COMMUNITY BASED ORGANIZATIONS FACILITATING ACCESS TO ANTIRETROVIRALS IN AFRICA A Selective Review December 2004

With support from

A call for Supporting Community-Based Organizations In their Efforts to Scale up Access to HIV Treatment and Care in Africa

iven the urgent and ever growing demand for HIV treatment and care, it is time to support community-based initiatives worldwide, to marshal resources, and to bring together funding organisms and policy-makers.

G

Over the last seven years, SIDACTION, a French Aids institution, has given numerous grants to Aids Service Organisations in sub-Saharan Africa. In 2004, we provided financial and technical assistance to 84 projects (global care projects, access to HAART programmes, training and core cost projects), run by 50 organisations, in 24 different countries on four continents. Through our various experiences in supporting african organizations, we witnessed first hand their increasing involvement in providing healthcare services to people living with HIV/AIDS. In Burkina Faso, two CBOs began to import generic HIV medicines before other providers and procurement agencies. In Burundi, community groups, particularly the largest organization of people living with HIV, have been the primary structures that prescribe and deliver ARVs in the country. In Mali, before the government launched its own programme, ARVs were first brought into the country through community organizations in an effort supported by patients and health professionals to increase access. In South Africa, AIDS treatment activists have conducted ground-breaking work in advocacy, community mobilization and litigation to increase access to care and treatment across the continent and beyond. Acting out of pure necessity, some community-based organizations become either a substitute for systems that currently neglect people's health care needs, or they complement existing infrastructure by providing additional important services such as educational or psychosocial support. Others have adopted the necessary role of watchdogs, to ensure a fair and equitable distribution of treatment as antiretroviral programmes scale up. These support groups, providers of healthcare services and grassroots activist movements, may be inspirational for policy makers in their efforts to scale up access to treatments, as they propose a community model of comprehensive care and support to people living with HIV and AIDS.

Though it is fundamentally the responsibility of governments to protect and ensure each person’s right to health, the support of private foundations and international donors to such groups can be a decisive factor in the expansion of access to antiretroviral drugs in Africa. Community-based organizations and people living with HIV and AIDS represent much needed and under-utilized partners who can provide critical services, reach under-served groups, and fill gaps in institution-based health care. Funding would reinforce their capacity to continue to deliver critical services, pave the way for other funding institutions like the The Global Fund to Fight AIDS, TB and Malaria to follow suit, and finally, encourage national governments to scale up access to antiretrovirals for and with their communities.

1 We present here more than 200 organizations involved in the provision of care and treatment for people living with HIV and AIDS in Africa. The list is not exhaustive; still you may wish to tour these groups and see for yourself the potential embodied in this already existing African community-based infrastructure. We invite you to bring your support and build with all partners a response to the AIDS epidemic in which community-based organizations can contribute their whole potential.

SIDACTION

SIDACTION was founded in 1994 as a French non-governmental coalition of researchers, care providers, and organizations involved in the fight against AIDS. Its mission is to raise the necessary funds for the implementation of programs such as prevention, research, and comprehensive care treatment in France as well as in numerous developing countries, to fight for the rights of those infected and affected by AIDS and their communities by helping them confront their disease as well as supporting community health programs.

PARTNERSHIP / DIRECT SUPPORT AND FUNDING OF LISTED ORGANISATIONS

For suggestions of partnership arrangements with SIDACTION or a pool of listed organizations, private foundations or bior multilateral funding institutions are welcome to contact the Community Access team at: SIDACTION Equipe Accès Commun + 33 (0)1 53 26 45 32

[email protected]

UPDATING THE DATA

A template of the questionnaire used for this study is included in this catalogue’s index. All of the organizations listed

are invited to update the information included here using this questionnaire as a guide. Organizations not included in this catalogue are invited to do so as well. Answers will be included in the database of the Community Access website after verification. An on-line questionnaire is also accessible to those who would like their organization to be included in the database.

