Nowadays we are increasingly asserting the concept of Global Health: we live in a globalized and interdependent world, where the intensity of migration, trade and communication between people and countries is steadily increasing; but in most countries, access to healthcare for African people is still a dream. Strengthening individual health systems is now a priority for the development of the poorest countries, although set by the UN as one of the Millennium Development Goals (MDGs) for the foreseeable future.
In recent years the work of DREAM has shown how investments in treatment for AIDS have had a huge impact on health systems. Trained staff, new infrastructures, organization of services and care models have contributed to a change of the national guidelines and suggested a characteristic organizational model of African treatment management, completely new and suitable also for other diseases. Currently, through treatment, HIV patients achieve a good quality of life and, as everybody else, will fall ill due to other pathologies. The newfound life of so many patients raises new questions that cannot be avoided.
Today, the DREAM program of the Community of Sant’Egidio is a model of contrast against HIV / AIDS and malnutrition, but also against other infectious diseases and many chronic pathologies that, from the best diagnostic-therapeutic protocols of the rich world, found its appropriate setting in Africa. In this sense, the program is able to offer a substantial contribution to the continent, which cannot be substantiated only in the replication of HIV care in many centers of many African countries, but can also be a model of contrast to many other infectious and chronic pathologies.
Particularly important for DREAM is the continuous research of excellence for those pathologies, the most advanced from the developed world, to free Africa from many diseases.
To emphasize the growth occurred in these years, we have committed to a wider meaning of the DREAM acronym.
Not only “Drug Resource Enhancement Against AIDS and Malnutrition” but also “Disease Relief through Excellent and Advanced Means”. The dream grows.
This DREAM, which we could define DREAM 2.0, faces this new challenge. The long experience of these years, the model produced and the active and concrete support of many European and African professionals have enabled us to make this leap.
The example of how the Ebola emergency was dealt with in the DREAM centers in Guinea Conakry clearly shows how the model carefully built over the years by DREAM has proved to function and to be effective if extended to other diseases. It is necessary to keep in mind that the pandemic, which has caught the world by surprise, unfortunately is not the only zoonosis, i.e. the diseases and infections naturally transmitted between animals and man, which may occur in the future.
It should be noted that despite the existence of appropriate means of prevention and control, today there are conditions that can, on the contrary, facilitate the emergence of other pandemics, such as the globalization of markets, greater speed of transport and the increased mobility of population worldwide. To this we must add the mutations of the virus determined by human intervention. The transmission of the virus from animals to humans, the spillover, as happened with Ebola, is related to qualitative transformations of the environment from deforestation, of the hoard of natural resources (minerals, timber, etc.), land (land grabbing) and the development of monocultures for export, a phenomena aggravated by the world situation of global warming. In addition, in the future it will be increasingly difficult to permanently solve health crises like the current one without acting on its social and environmental causes. The viruses that circulate in the animal species are in fact usually in a condition of evolutionary stasis, reproducing the infected host without causing the disease. Despite the availability of advanced methods that allow the detection and characterization of emergent viruses, following the changes due to the migration between species and its adaptation to the host, it remains impossible to predict when and how a new pandemic will arise. This uncertainty determines the need to prepare in advance responsive strategies to any eventual other emergencies.
Therefore, the virulence of certain animal diseases in different regions of the planet transpose the destruction of ecosystems (deforestation), expropriation of rural communities (privatization) to tightening up the conditions of work in the areas of export (super exploitation), but also the dismantling of past social systems established by the States (structure adjustment plans), to the health system. These determine the price that a certain kind of globalization is going to charge the people, particularly the poorest and the most vulnerable.
However, to counter future outbreaks, we need to build interconnected systems, fair trade and ecological solidarity which should not be considered a “luxury” from the North of the world, but instead an urgent necessity for the whole world. Ultimately, what is needed is a globalization of solidarity, as recalled by Pope Francis in his encyclical on environmental issues Laudato sì.
DREAM 2.0 is getting ready for all this.
It is a large enterprise: many constraints, especially economic, would lead to say that it is impossible. But it is possible, if we have the courage to listen together to the reason and the heart. What is not needed is a scared and helpless gaze, but instead a smart and concerned approach which may change and free from disease the lives of many Africans.
DREAM does not abandon Africa, but is maturing an even more ambitious dream and goes on!