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Ensuring HIV viral load suppression among adolescents in refugee camps by implementing Munanka HIV Viral Load Suppression Model, attached.

Photo of Bhoke Munanka
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What problem does the idea help to solve and how does your solution work? (2,000 characters maximum)

The study conducted by Zanoni BC and Mayer KH in 2014 revealed that adolescents living with HIV tend to experience worse immunological and viral suppression outcomes compared to adults which in turn contributes to their higher mortality rate. Fortunately, UNAIDS released a 90-90-90 strategy in the same year that targets to end the AIDS endemic worldwide by the year 2020. That is the 90% of the individual living with HIV should have been diagnosed, 90% of diagnosed are in antiretroviral treatment (ART) and 90% of the individual subjected in antiretroviral treatment should have a low rate of the viral load. However, this hasn’t been the case to-date. Basically, HIV/AIDS viral non suppression is impacting many male and female adolescents globally, Including the adolescents in refugee camps who are potential people to grab economic opportunities to sustain their life and contribute to national development. There are several factors that place adolescent refugees at risk for HIV infection and non suppression of HIV viral load in refugee camps including: poverty, food insecurity, engaging in unsafe sex, multiple sex partners, being raped on the move or even in the camp, sexual and gender based violence, unawareness of HIV transmission, unreliable access of HIV health care due to the poor roads connecting refugee camps, poor morale among health service providers due to lack of sufficient incentives as well as many refugees camps being located in rural and remote areas. Obviously, everyone needs a sex partner in life, thus my idea will focus on: Creating HIV/AIDS Awareness, Providing HIV/AIDS Mobile Support, Random Economic Empowerment, Guided HIV Testing, Reliable and Monotonous Antiretroviral Drugs Supply, Performing ART Drugs Resistance Test and Participatory Monitoring of ART Drug Use among adolescent refugees. Besides, they will be encouraged to perform safe sex (i.e. use of condoms) and abstaining from early sex. The solution works by implementing Munanka model.

Geography of focus (500 characters)

The idea focuses Nyarugusu Refugee Camp found in the western part of Kigoma region, Tanzania, which is one of the largest and famous camp accommodating about 150,000 refugees from Burundi and the Democratic Republic of Congo. Indeed, it is the third largest camp in the world. According to the 2012 Women’s Refugee Commission report, adolescent girls in this camp are facing violence, abuse, neglect, exploitation and discrimination that threaten their lives and impede their growth and development.

Building Bridges: What bridge does your idea build between people on the move and neighbors towards a shared future of stability and promise? (500 characters)

The idea bridges the gap between the infected and non-infected adolescent refugees and hosts by stopping further internal displacement. Furthermore, this idea will change the mindset of the refugees and host communities on HIV stigma. The HIV infected people need love and affection from surrounding and neighbor communities to live a promising life. This will definitely make refugee adolescents healthy and open minded towards a shared future of stability and promise with the host community.

What human need is your idea solving for? (1,000 characters)

Basically, this idea will bring peace, joy, hope and dignity once adolescent refugees get tested for HIV and those diagnosed with HIV subjected to the antiretroviral therapy and placed in retention programme for suppressing HIV viral load. It is expected that, the adolescent refugees will not only have low rate of viral load but also the surrounding community will no longer be at high risk of HIV infection since the infected ones will be already placed in antiretroviral treatment.

What will be different within the community of focus as a result of implementing your idea? (1,000 characters)

The HIV viral load suppression will be realized, through: Creating HIV/AIDS Awareness, Providing HIV/AIDS Mobile Support, Random Economic Empowerment, Guided HIV Testing, Reliable and Monotonous Antiretroviral Drugs Supply, Performing ART Drugs Resistance Test and Participatory Monitoring of ART Drug Use. The implementation of these actions and their impacts will be measured through a panel survey (baseline, mid-line and end-line), both quantitative and qualitative (in-depth) survey that will be carried out to randomly sampled males and females adolescent refugees regardless of their health condition in order to assess the impact of implementing Munanka HIV viral load suppression model within 18 months. The baseline survey will be conducted early 2020, mid-line in mid 2020 and end-line will be carried out early 2021-a gap of six months in between the surveys.

