The ICASA conference is the main conference on AIDS in Africa. About 7,000 delegates participated in the conference this year in Abidjan, from 4 to 9 December. It was an occasion to take stock of the strategies for controlling the epidemic which, as is known, is especially rampant in Africa. Over the course of the conference the topics covered were the critical points of the 90-90-90 approach, HIV’s peculiarities amongst teens, and the new opportunities regarding drugs and prevention.
The DREAM program presented two projects, one from Malawi and one from Cameroon: a presentation on the screening of cervical cancer in Malawi, in which more than 3000 women participated over the course of two years; a poster showing DREAM’s results in Cameroon in terms of retention and virological success.
The conference was an occasion to meet and share experience. Many asked about DREAM, including Ivory Coast’s representatives from the Ministry of Health.
The second international workshop of the managers of the laboratories of the DREAM program in Africa concluded last week in Maputo. A group of biologists and lab technicians who manage the implementation of quality systems in eight of the largest laboratories of the DREAM program were present at the workshop. The purpose of the event, which was financed by the Italian Episcopal Conference, was yet another occasion to confront each other, share challenges and experiences and find common solutions to improve the efficiency and effectiveness of the laboratories.
Each manager presented evaluations of the activities of the past year for their own laboratory, paying particular attention to the integration with the national networks and the work carried out to increase the number of health centers reached, at the same time maintaining the quality of the services offered and the analytical response times. The managers of the quality systems were able to analyse and compare the progress achieved in terms of the implementation of the ISO15189 – 2012 regulation, gathering from each other’s experience advice, concrete examples and encouragement to continue their work. Everyone greatly benefitted from meeting and listening to each other again.
The workshop marked another milestone in building upon the collaboration and debates which began last year in Blantyre, carrying on over the course of the whole year through remote contact and communication. An important milestone in constituting a network of professionals who are in growing collaboration, who willingly exchange opinions and advice and who strengthen their own identity as a system of excellence, available not only to all the patients of the DREAM centers, but also to the many other public health centers. These centers are more and more a part of the DREAM laboratories, where they are guaranteed increasing quality and expertise.
DREAM was present at the International AIDS Society 2017 Conference in Paris.
The conference saw more than 6,000 professionals employed all over the world in the fight against the HIV infection. The results obtained with the treatment over the last few years were cause of great enthusiasm, with more than 50% of HIV-positive people all over the world following therapy.
It is a big leap forward in reaching the 90-90-90 goals set by UNAIDS for 2020.
In spite of the positive data, some areas are still lacking, particularly the scarce access to antiretroviral therapy in Africa and Eastern Europe, resistance to drugs (alarming especially in children), the Retention in Care and the treatment of the key population (teens, sex-workers, homosexuals, children).
Other important topics discussed were the co-infection of tuberculoses and hepatitises, the
mother-child prevention and the emergence of chronic aging diseases in HIV-positive patients.
DREAM contributed in two ways. A study conducted in Mozambique on advanced diagnostic algorithms for tuberculosis and a poster on retention in Malawi: both generated interest amongst researchers working in the sector.
Despite the encouraging data and the work towards spreading forms of treatment such as the one employed by DREAM, the fight against the HIV infection has its path littered with gaps as regarding to access to therapy in Sub-Saharan Africa and the enormous challenge of Retention in Care.
DREAM is on the field everyday fighting this battle side-by-side with many Africans.
On Friday 21 July a conference took place in Kinshasa in the PNLS room (National AIDS Control Program), called “Sharing the experience of the DREAM activists in the fight against HIV/AIDS”.
The idea originated from the growing interest of the National Program, responsible for taking charge of the HIV patients, towards the DREAM experience, which shows excellent retention statistics also in the DRC. For a few years now DREAM has also carried out an important awareness program in support of adherence to the treatment, especially in the suburban districts, thanks to the support from the activists. Therefore through an initiative of the PNLS all key actors of the sector were invited, particularly those responsible for the take charge of the psychosocial aspect and the community sector, the representatives of the networks of HIV-positive patients, and representatives from international organizations such as the CDC or WHO. Important also was the presence of institutions which collaborate with international funds such as Global Fund, PEPFAR and other NGOs such as MSF and ICAP. Various representatives from other health centers and maternities in the N’Sele health region (Kinshasa) were also present, who collaborate with the DREAM center in the area.
During the conference various topics were presented, such as the context in which the figure of the activist is born and operates in, and the main characteristics of what has by now become an important full-fledged professional. Furthermore the requirements were listed along with the training which DREAM carries out, as well as the various aspects which fall under the activist’s role and his/her relationship with the center and its personnel. Finally the data from the activities was presented, particularly from the last 2 years, when activists worked side by side with the medical team. The results, even though partial and necessarily still limited in time, showed the essential contribution of the activists in support of retention: in particular, aspects found to be especially problematic were highlighted, through various interventions, such as the take over of teens, reinforcing adherence, the active search for the “lost” patients who do not show up at the appointments, and the counseling and support for couples where only one individual is HIV-positive. Others explained the “parrainage” program towards teens, in which one closely supports a neighboring teen not adhering to treatment. It is a real challenge and a fight which focuses on involving the family, often grandparents or uncles which are also in a precarious situation, and gain the trust of the boy or girl.