SOURCES

SIDACTION has made every effort to ensure the accuracy of the information presented in this report. Reader’s attention

is drawn to the description of the specific sources and limitations of information provided here: The information in this catalogue was collected by SIDACTION from January to April 2004. Results from a survey involving 1000 participants were combined with information compiled from SIDACTION’s annual reports, as well as cumulative knowledge acquired over the last seven years of our partnerships with 40 such organizations. The data and information contained herein are being provided as is. SIDACTION makes no representations or warranties, either

expressed or implied, as to their accuracy, completeness or fitness for a particular purpose, and does not accept any responsibility or liability with regard to the reliance on, or use of, such data and information.

ALGÉRIE AIDS ALGERIA Tel : 213 70 21 26 28 Fax: 213 21 23 63 01 [email protected] Contact: Adel Zeddam Started: 1996 City: Algiers Country: Algeria

Last Updated : April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and care givers:

10

AIDS Algeria is one of the few associations in the country that are openly involved in the fight against HIV/AIDS. The organization conducts on-site HIV testing as well as pre- and post-test counseling. They also conduct psychosocial follow-up for patients on ARV therapy and offer them educational workshops on anti-retrovirals. Currently, among the beneficiaries of the organization 10 people are on ARVs.

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ANGOLA HOSPITAL DIOCESANO NOSSA SENHORA DA PAZ Tel: Fax: [email protected] Contact: Irma Milagros Moreno Started: 1995 City: Cubal Country: Angola

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and care givers:

50 0 6 10

The Diocesano Nossa Senhora Da Paz Hospital provides testing facilities and basic medical follow-up to patients living with HIV/AIDS in Angola. At the hospital, pre and post test counseling is provided along with on site blood testing. Treatment is provided for most common opportunistic infections and since most of the medication used is donated to the hospital, patients are not obligated to pay full price. The experience of the Diocesano Nossa Senhora Da Paz Hospital indicate that there is a dire need for more treatment in Angola. “In the year 2003, we diagnosed 168 new cases of HIV/AIDS in our hospital alone.”

National Association for Communitarian Action of HANA Tel: 092 623306 Fax: [email protected] Contact: Mr. Augusto Mateus Chamela / Mr.Moises Sovi Started: City: Lubango Country: Angola

Last Updated: April 2004

Within the organization: Patients receiving care: 83 000 Patients on ARVs: Doctors and medical assistants: 16 Nurses and caregivers: 21

The National Association for Communitarian Action of HANA is a faith-based organization. They work mainly with very poor communities for the prevention of HIV/AIDS and sexually transmitted diseases. Their approach is to teach their clients about the value between health and their lives, giving them the opportunity to talk one on one with members of the association. “If treatment were accessible to all, the project would like to medically follow up all 83,000 of these extremely poor southern and south eastern inhabitants of Angola.” It is also their priority to work with the young and teach them about sexually transmitted diseases. They aim to protect the children from sexual abuse and provide them with treatment and education. They work by establishing partnerships with local organizations. HANA had established a pharmacy to fill prescriptions in June of 1999 but it has since been closed. The owner of the building where the pharmacy was located asked for an additional 300 US dollars a month in rent, and HANA was forced to forfeit the pharmacy due to a lack of funds. From 1999 until 2004, when the pharmacy was closed, the project had attended 150-200 people per day and 4,500 to 6,000 people a month. Since many of their clients are too poor to pay for any medical attention, HANA accepts goods produced by the clients as forms of payment. As of late, the project has been reduced to a program of prevention and education because funds have dried up. The small size and relative inexperience of HANA has prevented them from accessing funds. “Financers do not believe that smaller projects like HANA have enough experience, but in reality it is these smaller organizations who are most in need of funding in order to gain some experience and be able to help more people.”

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BENIN ACTION SOCIALE Tel: 229 07 75 72 / 68 39 03 [email protected] / [email protected] Contact: Eugène Djidjiho Aguemon Started: 1999 City: Porto-Novo Country: Benin

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

68 62 2 3

Action Sociale is a development NGO which does prevention, conducts sensitivity training and tries to motivate people to take an HIV test, provides school and nutritional support to AIDS orphans and does follow-up for around 70 HIV+ people by providing them with basic medical care. The organization has an information center, a counseling and testing center and a clinic through which it dispenses free medicines for the most common opportunistic infections to its members. While waiting for authorization from the Beninese government to prescribe ARVs the organization provides financial aid for purchasing those medicines in addition to psychosocial support and medical follow-up to the 62 patients currently on ARV treatment (provided within the governmental program), and gives information seminars on antiretrovirals. “In our organization, 25 men and 37 women urgently need to be placed on ARVs. If ARVs were accessible to everyone, the organization could follow an additional 150 patients."

