Radical Partnerships to End the HIV Epidemic: Collaborative innovation under Gilead’s Zeroing In™ Initiative

Malawi’s impressive progress towards ending the HIV/AIDS epidemic over the last 8 years has made achieving the 95-95-95 UNAIDS treatment goals likely and ending the epidemic by 2030 truly possible. GAIA Global Health has been a key implementing partner to the government’s strategy to end the epidemic through our innovative and effective care models in rural communities. Since GAIA’s mobile clinics were first launched in 2008 to improve access to healthcare and HIV services, GAIA has provided integrated horizontal systems of primary health care for rural communities, with total clinic visits now topping 2.6 million, almost 120,000 clients tested for HIV, and client positivity dropping from 23% to 2% in 2022.

For the past 12 years, Gilead Sciences has been a vital private sector partner to GAIA’s work to improve health outcomes in Malawi. Gilead is a thoughtful champion for the work “that needs to be done beyond the science,” supporting local communities to lead the way to address barriers to care, and accelerating the radical partnerships that are key to ending the HIV epidemic - radical partnerships requiring not only innovation but new levels of trust and courage, recognizing that today’s complex and uncertain challenges must be tackled together. 

As Malawi nears HIV epidemic control, targeted testing and prevention services are critical for populations with low prevalence but high recent infection risk, namely men 25-34, adolescent girls and young women and key populations such as female sex workers. In 2022, with funding from Gilead’s Zeroing In™: Ending the HIV Epidemic grant program, GAIA launched new partnerships to further integrate additional outreach services for these important populations within our primary health care model - services that are key to destigmatizing care, improving access for key populations, and ensuring care is available for those at highest risk.

With Gilead’s support for the Services at the Far End of the Road (SAFER) project, GAIA collaborated with Pakachere, a local NGO trusted within the sex worker community, and district providers to expand moonlight outreach events and make integrated services accessible for female sex workers. This collaboration provides comprehensive services for these women, including gender based violence counseling, STI and cervical cancer screening, family planning services and HIV testing - 7% of those tested for HIV were found positive and linked to treatment and care.

Through SAFER, GAIA enhanced key reproductive health services at our clinics to prevent new infections, including community-based antenatal services. Through radical collaborations with Medecins Sans Frontieres, Partners in Hope, Population Services International and the local District Health Office, we facilitated cervical cancer screening and treatment opportunities and connected clients to follow on care. This screening is critically important given Malawi’s high rate of Cervical Cancer (7x global average) and the higher risk for women living with HIV (5x those who are seronegative).

Under SAFER, we grew our collaborative work with Baylor Foundation Malawi to ensure ART is available in the community for our clients.* We also built on our successful approach to reaching men and expanded outreach activities, providing HIV services to 2,388 men, nearly doubling the number of men tested, with 3% testing positive and linked to treatment and care. And we enhanced our health talk content to address the needs and behaviors of target populations, including important updated information on availability of PEP and PrEP, VMMC, and Undetectable=Untransmissible (U=U) messaging (Tizirombo tochepa = Thanzi, T=T in the local language, Chichewa). 

With Gilead’s support, GAIA is successfully reaching key populations at risk and reducing disparities in access to care at a critical time in Malawi’s progress towards HIV epidemic control. Malawi’s newly released Health Sector Strategic Plan (January 2023) shows the country is not resting on the impressive progress made to achieve epidemic control, but continuing to set ambitious targets to end HIV and reduce associated morbidity and mortality. Together with grant funding from thoughtful and creative partners, like Gilead, and radical collaboration with government and private implementing partners, GAIA will continue to innovate and deliver cost-effective interventions for those at highest risk or living with HIV.

Note: ART is provided free to all Malawians by the Malawi government with support from the Global Fund. GAIA does not directly provide ART to clients, but facilitates community-based outreach efforts.

Learn more about Gilead's Zeroing In initiative