By Jo Musonda

Last Tuesday on December 1, the world celebrated World AIDS Day. And this month marks my 25th anniversary of working in the HIV/AIDS sector. I’ve been reflecting on how the world has changed for people living with HIV within a quarter of a century.

In the beginning of my career in London, most of my patients were gay men. So telling your loved one that you had HIV was a double disclosure of coming out about your status and being open about your sexuality. It was stigma that really got me interested in working in HIV in the first place.

People were genuinely terrified about knowing their status, as what was the point of knowing you were going to die a terrible death? Increasingly, more people from sub-Saharan Africa, primarily Ugandans, Kenyans, Zimbabweans and Zambians – were testing positive too.

Following the Rwanda 1994 genocide, I dreaded giving the HIV results to every Rwandan woman I counseled as the vast majority were HIV positive after experiencing rape being used a weapon of war. Women were advised to try and avoid getting pregnant as the virus would more than likely be passed onto the baby.

Fast-forward two years later in 1996 and a huge breakthrough happened. By combining three or more different drugs or antiretroviral therapy (ARVs), people were living much longer and getting far fewer HIV-related infections. As a result, many began getting tested as now there was a reason to know your status.

During that time, I was working for an NGO called Body Positive. We literally moved from funeral planning to back to works schemes within one year. The change was incredible!

In 2003, I moved to Zambia. What a shock to the system. It was like going back in time. There wasn’t HIV treatment available, except for a handful of wealthy individuals who could afford private prescriptions. The country was in a constant state of mourning. I attended more funerals in my first six months than I had ever gone to before.

Zambian pregnant women didn’t want to know their HIV status in case their husbands beat them or left them for testing positive. And a new phenomenon that I’d never encountered in the United Kingdom: there were now street kids everywhere, hundreds of them, orphaned by AIDS.

I was overwhelmed with what I could do but also struck by the resilience of the Zambian people and their determination to change the system.

Many said that gaining universal access to HIV treatment, such as ARVs, couldn’t happen in Africa. The drugs were too expensive, the health systems were too weak and the road structure too poor. The list of “why nots” went on and on.

However in 2005, the President’s Emergency Plan for AIDS Relief (PEPFAR) enabled ARVs to become available in Zambia and at no cost. Looking back on a decade of improved access, prevention programs, free HIV testing and treatment, I can see how far Zambia has come, with half a million people now currently taking ARVs in Zambia alone.

People are now living with HIV, not dying from it.

People are getting tested for HIV, especially during pregnancy. And even husbands are going to antenatal clinics with their wives and testing together.

People are talking about HIV, accessing treatment, increasingly becoming open about their status, having children being born HIV-free, supporting their families and living their life with hope.

Many organizations, including PCI, have helped communities tackle HIV, both in terms of raising awareness, improving prevention, accessing condoms and HIV testing, reducing stigma, preventing mother-to-child transmission (PMTCT) and caring for orphans and vulnerable children (OVC), affected by HIV.

I’m very proud that PCI Zambia has been part of that journey and has helped to improve the lives of people living with HIV (PLWH). Things are not perfect and there is still so much to do but it’s important for us to take a moment to reflect on how much we have achieved as we continue to innovate on how to improve global health and look to an eventual future when there could be zero new HIV infections.

Jo Musonda is the Country Director, Zambia for PCI.