SEDEKON Tel: 229 50 01 43 [email protected] Contact: Père Bernard Moeglé Started: 1995 City: Abomey - Davougon Country: Benin

Last Updated: April 2004

Within the organization: Number of patients receiving care: 150 Number of patients on ARVs: 0 Doctors and medical assistants: 0 Nurses and caregivers: 10

This small but active organization provides HIV testing services and follows 150 people living with HIV/AIDS who receive medical care for opportunistic infections. External assessments concluded that the organization provides quality community based care. Not a single member is currently on ARV therapy even though the organization wishes to get involved soon. In order to do so, needs are as follows: funding of ARVs, additional personnel, additional training, and completion of the new healthcare center.

JEUNESSE AMBITION • (YOUTH AMBITION) Tel: 229 22 26 43 Fax: 229 22 26 43 [email protected] Contact: Lucien Ahouandjinou Website: www.bj.refer.org/benin_ct/cop/ja/accueil.htm

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Started: 1993 City: Porto-Novo Country: Benin

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARV s: Doctors and medical assistants: Nurses and caregivers:

9

Through the management of a school for street children and Aids orphans, JEUNESSE ET AMBITION has a good experience in providing total care. The organization proposes psychosocial follow-up to patients, pre and post-test counseling, and education/information workshops on ARVs. The organization gives support to patients whose health status requires them to take ARVs, orients them towards and assists them with the application process to qualify for the Beninese government-run ARV treatment program (IBAARV). Nine members of the organization are currently on ARVs.

BENIN ARC-EN-CIEL • (Rainbow)

Last Updated: April 2004

Tel: 229 384 444 Fax: 229 307 213 [email protected] Contact: Annick Apovo

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

Started: 1994 City: Cotonou Country: Benin

600 200 3 6

The center was created in 1990, with the aim of dispensing comprehensive medical care and social support through a mobile clinic to very poor populations living with HIV. Today they are able to deliver comprehensive care (HIV test, treatment of opportunistic infections, follow-up for patients on ARVs) and psychological support (counseling by a social worker, start-up of an orphan care project, home visits). Arc-en-Ciel follows 600 patients, around 200 of whom are on ARVs in partnership with the CNHU (National University Hospital Center). Arc En Ciel has since transformed its mobile clinic into a hospital: its 10 beds are always full and the conditions are less than ideal (no ventilation, rain falling into the rooms, lack of privacy…) The center is financially and materially lacking, there isn’t enough personnel to handle the ever-increasing patient load and there is little petty cash to pay for transportation for home visits. To relieve the situation of the center, RACINES organization proposed a comanagement plan whereby they will buy medicines as well as pay for the lab tests for PLWHAs. But even with RACINES’ help Arc En Ciel is still lacking financially and materially.

ACTION ESPOIR ET VIE • (HOPE AND LIFE ACTION) Tel: 229 38 08 47 Fax: 229 31 63 87 [email protected] Contact: Marins Acotchou Started: 1997 City: Cotonou Country: Benin

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

0 40 0 0

AEV was founded at the initiative of people living with HIV/AIDS in Cotonou who decided to get together to end their isolation and become informed about the illness. Today it is the main PLWHAs organization in the country: it includes 100 members, 30 of whom are actively involved. Since the start of the national ARV treatment access program the number of members of this organization has dramatically increased. They mainly do psychological support (home visits, nutritional support on an as-needed basis), as well as some medical follow up (treatment literacy, training healthcare workers), and help their members create income generating activities. Treatment literacy is one of the main strengths of the AEV. Numerous counselors who currently work at the Benin government-run ARV program (IBAARV) received their training at the AEV. AEV’s counselors also run training sessions at the HIV test center as well as at the University hospital (CNHU). Finally, around 30 members are on ARV treatment through IBAARV. The AEV is therefore well placed to play a role in observing treatment access in Benin. In order to facilitate access to ARVs for their members, what they most need is food support, financial aid for the creation of a trust fund, free-lance doctors, and community pharmacy…

