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The origin of the DREAM Program

After the peace agreement in Mozambique, the Community of Sant’Egidio became conscious of the growing drama of AIDS in the country: a large number of deaths, including many young people and even members of the Community. The scientific world, local governments and the World Health Organization identified in prevention the only possible approach to HIV / AIDS in Africa.

The failure of this choice, apparently very cost-effective but unscientific, was highlighted by the growing number of deaths in all of Africa, the impressive reduction of life expectancy in the affected countries and especially the failure to contain the infection. From this conviction, with sound scientific basis, a work of advocacy with the Government of Mozambique began in 1999 in order to legalize the use of the therapy in the country and allow the import of the antiretroviral drugs used in the western world, which, until then, was not possible in the country. Understandably, authorities expressed doubts and fears: a similar attempt in South Africa had quickly worn out, leaving very problematic social consequences. What guarantees could the Community give in terms of continuity and sustainability at least in the short term? Who would have funded and supported a strand rejected at the start and not even considered by all relevant international and national actors?

Negotiations with the Mozambican authorities began and, at the same time, an approach to AIDS through home care to the sick and the treatment of opportunistic infections. Initially many denials to the request of introduction of the therapy were received but, after two long years for the patients and thanks to the great merit acquired by the Community in peace talks, the first yes arrived to those Italians, dreamers and apparently very little realistic. It ‘s true: there was not a financial plan, but there was the insistence of the “evangelical” widow seeking justice in the courts of this world and of the inappropriate friend that opens a door that would never be opened in the dark night.

Finally, in 2002 the first DREAM center for the prevention and treatment of AIDS was implemented at the Hospital of reference for Tuberculosis, new lazaretto of the modern era, in the suburbs of Maputo. It was located there in order to not be too evident nor easy to reach so as to not interfere with the health programs of the country. A center located in the outer edge of the city both geographically as well as under the human point of view, for the life of the many patients who began to come around.

The suburbs, permanent axis of the life of the community, today indicated by Pope Francis as a starting point for changing the world. Even for the Community of Sant’Egidio, a suburb from which to overturn the decision that made impossible the dissemination of HIV treatment in Africa.

Ours was and is a vision. And those who follow the strength of a vision change the world and are freed from the repetition and the preservation of the existing.

So, from the suburbs, DREAM has begun to take its first steps convinced that it was not possible to accept an absurd idea, but widely shared in those years: that Africa should be left with 30 million people living with AIDS without treatment, which within a few years would almost reach the size of a genocide. It was therefore necessary to work to show that antiretroviral therapy was possible with the same level of quality, excellence and efficiency that we witnessed in Western countries.

The pioneering commitment of DREAM in the treatment of AIDS in the continent was joined only by a few voices of the international scientific world, aware that treatment programs could actually be introduced in Africa. A consideration of this kind was expressed by the president of the International AIDS Society, Joep Lange, at the International AIDS Conference in Barcelona in 2002: “If we can bring fresh Coca Cola to every remote corner of Africa, it should not be impossible to do the same with drugs.”

With time and evidence of experience, the immovable certainties of International Agencies that initially didn’t even take into consideration the possibility of introducing treatment in developing countries, started to break.

DREAM was established specifically to fight AIDS in the African territory: to make possible and accessible not only antiretroviral therapy, but also the whole complex of measures and factors that could make it effective. These include in particular health education, nutritional support, advanced diagnostics, training of personnel, fighting malaria, tuberculosis, opportunistic infections and especially malnutrition.

Therapy enhanced the effectiveness of the practice of prevention itself. Today there is no longer fear of the test, the anguish of knowing what before was a declaration of early death: knowledge becomes therefore protection of the individual as well as of others. Also because of the disease, marginal and marginalized women have become the center of a new awareness and represent a chance to react and live the beginning of a new life. With them, the men, the village, the neighbors. The children, born healthy, are not added anymore to the millions of orphans destined to the streets, or families of grandparents and children, without any intermediate generations.

We are amazed by the impressive success of the program, its fast spread in Africa and the influence exerted on Governments and International Agencies in order to alter the attitude towards antiretroviral therapies. The achievements have indeed played a palpable role also in the World Health Organization in the reshaping of therapeutic protocols for Africa.

DREAM has certainly shown its strength under the scientific point of view; it is enough to think about the solidity of the culture of its members, not only people of good will, not utopian dreamers, but conscious bearers of scientific certainty gained in the study and research on infectious diseases. The effectiveness of the program has been substantiated in the practical application of diagnostic-therapeutic protocols, normally used in the Western world and in Africa with the patients and with the help of African professionals. It can be said that a large part of the success is due to the original DREAM interpenetration of the academic scientific component and that of practical application.

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