PEPFAR’s community partnerships make a generational impact: Nozi’s story

Learn more about Hannah Johnson.
Hannah Johnson
Program Manager, Global Policy
George W. Bush Institute
Co-founder of mothers2mothers, Robin Smalley (left), and Nozi Samela with Mrs. Laura Bush at a mothers2mothers event in 2010.  

In 2005, Nozi Samela was 20 years old, six months pregnant with her first child, and incredibly overwhelmed. She traveled to the local clinic in her native country of South Africa that March for her first prenatal care appointment, where she was told that she was HIV-positive.

Over 20 years ago, an estimated 36 million people were living with HIV/AIDS and nearly 22 million lives had been claimed. HIV prevalence among pregnant women in South Africa was at its highest level to date and almost one in three women age 20 to 24 were infected with HIV, according to UNAIDS reporting. 

“There were a million thoughts going through my mind,” Nozi told me when recounting that day at the clinic. “I knew what it meant to be living with HIV at that time in South Africa. And it meant almost guaranteed death. So, I was scared for my life, for the baby that I was carrying.” 

Nozi followed the nurse to a room of about 20 women living with HIV. Healthy babies were on the floor playing while their mothers met, laughed, and enjoyed each other’s company. She couldn’t believe what she was seeing, that women living with HIV could be healthy and have healthy babies. A mother told Nozi that her baby could also be born free of HIV.  

The women Nozi met were part of an organization that would change her life – mothers2mothers. Since 2001, mothers2mothers has employed local women living with HIV as community health workers to meet the growing needs of communities across Africa. These women, known as “Mentor Mothers,” work in local communities and at health centers providing health services, education, and support to women, children, and their families. 

Nozi went to support groups as often as she could after that first meeting and was consistent with her HIV treatment. A few months later, she gave birth to a healthy baby boy. Nozi said the day she learned her son was HIV-negative was “one of the happiest days of my entire life.”  

“It felt like I had won…this was a turning point for me too because it’s when I started believing that you know things can be ok, I can live,” she said. “And that’s when I wanted to find out more now, not how to save the baby but how to live and how to stay healthy.” 

Nozi signed up to be a Mentor Mother the first chance she had, but her joy suddenly turned to heartbreak when, at age three, her son was killed in a car accident. Nozi told me she managed to overcome the passing of her son and found hope for the future again with the support of her family and colleagues at mothers2mothers. Over the years, she worked her way up in the organization and now serves as the regional communications manager, sharing mothers’ stories with the world.  

Mothers2mothers is one of many organizations supported by the President’s Emergency Plan for AIDS Relief (PEPFAR). The work of local organizations like mothers2mothers has allowed PEPFAR to support life-saving antiretroviral treatment for nearly 20.1 million people, enable 5.5 million babies to be born HIV-free, and provide critical care and support for 7 million orphans, vulnerable children, and their caregivers.  

Nozi sees herself as a PEPFAR beneficiary. The program has given her a job in her community and across her continent, and she is still taking antiretroviral treatment, provided for free in South Africa thanks to support from PEPFAR. 

Partnerships are the foundation for PEPFAR’s model for success. The program’s integrated approach brings communities, governments, and funders together to design programs that meet the needs of local people. This model has also allowed PEPFAR to impact democracy, civility, and economic growth over the last 20 years.  

Much like PEPFAR, mothers2mothers is much more than a program for HIV. Nozi found that her mentors constantly pushed her out of her comfort zone, giving her opportunities to practice leadership skills and recognize her full potential. Nozi has passed this practice on to the women she mentors, mostly young mothers like herself. Today, many of these women approach her on the street or in the grocery store, remembering the impact Nozi had on their lives.  

“I am most proud of having been part of an organization that brings change in communities, in countries, and in the sub-Saharan African region… hearing how universal the stories of hope actually are and how many times women who say, ‘if it wasn’t for me meeting the Mentor Mothers that day, I don’t know what would have become of my life,’” she told me. “For me it is always the individual stories that make feel like yes, I’ve done something with my life.”  

Mothers2mothers has created nearly 12,000 jobs for women living with HIV, supported almost 15 million people, and achieved virtual elimination of mother to child transmission of HIV among their clients. While mothers2mothers continues to deliver services designed to prevent and treat HIV among children and adults, Mentor Mothers also provide health services, education, and support targeted at other preventable and treatable diseases that disproportionately effect people living with HIV and marginalized communities, such as cervical cancer, tuberculosis, diabetes, and malaria. This is in line with PEPFAR’s commitment to integrated, community-led service delivery. 

Today Nozi says she has “three plus one” children, including her 11-year-old and 4-year-old daughters, an eight-month-old, and her 16-year-old cousin – all born HIV-free. She’s also working towards a Bachelor of Arts in Communication Science. Nozi dreams of a future where her family remains healthy, her girls live in a more equitable world with limitless opportunities, and everyone in Africa has access to a Mentor Mother and HIV treatment. 

PEPFAR is a product of the generosity of the American people, allowing organizations like mothers2mothers to ensure that women can deliver healthy babies and live vibrant, productive lives.  

Speaking to the American people, Nozi said, “It would be incredible if they could listen to these stories and know just how much we value the support that they’ve given us over the years… if it was not for their support, who knows, maybe you wouldn’t be talking to me today. Maybe I wouldn’t be counting these three children plus one. And maybe even if I were, I wouldn’t have had the opportunity to realize my full potential.”