# Protecting the most vulnerable in Latin America and the Caribbean during times of COVID-19 - Stories - The Global Fund to Fight AIDS, Tuberculosis and Malaria
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# Protecting the most vulnerable in Latin America and the Caribbean during times of COVID-19
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Published: 10 February 2021
Latin America and the Caribbean have made significant progress in the fight against HIV, tuberculosis and malaria in the last few decades. But the COVID-19 pandemic has hit the region hard, and its indirect effects could allow infectious diseases to resurge.
With less than 10% of the world population, Latin American and the Caribbean had 28% of all COVID-19 cases and 34% of all deaths by October 2020. Since the pandemic began, the Global Fund partnership has raced to support the region’s governments and community organizations to protect hard-won gains on HIV, TB and malaria, and to support country responses to COVID-19.
With communities in the lead, the Global Fund is supporting innovative tools and solutions to respond to the COVID-19 crisis. These include digital applications for booking an HIV diagnostic test, video calls to monitor adherence to TB treatment, expanded molecular diagnostics and laboratory surveillance, and protective equipment for health workers who distribute mosquito nets door to door. The crisis has also created opportunities for the region to shift to more effective practices such as multi-month dispensing of antiretrovirals for HIV and expanding self-testing, gains that will stay for programs in the long term. But the Global Fund is also running out of resources to fight COVID-19 and more funds are urgently needed. As economic disruption increases inequality and pushes the most vulnerable deeper into poverty, it is more important than ever to make sure no one is left behind.
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When COVID-19 arrived in Guatemala, the community health center where Bryanna and her fellow sex workers got tested for HIV closed its doors. With support from the Global Fund, a pilot of self-testing kits is helping people like Bryanna continue to access to HIV prevention and diagnosis. The kits are delivered by post and include a self-test, condoms, lubricants and brochures on how to stay healthy. “The kit is very easy to use, and I can do it at home, so now I can test myself periodically,” said Bryanna. The Global Fund / James Rodriguez / Panos
In Latin America, three out of 10 people living with HIV refrained from accessing services amid the COVID-19 pandemic. In Panama, community-based organizations are using social media to reach key populations, including sex workers, men who have sex with men and transgender people. “Before we went to public places — parks, bus stops, nightclubs — where the young men would gather. We would meet, give talks and deliver condoms. With the pandemic we had to change,” explained Fredy, a community outreach worker with the Asociación de Hombres y Mujeres Nuevos de Panamá. Since April 2020, peer groups and transport companies in Panama have been delivering antiretroviral therapies to people living with the disease across the country. UNDP Panama/ Grey Díaz
In Haiti, COVID-19 threatened to hinder malaria prevention efforts, a prospect which could have had deadly consequences for the poorest country in the Western Hemisphere. With the support of the Global Fund and other partners, Haiti conducted a mass mosquito net campaign in 2020, adapted for times of COVID-19. The purchase of protective equipment such as gloves and masks allowed front-line health workers to maintain social distancing and distribute the nets door to door, rather than having community members gather together at a central location to collect the nets. Between 2010 and 2018, Haiti cut cases of malaria in half thanks to its community strategy and surveillance system in hard-to-reach areas. Successes in the fight against malaria give Haiti an opportunity to apply lessons learned to the new fight against COVID-19 to keep communities safe. DaliReel Productions / Nothing But Nets
Since the start of the COVID-19 pandemic, Kenny Espinosa, an HIV activist and health community worker in Colombia’s capital Bogota, has been busy making sure the most vulnerable are not left behind. Kenny, who works for the Colombian Network for Diversity Support, organizes counseling sessions and workshops on health and HIV to key populations such as men who have sex with men, transgender people, sex workers and migrants from neighboring Venezuela. Colombia has been one of the countries worst hit by COVID-19 in Latin America. Quarantine restrictions have exposed already marginalized communities to even more stigma and discrimination. “Most members of the LGBT community are on social media, so the TeCuidamos.com app has really helped us to break down barriers,” said the 25-year-old. “We can’t sit idle. There are solutions to fight against discrimination and to help the most vulnerable populations.” The Global Fund / Jose Miguel Gomez
