A Knock at the Door: THRIVE's Life-Saving Impact
- hivtoolkit
- Jun 25
- 3 min read
Updated: Jun 27
Night's Story
Global funding cuts are threatening to reverse decades of hard-won progress against HIV, increasing the risk of illness and death, particularly among the most vulnerable children and adults who will be the first and hardest hit.
When the funding freeze took effect, community outreach services ground to a halt, including the ones that were used by Night, an ART client in Uganda. Community healthcare workers (CHWS), including cough monitors, peer mothers, and linkage facilitators, were instructed to stop working. Night, who had been receiving her HIV medication through community visits to her home village, was suddenly cut off. Although official communication to resume some work was given within 12 days, many CHW contracts were ultimately not renewed. Resolved to continue supporting clients, some returned to the ART clinic and continued working on a voluntary basis, like Sarah Aturinda, a peer mother previously funded by PEPFAR-supported programs.
For Night, the impact was immediate and devastating. Without community-based ARV refills and unable to afford transport to the hospital, she stayed home. Weeks and months went by without her taking treatment. Her health deteriorated. Weakened and alone, she eventually became bedridden and too frail to seek help. She might have slipped away unnoticed—if not for Sarah Kulabako Lugolobi, an AHD Community Facilitator with the Unitaid-funded THRIVE (Transforming Advanced HIV Disease CaRe in LMICs through ComprehensiVe and Equitable Access) project.
The THRIVE Project, led by CHAI in partnership with AFROCAB and Penta, is working to deliver life-saving care to people living with advanced HIV disease (AHD). The project is centered on local leadership and community-owned solutions to find and serve people living with AHD where they are. In collaboration with national governments, AFROCAB and CHAI are strengthening health systems at every level, ensuring no one is left behind. AFROCAB’s engagement at the community level is especially critical in identifying those who have fallen out of care—and finding ways to bring them back. For people like Night, this work is not just impactful, it's lifesaving.
One day, while Sarah Kulabako Lugolobi, THRIVE AHD Community Facilitator, was doing home visits in the area, she heard a faint cry coming from inside Night’s house — one of the homes on her list for that day:
“Ngenda Kufa”- “I am going to die.”
When Sarah entered Night’s home, she found her barely conscious and unable to care for herself. Sarah washed her, comforted her, and mobilized resources to get her to the hospital for evaluation. Sarah reached out to a local support group to arrange a caretaker for Night. They identified Sarah Aturinda, who had previously worked as a peer mother and was a support group member, to be Night’s caretaker. She also linked her to a THRIVE AHD Community Champion at the hospital for continued support.
At the hospital, Night was admitted, re-initiated on ART, given nutritional support, and tested for TB and other infections. Night is now back on treatment and slowly recovering.
“When they found me, I thought I was going to die. But now, I’m confident, I am going to live…and I’m going to stay on treatment.”
Across countries, the global funding cuts have severely disrupted HIV and AHD services. While Sarah Kulabako Lugolobi was able to intervene in time with support from the THRIVE project, too many other clients have lost access to care. Urgent action is needed from the global HIV community to ensure the continuity of essential care, especially as service disruptions are expected to lead to an increase in AHD cases.
Through the generous support of Unitaid, the Clinton Health Access Initiative (CHAI)-led THRIVE Project is enabling access to critical prevention, screening, and treatment commodities for advanced HIV disease to dramatically reduce mortality among adults and children living with HIV. The THRIVE project is conducted in partnership with Afrocab and Penta.
