In Cameroon, COVID-19 pandemic preventing HIV/AIDS patients getting treatment

YAOUNDÉ, Cameroon – As COVID-19 hits Cameroon’s health system, there are worries that people suffering from HIV/AIDS aren’t getting the help they need.

The West African country has seen 21,000 cases of the new coronavirus, with 400 deaths recorded.

However, the United Nations estimates 540,000 people were living with HIV in Cameroon, with a prevalence rate of 3.6 percent of the population.

Catholic Relief Services (CRS) is the overseas development agency of the U.S. bishops’ conference and has been working in Cameroon with the support of the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, since 2014, supporting orphans and vulnerable children and their families living with or affected by HIV.

PEPFAR was launched by George W. Bush in 2003, and since then has provided over $85 billion in funding for HIV/AIDS treatment, prevention, and research. The U.S. government estimates is has saved over 18 million lives around the world.

However, CRS is worried these advances could suffer a setback due to the coronavirus pandemic.

“This work has been complicated by the COVID-19 pandemic and there is concern is that COVID-19 will lead to a spike in AIDS-related deaths in Cameroon,” said Dr. Leslie C. Chingang, who heads HIV/AIDS programs for CRS in Cameroon.

A major program of CRS in Cameroon is KIDSS – Key Interventions to Develop Systems and Services for Orphans and Vulnerable Children.

Chingang told Crux that programmatic data in the big cities of Yaoundé and Douala revealed that as result of the COVID-19 pandemic, most project participants were not able to report for their medical check-ups or to collect medications from the HIV treatment facilities.

“They expressed panic and fear of contamination by COVID-19 since the government also used the same health facilities as COVID-19 treatment centers. KIDSS sensitized the children and adults living with HIV about COVID-19 and recommended that project participant stay in their homes as much as possible,” she said.

According to Joel Wanyoike, who works on the KIDSS project, HIV diminishes a family’s economic potential.

“All resources for the family can end up paying for medical care,” he told Crux.

He said people living with HIV/AIDS face not only stigma, but also find it hard accessing good quality medical services and continual treatment to achieve adherence.

“You need to address the needs of the child and the caregiver who is responsible so that the child can remain healthy, reduce episodes of illness, go back to school, do well in school and reduce absences at school,” he said.

Chingang told Crux that in order to ensure that support for people living with HIV continued when COVID-19 cases were reported in Cameroon, CRS quickly re-thought their service delivery approaches.

“Case workers typically visited program participants within their homes, engaging in face-to-face consultations — an activity that was halted to ensure safety for staff and program participants from COVID-19 transmission. The project adapted by conducting rapid assessments, which were administered virtually. Additionally, counseling support services were provided through voice calls and messaging,” she said.

To ensure that life-saving drugs continued to reach people with HIV, when COVID-19 cases were first reported in Cameroon, CRS adjusted its HIV programming to support home delivery of antiretroviral therapies and testing services.

The project also responded to the need for awareness among people with HIV to ensure they are protected from COVID-19.

Chingang said prevention messaging about avoiding COVID-19 was integrated into training for partners and caseworkers for use during consultations. In addition, protective materials including masks were also shared with partners where face-to-face meetings were required.

“The project made use of digital solutions to build the capacity of CRS and partners’ workforce through virtual training on topics such as case management, data collection tools, finance and compliance, and COVID-19 preventive measures. The virtual training was facilitated by CRS technical trainers who worked from their homes. This training approach was effective, as evidenced by the virtual training outcome results. The lessons learned through this experience go a long way in strengthening the project’s resolve to pursue continuous mentorship and trainings of the workforce and to be able to support vulnerable children and families living with HIV,” she explained.

“We also adapted the roll-out and decentralization of data entry in the project web-based database dubbed COLMIS (Cameroon OVC Longitudinal Management Information System) which strengthened data management, virtual performance tracking and helped to enforce COVID-19 safety measures by allowing data entry clerks and case workers to key in data using either mobile devices or computers,” Chingang continued.

“The project created zonal WhatsApp groups which are used for providing timely feedback to those teams. In addition, the project case workers used mobile devices to provide targeted WASH and COVID-19 preventive messages to participants,” she said.

Wanyoike told Crux that the PEPFAR initiative “has saved over 18 million lives, prevented millions of HIV infections, and accelerated progress toward controlling the HIV and AIDS in more than 50 countries.”

“Catholic Relief Services has reached 50,000 children and their families in Cameroon, thanks to the support of USAID’s PEPFAR program, and Church and civil society partnerships along with the Cameroonian government,” he said.