Raising Awareness, Decreasing Stigma

A patient receiving needed medication, which is supported through UNDP’s health system strengthening efforts, Western Bahr el Ghazal state. UNDP/Brian Sokol


During her last pregnancy, Alice[1] became ill and visited her local hospital for testing where she found out that she had both HIV and tuberculosis (TB).  Her husband had recently died and left her to care for their four young children on her own. While her father took care of the children, Alice received three months of treatment at her local hospital.  Today, she is healthier, stronger and energetic.


It is estimated that more than 100,000 people are living with HIV in South Sudan, but only about 4,678 people access Anti-retroviral therapy (ARVs). For people living with HIV, contracting TB only adds to the challenges they face, as health services and treatment are limited.  Moreover, with both HIV and TB heavily stigmatized, those affected are often reluctant to seek treatment, even where health services are available.


The TB and HIV collaborative programme through the Global Fund to Fight AIDS, Malaria and Tuberculosis targets people with HIV who are at risk of TB by providing information on prevention, surveillance, testing, counselling and most importantly hope to those living with HIV and TB. As Principle Recipient of the Global Fund, UNDP has administered six rounds of funding since 2004, delivering an average of USD 25 million per year.


Alice received treatment through this collaborative programme.  She was admitted to the Central Equatoria state hospital in Yei, where the TB ward has 52 beds and healthcare workers provide daily informational sessions on key health topics from preventing the spread of HIV and TB to the importance of good nutrition and hand-washing.  In 2012 1,497 TB/HIV co-infected people received ARV treatment, and 4,882 people with tuberculosis received TB treatment. Of those who received the TB treatment, 94% are positively reacting to treatment (smear converted) and 76% were successfully treated.


Alice has also become instrumental in raising awareness in her community about the link between TB and HIV and available health services.   Alice explains her motivation “I want to tell people about HIV and TB so the community is not closed to TB and HIV patients”.  As a peer educator she speaks to her family, friends, neighbours and community members in church, the market, and their homes to encourage them to get tested, provide resources, and educate them on the symptoms and prevention methods for these diseases.  Such activism is invaluable as it supports health education, raises visibility that TB can be cured and HIV managed and helps communities and patients overcome any stigma. According to Alice, the outlook is positive. “With time, there will come an understanding”.


The Global Fund currently is the only source of funding to address HIV; and the major source of funding for health services to fight TB and Malaria in South Sudan.  By collaborating with sub-recipients and implementing partners, needed health services have been provided to over 155 health care facilities throughout the ten states.   UNDP is also ensuring that clinics have the capacity to offer those services by providing on-the-job coaching and training to staff who provide diagnostic counselling and testing. As a result, the number of TB patients offered HIV diagnostic counselling and testing rose from just one person in 2005 to 12,753 in 2012.  At the same time because of the training in inventory management, in 2012, no TB facilities experienced out of stock medicine and all new TB patients were registered and notified to the National Tuberculosis Programme.


[1] Not her real name

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