Written by: Jenna Jacobs | jjacobs@cshl.edu
*Interview conducted by Hannah Stewart
During our May 2022 meeting, “Optimizing Effective Coverage of HIV/STI Prevention and Care Programs: A Program Science Approach,” Banbury spoke with Solange Baptiste, M.S., about her experience as Executive Director of the International Treatment Preparedness Coalition (ITPC). With over 15 years of global program management and advocacy experience, Solange leads community activists and allies in delivering ITPC’s mission of enabling people in need to access optimal HIV treatment. She received her B.S. from Tuskegee University, and her M.S. from the Harvard T.H. Chan School of Public Health.
Can you describe the work that you have been doing with the International Treatment Preparedness Coalition (ITPC)?
ITPC started in 2003 in Cape Town, South Africa. They were looking at the issue of access to treatment for HIV in a time when antiretroviral (ARV) drugs were super expensive and available primarily for people in the Global North; meanwhile, people in the Global South were dying.
There was an International Treatment Preparedness Summit that took place with about 120 people across the globe to talk about access issues and how to prepare people for treatment: the basics of health education, treatment literacy, side effects, peer support, and so on. The Summit went on to become the Coalition.
We’re in the business of preparedness across many diseases; for ITPC, HIV is an entry point to the right to health. We’re looking at tuberculosis, hepatitis C, and, now, many noncommunicable diseases as well. We’re looking into the availability and pricing of insulin and hypertension medicines, for example.
I am the Executive Director of ITPC. I am originally from Trinidad – a small island in the Caribbean – and am now based in South Africa. My role is to ensure that ITPC is a credible, visible voice for communities regarding access to whatever it is that they need in terms of treatment, diagnostics, and care – concerning their health and rights.
I read in your open letter on the ITPC website that ITPC’s Global Activist Network became the “eyes and ears on the ground” during the COVID-19 pandemic. What did that look like? How did COVID-19 reshape how the ITPC operates?
We started to get requests from people within our network asking for support to fulfill their needs. One of our strategic pillars is called, “Watch What Matters,” and we, quite literally, monitor what matters to communities and determine what their needs are. We then address those needs, and leave once they have been fulfilled.
People were asking for things like food, personal protective equipment, cellular data, and transportation. Food insecurity, transportation, education for children, and safety from gender-based violence are some of the more pressing needs. For us, it was not about what was within the budget, but what the needs were. Fortunately, we have a very good relationship with our donors – the Robert Carr Fund, the Bill & Melinda Gates Foundation, and others – and they were able to say, “Do what you need to do, because we are all in unprecedented times.”
The World Health Organization (WHO), The Joint United Nations Programme on HIV/AIDS (UNAIDS), and others will often come to us and ask, “What are you hearing? What are the needs?” When the COVID-19 pandemic started, we were carrying out community-led monitoring as a technical support provider with UNAIDS and the Global Fund, and community-led monitoring is actually quite applicable in the context of the pandemic. We were able to look at the impact of COVID-19 on HIV services; for example, could people still go outside to collect their medicines? Countries with fragile health systems depended upon the existing HIV architecture – healthcare workers and community leaders – to understand what was happening during the COVID-19 pandemic. They were on the frontlines of the response effort.
How did you become interested in HIV treatment access and advocacy?
I really hate injustice. I find that it’s most appalling when someone can die because they do not have money to get the medicine or services that are available; I have many personal experiences with family members who were not able to get care in time.
I really try to sit at the intersection of medicine and politics; I was a strong proponent and advocate for science – I thought it was all about science – but then I got in touch with reality and realized that you could have the best innovation, the diagnostics, the medicines – but the socioeconomic and political ways that these things play out could mean that countries or individuals won’t have access. We saw it with COVID-19 vaccines.
November 2021 was the 20th anniversary of the Doha Declaration. What do you want to see happen in terms of treatment access in the next 20 years?
I don’t know if it will happen, but what I would like to see happen is related to this concept of Global Public Investment (GPI). Health is, in a very true sense, a right, but how do you realize that right? I think that health is still seen as a capital good, and when you rely on market to determine your price and your supply, you are not putting people first; you are putting profit first.
The existing paradigm dictates that countries with the most money have the most power and influence. Until we can sort that out as a systemic, geopolitical issue – and I’m not sure that there are incentives in place to make that happen – I am worried about where we are headed. Countries are acting in their own self-interest rather than recognizing that we are all on this planet together; if there is COVID-19 anywhere, it threatens the lives of everyone, everywhere, for example.
We have a lot of great ideas in terms of universal health coverage and sustainable development goals, but you can see the complete impotence of these systems when you consider the geopolitical angles.
You deal with particularly heavy topics in your work. How do you decompress?
My children and husband keep me grounded. I love to cook; I enjoy preparing meals for them. I also love to exercise with my virtual reality headset [laughs]. I don’t always have time to go somewhere, so I have to find efficient ways to do things like exercise. I love a good series, a juicy podcast – I just try to be normal. You can get so caught up in the macro problems that you forget to be grounded, so I try to make sure that I stay sane.
You have been to the Banbury Center once before in 2018. What do you think of the Banbury style of meetings?
Oh, I really enjoy them. It’s sort of a weird, bubble environment. But you’re not in one space; you’re in different buildings, and I do appreciate the walks because they give you the chance to decompress.
The meetings are pretty intense; I assume this is a sort of think tank, and with the Chatham House Rule – or your version of that – you create a safe space where you can blue-sky. I feel that it’s an enabling environment for thinking where you can just sit down and say, “Okay, so, how are we going to solve this big problem?” I do like that.