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BENIN RACINES • (Roots) Tel: 229 33 50 91 / 90 38 01 Fax: 229 33 50 91 [email protected] Contact: Mesmin Emmanuel Dossou-Yovo Website: http://racines.africa-web.org Started: 1999 City: Cotonou Country: Benin

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

170 20 1 3

From 2000-2004, Roots has been conducting prevention activities in working class neighborhoods of Cotonou through setting up information booths, conducting sensitivity training workshops in video clubs, and sports and theatre activities. A partnership has been started with the nearest testing center (CIC) to accompany young people through the process of getting an HIV test. Because of the HIV+ status of some young people RACINES became closer to AEV (Action Espoir Vie, the main PLWHAs organization) to propose offering psychological support, help with structure and the creation of tools for home visits, and setting up a community pharmacy. To improve medical care and psychosocial support available in Cotonou, RACINES decided to work with ARC EN CIEL and the out patient clinic CTA, paying doctors’ salaries at those two healthcare centers and helping with testing and with home visits. Given the frailness of the medical care program, RACINES decided to co-manage the ARC EN CIEL Center, to fund lab tests required for qualifying for ARV treatment and to help the CTA materially and in buying drinks and food. In order to further help ARC EN CIEL, RACINES opened a healthcare annex thanks to the financial support of a number of European partners. Approximately 170 people currently receive medical care and support at RACINES’s own healthcare center (" Espace ADIS "). Financial assistance is available for purchasing medicine, clients on ARVs receive medical and psychosocial follow up, and the center also conducts educational/informational workshops on treatment. While waiting for agreement from the PNLS to become directly involved in an ARV program, the organization helps patients with the following: 1/ Funding CD4 counts and other lab tests required to apply to the ARV program for those who cannot afford treatment, 2/ Presentation of applications to the “eligibility committee, " 3/ Other kinds of support (food, transportation, medical care…) to those on ARVs.

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BENIN LES AMIS DE PASTEUR • (Pasteur’s Friends) Tel: 229 212 222 Fax: 229 212 700 [email protected] Contact: Dr Lucien Dossou-Gbete Website: www.chu-besancon.fr/aptaa/aptaa_clp.htm Started: 1996 City: Porto-Novo Country: Benin

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

65 25 6 15

Les Amis de Pasteur is an organization coupled with a private institution, the Louis Pasteur Clinic. The group works in collaboration with several structures, notably the Association pour le Partage des Traitements Anti Sida avec l’Afrique (APTAA, or The Organization for Sharing AIDS Treatment with Africa), a French organization which funds ARVs and followup lab work for HIV+ people. The Pasteur Clinic conducts HIV-testing (pre and post-test counseling, on-site blood tests) and routine medical followup with the option of hospitalization. Both HIV tests and consultation are more expensive than those provided by the nearest public facility. 65 patients are receiving regular follow-up and treatments for the most common opportunistic infections. The Clinic doctors have been prescribing ARVs since 1997. 25 members of the organization are currently on ARVs, entirely funded by APTAA. Patients procure their ARVs either at the Clinic pharmacy (in partnership with APTAA) or at the local public hospital (government program) and treatment is free of charge for those who qualify for the program. Among those who currently receive care 4 men and 7 women are in emergency need of being placed on ARVs.

"ARV treatment should be free for those who are HIV+. It is the best that can be hoped for but both lab work and needs regarding other health problems should also be funded. The idea is to do everything possible to reduce the circulation of HIV throughout the world by removing all financial obstacles."

