Laboratory technicians test a blood sample for HIV infection at the Reproductive Health and HIV Institute (RHI) in Johannesburg, Nov. 26 2020.
Laboratory technicians test a blood sample for HIV infection at the Reproductive Health and HIV Institute (RHI) in Johannesburg, Nov. 26 2020.

JOHANNESBURG - Thabani Raymond Kalala, or “coach,” as he prefers to be called, was diagnosed with HIV six years ago. He lives in a small town in rural South Africa, but this year, as societies across the globe went into viral lockdowns, his world expanded.  

The 33-year-old community development worker was part of a pilot project called Coach Mpilo -- the word means “life,” or “health” in isiZulu. As a “coach,” he works with 54 newly diagnosed men and boys, supporting their battle against HIV and boosting them, in ways big and small.

The launch of the project, earlier this year, coincided with the beginning of global shutdowns to stop the spread of coronavirus. However, he says, that hasn’t slowed down progress.  

“I think the program has been successful,” he told VOA by phone from his rural village along South Africa’s southern coast. “However, the challenge is, we had to cut down many people, actually we had to cut down many coaches. … We need to try, I'm not sure if this is possible, but if we can get more coaches, because the program has been very successful to such an extent that even the facilities that we work in have seen the difference that we've been doing.”

Laboratory technicians test a blood sample for HIV infection at the Reproductive Health and HIV Institute (RHI) in Johannesburg, Nov. 26 2020.

This small initiative is one of the ways that, 40 years after the emergence of AIDS, the nation with the world’s heaviest burden of HIV continues to innovate. The coaching program will soon be fully funded, for about $1 million a year, from the $90-billion U.S. President's Emergency Plan for AIDS Relief.

Those funds, which cover about 4,000 “players” and 50-plus coaches across South Africa, go a long way. Organizers say the results have been astonishing in terms of getting participants to stay on their medication.  

“I think this has been like a revolutionary program for us because it has never happened before where HIV-positive men come together, and support each other in a way that is very sincere and honest and which has, like, a brotherly kind of relationship,” said project coordinator Silver Shabalala.  

“We've seen that. I mean, the retention rate for Coach Mpilo in the six months that we piloted the project, it was a 98 percent retention. We retained almost 4,000 men that had been lost to treatment. And if you look at (Department of Health), their retention is almost like 24 percent, during COVID. So this was really something that was amazing in terms of the retention rate.”

On Tuesday, Dr. Deborah Birx, the U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health Diplomacy, said the dual pandemic has not stopped progress. Today’s HIV drugs can beat the virus down to undetectable levels in the blood, meaning it cannot be transmitted.  The U.S. funded effort against AIDS has saved more than 20 million lives, resulted almost 3 million babies being born HIV-free and helped raise the number of people in treatment.  

But, she says, doctors can’t do it alone. That’s why they need community partners.  

“In some cases and in some countries we're actually seeing more stigma and more discrimination among key populations,” she said via teleconference -- echoing comments made by coaches and participants in the Coach Mpilo program. “This is not getting better. If anything, the structural barriers that exist now are getting higher and more difficult to address. And that's why we have to put effort not only into setting up these peer-led services, but protecting those peer-led services so that they can be successful.”

“Coach” Kalala has one message for the world during this very strange time. It’s precisely the kind of thing a coach would say -- words that resonate well beyond his small town of Mtwalume, and well beyond one pandemic, or even two.  

“People shouldn't feel sorry for us,” he said. “We’re just ordinary human beings, like every other, every other person who takes TB treatment, who takes BP treatment, you know. I think support is very important. Do not stigmatize.”