The leading role of expert safety knowledge in supporting the mission of caring for patients during man-made and natural disasters: state of emergency medicine in Ethiopia, Myanmar, and Ukraine.

Preparedness to endure extreme situations such as natural disasters or military conflicts is not commonplace in healthcare training programs. Moreover, multidisciplinary teams in health services rarely (if ever) include experts in security. However, when emergency situations occur, prevailing healthcare demands do not cease to exist, and unexpected demands often surge due to the shortage of other services and supplies or as a consequence of the emergency condition itself.With services in 45 countries, AIDS Healthcare Foundation (AHF) has operated in several conflict zones, facing broad and challenging security demands. Since 2017 AHF has implemented the Global Department of Safety and Security (GDSS), a dedicated intelligence and safety program that had a key role in the security monitoring, preparedness, and defense responses, assisting staff members and clients during recent conflicts.In this manuscript, we describe the experience of AHF's GDSS in three recent military conflicts in Ethiopia, Myanmar, and Ukraine, and provide insights into steps that can be taken to assure staff safety and support the mission of caring for patients throughout catastrophic events.

Safeguarding HIV prevention and care services amidst military conflict: experiences from Ukraine.

Ukraine stands out among European countries concerning HIV epidemiological data. Since February 2022, the military conflict with Russian forces has posed unprecedented challenges to HIV prevention and care. AIDS Healthcare Foundation (AHF), a global non-profit organisation with operations in Ukraine since 2009, implemented a preparedness plan to protect staff members and support local facilities in the continuity of care throughout the war. In this manuscript, we describe the strategies adopted by AHF to anticipate the risk of military conflict, steps to implement a preparedness plan, main challenges faced by local staff members and managers, adaptations needed as the conflict evolved, and indicators of HIV care 1 year before and 1 year after the onset of the conflict. Our experience shows that safeguarding the organisation's human resources has been a prerequisite to sustain services throughout the war.

Impact of coronavirus disease (COVID-19) on HIV testing and care provision across four continents.

OBJECTIVES: The coronavirus disease (COVID-19) pandemic has been associated with severe disruptions in health care services, and nonpharmacological measures such as social distancing also have an impact on access to screening tests and on the long-term care of patients with chronic conditions globally. We aimed to describe the impact of the COVID-19 pandemic on HIV testing and treatment and to describe strategies employed to mitigate the impact of COVID-19 on HIV care. METHODS: In this retrospective cohort study, we used secondary data from the AIDS Healthcare Foundation (AHF) Global Quality Program from 44 countries in four continents (Asia, Latin America and the Caribbean, Europe and Africa), and compared information on HIV testing, percentage of positive results, number of in-person appointments, and number of new enrolments in HIV care from 1 January 2020 to 31 August 2020 with the equivalent period in 2019. RESULTS: Despite marked inter-country heterogeneities, we found that COVID-19 was associated with a significant reduction in HIV testing, an increase in the percentage of positive tests, a reduction in the number of in-person consultations and a reduction in the number of new enrolments in care, despite the implementation of several mitigation strategies. The impact of COVID-19 differed across continents and key populations. CONCLUSIONS: Our findings suggest that, in the years to come, health care services must be prepared to respond to the impact of COVID-19 on HIV testing and care. Providers and facilities should build on the lessons learned so far to further improve mitigation strategies and establish care priorities for both the pandemic and the post-pandemic periods.