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BOTSWANA COCEPWA • COPING CENTER FOR PEOPLE LIVING WITH HIV/AIDS Tel: 393 7156 Fax: 393 7159 E-mail: [email protected] Contact: Mrs. Helen Ditsebe Mhone http://www.cocepwa.co.bw/index2.htm Started: 1999 City: Gaborone Country: Botswana

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

24 20

COCEPWA began in Gaborone as a private initiative launched by people living with HIV. It has now been expanded to six centres operating countrywide as the main community based component of the national treatment access programme. COCEPWA has a “drop- in centre” where people can find counsellors, participate to support group meetings or just “have a cup of tea and a chat” with other people living with the virus. COCEPWA has counselling offices at Marina hospital, the first place where people began receiving ARVs. They also have a medical doctor available for their clients, who can help with specific questions about HIV/AIDS and the new AIDS drugs. Finally, they run a “buddy programme” for members who need long term support. A buddy is a member of COCEPWA who received special training and gets matched to a member of COCEPWA who needs support. COCEPWA also organises at regular times courses and workshops about • HIV/AIDS Basics (offered every month) • PLWH/A Leadership training (annual training) • Buddy Training • Speakers Training • Nutrition for PLWH/A • ARV's and Adherence • Peer Counselling.

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BOTSWANA BONEPWA • BOTSWANA NETWORK OF PEOPLE LIVING WITH AIDS Tel: 002673906224 Fax: 002673190977 E-mail: [email protected] Web Site: http://www.bonepwa.botsnet.co.bw/ Started: 2000 City: Gaborone Country: Botswana

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

Bonepwa runs a centre for counselling and education on HIV/AIDS related subjects. They are active in facilitating access to information amongst PLWHAs, including treatment literacy on ARVs. Bonepwa has implemented an ARV adherence program to guarantee the proper usage of ARV medication. “Bonepwa has an ARV adherence program where 4 staff members are employed and we are trying to increase this to 8 employees in the IDCC centres. They are the link between the program and the patients . We have planned training on ARV adherence and try to mobilize the community on ARV education in an effort to compliment the ARV treatment given by the government, but our coverage is still low”.

HOLY CROSS HOSPICE Tel: 390 2980 Fax: 390 2980 E-mail: [email protected] Started: 1994 City: Gaborone Country: Botswana

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses: Caregivers:

105 56 2 3 105

At the Holy Cross Hospice, patients are offered access to medical treatment and follow-up. Their team of 2 doctors and 3 nurses cares for the 105 patients at the hospice. Clients are provided essential treatment for the most common opportunistic infections at a reduced price, when available. The Holy Cross Hospice also provides support to those undergoing ARV treatment, providing them with transport to and from their treatment centres, doing treatment literacy too. It is one of the primary goals of the Holy Cross Hospice to establish a comprehensive ARV program of their own in the near future.

“Even though we are involved in giving access to ARVs, we have problems. People do not want to volunteer, maybe because of their poor standard of living and the fact that they need a source of income. For these people if seems to be a waste of time to volunteer instead of going around to beg or do little jobs.”

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BURKINA FASO ESPOIR ET VIE • (Hope and Life) Tel: 226 61 78 66 Fax: 226 97 25 38 [email protected] [email protected] Contact: Colette Koala Website: http://perso.club-internet.fr/sos_esf/EspoirEtVie.htm Started: 1997 City: Bobo-Dioulasso Country: Burkina Faso

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

125 13 4 2

One hundred and twenty five people receive medical care including medicines for the most common opportunistic infections, provided mostly through donations. The organization does not directly prescribe ARVs but gives financial support to clients to pay for treatment, and offers medical and psychosocial support together with informational workshops on ARVs. Thirteen members of the organization are currently on ARVs.

IPC Initiative Privée et Communautaire de Lutte contre le VIH/Sida

Last Updated: April 2004

(Private Community Initiative against HIV /AIDS) Tel: 226 38 03 60 / 64 Fax: 226 38 12 46 [email protected] / [email protected] Contact: Millogo Brice Bématogoma Started: 1994 City: Ouagadougou Country: Burkina Faso

