As a Sri Lankan medical professional working on global health issues, Dr. Diyani Dewasurendra advocates for critical HIV-related issues such as the prevention of mother-to-child transmission (PMTCT) and U=U (Undetectable = Untransmittable). “PMTCT is essential because it is the only effective way to prevent HIV transmission to infants and to reduce related complications,” she said.
She also highlights the importance of U=U as a powerful educational and counselling tool: “U=U promotes antiretroviral therapy (ART) as a vital tool in HIV prevention while helping to reduce stigma and discrimination against people living with HIV.” Raising awareness of both PMTCT and U=U, she believes, can significantly reduce the transmission of HIV, both globally and in Sri Lanka.
Dr. Diyani Dewasurendra is a medical doctor specialising in dermatology and HIV care. Dr. Dewasurendra’s work reflects her commitment to global health and her ongoing dedication to fighting the HIV epidemic in some of the world’s most underserved regions.
In an email interview with the Sunday Observer Dr. Dewasurendra discusses her pioneering work in HIV care and prevention, the global strategies shaping HIV prevention worldwide, and the ongoing efforts to ensure equitable access to healthcare for all at-risk populations across the globe.
Q: Could you tell us about your background and the research you have conducted related to AIDS?
A: I am a medical doctor specialising in dermatology and HIV care, with a dedicated focus on improving the lives of people living with HIV. Since 2016, she has been at the forefront of HIV care, combining her expertise with a deep commitment to humanitarian work.
After completing my training in Austria, I began my career with Médecins Sans Frontières (MSF) also known as Doctors Without Borders, where I have completed eight missions, four of which have been in high-need HIV contexts such as Malawi and South Sudan. Currently, I am in Tigray, Ethiopia, where I am supporting efforts to implement HIV pre-exposure prophylaxis (PrEP) among key populations, playing a critical role in preventing new HIV infections in vulnerable communities.
Q: How have you and your work contributed to reducing HIV/AIDS cases, and what challenges remain in achieving the targets?
A: While access to antiretroviral treatment has improved globally, significant challenges remain, particularly in the care of patients with advanced HIV. One of the ongoing struggles is preventing mother-to-child transmission (PMTCT) of HIV, with stark differences in care standards across the regions where I’ve worked. Stigma and discrimination continue to be major barriers, preventing many people from seeking or receiving the care they need.
During my time in Malawi, we were able to make significant strides by introducing chemotherapy for Kaposi Sarcoma, a cancer that disproportionately affects people living with HIV. This was a critical step in improving the treatment options for those facing this often neglected condition.
In South Sudan, my team and I worked to establish a more patient-centred approach to chronic care, addressing not just HIV but also other health conditions like Hepatitis, Hypertension, Diabetes, Asthma, COPD, and mental health issues. This holistic approach aims to improve overall health outcomes for people living with multiple chronic conditions, recognising the interconnectedness of these health challenges.
While progress has been made, much work remains to ensure equitable, accessible, and stigma-free care for all people living with HIV.
Q: What are the latest strategies used worldwide to prevent the transmission of HIV/AIDS in high-risk populations globally?
A: We are actively rolling out HIV Preexposure Prophylaxis (PrEP) with oral medication, which has already been partially implemented among key populations at risk. PrEP, as part of a broader preventive care package, plays a crucial role in reaching the UNAIDS goal of reducing new HIV infections to under 370,000 per year.
More and more countries are committing to comprehensive prevention strategies to curb new HIV cases, but there is still much work to be done. A key priority is ensuring sustainable access to PrEP services for all populations at risk. This includes the introduction of long-acting Cabotegravir (CAB-LA) injections, which offer a promising new option for prevention. It’s vital that we continue to expand access to these life-saving treatments, especially in high-risk communities, to make a lasting impact in the fight against HIV.
Q: What role do education and awareness campaigns play in HIV/AIDS prevention in underdeveloped communities?
A: Awareness, education, and advocacy are essential to the success of any HIV Preexposure Prophylaxis (PrEP) program. At MSF, we take a multidisciplinary approach to promoting PrEP, ensuring that we not only raise awareness about its benefits but also actively work to address the barriers that prevent people from accessing health care. By engaging with communities and providing the information, we aim to make PrEP more accessible and effective, ultimately helping to reduce new HIV infections.
