Alliance India: Emerging Challenges of COVID-19 and Community Action

allianceindia 11 April, 2020

A woman receives her ARV medications provided to her at the doorstep by one of our frontline workers in Pali, Rajasthan.

On 24th March, the Government of India directed a national lockdown for 21 days in a bid to contain the novel coronavirus. The unprecedented situation has left the poor and vulnerable people facing huge challenges such as loss of livelihoods, hunger, and inaccessibility of medication for critical diseases such as HIV, TB, diabetes and renal disease.

Alliance India serves the most disadvantaged and marginalized communities including transgender, women in sex work, men who have sex with men, migrants, people who use drugs, truckers, people living with HIV, and TB patients. In the COVID-19 induced lockdown, their lives are at greater risk more than the others.

There are 2.1 million people living with HIV in India. Alliance India serves nearly 1.4 million people living with HIV through 320 care and support centres (CSCs) in all 32 states and union territories. People living with HIV are immunocompromised, and people with TB may have pre-existing respiratory dysfunction. This puts them on a higher risk of coronavirus infection. Our priority, therefore, is to health services for communities in our care.

Frontline workers braving COVID-19 to deliver life-saving medications to people living with HIV.

Alliance India is working with civil society partners and government agencies to ensure access to antiretroviral (ARV) medication. In partnership with State AIDS Control Societies across India, our 1574 outreach workers put their own lives on the line to supply antiretroviral medication to those who weren’t able to access due to non-availability of transport services. Our 320 CSCs across India are taking various steps to support communities, including the supply of essential food provisions.

More than 1,08,988 people living with HIV were able to collect life-saving ARV medications from the nearest community distribution centre. Additionally, outreach workers completed door-step delivery for 20,766 people living with HIV. Most of them were elderly and orphans either in critical condition or living in hard to reach areas.

“I thought I will not survive. Both, the lockdown and HIV would kill me soon. But now you make me feel that I still have a chance to live. Thank you for standing with me”, said a person living with HIV from Adisaptagram, Hooghly.

Alliance India has been reaching out to the high-risk communities such as men who have sex with men (MSM) and the transgender (TG) communities through weekly Facebook live sessions to provide vital information on COVID –19 prevention measures reaching more than 25,000 online audience. The transgender and hijra communities, mostly surviving on badhaai (begging) and sex work, in the Mayur Vihar area of Delhi are severely impacted. Our partner, Basera Samajik Sansthan under the Wajood programme quickly came to their rescue. The Community Based Organisation with the help of local stakeholders is providing nearly 70 transgender and hijra with food packages for the entire lockdown period.

Food distribution among transgender and hijra community at Mayur Vihar, Delhi.

The announcement of nationwide lockdown could have made things difficult for people who use/inject drugs to access OST services. Opioid substitution therapy (OST) is a replacement drug, a prescribed medicine, which is usually administered orally in a supervised clinical setting for people who use/inject drugs. However, National AIDS Control Organization (NACO) quickly provided guidelines for one-week take-home OST doses to clients and ensured that their life-saving services were not interrupted.

However, when we learnt that the information hadn’t reached the nodal officer in Gorakhpur, we worked with the state drug user community network to raise this matter with NACO officials. NACO immediately intervened. The timely intervention by the community network led to OST centres providing take-home doses to people enrolled in the harm reduction programme.

Alliance India is working closely with state drug user community networks to reach out to community members needing essential Harm Reduction supplies and antiretroviral medicines in these extraordinary circumstances. We are committed to ensuring that services reach the most at risk and hard to reach communities of people who use drugs.

There is a possibility that the government might extend the lockdown further. It is a rapidly evolving situation. In these uncertain times, Alliance India remains steadfast in its resolve to strengthen the resilience of communities in order to mitigate the challenges of COVID-19 outbreak. We are also soliciting support from several corporate entities to provide safety items for our field staff.

Together, we shall overcome!