The India-Africa strategic partnership represents an immense opportunity and promises for a multi-dimensional and dynamic South-South collaboration and cooperation. A key area of focus in this collaboration was to establish a consortium between Indian and African clinical research centers (CRCs), centers of excellence and community experts. Such a regional collaborative network would enable community-to-community engagement and therefore catalyze, community-driven and assisted, joint population-based studies toward strengthening the ongoing programmatic efforts for addressing the HIV burden in the region.
A community experts representing KPs from Africa was organized by IAVI to provide a platform for the community members on both sides to engage with each other and deliberate on opportunities geared toward creation of a suitable consortium between Indian and African clinical research centres (CRCs), key population communities and other institutes and organizations of regional importance. The African delegation included representatives from various community-based organizations from across Kenya, Rwanda and Representatives from IAVI offices in Africa and India were also present.
Such a regional collaborative network would enable leveraging of complementary strengths in the conduct of joint population-based studies, which can catalyze the indigenous development of safe, affordable and effective tools and strategies to address the HIV burden, and also that for other common diseases in the region.
Specifically, the visit was organized to allow focused discussions on the following objectives:
♦ To build familiarity and collaboration with community engagement best practices and community partners respectively at the different India-Africa sites in view of community leadership and capacity;
♦ To exchange knowledge and experience with regard to the HIV testing practices which are already in existence in both regions and learning from the gaps and strengths to inform the development of a robust and implementable protocol;
♦ To identify and agree on community engagement aspects needed to promote HIV testing methods and assess the impact on (with a focus on the role and leadership of the target population) the following areas:
- • Community involvement, mobilization, engagement and ownership building strategies.
- • The incidence of HIV and transmission dynamics of HIV infections.
- • Psychosocial vulnerabilities (including interrelation of violence, stigma, low self-esteem and mental health) and risk factors.
- • Identification of new pockets of HIV infections and reaching out to hidden populations for HIV-testing using innovative strategies including social media.
- • Exploring ways of improving linkage and adherence to treatment (and other effective preventive interventions) based on mutual learning.
Utilization of new technologies and digital platforms (e.g., biometrics, mobile phones, social media, and online networking) to outline social and sexual networks.
The program that was developed for the visit was observed with very little alterations in provided time depending on the length of some of the discussions and other intervening factors e.g. traffic and drastic weather changes.
The following objectives were captured during the visit:
♦ Identification of further areas of partnership and the Initiation of conversations to strengthen context relevant program developments.
♦ There was enough knowledge and experience transfer on the strategies as deployed in the different contexts. Contacts were shared amongst the team for proceeding with some of these strategies as well as further inquiries.
♦ Discussions conducted on HIV self-testing amongst other initiatives including research.
♦ Options were sought so as to identify and ensure the hidden populations also access health care in both the public and the private institutions. One of these that has worked well is the use of social media as a mobilization platform; others were as captured in the recommendations below.
Further recommendations emerged:
♦ Strengthening capacity through knowledge and good practice by Continuing with peer to peer exchange learning: There is a lot we can learn for each other like the way to set up community Ethical Review Boards: With the formation of the SOGIE research in Kenya we would like to expand and learn for the Organization in India how they were able to have their own community review board.
♦ Set us mailing or list serves to continue with the collaboration; This way we can learn from reports and best practices from the organizations in India, Kenya, and Rwanda.
♦ Identify research areas we can work together Kenya and India and Rwanda or develop joint research programs that can have cross learning areas- Self-testing, PreP or Drugs abuse.
♦ Ensure community is involved and gives feedback on ongoing research discussion: Social Media and self-testing.
India has achieved a lot of programming with and for key populations. The programs are inclusive and pull the participation of the ‘Hijra’ (transgender) communities in prevention aspects as well; an intervention that has not been fully deployed. However, in both Kenya and India there still exists legal barriers that criminate same-sex conducts. Constitutional protection is one way of ensuring the total enjoyment of rights including access to health care. However, the attempts to reverse this in India was faced by a large opposition which made it very impossible to maintain the legal state as was ruled in 2010 by the Indian Courts. This then becomes another better avenue to learn further about the strategies that were not well implemented as well as share complementarities to the approaches. Media engagement including social media served as a key learning point to borrow from largely in order to access the hidden populations with services and information.
Overall, the trip aided in building familiarity with community engagement best practices based on cultural, religious and systemic differences in the regions. This understanding will enable in the creation of a collaborative platform to build a network of communities on both sides, leading the specific research initiatives that leverage on mutual strengths to address the common burden of HIV/AIDS in the region.