The conference “The DREAM Program in Africa. The Mozambican case: from peace agreements to the fight against HIV” took place on 18 January at the Clinica Moncucco in Lugano.
The clinic counts amongst its partners the FAI foundation (Fondation Assistance Internationale), which has been supporting the DREAM Program in Mozambique and has provided its continuous help and contribution for almost a decade.
Speakers at the conference included Dr. Noorjeahn Magid, Clinical Director of the program in Mozambique, Dr. Laura Zagrebelsky, Italy’s representative for the Global Fund and Dr. Guidotti, Secretary General of the DREAM Program.
The FAI President and Vice-president, Dr. Respini and Dr. Mancini, expressed their enormous enthusiasm and passion for the program. They looked back on the work and collaboration over the years and the huge success and strength which characterized them, making the program a key example of the FAI foundation itself.
Dr. Noorjeah recalled the fight, the challenges and successes through her own story, arousing deep emotions and sympathy for both Mozambique and DREAM.
Dr. Zagrebelsky cited the program as being a true model of success and effectiveness for the Global Fund. She highlighted how this great collaboration helped spread the program throughout Mozambique, reaching many sick, which in turn contributed to a 40% increase of people receiving treatment.
The audience was moved by the touching images from the program and the voices of the activists, heard in a video, who received great admiration.
Towards the end of the conference a new agreement was signed which will allow DREAM to open a new center in Bangui, Central Africa.
The humane, scientific and spiritual adventure of the program continues with growing passion and new friends.
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.