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World AIDS Day: Mombasa doctor honoured amid threat from pandemic to erode gains 

Nairobi, 3 December 2020 - Dr Abdulnoor Ismail Mohamed, manager of the UNODC-supported Opioid Substitution Therapy (OST) Clinic in Mombasa County, yesterday received a PEPFAR Heroes Award 2020 from the U.S. Ambassador to Kenya, Mr. Kyle McCarter.

The PEPFAR Heroes Awards are presented annually – coinciding with World AIDS Day on 1 December – to recognize outstanding efforts to support people living with HIV/AIDS.

Dr. Abdulnoor was recognized for his relentless efforts, personal initiatives and dedication to ensuring People Who Use and Inject Drugs (PWU/ID) in Mombasa County have continued to receive the essential services they need despite the COVID-19 pandemic.

“Notable was his steadfast leadership in operationalizing the Shimo La Tewa OST dispensing site to serve people in the prison and surrounding communities during the pandemic, for example, ensuring that clients received movement permits so they could still cross lockdown areas to access treatment. Dr. Abdulnoor also initiated mobile dispensing of methadone in Mombasa’s Old Town in collaboration with NASCOP and Kenya Red Cross to serve clients residing in this locality, and is credited with the overall high retention rates of clients in the programme by scaling up coverage of OST services despite COVID-19,” the Head of UNODC’s Health and Social Development Pillar at the Regional Office for Eastern Africa, Dr. Fayzal Sulliman, said.

The Shimo La Tewa OST clinic, or Medically Assisted Therapy (MAT) clinic, was funded by PEPFAR through USAID, with UNODC as the implementing partner, working in conjunction with Mombasa County and the Kenya Prison Service.

This facility has ensured continuum of care for over 100 clients in prison and reduced travel for other clients in surrounding communities throughout the pandemic.

“People who use drugs are much safer here in the treatment programme than on the streets or in the dens. Cases of overdose have increased, and this should not be the case,” Dr. Abdulnoor said.

“That’s why we still want to induct them despite the prevailing pandemic. All safety measures and UNODC guidelines are being strictly observed. Our clients will get Personal Protective Equipment here, and through Civil Society Organizations, and they also get the right information on COVID-19 and better access to treatment services as compared to being on the streets,” Dr. Abdulnoor added.

This year’s World AIDS Day – the 32nd edition since its inception – was commemorated against the backdrop of the COVID-19 pandemic that has plunged the world into an unprecedented crisis which is threatening to erode gains made in the fight against HIV/AIDS over many years.

The COVID-19 pandemic has presented unique challenges to HIV programmes, especially those targeting key populations such as PWU/ID. Staying at home, maintaining social distancing, regular hand washing with soap and access to health services are difficult to implement among this target group due to history of social exclusion, stigma and discrimination.

In her address during a global World AIDS Day event, the UNODC Executive Director, Ms. Ghada Fathi Waly, called for global solidarity and shared responsibility to strengthen the AIDS response, noting that: “We can only reach our target of ending AIDS if we put people at the centre of our efforts and leave no one behind”.

The pandemic has stretched health providers to breaking point in many countries, and the response measures put in place by governments have created a significant dislocation in the global economy.

“Like all epidemics, it is widening the gaps and inequalities, and amplifying the challenges that already existed,” the Chief of the UNODC HIV Global Programme, Ms Fariba Soltani, observed.

A recent study by UNAIDS warned of retrogression of the HIV epidemic in Sub-Saharan Africa caused by COVID-19. The report noted further that the global AIDS response could be set back by 10 years or more if the COVID-19 disrupts HIV services, a situation partners are determined to avoid.

UNODC’s Regional Office for Eastern Africa has been at the forefront of promoting evidence-based, human rights-centred and gender responsive HIV treatment and care interventions for PWU/ID.

In Kenya, to minimize diversion of this controlled substance, methadone is currently provided as Directly Observed Therapy (DOT), where every enrolled client visits a designated facility to get their daily doses that must be ingested in the presence of an authorized health practitioner. 

Many PWU/ID earn their living through informal employment, sex work and menial jobs. Containment measures, such as the curfew, negatively impacted PWU/ID livelihoods, while enforcement of containment measures put them at greater risk of human rights violations by law enforcement officers.

“I should be at home by 7:00 pm or I will be beaten by police. But I don’t have a home, I live on the streets,” stated by a methadone client.

Earlier this year, normal programmes and interventions such as provision of clean needles and syringes, condoms and Health Information Education Communication through outreach became impossible as PWU/ID fled usual meeting areas for fear of arrest by police enforcing social distancing.

UNODC responded, initially by mobilizing resources and supporting procurement of essential Personal Protective Equipment (PPE) for health care workers and MAT clients at target sites in Mombasa, Kilifi and Kwale Counties.

UNODC also supported COVID-19 responses within prisons in the region, especially in setting up isolation centres for COVID 19 suspected cases and provision of PPE.

Dr Abdulnoor was one of six recipients of a 2020 PEPFAR Heroes Award in Kenya that were announced by Ambassador McCarter during a virtual event.

Through over 100 PEPFAR-supported implementing partners, the US Government is providing high quality comprehensive prevention, care, and treatment services in counties most affected by HIV/AIDS in Kenya.

Photo of van: Mobile van used in mobile dispensing of methadone in Mombasa Old Town during the lockdown due to the pandemic

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Mobile Van used in mobile dispensing of Methadone in Mombasa Old Town during the lockdown due to the pandemic.