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

125 13 4 2

IPC “aims to bring technical support to organizations initiating projects in communities in view of the goals that they have given themselves.” The IPC therefore does not intervene directly with HIV+ people but supports partner organizations and help them to reinforce their capacities. They help them identify financial partners who in turn will enable them to develop the appropriate activities. NGOs in Burkina Faso that provide care have personnel, material and technical problems. Most have no structural “security” – the head office, staff and budget are ad hoc. These difficulties reduce the overall functionality of these organizations. Also, despite the efforts made IPC believes that the NGO setting is not ideal for HIV+ people. The fear of stigmatization associated with looking like an AIDS organization remains strong. For its part IPC works with 9 organizations that are currently providing care. These organizations are, in Ouagadougou: the AAS, ALAVI and La Bergerie, in Bobo Dioulasso: REVS+ and Espoir Vie, in Ouahigouya: AMMIE, in Yako: JADB, in Kaya: Song Tabba and finally, in Dedougou: CV. “We are currently preparing-- with partner organizations-- our involvement in an accelerating access to treatment initiative, including ARVs, called TAP which is supported by the World Bank.”

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BURKINA FASO REVS + • Responsabilité Espoir Vie Solidarité

Last Updated: April 2004

(Responsibility, Hope, Life, Solidarity) Tel: 226 97 05 17 / 97 72 77 Fax: 226 97 05 17 [email protected] Contact: Martine Somda, Fanta Bassolet, Olga Ninon Website: http://www.vihinternet.org/asso/revs/ http://www.aidsalliance.org/_res/research/ Burkina%20Faso/Case%20Study%20REVS+%20(French).pdf Started: 1997 City: Bobo-Dioulasso Country: Burkina Faso

Within the organization: Patients receiving care:

683

Patients on ARVs:

126

Doctors and medical assistants:

3

Nurses and caregivers:

6

REVS+ is a PLWHA organization that never stops growing. With 100 core members the organization can count around 40 of them as truly active-- mostly women. This organization has gradually increased its services. It is well known beyond the region of Bobo Dioulasso. It is also known for its independent spirit. The work with HIV+ people begins at the head office or at the hospital. Collaboration with the hospital is very strict. Besides an almost permanent REVS+ volunteer at the hospital two other volunteers conduct morning visits as part of the hospital medical team that helps them to locate other PLWHAs. They do counseling inside the hospital and help the doctors in telling a patient that he/she is HIV+. This is one way to fight against mandatory testing, which happens often and is not followed by communicating the result of the test to the patient. The organization has nine teams of two who deliver home-based care. There are more medicines available due to a donation to the hospital, which enables fairly good access to generic medicines for around 800 patients. In 1999, close to 100 patients and their families were cared for at home. A quarter of these died during the course of that same year. On average, bedridden patients require 2 times greater medical care than other patients. The organization has ensured a minimum of care for close to 12 AIDS orphans for about a semester. Finally, sensitivity training is conducted due to the large number of members trained in the organization and their knowledge of diverse languages. At the organization, medical consultation is free while at the closest public facility a consultation can cost up to 2 000 FCFA (around $3). 683 people receive medical care while 116 women and 84 men are in emergency need of ARVs but do not have access. The medical personnel have prescribed ARVs since June 2002. They provide medical and psychosocial follow-up to patients on treatment and conduct educational workshops on ARVs. The staff has undergone specific training for this, and receives regularly updated information on treatments. Among the beneficiaries of the organizations 126 people are currently on ARV therapy, 64 of whom are receiving free care with help from partners in the North. Program to help with compliance for those on ARVs has been established. The organization also runs a program in reduction of mother to child transmission: in 2003 8 women benefited from this program.

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BURKINA FASO URBLS • UNION DES ROUTIERS BURKINABE DE LUTTE CONTRE LE SIDA

Last Updated: April 2004

(Burkina Faso Truck Drivers United Against AIDS) Tel: 226 97 06 27 / 60 38 29 Fax: 226 97 06 27 E mail: [email protected] Contact: Alfred Ouedraogo Started: 1994 City: Ouagadougou / Bobo-Dioulasso Country: Burkina Faso

Within the organization, in Bobo Dioulasso: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

