The most important factors for long-term sustainability are strengthening healthcare infrastructure, ensuring adequate financing for health, and helping to build local healthcare capacity through training and support. Public-private partnerships have a critical role to play in this process, drawing on the complementary expertise of all stakeholders—governments, international agencies, community organizations, donors, the private sector, nongovernmental organizations (NGOs), patients and others—to identify the most promising and efficient ways to address the impact of HIV in a variety of resource-limited settings.
In this section, we outline some of the many programs and partnerships Merck supports around the world to help address the challenge of HIV.
African Comprehensive HIV/AIDS Partnerships (ACHAP)
In 2000, the Government of Botswana, The Merck Company Foundation/Merck, and the Bill & Melinda Gates Foundation established the African Comprehensive HIV/AIDS Partnerships (ACHAP) to support and enhance Botswana's response to the HIV/AIDS epidemic through a comprehensive approach to HIV/AIDS prevention, care, treatment and support. In 2010, Merck renewed its commitment to ACHAP with an additional grant of $30 million for the period 20102014—bringing its total to $86.5 million over 15 years. Merck also agreed to continue the donation of its antiretroviral therapies (ARVs) for the duration of the partnership. By 2010, over 90 percent of people in Botswana in need of treatment were receiving it, compared with 5 percent when the program began in 2000. Learn more.
Keeping HIV-Positive Mothers and Their Babies Healthy: mothers2mothers
Since 2008 Merck has supported mothers2mothers (m2m) to facilitate HIV-prevention programs for mothers at prenatal clinics in rural Lesotho. The program aims to reduce the number of babies born with HIV through the prevention of mother-to -child transmission (PMTCT). M2m also develops and implements HIV-skills training for women in HIV management, in order to better serve the community. Since m2m initiated its program in Lesotho, the organization has opened 66 sites, hired 24 site coordinators, trained 86 “Mentor Mothers,” enrolled 13,600 patients and fostered 80,900 client interactions
Educating and Empowering Young People through Soccer
Merck has supported Grassroot Soccer's program in Namibia since 2008. The Football for an HIV Free Generation (F4) program combines outreach programs for youth that foster educational, leadership and life-skills development. The key aims are: (1) to reduce the rate of HIV infection; (2) to engage young people across Namibia as advocates in the fight against HIV, to help them make a positive difference in their communities; and (3) to help boost leadership and increase country-level focus on improving HIV prevention. The Namibia program, which began in 2006, has trained 184 coaches and graduated 11,025 young people.
Eastern Europe/Middle East
Promoting Prevention and Raising Awareness in the Russian Federation
Merck has supported the Social Partnership Development Fund (SPDF) in the Russian Federation to expand HIV prevention and community outreach projects. The strategic aim of this fund is to raise awareness of HIV treatment among people living with HIV/AIDS, medical specialists, service providers and healthcare officials. The SPDF has provided web-based updates on HIV treatment and care guidelines, has expanded HIV information on drug registration/availability, and has developed and disseminated materials on HIV treatment in Russian.
Educating and Empowering Young People: U Ch00se (Bulgaria)
Since 2009, Merck has supported the U Ch00se campaign in Bulgaria to increase awareness about the prevention and consequences of STDs (mainly HIV/AIDS and HPV) among youth and young adults between the ages of 11 and 26. The campaign aims to teach by disseminating information, encouraging communication to promote key messages, and training peer educators.
Since 2010, the campaign has established an online presence that includes educational information, a blog and other opportunities for dialogue about topics that can be hard to talk about. The campaign also produced a film profiling the youth point of view on the issue of STDs. Additional updates on the program’s progress in 2011 are forthcoming.
China-MSD HIV/AIDS Partnership
The China-MSD HIV/AIDS Partnership (C-MAP), a collaboration between The Merck Company Foundation and China's Ministry of Health, works toward the comprehensive prevention and treatment of HIV/AIDS in China. Established in 2005 with an initial seven-year, US $30 million commitment from The Merck Company Foundation, the program is the most extensive HIV/AIDS prevention and treatment initiative to be conducted to date through collaboration between the Chinese government and a foreign company in China. First introduced in three counties in Liangshan Prefecture, Sichuan Province, C-MAP has been extended to another 20 regions and prefectures in Sichuan, reaching a total of 62 project sites. In the areas served by the partnership in China’s Sichuan Province, the number of AIDS patients on treatment increased from 0 to close to 1,500 in just three years. Learn more about C-MAP and the progress being made through this collaborative effort.
"Reaching Out" to People Living with HIV/AIDS (PLWHA) in Malaysia
In 2010, Merck supported the Malaysian Society for HIV Medicine's "Reaching Out" program, which is designed to help women, single mothers and injecting drug users (IDU) living with HIV/AIDS in need of psychosocial support and life skills. This support led to MASHM implementing in 2011: (1) workshops for HIV caregivers that will provide updates on the use of new agents and their development for ID specialists focusing on both national and international guidelines; (2) life-supporting skills and psychosocial support to women, pregnant women and single mothers living with HIV; and (3) self-management support to IDUs on HAART (highly active antiretroviral therapy) regimens.
Merck is committed to reducing healthcare disparities and improving access to HIV treatment and care in the United States. As part of this commitment, Merck engages in collaborations to reduce the impact of HIV on those most in need and most at risk. Merck works with leading AIDS service organizations (ASOs) to develop solutions that strengthen access to treatment, care and support for disproportionately affected communities.
The Black Treatment Advocates Network (BTAN)
Black Americans face a severe burden of HIV in the U.S., accounting for almost half (46 percent) of all people living with HIV. Among individuals living with HIV/AIDS in the U.S., Black Americans are less likely to receive HIV treatment and often are the least likely to remain in care.
