In 2004, I started at the Malawi Mission as a Family Planning Specialist. In 2005, following a reduction in force and one voluntary separation, there were only four technical people in the health office: the health office director, a child health specialist, an HIV specialist, and myself. I had family planning and international health expertise and background as a midwife, and since there weren't many people in the office, I needed to be able to provide assistance for both PEPFAR and non-PEPFAR related tasks.
By the time I joined, USAID had expanded and strengthened the physical infrastructure for family planning and sexually transmitted diseases, which were called family health clinics. This was also a time when HIV was very stigmatized but family planning wasn't as much, and HIV patients needed both privacy and the space to receive care. The HIV response ended up taking up most of the family planning facilities so they could be more private, which was liberating for people who visited the clinic and who didn't want others to know why. This was the beginning of the emphasis on the integration of both family planning and HIV services.
My greatest achievement with USAID and PEPFAR was to see the programs grow. Not only for family planning, but for PEPFAR, Maternal and Child Health, PMI, and TB. All of the programs have grown.
My greatest achievement with USAID and PEPFAR was to see how the programs grew in all areas. Not only with family planning and PEPFAR, but for preventing child and maternal deaths, malaria prevention, nutrition, and tuberculosis as well. I was affected by HIV in my family. I lost my first son. Having formerly been a healthcare worker in Malawi, health facilities at the time did not have anti-retroviral therapy, and care was only about managing the opportunistic infection and waiting for the person to die. It was so sad to see people coming in and there was nothing you could do. When these new programs arrived, to me it meant a lot. The PEPFAR program really was life-saving.
Lilly Banda is the former Health, Population, and Nutrition Deputy Team Leader at USAID Malawi
