Tadala still has flashbacks to the moment when her little sister stopped breathing. That day the children’s ward of Queen Elizabeth Hospital in Blantyre, Malawi, was filled with patients. Despite the whirring fans overhead, the summer heat was unbearable. Nurses rushed from bed to bed, adjusting health charts and administering medication. At first they didn’t notice the small girl in an oversized dress, crying alone by her sister’s bed. “It was too big for her, a one-year-old girl, the disease was too big,” Tadala recalled of her sister’s first battle with HIV. Her mind went blank as the doctors appeared beside baby Leoni*. More medicines arrived, followed by needles, and intravenous fluids. Tadala held tightly to her sister’s tiny hand. “She’s going to be OK,” a doctor told her in native Chichewa. Tadala slept on the wooden chair by her sister’s bed that night. It was another six months before she could take Leoni home.
At the time, Tadala didn’t really understand what people meant when they spoke about HIV. She had just turned 10, but in the the space of a year, the pieces of her life in the town of Limbe just outside Blantyre had quickly come unstuck. Her father had died suddenly and soon after, her mother Violet* and newborn sister Leoni were rushed to different hospitals with HIV complications. Tadala found herself in charge of the family’s small house and her four other siblings. “I was so scared,” she said. “All I could think was: it’s over for us. It’s like a journey when your car has broken and you feel like you can never continue on.”
Around 1.1 million people in Malawi are currently living with Human Immunodeficiency Virus (HIV); roughly 10 percent of the population, but it is an illness with an impact far beyond the people who get sick. Over the past two decades, the global AIDS epidemic has impacted the African continent severely, however, recent efforts to combat the spread of HIV have seen remarkable success. The percentage of people living with HIV in Malawi dropped dramatically to 10 percent from 16 percent over the last decade and the country’s aggressive investment in ‘treatment as prevention’ has led to a widespread shift in perspective on how to eradicate the virus. The President’s Emergency Plan for Aids Relief (PEPFAR), along with the United Nations and The Global Fund have pledged to end AIDS by 2030. The goal is to provide universal Anti-Retroviral Treatment (ART) for every patient diagnosed, regardless of their viral load (or CD4 count). But, with 1.9 million people worldwide becoming newly infected every year, the challenges to containing the virus are also rapidly evolving.