LocationsOne part of UNDP’s work with the Global Fund to address HIV and TB and improve health services across Sudan
Hanadi Babiker Faki Ali has been living with HIV since 2012 and she leads a rich and full life. At home, she’s a happily married mother of three healthy children. At work, she’s the Secretary-General of the Kessala branch of Sudan’s Association of People Living with HIV, where her mission is to make sure that all people living with HIV have the chances she’s had to pursue a meaningful family and work life.
“When I was a counsellor at the Association, I saw the loneliness of people living with HIV and how deeply affected they were by not being able to marry,” says Hanadi. “So, I suggested a new idea: facilitating marriages.”
The Association, which has received support from UNDP and the Global Fund to boost access to life-saving medicine and services, was already organizing social events to bring people living with HIV together for mutual support. But connecting them for marriage was an entirely new challenge: one that could transform many lives but would also meet with resistance.
There are an estimated 48,000 people living with HIV in Sudan, but the disease is little understood and discrimination is rife. In the latest Sudan survey from UNAIDS, 66% of people said they would not buy groceries from someone with HIV (a standard question used to gauge levels of stigma) and families can be very opposed to the weddings of those living with HIV, worrying about the care needed with someone with HIV and the risk of having children who might inherit the condition.
Hanadi had to overcome both the fear and the practical objections. “Once we find two people who want to get married, we approach organizations and philanthropists for financial support and formally propose it to the bride's family,” she explains.
“If the family agrees, the marriage goes ahead as normal. If they refuse, we hold the ceremony at the Association’s office. The marriage ceremonies are conducted in an atmosphere of public celebration and, for me, these moments of celebration are profound achievements and the realization of a happiness that once seemed impossible.
The war has devastated health services and driven people away from the clinics and doctors they used to rely on. Sudan is the world's largest displacement crisis, with some 12 million people forced from home.
“Despite challenges caused by the war, I have supervised many marriages in Kassala with people from states across Sudan – over 50 since I started in 2015. These couples have had healthy children, and three families even named their daughters ‘Hanadi’ to say thank you.”
After marriage, the Association provides psychological and health check-ups, including viral load evaluations and HIV testing for children at six and 18 months. They also help couples stick with anti-retroviral regimes, which is a key part of preventing mother-to-child transmission, but which has become much harder since the war.
A recent assessment from UNDP showed an 84% reduction in the number of facilities offering HIV services since the outbreak of violence, and many patients have been forced from home, losing contact with the doctors and clinics they trusted, as well as access to medicine.
The Global Fund supports UNDP to procure HIV medicines into Sudan and organize distribution around the county, even into the most conflict-affected areas, while the Association helps with tracking patients and getting medicine that last mile, using a network of volunteers who take public transport through conflict zones to deliver drugs and sometimes store medicines at home to prevent them being looted from clinics.
It can be dangerous work – and it’s never easy – but Hanadi and her team are determined to keep services going, inspired by a sense of mission, and by the difference they can make in the lives of people around them.
When a 20-year-old friend of Hanadi’s contracted HIV and was shunned by her family and community, Hanadi connected her with an engineer living with HIV from a neighbouring state. They got married and after she became pregnant, Hanadi helped her stick to the preventive treatment schedule for 18 months.
Then came the child's test.
“The test day was filled with anxiety,” recalls Hanadi. “The mother was very scared, so I carried the child as we waited for the results. When the doctor told us the child was healthy, it was a moment of indescribable joy. The mother cried, the father prayed in gratitude, and everyone around congratulated them.”
Today, they are still together, and their daughter is two years old.
One part of a larger health story
Mobile X-ray equipment and training provided by UNDP and the Global Fund can help diagnose TB and other illnesses even in isolated communities.
UNDP’s work to prevent and treat HIV is made possible by a grant from the Global Fund, which also covers efforts to address TB, another illness that has been worsened by a war that has decimated state medical services and forced almost 12 million people from home – often into overcrowded and unsanitary conditions where TB is most likely to spread.
Although TB is preventable and treatable, it still kills more than 1.5 million people globally, making it the world’s largest infectious disease and one that’s closely correlated with poverty and conflict. In Sudan, 26,000 people are diagnosed each year.
UNDP works with national authorities to improve both testing and treatment of TB. This means bringing services to areas where they have been stopped by war or overwhelmed by people fleeing the violence. We provide mobile x-ray units that reach the places that are worse affected and train medical staff to use them, resulting in faster diagnoses and more effective treatment.
We also work with the national authorities to strengthen health systems more generally. This includes procuring medical supplies – some US$3.5 million worth since 2023 – and improving warehousing and logistics to get these supplies where they're most needed.
We import vital equipment, from medical waste incinerators that make communities healthier to oxygen machines that expand the range of treatments possible, and we train frontline healthcare staff and support teams.
In partnership with IOM and UNFPA, we run fully equipped mobile medical units across four states that bring lab facilities and primary care to communities where these are not normally available, even making it possible to provide a travelling delivery ward to help bring down maternal mortality rates, which are kept high by a lack of skilled attendants and emergency care.
For more on our work with the Global Fund to improve access to healthcare and other essential services, see: https://www.undp.org/sudan/projects/equitable-access-essential-services
