Case Study- Zambia. An Interview with Marshall Mweshi, an HIV/AIDS information advocate and affiliate with the Network of Zambian People Living with HIV (NZP+)
James N. Nkhoswe and Renée Hartig
Yesterday we posted on the current situation with living with HIV/AIDS, discussing how treatments are coming to fruition but COVID-19, red-tape, religion, and poverty are creating bottlenecks for getting those treatments to patients. Today we interview Marshall Mweshi, an HIV/AIDS information advocate.
Q: What is the name of the organization that you work with?
The Network of Zambian People Living with HIV (NZP+). There is also a mini group: Luyando Support Group – to empower women and gather funds for entrepreneurship, targeting mostly rural areas (where it’s difficult to access drugs), and provide good nutrition.
Q: Is the work volunteer-based? Can other individuals become involved in this effort?
All work is voluntary and anyone is welcome to join. Both local and international individuals interested to join and help out, whether in Zambia or abroad, are welcome to come on board and help empowerment in any form, whether monetary based or to meet the group and share their lives with people living with HIV/AIDs (PLWHA).
Most work is to support group projects, such as agriculture and tailoring, as well as education and information on how to take care of their children (most of them are also living with HIV/AIDS). To teach PLWHA to be independent and not rely as much on the government.
Q: Who are the partners (local, regional, continental and/or international)?
We partner with local community leaders as well as internationally with our partner, Adam Cape, from the UK.
Q: What would you say is the mission or goal of this organization?
Our current focus is Southern Zambia. We would like to move the project to many parts of Zambia and grow it nationwide, targeting new areas both in urban and rural (e.g., Choma) areas.
The challenge is to address a healthy diet that is lacking. Hence, mothers are stopping children from taking drugs, even though drugs may be accessible in urban areas.
Our overall goals are door-to-door communication, home visits (check-ups) on people on ART [antiretroviral therapy]. To see that PLWHA have a normal life and are able to access drugs as well as food and other services, such as education, is our mission.
Q: Is there a measure or metric used to help infer the success of the organization in carrying out its goals?
Engage with other organizations and help bring more people on board, taking for example the work done already in Choma, Zambia.
Q: Where is the work primarily focused?
In Southern Zambia: Livingstone rural areas, such as Libuyu. Urban areas too, like Maramba and Choma. In these regions we focus on the lack of information, education projects, and food. Women are mostly targeted because they are the ones who have the most parent-child time and are most affected.
Q: Is there motivation to expand efforts to reach a greater number of people?
That motivation can only come, if at all, by reaching out to a number of people. This is contingent upon further engagement.
Q: What may be one of the biggest benefits that this program provides?
To see a change in their livelihoods, for the adults and the children, and see to it that they are able to engage in different businesses and fulfilling activities.
Q: What do you personally enjoy about this work or what is one thing that brings you satisfaction?
It’s an unbelievable feeling […] coming from the people living with this virus. I’ve seen the difficulties, I’ve seen their difficulties. To see that working, it really gives me satisfaction. To hear PLWHA say: “I can do anything even if I have HIV/AIDS,” it gives me such satisfaction to hear that.
Q: What more do you think could be done to help improve the current situation?
To learn from people and organizations and to learn from ideas to be able to see a number of things that should be done differently and be improved on.
Q: How do you deal with a situation which may be influenced by religious leaders?
It is a problem on the ground and a major issue when it leads people to stop taking the drugs. Organizations have to work with churches, but also education is needed to help support the community.
Q: How can you ensure funds are directed where they are most needed? Funneling investments?
A number of people have not been reached out to, a lack of full engagement on the ground, this is something evident by the lack of support for those people on the ground. Giving out money is not as sustainable as providing education and engagement. I would like nothing more than to see that everyone is engaged and receives the right information.
Scientific evidence supports the use of antiretroviral drugs to treat HIV/AIDS, providing PLWHA with the means to live a long, healthy life1,2. Thanks to biomedical research with animals, we have such drugs at our disposal and new advances in treatment are well underway (such as with gene-editing technology). Clinical trials are always necessary to test the efficacy in humans. While some individuals may not be inclined to take pharmaceuticals or cannot afford treatment, herbal remedies have been promoted by various traditional practitioners, particularly within spiritual communities. Traditional healing must nonetheless be subject to the scientific process3, just like any other treatment, to corroborate potential healing power (see clinical trials in Zambia). New medical discoveries and advancements must receive fair reception for trial and experimental justice within encouraging time-frames to permit the observation of effects. To ease the burden of taking medication daily, researchers have been developing a long-lasting drug-delivery system in the form of a subcutaneous implant3,4. A seven-year study in animals showed how this new technology can deliver different types of drugs needed in tandem and consistently deliver for long periods of time before needing a replacement. Efforts to improve the accessibility and delivery of life-saving drugs may well help us reach the goal for 2030, while biomedical researchers continue to develop a vaccine for HIV.
1 Mascolini, M. (February 22-25, 2016). Conference on Retroviruses and Opportunistic Infections (CROI). USA, Boston MA.
2 Flexner, C. (July, 2018). Antiretroviral implants for treatment and prevention of HIV infection. Current Opinion in HIV and AIDS: Volume 13 – Issue 4 – p 374-380 doi: 10.1097/COH.0000000000000470
3 Chinsembu, K. (October 23, 2009). Model and experiences of initiating collaboration with traditional healers in validation of ethnomedicines for HIV/AIDS in Namibia. J Ethnobiol Ethnomed. ;5:30. doi: 10.1186/1746-4269-5-30. PMID: 19852791; PMCID: PMC2771007.
4 Weld, E. and Flexner, C. (January, 2020). Long-acting implants to treat and prevent HIV infection. Curr Opin HIV AIDS. 5(1):33-41. doi: 10.1097/COH.0000000000000591. PMID: 31764198; PMCID: PMC7050620.