With many health facilities in Colombia closed or repurposed to fight COVID-19, people living with HIV have struggled to access lifesaving services. With the support of the Global Fund, an app called TeCuidamos.com offers quick access to HIV diagnosis. It also provides prevention and counseling to men who have sex with men, transgender people, and sex workers. Developed by la Empresa Nacional Promotora del Desarrollo Territorial (ENTerritorio), the project is being implemented in Bogota, Medellin and five other Colombian cities. The Global Fund / Jose Miguel Gomez
Despite progress in prevention and control of tuberculosis, the disease is still a major public health problem in Latin America and the Caribbean. Lockdowns and social distancing forced by COVID-19 have interrupted treatment and prevention services, which could lead to more illness and deaths. In the Dominican Republic, health providers are using video calls to remotely observe people living with tuberculosis to ensure they adhere to their treatment. Health workers can record treatments through video calls. The Global Fund / John Rae
The COVID-19 pandemic is taking a heavy toll on vulnerable populations such as the LBGT community, indigenous people, prisoners and migrants, which already suffer from stigma and discrimination. The Global Fund is helping countries to strengthen human rights during the COVID-19 pandemic. In Honduras, the Global Fund is supporting online psychosocial help and human rights activities so that people living with HIV have access to medication. The Global Fund / John Rae
The fight against malaria continues village by village in the most remote corners of the region. In 2018, Paraguay became the first country in the Americas in more than four decades to be certified malaria-free. Despite wars and earthquakes, the small nation of El Salvador will join Paraguay this year in achieving the Herculean feat of eliminating malaria. Progress has been extraordinary against the mosquito-borne disease in most endemic countries in Latin America, with a 62% fall in cases between 2000 and 2015. Before COVID-19 hit, however, some countries had reported an increase in cases. This is especially worrying in areas where indigenous communities live in cities in the Amazon and Pacific regions. The Global Fund / John Rae
The Global Fund is helping Bolivia fight the pandemic and mitigate the impact of COVID-19 on HIV, TB and malaria programs. Global Fund support has allowed GeneXpert machines, currently used to test for TB, to be repurposed to also test for COVID-19 and has strengthened epidemiological surveillance of COVID-19 among people living with HIV. The Global Fund / Vincent Becker
In Latin America, online training of health staff has become essential to strengthen the response against diseases such as HIV and tuberculosis during the COVID-19 pandemic. In the Dominican Republic, Global Fund investments are supporting a unified system for the transportation of biological samples and the return of test results for HIV and tuberculosis. Lockdowns and other restrictions caused by the COVID-19 epidemic, however, impeded the training of laboratory personnel responsible for the collection of samples, including laboratory technicians, administrative teams and drivers. In response, the Global Fund supported an online self-training course, which is certified by the National Health Service and the Ministry of Health. By mid-March, more than 1,000 students had registered for the course and 767 had completed it. One of the participants, a laboratory bioanalyst, said: “This is an excellent training as we learn and strengthen our knowledge from home.” The unified system for the transportation of samples allows operational efficiencies and faster results, contributing to better service quality and sustainability. Photo: GIS
The Global Fund has invested US$2.4 billion to help Latin America and the Caribbean meet the Sustainable Development Goal 3 targets of eliminating HIV, tuberculosis and malaria by 2030 and to build strong systems for health. But COVID-19 is causing a serious setback in the region’s living standards. The International Monetary Fund projected that Latin American economies would contract by 8.1% in 2020 in its October 2020 forecasts. Since the COVID-19 pandemic began, the Global Fund has spent close to US$30 million to help the region mitigate the impact of the pandemic on HIV, TB and malaria programs and to help fight COVID-19. This partnership is working – new tools and solutions are being developed and distributed but more funding is needed to keep delivering results. UNDP Bolivia / Miguel Samper UNDP Bolivia / Miguel Samper
Global Fund and COVID-19
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