To address the critical disparity in HIV-treatment outcomes and strengthen the link to care, in 2010 Merck established a collaboration with the Black AIDS Institute (BAI) to launch the Black Treatment Advocates Network (BTAN). BTAN trains, mobilizes and equips teams of treatment advocates to link HIV-positive Black Americans with care, raise science and treatment literacy, and strengthen local and national leadership. The initiative has trained 150+ high-potential advocates and supported access and linkage efforts in high-prevalence communities. BTAN has served more than 70,000 people living with HIV/AIDS and is active in nine high-burden U.S. regions. Through this initiative, Merck and the BAI work together to address disparities in HIV care in Black communities across the United States.
"Everyone Has a Story"
In the United States, women account for more than one-quarter of all new HIV/AIDS diagnoses. Among Black Americans, one in 30 women will receive a positive HIV diagnosis at some point in her lifetime.
To address the disproportionate impact of HIV on Black American women, in 2009 Merck began collaborating with SisterLove, Inc., an Atlanta-based HIV/AIDS service organization, to develop a mini documentary that addresses the unique challenges HIV-positive women of color face. The result was “Everyone Has a Story” (EHAS)—an educational capacity- and skills-building initiative for healthcare professionals (HCPs) and HIV-positive women. EHAS uses video-based storytelling to empower individuals to address stigma, navigate disclosure, build strong relationships with providers and live healthier lives. It also improves cultural competency among HCPs. Since launching EHAS in March 2011, Merck and SisterLove have distributed more than 6,500 workshop guides to community organizations, clinics, universities and international decision-making bodies in high-burden cities across the U.S. and in South Africa. The initiative remains active across the United States.
Treatment Education Training Program
For more than three years, Merck has supported AIDS Project Los Angeles (APLA) to develop and implement a three-day training program that brings together a diverse range of HCPs in Los Angeles, California, and Tucson, Arizona, to learn new information on key topics in HIV treatment and care. This program helps to reduce racial/ethnic disparities in timely access to HIV primary care and increases the capacity of HCPs to deliver accurate HIV-treatment information to patients.
"You Are Not Alone"
With Merck's support, Gay Men's Health Crisis (GMHC), an internationally recognized ASO, developed a social marketing campaign—“You Are Not Alone”—to raise awareness about the importance of medical care, treatment and adherence. The campaign targets the most affected groups in the U.S., including young men of color who have sex with men, women of color and Latinos. It provides critical information to help HIV-positive individuals access treatment, health information and healthcare services. Together, Merck and GMHC have distributed more than 70,000 brochures to the HIV community.
Sharing Stories, Creating Hope (Compartiendo Historias, Construyendo Esperanza)
Hispanics/Latinos make up 16 percent of the total U.S. population yet account for 20 percent of all new HIV cases. Hispanics/Latinos also experience disproportionately high of rates of delayed testing, diagnosis and entry into care.
To address these disparities, in 2011 the Latino Commission on AIDS and Merck came together to develop Sharing Stories, Creating Hope, a groundbreaking multimedia educational initiative. Set to launch in 2012, this bilingual initiative will support capacity-building efforts across the U.S. to enhance interactions between Latinos/Hispanics living with HIV and their healthcare providers, and to support access and adherence. The videos will feature interviews of patients and providers discussing strategies to overcome barriers to initiating and sticking with care and treatment.
The Quilt in the Capitol and the “Call My Name” National Tour
In 2012, Merck began collaborating with the NAMES Project to bring the AIDS Memorial Quilt to the International AIDS Conference in Washington, D.C., and to support a four-month “Call My Name” national tour. The “Call My Name” tour uses quilting workshops to raise awareness of HIV in disproportionately impacted communities and to commemorate lives lost to the epidemic. Merck’s support of Call My Name and the Quilt in the Capitol effort are part of its long-standing commitment to reduce health disparities in HIV treatment and care.
Vivo Positivo and Accion Solidaria
In Chile and Venezuela, Merck has supported the ASOs Vivo Positivo and Accion Solidaria to train HIV counselors; help people living with HIV/AIDS (PLWHA) better manage care, increase adherence and improve quality of life.
The media has a critical role to play in raising awareness of HIV/AIDS. Merck has supported the Latin America Media Partnership on HIV/AIDS (Iniciativa de Medios Latinoamericanos sobre el SIDA or (IMLAS in Spanish)) to encourage a regional response to HIV/AIDs; to persuade the media to address HIV-related stigma and discrimination, and to promote HIV prevention and awareness across Latin America.
The IMLAS program PASION POR LA VIDA / PAIXAO PELA VIDA ("Passion for Life") is the first regional media effort to inspire and empower people to help stem the spread of HIV/AIDS. Profiling courageous individuals living with HIV across the region, the campaign aims to put a face on the region's HIV/AIDS epidemic, encourage the audiences to become better informed about HIV/AIDs, and reduce HIV-related stigma. The campaign's message of hope and positive action is broadcast in 13 nations by members of IMLAS—a regional partnership of the Global Media AIDS Initiative (GMAI).
Instituto Vida Nova
In response to the epidemic and in support of the Brazilian government's well-recognized commitment to address HIV/AIDS, Merck provided financial support to HIV programs developed by local nongovernmental organizations (NGOs).
For example, Merck supports Instituto Vida Nova (IVN), an organization whose mission is to improve quality of life for HIV/AIDs patients and their families in the city of São Paulo and to help protect skilled home-care professionals who are vulnerable to infection through their work. IVN provides healthcare and social development programs to 602 people living with HIV/AIDs in the city.