In my work, I meet many women who have had difficult times in their lives. As the National Coordinator for the International Community of Women Living with HIV (ICW) Malawi Chapter, I organize awareness campaigns, support organizations' HIV work and provide a space for women to talk about their HIV status and reproductive health. I myself was diagnosed with HIV in 2004; but, 13 years later, I find the social stigma I felt then still affects many women in Malawi today.
Chimwemwe, a 31-year-old woman living in Kaliyeka, one of the poorest neighborhoods in the outskirts of Lilongwe city, has a typical story. She and her husband lived a difficult life mainly from hand to mouth in which during some days of the month they would not be certain of their next meal, but Chimwemwe started a small-scale business of selling food items door to door. When she was pregnant with her last child, she became sick. Her husband persuaded her to visit traditional healers from his home areas, but she did not improve after. One day she became so sick that she could not manage to walk or do anything, and her friends decided to take her to the clinic for treatment. It was there that she was found to have tuberculosis (TB) and HIV. She was put straight away on TB treatment and later started on antiretroviral therapy (ART).
Upon discovering that his wife had HIV, her husband divorced her for "bringing the virus into the home." Chimwemwe denied that she was the one that brought HIV into the family, as she was always faithful to her husband, but the husband did not listen. Chimwemwe's story ends well, however. With treatment and community support from groups like ICW Malawi, she got her health back. Since then, she's continued raising her three children, ages five to 11 years old, alone from her small business, which has grown into selling second-hand clothes.
I find Chimwemwe's story compelling because of her courage and resilience in the face of rejection and deep-rooted cultural beliefs: she had to overcome many barriers to treatment. Her story is similar to mine in that she was saved despite enduring hardships, and it shows that to achieve the 90-90-90 target, we need to put more effort on reducing cultural barriers and gender stereotypes in Malawi.
According to the Global Fund to Fight AIDS, Tuberculosis and Malaria — the organization that helped me first get ART and vertical transmission services so my son would not contract HIV — in Malawi, among adults living with HIV who know their status, 89 per cent report use of ART and, among these, 91 per cent have their HIV virus suppressed, but more outreach is needed to get people aware of their status. Malawi has recently signed a new grant with the Global Fund that will help it reach the 90-90-90 targets by 2020.
In Malawi, HIV prevalence is one of the highest in the world, but women have a prevalence rate of 12.8 per cent compared to 8.2 per cent for men. For all the gains made here, external and internal investment in HIV is declining and what is being cut first are community-based interventions that can reach out to women like Chimwemwe. Without this outreach, women will not have equal access to health care.
I'm calling on the government to increase domestic resources and prioritize treatment, care and support services to all, including women. By doing advocacy work and influencing change of policies, my organization is trying its best to stand up for the right to health for all women.
Clara Banya is the National Coordinator for the International Community of Women Living with HIV (ICW) Malawi Chapter and a member of the Global Fund Advocates Network Speakers Bureau, a group of advocates who have seen the impact of the Global Fund to Fight AIDS, Tuberculosis and Malaria in their lives.
This blog is part of the blog series: Barometer Rising: No time to backtrack the fast track to ending HIV as a global health threat by 2030 by the Interagency Coalition on AIDS and Development (ICAD) in recognition of World AIDS Day (1 December). The series features a selection of blogs written by our member and partner organizations. Contributors share their broad range of perspectives and insight on the right to health within Canada and globally to critically reflect on the response to HIV knowing we are now just 2 years from the 2020 Fast-Track targets (90-90-90) and just over a decade away from the 2030 Global Goals for Sustainable Development (SDGs).
Are we on the right track or are we on the back-track?
Disclaimer: The views and opinions expressed in this blog series are those of the authors and do not necessarily reflect those of ICAD.