A result of the cumulative effects of widespread poverty, frequent droughts, armed conflict, political turmoil, intercommunal violence and population displacement, the dire food and nutrition situation in Mali has been severely compounded by the ongoing COVID-19 health crisis. Latest alerts from government-run early warning systems report that the current pandemic has been estimated to negatively affect the food and nutrition situation of an additional 5 million people in Mali. This includes 2.4 million men, women and children who are unable to meet their basic food and nutrition needs and require emergency food assistance. This is of particular grave concern among already vulnerable and disadvantaged populations in Malian communities, such as HIV+ individuals. In a UNAIDS report, when asked, “Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had HIV?” 46% of Malians responded “No,” hinting at the deep-rooted levels of stigmatization against HIV+ individuals.
This is where the l'Association de l'Espoir, “Sikoro Hope'' support group for people living with HIV and the nutritional support program come into play. These two programs are essential resources to the HIV+ community in Mali for many reasons: nutritional health of people receiving ARVs, stigma-reduction activities, and community building. The l'Association de l'Espoir, “Sikoro Hope” is a support group with the mission of fighting the social stigmatization that affects people living with HIV in Mali. Allowing for participants to share their personal experiences and emphasizing the importance of preventing further transmissions, the group provides a critical support system to address the initial shock of the HIV+ diagnosis for new patients.
Moreover, the program provides healthful meals to patients and their families. Meals are prepared by HIV+ patients for HIV+ patients and their families twice a week via the Nutrition Program. The Nutritional Support Program was created in 2008 in response to concerns about patient adherence to ARV treatment. GAIA VF’s doctors detected that food insecurity was negatively impacting patients’ ability to correctly take medications. This is especially important for an HIV+ pregnant women who require additional nutritional support during pregnancy and while taking ARV medication. In 2019, thanks to the generous support of donors, the program was able to provide 3,999 meals to those who needed it most; thus far into 2020, the program has served more than 1,500 individuals. More than provide healthy foods to the HIV+ community in Mali, the Nutritional Support Program also aims to reduce the high degree of misunderstanding about the HIV virus in Mali. The program deliberately practices the traditional Malian style of sharing a meal together that involves sitting around a communal bowl to eat. This custom between patients and clinic staff is a stigma-reducing activity that works to restore trust amongst people who refuse to share a meal with individuals that they believe are HIV+ in Mali. Now, with the growing public health challenges posed by the coronavirus, these community support programs are facing even greater demand.
As a result of COVID-19, the World Bank estimates that between 40 and 60 million people will fall into extreme poverty (under $1.90/day) in 2020 compared to the previous year. In Mali, over 40% of the population already lived below the international poverty line even before the current health crisis. Today, the support programs critically essential to the HIV+ Malian community are perhaps of even greater importance than ever before. During these tumultuous times, donations of any size go a long way in ensuring that marginalized communities are provided with adequate sustenance and resources. As we all face this global challenge, it is important to be aware of the unique barriers marginalized communities face as a result of this pandemic, and to support, as best we can, the needs of these communities.