Model of care began in Haiti, influenced global policy, and spread around the world

Posted on July 28, 2022

In 1986, Partners In Health began caring for patients diagnosed with HIV and AIDS in Haiti. Clinicians with Zanmi Lasante, as PIH is known in Haiti, started with free testing, counseling, and inpatient care. Soon thereafter,  PIH leadership joined a growing global advocacy movement fighting for accessible, affordable, lifesaving antiretroviral treatment and the rights of all patients, despite nationality or economic status.

By the late 1990s, PIH was among few organizations providing free, comprehensive HIV/AIDS treatment to marginalized patients. Haitian men and women living with the virus rose from their deathbeds, in what became termed “the Lazarus effect,” as their conditions improved with community-based care and support.  

Word of PIH’s success in Haiti spread rapidly. Over time and at the invitation of national governments, PIH began collaborating with colleagues in Peru, Rwanda, Lesotho, Malawi, Liberia, and other countries to replicate its model of HIV/AIDS care globally. Though its reach broadened, PIH’s mission never waned: the work has always centered on accompanying patients throughout their medical journeys and beyond, with social support, compassion, and top-notch care. 

Explore the timeline below for more information about PIH’s global work in HIV and AIDS:

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1991 

The First Patients

The first person living with AIDS walked through PIH’s clinic doors in Haiti in 1986. Free testing, counseling, and inpatient care soon followed for hundreds of people living with AIDS.

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1992 

Paul Farmer’s AIDS and Accusation

Farmer’s book offers a systematic analysis of the racism driving theories that Haiti was the source of HIV in the western hemisphere.

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1998 

HIV Equity Initiative

PIH launched one of the first programs to provide free, comprehensive HIV and AIDS treatment. Newly recruited and trained community health workers delivered medications and accompanied people living with AIDS through treatment.

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1999

Paul Farmer’s Infections and Inequalities

Farmer shows how entrenched beliefs about “cost-effective treatment” and patient “non-compliance” blame people living with AIDS for their illnesses, such as HIV, rather than call out systematic forces of oppression.

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2001 

Cange Declaration

As Haitians living with HIV regained their health, some became activists, issuing the Cange Declaration and calling for increased access to lifesaving drugs.

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2003 

Global Advocacy and Influence

PIH’s success in Haiti was key to expanding ARTs globally, contributing to the development of the Global Fund to Fight AIDS, Tuberculosis and Malaria, and PEPFAR.

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2005 

National HIV and AIDS Program in Rwanda

PIH was invited to Rwanda to support the country’s HIV and AIDS program by integrating HIV care and treatment in many primary health centers in Rwinkwavu District

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2010 

CHWs Improve Outcomes in Peru

A study in Lima, Peru showed people living with HIV and accompanied by a CHW had better outcomes at 12 months, including higher viral suppression.

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2014 

Doubling Access in Rural Lesotho

PIH supported the government of Lesotho to revamp 72 inadequately resourced and understaffed clinics throughout four districts, increasing HIV treatment enrollment by 133%.

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2018

Post-Ebola Improvements in Liberia

A study of post-Ebola care in Liberia found that CHW support resulted in better ART coverage and retention of patients living with HIV.

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2021

Leaving No One Behind in Malawi

PIH launched in Malawi the Tracing Retention and Care Enrollment (TRACE) program to welcome people living with HIV back into care. With CHW outreach, 86% re-engaged with HIV care.

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2022

HIV and AIDS Care Continues Amid COVID

As new threats emerged in the form of COVID-19, highlighting old challenges in care delivery, people living with HIV continued to receive lifesaving HIV treatment, offering hope.

Originally published on pih.org

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