87 7 3 3

The Ouagadougou office of the URBLS conducts two kinds of activities: HIV prevention in railway stations and along highways, and care and treatment resulting from a January 2000 training seminar. The organization has begun to undertake a plan of action spanning the next three years, which will target principally asymptomatic HIV+ truckers. In Bobo-Dioulasso, the URBLS has been providing care and support for HIV+ truck drivers and their families since the beginning of 1998. This project has made it possible to reinforce and develop psychosocial and medical care. URBLS’ work complements the work of other local organizations namely the CADI (HIV test center) and REVS+ (PLWHA organization). In terms of home-based care the active patient file of the organization of the second semester of 2004 included 52 families. A team of ten cares for patients at the hospital and at home and brings medicines to patients or refers them to the organization’s nurse. A doctor volunteers his services and prescribes both medical exams and ARVs. Because of the health insurance plan of Santé Bobo 45 families receive some or all of the medicines they need. Finally, income-generating activities (micro-credit) have recently started helping 16 families. Seven people in the organization are currently taking ARV therapy and can regularly participate in a “compliance club.”

RAME • Réseau Accès aux Médicaments Essentiels

Last Updated: April 2004

(Network Access to Essential Medicines) Tel: 226 24 44 55 Fax: 226 34 43 94 [email protected] Contact: Simon Kaboré Started: 2003 City: Ouagadougou Country: Burkina Faso

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

RAME, (Réseau pour l’Accès aux Médicaments Essentiels), conducts educational and informational workshops on ARVs, runs a think-tank on the mechanisms of access to treatment and lobbies decision-makers to adopt policies most favorable to access to medicines. Within this context RAME recently organized a meeting involving community-based organizations on decentralizing access to ARVs in the country. The Bobo meeting followed a meeting in Ouagadougou on October 25, 2003 with community doctors and December 12, 2003 with those in charge of the various AIDS organizations on the process of decentralization of ARVs in Burkina Faso.

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BURKINA FASO AJPO • ASSOCIATION DES JEUNES POUR LA PROMOTION DES ORPHELINS Last Updated: April 2004 YOUNG PEOPLE’S ORGANIZATION IN SUPPORT OF ORPHANS Tel: 226 26 39 53 [email protected] Contact: Nathalie Sawadogo

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and nurse’s aides:

Started: City: Ouagadougou Country: Burkina Faso

187 12 2 3

The organization conducts testing (pre-and post-test counseling) and providescare and treatment for HIV+ people. Certain medicines for treating the most common opportunistic infections are available mostly through donations and are free for patients. Although the organization does not have any ARVs it still conducts psychosocial and medical follow-up on those who take them and coordinates informational workshops on ARVs. Twelve members of the organization are currently on ARVs. “What are your principal needs in order for the organization to become involved in access to ARVs? Funding for ARVs, recognition and permission from the Minister of Health of our healthcare center, training of the medical team, institutional support."

ALAVI • ASSOCIATION LAAFI LA VIIM Tel: 226 36 91 16 / 21 32 37 Fax: 226 31 68 02 [email protected] Contact: Laure Salambere Website: www.alavi-burkina.org www.vihinternet.org/asso/alavi/ Started: Country: Burkina Faso

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and care-givers:

This organization has considerably stepped-up its care activities over the last few years, providing, in particular, free medical consultations whether they take place at the main office or at clients’ homes. Comprehensive care is available and ranges from HIV-testing (more than 3000 people tested in 2003) to tuition/school support for at-risk children and orphans (around 400) including home-based nursing care. More than 100 families received provisions. Support group meetings take place every two weeks and group members serve a community meal at each meeting. Over 6 months from January to June of 2003, 770 patients received therapeutic support: 94 men, 256 women and 53 children; 350 requests for medical follow-up were recorded - 256 of whom were from women, 94 from men and 66 from children. Thirty home visits to dispense nursing care were effected as well as 115 visits to hospital and to homes. Since 1999, the organization’s doctors have been prescribing ARVs and insure the necessary medical follow-up, including: choices of therapy, lab tests, follow-up for side effects, etc. Fourteen adults were placed on ARVs in 2002, 98 in 2003, but until now not one child has received ARV treatment. Grant proposals for funding ARVs are regularly submitted and the medicine is distributed through the ALAVI community pharmacy. To insure that the medicines are up-to-date, the organization has started a revolving fund or community kitty supported by contributions from clients.