At the same time it also means setting up support networks, such as the payment of school fees, which contributed to the majority of these teens adhering to treatment and finally suppressing the viral load.
The WHO representative Dr. Nicolas Nkiere Masheni lastly wished to highlight how one cannot fight against AIDS and Tuberculosis only through a medical point of view, but instead a global approach is required, involving the activists that may have an important role for the treatment’s success.
The conference ended with the sincere gratitude of the Director of the PNLS, Dr. Théodore Assani Salubezya, who highlighted the importance of the special effort that the DREAM Program makes in treating children and teens.
The activists, who were visiting Kinshasa for the first time, publicly took sides defending their work and their contribution and demonstrated yet again how not even an excellent program may reach quality goals if it doesn’t have a soul, if it is not willing to go that extra mile.
Thanks to its important results, the DREAM Program of the Community of Sant’Egidio is the example of how men and women, if freed by the stigma and given dignity through a qualifying service, are willing to help others and make a difference in the treatment of AIDS and change the society in which they live.
16 years later, the biennial event organized by the International AIDS Society returns to Durban, South Africa. The International AIDS Conference is one of the most important events in the world for the fight against HIV / AIDS: 18,000 delegates from all over the world including scientists, doctors, researchers, policy makers and NGOs are debating at a high level on the various topics regarding the fight against the virus.
Among them is also the DREAM Program of the Community of Sant’Egidio, which presented a few scientific studies regarding subjects of great epidemiological impact carried out together with the DREAM colleagues in Malawi and Mozambique, and in collaboration with various international institutions (“Non-communicable chronic diseases in HIV-infected patients in Malawi and the impact of antiretroviral therapy”, “TB diagnosis with combined point-of-care tests in HIV+ patients in Mozambique”, “Consequences of an adherence support program and genotypic resistance testing for second-line ART eligibility”, “Growth patterns of African breastfed children exposed to maternal combination antiretrovirals (cART) pre and postnatally”).
DREAM also participated in the pre-conference on tuberculosis. It displayed data from the research for the identification of optimal strategies for the diagnosis of TB in patients infected with HIV (today still an unresolved challenge in Africa), raising great interest from experts.
Furthermore DREAM was invited to make a speech at the pre-conference organized by Caritas, Catholic HIV & AIDS Network, Cathca, Cabrini Ministries and Southern African Catholic Bishops’ Conference. DREAM was presented as a best practice and a replicable model in order to achieve an effective service for treating HIV / AIDS in Africa. Moreover it was highlighted just how much DREAM represents a big support for the various Departments of Health of the countries it operates in.
The meeting in Durban is an important opportunity for sharing past experiences and best practices in order to speed up the elimination of the virus. The Secretary General of the United Nations opened the meeting stating: “May Durban 2016 mark the commitment towards a new era in which we finish what we started”. Yet again the DREAM Program of the Community of Sant’Egidio shares its long and efficient experience in this fight.
NEW YORK, June 9th – A dream against a nightmare. Pacem Kawonga, a woman from Malawi witness of the campaign against AIDS in Africa by means of the DREAM program of the Community of S. Egidio went to the UN to speak at the summit taking place these days on the issue of the fight against AIDS. “This is an example of long-term vision against the tendency to focus only on the short term,” said the Italian Deputy Foreign Minister Mario Giro, speaking at a side event organized by missions of Italy, Germany, Kenya and Malawi. DREAM began in 2002 and thanks to the contribution of both public and private donors it continues to provide excellent, free care to more than 300,000 patients in ten African countries. The Program administers antiretroviral therapy for pregnant women, preventing the contamination of their children. “On one hand, we need more resources, and on the other, we need to look at this as an example of partnership in order to develop more efficient cooperation models,” said Mario Giro. Pacem Kawonga, one of the first HIV-positive patients treated DREAM, at its first center in Malawi, by the first DREAM center opened in Malawi, brought to the summit her experience; that of a healthy mother of two healthy children who has, now for years, dedicated her life to helping thosuands of other women experiencing the same situation she faced. Mario Giro stressed the need to consider prevention and care in an integrated way: saying it was “another key element of the strategy.” Supporting the ideology that for every dollar spent on drugs, a dollar must also be spent for prevention, by investing on human capital and training, the Deputy Minister also stressed the importance of focusing on the most vulnerable groups: refugees, migrants, prisoners, “sex workers”. As for the contribution to the Global Fund against AIDS, “Italy is back. An additional 40 million dollars are ready to be used to support the project and we will not stop there, “said Mario Giro, announcing the convening of a conference in Rome on June 27. This conference will create a momentum for the donor conference in Montreal in September when Italy will define its commitment for the 2017-2019 period: “We were back among the big contributors in 2014 with a three-year commitment of 100 million euros to save 17 million lives, but there will be an increase in Montreal.”