Rwanda Leads Global HIV Response with Innovative Care Delivery
Living with HIV in Rwanda is a vastly different experience than it was a decade ago. Thanks to groundbreaking initiatives that prioritize patient needs and leverage community support, the nation has become a beacon of hope in the global fight against the virus.
Rwanda has achieved what was once considered unthinkable: exceeding UNAIDS’ ambitious 95-95-95 treatment targets ahead of schedule. This means that 95% of people living with HIV in Rwanda know their status, 95% of those diagnosed are receiving treatment, and 95% of those on treatment have achieved viral suppression. These remarkable achievements, spearheaded by the Rwandan Ministry of Health and the Rwanda Biomedical Centre (RBC), in collaboration with the World Health Organization (WHO), are transforming lives.
At the heart of this success lies a commitment to simplifying and personalizing HIV care. In 2016, Rwanda adopted the WHO-recommended differentiated service delivery model, a patient-centered approach that adapts HIV prevention, treatment, and care services to individual needs, ultimately reducing the burden on the healthcare system and empowering people living with HIV.
“It is one of the differentiated strategies that improved recipients’ adherence while alleviating the burden on the health care system from monthly visits,” explains Dr. Ribakare Muhayimpundu, the HIV/STIs/Tuberculosis/Hepatitis program officer at WHO Rwanda.
A key component of this model is multi-month antiretroviral treatment dispensing. Following WHO recommendations, people living with HIV who demonstrate good adherence and successful viral suppression can receive sufficient medication for three to six months at a time instead of monthly clinic visits.
This seemingly small change has had a profound impact, particularly for young people like Esther Uwababyeyi. Diagnosed with HIV at age three,
Uwababyeyi has been a beneficiary of these advancements throughout her life. “During my high school years in boarding school, I faced stigma surrounding my HIV status. I was reluctant to disclose my status, fearing discrimination. To manage the monthly clinic visits, I had to come up with excuses for my absences each month,” she recalls.
In 2019, Uwababyeyi’s life changed dramatically after successful viral load suppression and consistent adherence to treatment. She was enrolled in a three-month antiretroviral refill program, enabling her to schedule appointments during end-of-term holidays and complete her education uninterrupted. Upon graduating in 2022, her dedication to treatment led to an upgrade to a six-month refill schedule.
“Multi-month drug dispensing has saved our patients time and money,” says Dr. Simeon Tuyishime, Director of HIV Care and Treatment at RBC. “Instead of monthly visits, many of our patients now visit health facilities every three to six months. This change saves them money on transportation and gives them more time to care for their families. This convenience has also enhanced treatment adherence and viral suppression.”
Rwanda’s commitment to innovation doesn’t stop with multi-month dispensing. In 2027, the country further strengthened its HIV response by introducing a community-based peer education model. This powerful initiative works in tandem with multi-month dispensing to ensure high-quality care.
Trained peer educators, like Havugimana Faustin who began treatment in 2006, play a vital role, offering personalized support and encouragement to their peers.
“I make monthly visits to check on people’s adherence and address any emerging issues, ensuring timely referral to healthcare facilities, when necessary,” says Faustin.
How has Rwanda’s patient-centered approach to HIV care, particularly the adoption of the WHO’s differentiated service delivery model, contributed to exceeding the 95-95-95 targets?
## Rwanda: Redefining HIV Care, One Success Story at a Time
**Interviewer:** Welcome to the show, Dr. Muhayimpundu. Rwanda’s progress in battling HIV is truly inspiring. Can you shed some light on what makes the Rwandan approach so unique?
**Dr. Muhayimpundu:** Thank you for having me. Rwanda has embraced a patient-centered approach that prioritizes needs and convenience. We adopted the WHO’s differentiated service delivery model in 2016, which personalizes care based on individual circumstances.
**Interviewer:** The 95-95-95 targets are ambitious – exceeding them ahead of schedule is remarkable. What specific strategies have contributed the most to this success?
**Dr. Muhayimpundu:** Multi-month antiretroviral treatment dispensing has been a game-changer. Instead of monthly clinic visits, eligible individuals can now receive medication for three to six months at a time. This reduces the burden on both patients and the healthcare system, as highlighted in the WHO’s recommendations [[1](https://en.wikipedia.org/wiki/HIV/AIDS_in_Rwanda)].
**Interviewer:** We’ve heard about stories like Esther Uwababyeyi, who was diagnosed with HIV at a young age and has benefited significantly from these changes. Can you tell us more about the impact this approach has had on young people living with HIV?
**Dr. Muhayimpundu:** Absolutely. Simplified access to treatment allows young people like Esther to lead more normal lives. It empowers them to focus on their education and dreams instead of making frequent clinic visits.
**Interviewer:** Rwanda’s journey offers a powerful message of hope for the global HIV response. What lessons can other countries learn from your experience?
**Dr. Muhayimpundu:** Rwanda demonstrates that with strong leadership, community involvement, and a commitment to patient-centered care, we can overcome even the most daunting challenges. We encourage other nations to embrace innovative strategies and prioritize the needs of those living with HIV.
