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.
The role of Laboratory diagnostics in HIV and Co-Morbidities Management in the Era of Global 90-90-90
Over the course of August the first open day of the DREAM center “Elard Alumando” took place in Mandala, Blantyre. Malawi’s Minister of Health Atupele Muluzi was present, as well as many partners and collaborators of the DREAM Program in Malawi.
The day was an occasion to demonstrate to all of the stakeholders of the DREAM Program its main activities and the available resources (both in terms of equipment and human resources) which it can provide for the country and its partners, as well as the results that the Program wishes to achieve in the near future.
For years now DREAM has operated in Malawi, especially in the fight against HIV/AIDS, and has recently broadened its scope to other diseases such as cardiovascular diseases, cervical cancer, diagnose and treatment of tuberculosis, hepatitises and other non-communicable diseases.
With the August event the wish was to show how the Program can contribute to the effort that the whole country is undergoing to improve the health of its citizens. At the same time, the event was an occasion to inform the participants and create a public debate on a few particular topics such as the role of the laboratories in the 90-90-90 strategy, the topic of resistances to HIV and the role of the laboratories in the treatment of hepatitis.
Over the course of its 12-year activity in Malawi, DREAM has contributed in various ways to the fight against AIDS, but one of its fundamental contributions was the development of a network of molecular biology laboratories. Therefore central to the event was the topic of diagnostics and their role in facing the existing challenges. For this reason, all of the guests showed great interest during the visit to the laboratory, led by its manager Dr. Richard Luhanga.
In one of his first official visits to the healthcare facilities of the country, the newly-appointed Minister of Health showed particular interest in the fact that the event, which took place in a health center and not in a conference room, allowed for a humane interaction with the staff of the program. Therefore not only the healthcare personnel such as lab technicians, doctors and nurses, but also the patients and the expert clients, beating heart of DREAM’s activities. In his speech he also mentioned the will of the country to stay ahead in the innovation sector, and do so together with partners such as the Community of Sant’Egidio and the DREAM Program.
Furthermore the event was a precious occasion to strengthen the relations with the main organisations active in the health sector such as UNAIDS, UNICEF, the CDC, the Clinton Health Access Initiative and the national cooperations of various countries.
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.
Improving access to health services, especially in view of the treatment of the HIV virus, paying particular attention to teens and women. This was the subject discussed during the important conference held on 22 June in Maputo, with the participation of “Champions for an AIDS-free generation in Africa” – former African statesmen who dedicated themselves to this important aspect of healthcare and who were able to bring substantial improvements to the field, thanks to their good governance during their mandate. It was an occasion to unite influential and respected personalities able to steer and improve the health policies of Sub-Saharan Africa.
The next day, a large delegation of the “Champions” visited the DREAM center “Para Criança” of the Community of Sant’Egidio in Maputo, to see this reality up close, as well as the “best practice” example offered by DREAM: the former presidents Alberto Chissano (Mozambique), Kgalema Petrus Motlanthe (South Africa) and Speciosa Wandira-Kazibwe (Uganda), together with the institutional representatives of Lesotho, Swaziland, Kenya, Tanzania and Zambia. They were welcomed by the DREAM team, who showed them the health services offered by the center, where thousands of patients receive free treatment, and the highly specialized molecular biology laboratory annexed to the health center, one of 7 built by DREAM in the country.
The whole delegation appreciated the services offered and in particular President Chissano wanted to check his blood pressure and, referring to the many patients present, called for everyone to carefully follow through with the treatment and adhere to the check-ups and medical prescriptions. The President then wished to remind everyone how he has always appreciated the DREAM Program and accompanied it since the beginning, when anti-retroviral drugs were still not available in the country and how the Community of Sant’Egidio were pioneers in introducing therapy for the treatment of AIDS. One of the patients who regularly receives treatment in the center told the President how the DREAM center is like a home and a family. A family not only in Mozambique anymore, where it took its first steps, but spread across 10 countries in Sub-Saharan Africa. A “best practice” that the Champions agree should be spread and replicated so that an AIDS-free generation in Africa becomes a reality, following the footsteps of the thousands of children born healthy and free from the HIV virus, thanks to the treatment protocol carried out on the mothers in this DREAM center.
On 19 June 2017 at the “Giovanni Paolo II” Nutritional Center the first Community Vegetable Garden opened, promoted by the Community of Sant’Egidio in collaboration with Slow Food.
The project was made possible through the Sichem and Efraim Communities of Olgiate Olona, a town in the Italian municipality of Varese, which organized on 29 April a master class for charity: “4000 meatballs for Malawi”, together with a Malawian biologist from DREAM.
This pilot garden in the area of Machinjiri represents a concrete and sustainable solution for aiding the families affected by the economic challenges and food emergency.
This new adventure began with a 2-day training course held by two representatives of Slow Food in Malawi. 15 people participated of whom all, by cultivating the land, will be able to support their families and improve their living conditions.
On the first day of the course theoretical elements were covered, while on the next day the ground for planting was prepared.
The partnership between the Community of Sant’Egidio and Slow Food will allow to reach this goal of social value in a “Good, Clean and Right” way: slogan of the Slow Food association, which has been active in Africa for years now, working towards the development of food gardens through the “10,000 gardens in Africa” campaign.
Particular attention will be given to maintaining the biodiversity of the crops, giving value to the local species of fruit and vegetable and avoiding the monocolture of maize, partly responsible for the food crisis, as it requires a lot of water to grow.
Furthermore no chemical pesticides or GMO seeds will be used, but instead natural methods of fertilization and safeguard of the local plants and seeds, which are selected through the expertise and knowledge of the local farmers.
The team, composed of people who all led different lives and experiences and start now as farmers, began working with enthusiasm and unity of purpose.
The name selected for this garden is: “Mbeu kwa Ufulu”, which means “Seeds of Freedom”.
Freedom from pesticides and GMO seeds, freedom for the men and women of this marvelous country, stricken by hunger and hopelessness.
Seeds of freedom in view of a better future beginning from an invaluable treasure: the African continent and its people.