The fundament of gratuitousness is not to be considered last or secondary: all have access to DREAM since treatment and diagnostics are totally free of charge. This choice seamed due on the African continent, which is marked by the presence of hundreds of millions of people living below the absolute poverty line. Another consideration, following that of the patient’s inability of expense, should be added: therapy is for life and requires patient’s adherence to it. The complexity of care procedures, which results in a large number of appointments for monitoring health conditions, drug delivery and execution of the analysis, still has a cost for the patient. In fact many patients have to undertake long distances to reach the centers and therefore dedicate a few hours to those activities. This has a price since nobody receives contributions for transportation, and adherence to treatment involves a tangible and active participation of the patient also from the economic point of view.
Gratuitousness is imposed primarily for reasons of equity and justice, but it is also the secret of the very high degree of adherence to treatment by patients, which today is considered the true assessment of the success of the therapy.
On December 1, 2005, the UN Special Envoy for HIV / AIDS in Africa, Stephen Lewis, expressed his thoughts: “It is terrible to think that millions of children who should be alive, have died simply because the world imposes an obscene division between rich and poor. Why do we tolerate that there are two systems, one for Africa and another for the rich countries? Why do we tolerate the carnage of African children and save the life of every western child? “.
Free healthcare is the first method to break down the wall of separation between the rich who have access to health services and the poor.
In the healing of many patients the sense of generosity and giving is present, which are the strength and effectiveness of the gratuitousness of everything that the Community of Sant’Egidio does in the world. In a time of globalization, faced with the challenge of living together, crushed by economic materialism, the culture of gratuitousness is a revolutionary act that promotes social development, restarting the culture of solidarity, voluntary work, of cooperation, creating new opportunities for our societies. It is a different dimension without which the humanity of peoples is impoverished. To live in a new era and be capable of facing the current challenge of a complex and globalized world means also maintaining and enhancing our humanity. There is something that cannot be sold or bought of which we all have a vital need: the gift, the love, the friendship and the gratuitousness make up the quality of society and people’s lives and build a concrete solidarity between peoples, which changes the world.
Here is the secret of the extraordinary results of DREAM, obtained also thanks to the sharing and collaboration of so many men and women of good will whom we have met over the years throughout the streets of Africa. The fast expansion of DREAM in the last 13 years is due not only to the widespread presence of the Community of Sant’Egidio in many African countries and the commitment of many African health professionals, but also to the alliance with many religious congregations, NGOs, lay and volunteers who have chosen to join us in the fight against AIDS. This synergy has allowed increasing the reached number of patients. It was necessary, alongside the cooperation with communities of other religions and confessions, such as the Muslim community in Guinea Conakry, the Hindu community in Malawi, the Protestant and Orthodox churches in Mozambique, to convince many skeptic patients to be treated. It can be said that this was a positive contamination, which has multiplied the effectiveness of our work. It has been a contamination of good, of good healthcare, which has made Africa better as well as many citizens of the rich world.