opportunity to provide high quality diagnostic services to everyone, regardless of socioeconomic status.

“This gives me an immense sense of satisfaction.”

The Global Fund is supporting India to respond to COVID-19 and mitigate the impact on HIV, TB and malaria programs. This includes procuring testing tools and personal protective equipment for health workers, strengthening laboratories and diagnostics, and building the capacity of community health systems.

Dr. Erlina Burhan – A global leader in the fight against TB

Indonesia

Dr. Erlina Burhan has been a doctor for 30 years, spearheading the fight against TB in Indonesia. When COVID-19 hit, she took on another fight, and was appointed to lead her hospital’s COVID-19 commando team. She has also been closely involved in developing national policies to respond to the pandemic.

She has seen first-hand how the fight against TB has transformed over the last decade. “I was part of the initiation of when multi-drug resistant TB (MDR-TB) treatment started in Indonesia,” she says.

Dr. Burhan explains that during this time, back in 2009, there were only two hospitals in all of Indonesia that could treat MDR-TB patients, and each could accept only 50 patients. “Today, after more than a decade, we have more than 250 sites for MDR-TB services. This is really a good milestone,” she says.

A self-described optimist, Dr. Burhan says she has been able to see a silver lining throughout the COVID-19 pandemic, as many of the health protocols to protect people from the new virus, such as testing, tracing, hand-washing and social distancing, also protect people from TB.

“We have to make sure these positive things developed for COVID are also used in the fight against TB,” she says.

Decades of experience in fighting HIV, TB and malaria prepared many low- and middle-income countries in the Global Fund partnership to quickly respond to COVID-19, using the same laboratories, disease surveillance, community networks, trained health workers and supply chains that were already in place to fight HIV, TB and malaria.