While great progress has been made against HIV/AIDS in the past few decades, there are still 16 million people living with HIV today, with the scale of the epidemic growing in some communities. The issue is not a lack of tools or services to address HIV, but rather a lack of access and adoption of those services. The Elton John AIDS Foundation is changing that, supporting programs across the globe that address HIV/AIDS at every stage, from prevention efforts to supporting those living with HIV/AIDS.
We interviewed Mohamed Osman, Grants Director at the Elton John AIDS Foundation (EJAF), to discuss the progress the Foundation has made since working with FSG on a consulting engagement in 2013, the innovative programs they are supporting, and his advice for others working on often stigmatized issues like HIV/AIDS.
What is the Elton John AIDS Foundation’s mission, and what is your role at the foundation?
The Elton John AIDS Foundation (EJAF) is dedicated to reducing the spread of HIV/AIDS through innovative HIV prevention programs, eliminating the stigma and discrimination associated with HIV/AIDS, and supporting direct care for people living with HIV/AIDS. We have an ambitious agenda to create an AIDS-free future, which we think is within our reach right now.
My role as the Grants Director is to help realize our strategy by finding partners who are doing HIV/AIDS work in the field and giving them what they need to optimize their work. We advocate for and also learn from them, elevating their knowledge from working on the ground into the larger conversations happening around HIV/AIDS prevention and treatment.
How did EJAF and FSG partner on a consulting engagement, and what outcomes came from that project?
Working with FSG gave us clearer framework for our work. Together, we decided on 2 key priorities for EJAF’s grantmaking: scaling up the adoption of treatments that are available, and targeting communities where HIV continues to spread.
FSG helped us determine our priorities and break down our funding into a scenario to reflect these priorities. Sixty percent of our funding is dedicated to working with those left out of the current HIV/AIDS response—gay men, men who have sex with men, drug users, and people involved in commercial sex work. We haven’t been able to pull back the epidemic with these key affected populations, so we work with them through our Flagship Grants and Pioneer Grants.
The Flagship Grants invest in communities at tipping points, where the disease is being overcome for the majority, but marginalized community need more support to create a meaningful change. The Pioneer Grants are focused on more cutting-edge work, showing others that you can do this work—that, for example, you can work with sex workers through government programs with good results.
The other 40% of our funding goes towards broader HIV/AIDS work with young people and women, with a large focus on changing lifestyle habits, like encouraging testing and treatment. In our work with FSG, we also decided to allocate some of this funding to advocacy and learning. We advocate for affected populations to make sure they are consulted and they have a voice at the table, and we also advocate for sustained funding from governments and other organizations currently supporting HIV/AIDS work.
Overall, FSG helped us be more intentional, structured, and thoughtful about our work. The work isn’t completely different, but the way we talk about it, think about it, and measure it is much smarter. FSG allowed us to do more work with the right people in the right places to create impact.
EJAF’s goals are “no more discrimination, no more HIV infections, and no more AIDS deaths,” what do you think are the greatest challenges to achieving those goals today?
The big challenge for HIV—what’s holding us back—is stigma. HIV is very similar to diabetes in terms of the condition, management, and what medicines can do for you, but the method of transmission for HIV leads to stigma. Even in the UK, people are still fearful to come out as having HIV/AIDS, because they’re afraid of being excluded from society. If we can overcome this stigma holding people back, we’ll overcome HIV.
We’re exploring different projects around the stigma issue on multiple levels. We’re currently working with a program in South Africa called We the Brave, which is trying to break the cycle of gossip to encourage communities talk about sex, HIV, and treatments openly.
Another important step to getting past this stigma has been the adoption and availability of mobile phones. The anonymity provided by mobile phones allows people to engage in services much more than the traditional structured setting of a clinic. Harnessing new technology could be the link that helps breaks through the stigma.
What advice do you have to others working on HIV/AIDS, or other issues affected by stigma?
One of the biggest things I’ve learned is that we have to let the community lead. We also cannot push the community just because we feel like it’s time for them to stand up. We’ve found that the more people get on treatment, the more they are the champions of their own lives and champions for others. One of the best example I’ve seen of this is Mothers to Mothers, which is mothers living with HIV who come out and share their stories to support new mothers living with HIV. Once you have a peer who has gone through the same experience and is thriving, you can move past that fear. When you see someone who hasn’t been rejected, and hasn’t died, it might motivate you to step out.
Mohamed Osman is Grants Director at the Elton John AIDS Foundation in London. Born in Kenya, Mohamed has an MSc from the London School of Economics.