World AIDS Day 2020: A time to ruminate

It’s the 32nd World AIDS Day and I am committed to share my message of compassion and to remind us all that people can live life beyond AIDS. Partners all across the world are paying tribute to those working to prevent new HIV infections, providing HIV services, and advocating for equal access to treatment to enable those living with HIV/AIDS to live well. 

We hear that we missed our global targets for 2020 and another huge challenge of COVID-19 has complicated the services and programs. We need solidarity to maintain HIV services during COVID-19, because pregnant women cannot delay their antiretroviral therapy (ART), nor can an HIV+ infant, children and adolescents relapse into higher HIV load. The key populations still need prophylaxis. Nurses and midwives need more support and protection as they reach out to those living with HIV. It’s a year to strive and make it possible for future generations to live AIDS–free, no matter what.

Being AIDS-free was never an easy option for people like Sokha (not her real name). Her memory will last with me forever. She was only 6 years old and was diagnosed with HIV – the reason for her being abandoned at the Missionaries Of Charity Centre for HIV/AIDS Care just outside of Phnom Penh. She got infected while taking care of her sick mother, but had no one to take care of her. I met her during my weekly visits to help the sisters give care to people living with AIDS. Sokha climbed right into my lap and started telling me how her doll loved her mother and was missing home. My time with her was limited to 3 months only, but she is a constant reminder for me that every child deserves the right to be adored and protected.

As I was getting my thoughts together for this article I took out the box of memorabilia from my work. I found the STOP AIDS key ring with a condom from 1995. These key rings were a daring effort to bring HIV prevention messages to the general population. Early 90s were marked with a hesitation to talk about HIV/AIDS even among health care providers.

I remember we used to drop our voice a note or two when saying the word condom. Condoms were distributed freely after the HIV/AIDS education sessions. I can never forget the sight of children running around with funny looking balloons when we arrived at the village the next morning for a follow-up session. The participants had thrown out the condoms at the end of the session, only to be picked up and blown up as balloons by the children. STOP AIDS was a strong program slogan and huge amounts of resources were allocated. 

It still seems like it was a lofty call, ending HIV by 2030 still remains a major global health challenge.  WHO reports that there were 1,700,000 new HIV infections in 2019.

However, as I ruminate I realize that we may not have STOPPED AIDS, over the last decades we have definitely:

  • STOPPED the fear of AIDS
  • STOPPED the untimely death of people living with AIDS-related illnesses
  • STOPPED the indifference to AIDS epidemic in a large number of countries 

I also found the HOPE pin in my box of memorabilia. The fact that more and more people are receiving care gives us HOPE and encouragement to do more. In 2019, 68% of adults, 53% of children, and 85% of pregnant and breastfeeding women who were living with HIV received ART (WHO).

ART not only protects the mother’s health, but also ensures prevention of HIV transmission to their infants. The HOPE pin brings back the memory of my first case of full-blown AIDS.

One morning as I reached the office the guard came running to say that there was a bundle left for me. A young man wrapped in a blanket had been left at the gate. The project driver and I went through the whole city to find a place for the young man. He was accepted by the Missionaries of Charity Centre, and received compassionate care and attention by the sisters, until the day he passed.

A ray of hope filled my team’s heart, hope that something could be done for those with full blown AIDS, when ART had not been heard of.

Equitable Access to Treatment and Care

As more and more AIDS cases were brought in, the notion of impact had completely changed. Caring for people living with AIDS was becoming the biggest need. Treatment regimes though available were still not accessible to everyone in the early 90s. Covering large populations in need was a humongous challenge; we not only had to find new resources but we also had to fathom how to deliver with equity. 

Who was going to get prioritized for the treatment first was the biggest question. A question based on age, concurrent health problems, pregnancy and availability of resources. A question that the health experts and world leaders are facing again for COVID-19 vaccine, now that it is at the horizon. 

On December 1, capture the rays of hope.

Hope because we’ve got what is needed, and cannot give up.

We need to expand and intensify to:

  • Deliver HIV services and ART with equity through primary health care
  • Widen the range of interventions to transform the lives of communities we serve
  • Pivot and add Social Finance and Social Enterprise model for sustainability of HIV & AIDS resources
  • Build up on transferring existing research knowledge into programs  

We may be missing the global targets for 2020. But today on 1 December, let’s commit to find what remains to be done and do it better than before.


December 1, 2020


Zari Gill