Access to health services: Every individual counts

Disparities between groups within the population make it more difficult for groups with special needs to access appropriate services. However, some have found their needs met and others have not. The panel on the 'forgotten', without being exhaustive, wanted to focus on young people, people with disabilities and people in humanitarian crisis situations.

Christiane, a young Cameroonian woman in the prime of her life, has just been taken by HIV/AIDS. Was it the fear of living with such a burden or did she not have a sympathetic ear to calm her fears? She was an active activist in a network of young people living with HIV," says Patrick, who is moved to reveal that she had been behaving in a self-destructive manner for some time. At what point did the break-up occur? Christiane didn't know where to turn and this lack of support was fatal for her. Patrick, a member of the Brighter Futures Network, received a message telling him the terrible news and he raised his voice: Never again! This is the meaning of the fight to be waged, all together, so that children, adolescents and young people in West and Central Africa have access to appropriate treatment. He describes the approach used towards children and young people living with HIV as " 30 years of voluntary amnesia". An approach which, in an attempt to protect them and not expose their families, has made them invisible. Patrick invites public authorities, partners and civil society actors to effectively involve young people for a better understanding and care of their specific needs.

Among people with disabilities, the seroprevalence rate is between 3 and 11 times higher than in the general population, with a higher proportion of women. This group is particularly vulnerable to HIV due to socio-cultural and economic factors that reduce access to accurate information, sustainable income sources and even health facilities. In addition, people with disabilities, who are particularly exposed to violence, isolation and discrimination, need a specific approach adapted to their conditions, in addition to differentiated health services.

The precarious security situation in the Sahel favours the exclusion of a large part of the displaced population from the health system. The number of displaced people changes every day as a result of the daily attacks. In 2021, there were 350,000 people displaced by insecurity in the Tillabery region; in 2022, there will be 2 million in Burkina Faso. When health facilities are closed, looted or destroyed, many no longer have access to treatment, screening and testing are impossible, and health workers and community actors no longer have access to conflict zones. Awareness raising and drug supply are becoming real challenges. In Burkina Faso, eight networks have been deployed in the field to carry out awareness-raising, testing and treatment activities, which have made it possible to identify and put on treatment 20,000 new people who have tested positive for HIV/AIDS. Because of insecurity, some localities can remain without supplies for six months. This is why civil society actors are negotiating with the army so that these vulnerable people can have access to their treatment. The inclusion of people living with disabilities is essential to improve access to health services and ensuring their continuity in a humanitarian context is paramount.

Today, the Civil Society Institute for Health in West and Central Africa is raising the debate so that the forgotten or neglected groups are taken into account in the response to achieve the 95-95-95. The use of available data, the effective involvement of people and strong partnerships will allow for an accurate assessment of the needs and better refine the approaches and interventions for more effectiveness.