After the first COVID-19 case was detected in the SADC region in early March 2020, countries imposed restrictions or lockdowns of differing intensity and duration as an urgent response in dealing with the health crisis posed by the pandemic. These measures disrupted social and economic life and access to health services, many of which were reconfigured to manage COVID-19 cases. In the SADC region, national responses to COVID-19 occurred in a context of systemically weak and under resourced health systems and high burden of HIV, and other chronic illnesses among the populace. Community-led or outreach activities play a key role in mobilizing communities, combatting stigma, holding government accountable in policy and practice, and supporting health systems as well as have unique reach to populations who are disproportionately burdened by the HIV epidemic. Community-led HIV responses are the cornerstone to the HIV response in the region 3 but little is known about the impacts of the COVID-19 measures on the gains the region has made in the provision of HIV prevention, care and treatment. This brief presents the findings of a rapid assessment amongst 25 civil society organisations involved in the HIV response across the SADC region and provides recommendations for sustaining the community-led HIV response in the face of ongoing and future health crises.
We conducted in depth interviews with representatives of 25 civil society organizations (CSOs) in the SADC region. Countries included were Madagascar, Mozambique, Angola, Democratic Republic of Congo, Zimbabwe, Zambia, Mauritius, Seychelles, South Africa, Botswana, Malawi, Republic of Tanzania, Lesotho, eSwatini, and Namibia. We included a spectrum of CSOs involved in the community-led HIV response, including networks, and grassroots organisations to larger, more established organisations with national reach. Constituencies of the participating organisations included people living with HIV, adolescent girls and young women, school going youth, lesbian, gay, bisexual and transgender people, sex workers of all genders, and people who use drugs. Programmatic focus areas of the organisations included advocacy, campaigning and participating in accountability; community-based service delivery (clinical, psychosocial, socioeconomic support, legal assistance, services or support, community outreach), education, training, sensitisation, adherence support, income generation) and community-based research.