What is the inspiration behind your idea? (1,000 characters)

Adolescents of today are the tomorrow we look forward to and yet they are the same people affected with exploitation victimization, awareness on violence, violence perpetration and transactional sex and HIV risk, also, are the most vulnerable of at risk population in the refugees camp. Besides, as a mother I feel very indebted to the prosperity of displaced teens particularly at Nyarugusu refugees camp. Furthermore, there is a gap on the viral load prevalence despite of the fact that there are number of organizations such MDH, ICAP etc conducts survey on HIV but yet the viral load suppression is low. I am further inspired to be part of making the UNAIDS 90-90-90 a success strategy. In general this idea is important towards achieving: Suppressed HIV Viral Load among Adolescent Refugees, Grabbing Economic Opportunities in Refugee Camps, and Adolescent Refugees with Joy, Hope, and Dignity.

Describe the dynamics of the community in which the idea is to be implemented. (1,000 characters)

The adolescents refugees like other refugees are not stagnant, they are moving in and outside the host communities. Once the idea is implemented will help to lower the viral load since there are large number of refugees who are received in host counties and resettled back to their home countries. Therefore, if the infected adolescents have subjected already to the antiretroviral therapy will not cause new infections to other people but also the new comers to the camp will not be infected. Some infected adolescents in the camp are more likely to get pregnant and hence if they are subjected to ART will not cause infections to infants.

How does your idea leverage and empower community strengths and assets to help create an environment for success? (1,000 characters)

Different measures have been taken to suppress the viral load worldwide, however this has not been the case today in refugee camps. This idea will empower adolescent refugees through random economic empowerment which simply give seed fund to randomly sampled HIV tested adolescent refugees. The experience i have acquired from dealing with adolescents and HIV project give me strength to make this idea successful.

What other partners or stakeholders will work alongside you in implementing the idea, if any? (1,000 characters)

Meanwhile, iam working independently but iam looking forward to work with different organization such as UNICEF, TACAIDS, Management and Development for Health (MDH), FEMA and health facilities around the camp during implementation stage because they work in several programmes and projects that are close related to the idea iam presenting. Iam interested to work with these partners because they have enough experience in this and they will advise me better on what can be done to ensure an idea become a success to the refugees adolescent but also the answer to the 90-90-90 strategy of UNAIDs.

What part of the displacement journey is your solution addressing

  • Arriving and settling at a destination community

Tell us how you'd describe the type of innovation you are proposing

  • Systems design: Solutions that target changing larger system

Idea Proposal Stage

  • Blueprint: We are exploring the idea and gathering the inspiration and information we need to test it with real users.

Group or Organization Name


Tell us more about your group or organization [or lived experience as a displaced person?] (1000 characters)

I don’t have an organization but I have been working with adolescents in my community at an individual level whereby I’ve been educating them about HIV/AIDS, the essence of having safe sex and encouraging them to have one partner. Of recently, I worked with TACAIDs and UNICEF on a project involving youths whereby I learnt that in order to improve the mindset of youths we (society) have to focus on the livelihood knowledge, skills aspirations, the essence of operating an income generating activity, awareness on violence, exploitation victimization, violence perpetration and transactional sex, stress, mental health, hope, aspirations and risk preferences.

Type of submitter

  • We are individuals who are part of an informal group or collective

Organization Headquarters: Country


Organization Headquarters: City / State

Bukoba, Kagera


Join the conversation:

Photo of Sultan Hussein

Clever touch dear Bhoke,I've gone through idea and am impressed with the way you present it and how you plan to go for a solution also wonderful visual presentation,hope to see this change the targeted audience in a positive way,wish you all the best in the implementation phase hope you go through the next phase.

Photo of Sai Kishore Nellore

Hi Bhoke Munanka an interesting idea that you are working on and I read the issues faced by adolescent girls in camps. In this context, I invite you to have a look at the work my colleagues are engaged in, and helping adolescent girls and migrant women in India Hasina Kharbhih and Ibadaphunshisha Blah  where they have been working on the issue of sexual exploitation and trafficking. Migrant smuggling often leads to the crime of human trafficking. Many adults in their attempt to escape war or natural disaster end up being trafficked and forced or sold into slavery. The majority of women and children end up in sexual slavery. Let us work together make migration safer and more regular and after reviewing what Chau Tang Duncan and Tom Duncan  are doing with the Migration Lab Program I think there is tremendous scope for building strong partnerships with them and other mission aligned ideas on open ideo to join forces in addressing this illegal $150 billion dollar a year human trafficking industry. Please do check out the idea:

Photo of Bhoke Munanka

Hi @ Sai Kishore Nellore
Thank you indeed, this is awesome and much appreciated. I look forward to collaborate with them, explore opportunities and share ideas.