Innovative approaches to end HIV among key populations

Nick Veldwijk, Country Manager Pakistan & Nepal from Mainline

This is part 1 of a blog series on innovation. In this first episode Nick Veldwijk, Country Manager Pakistan & Nepal at alliance partner Mainline explains the basics and the innovative work in Pakistan.

If you thought I would present an innovative cure to end AIDS, I have to disappoint you; it is not there (yet). But, innovation within the Bridging the Gaps programme can increase access to services, empower key populations to claim their rights, and reduce stigma and discrimination among service providers and health institutions. Innovation can increase cost-effectiveness, efficiency and act as catalyst to reach our end-goal of ending the AIDS epidemic among key populations. Want to know how? Read the first edition of this new blog series on innovation and get inspired!

Innovation within Bridging the Gaps

In 2016, we started developing the innovation agenda for Bridging the Gaps. We defined innovation as the timely application of new knowledge/skills/systems (both technical and social) to effectively address an existing problem that could not be solved by previous interventions. This includes all new processes, skills and methods that contribute to the programme’s goals and that include a learning component. I was surprised to learn that the alliance partners already did a lot on innovation – from service delivery to advocacy approaches and community-led responses. We agreed that we needed a shared definition of what innovation means, and that we should focus more on exchanging lessons learned. But what is the importance of innovation?

Why innovation?

With fewer resources and changing environments, the need to develop innovative interventions is growing. The last three decades have seen remarkable progress in the prevention, care and treatment of HIV/AIDS. But we are not there yet. We see new populations, changing means of communication, and less supportive environments. New solutions are needed, and efforts to find such solutions are supported by the Dutch Ministry of Foreign Affairs.

Learning as the main objective

Innovation is not just about finding technical solutions, but can also involve social/psychological interventions , such as the Trauma Buster Technique (TBT) in Pakistan.

Trauma Buster Technique elimates PTSS

Its effectiveness also depends on the people involved, and is highly contextual. What works in Pakistan may not work in Kenya. Innovation should never be a goal in itself –it must link to our objectives. Learning should always be the main objective. Testing innovations, risking failure, and – most importantly – documenting and sharing lessons learned. Good documentation helps to convince others and can accelerate the adoption of innovative approaches in their regular programming. 


Innovative work in Pakistan

The AAU in Pakistan is a perfect example of an innovation that was scaled-up (by the Global Fund) after proven effective. The ARV adherence unit (AAU) is an eight week treatment service that prepares HIV+ people who use drugs to remain adherent to their HIV medication, even if they relapse into drug use. A recent study showed the effectiveness of this pilot intervention. Initially funded by Mainline, the AAU’s capacity was doubled and as of 2018, will be scaled up across the country by the Global Fund.

Another example within Bridging the Gaps is the setting up of several innovative approaches of Mainline together with local partner Nai Zindagi, that strengthen the access and quality of harm reduction prevention services and ARV treatment. A mobile ARV unit is currently helping to increase access to ARV medication in rural Pakistan, and we have established a mobile follow-up system that helps PLHIV+ clients remain ARV adherent.

Nick in the field in Rawalpindi, Pakistan

Nick in the field in Rawalpindi, Pakistan

These are some interesting examples that show how innovation can enhance the access and use of health service for key populations, empower them to claim their health and rights and catalyse the results towards the ultimate goal of Bridging the Gaps: ending HIV among key populations.