“In our organization, 63 men and 45 women are in emergency need of ARV medicine. If treatment were accessible for all we would be able to follow between 200 et 300 people on ARVs".

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BURKINA FASO AAS • ASSOCIATION AFRICAIN SOLIDARITE Tel: 226 35 35 48 Fax: 226 35 35 48 [email protected] Contact: Issoufou Tiendrebeogo Website: www.aas-burkina.org Started: 1991 City: Ouagadougou Country: Burkina Faso

Last Updated: April 2004

Within the organization: Patients receiving care: 1 020 Patients on ARVs: 153 Doctors and medical assistants: 3 Nurses and caregivers: 4

Started in 1991 and involved from the beginning in AIDS prevention, this organization has considerably developed its activities especially in the realm of comprehensive care of HIV+ people and their families. In 1998, The Association Africain Solidarité (AAS) opened a medical care facility, the OASIS Center. This program provided HIV + people with a place to meet, to learn, and to receive medical and psychosocial support while prioritizing the involvement of PLWAs in their own medical care and follow up. The AAS is now the largest community care and treatment center in Burkina Faso. It is one of the few facilities providing comprehensive care in a fully integrated way. In 2003, The OASIS center provided care for at least 1,000 adults and 500 orphans and vulnerable children. Among the organization’s clients, 153 people are currently on ARVs. This organization is one of the sites for obtaining ARVs in Burkina Faso. Because of a community trust, and an emergency petty cash fund (which helps in avoiding stockouts of ARVs) as well as a funding partnership, the AAS maintains an independence that insures continuity in its activities as well as in treatment access. The organization has set up a “house of compliance” for the follow-up of these patients. Among other activities and projects, the AAS recently received a mobile HIV-testing and prevention vehicle. For two years the AAS has been reaching out more and more to other communities, and this mobile unit helps reach out even more to surrounding neighborhoods, cities and villages in the area. The mission of the Orphans and Vulnerable Children’s section is to provide direct and indirect follow-up and care to orphans and children at risk for HIV: medical services, schooling, food and above all recreational activities like summer camp and making crafts.

"Consultations take place once a month for all the children and Thursday consultations are specifically for HIV+ children. Treatment is provided only for opportunistic infections. However, we have to say that 2003 did not witness much success for this service since we lost a number of HIV-infected children (8) due to lack of ARV treatment. But, with the involvement of partners from the North we plan to start 10 children on ARVS in 2004."

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BURKINA FASO AMMIE Tel: 226 55 09 24 Fax: 226 55 01 99 [email protected] Contact: Cécile Beloum Ouedraogo Started: 1992 City: Ouahigouya Country: Burkina Faso

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

850 45 3 15

Located in Yatenga, a remote province in the north of Burkina Faso, AMMIE is one of the only organizations providing care to HIV+ people outside Ouagadougou and Bobo Dioulasso, Burkina Faso’s two larger cities. It is seen as an important organization in the HIV/AIDS care-providing landscape in Burkina Faso. It brings together teachers, doctors and nurses with the goal of improving the quality of life in isolated villages. Their priorities are: • Education in order to insure autonomy of the structures once they are set up including literacy and management classes. • Economic encouragement including active support of women’s village groups to help them define income-generating activities to be initiated and developed. • Health, particularly children’s health, training of health-care workers including midwives, the creation of maternity clinics and pharmacies, and HIV prevention and testing (pre- and post-test counseling and on-site blood tests) medical follow-up with an active list of 850 HIV+ patients. The doctors who are affiliated with the organization prescribe ARVs and provide medical and psychosocial follow-up to 45 patients on treatment.

LA BERGERIE • FOI UNIVERS COMPASSION

Last Updated: April 2004

(Faith, Universe, Compassion Hostel) Tel: 226 34 41 51 [email protected] Contact: Wendtoin Ouedraogo Started: 1994 City: Ouagadougou Country: Burkina Faso

In the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

860 40 4 8

La Bergerie / Foi Univers Compassion defines itself as a religious, humanitarian and development organization. It was one of the first to become involved in the care of HIV+ people, at a time when ARVs were not accessible in the country. The organization conducts HIV testing (pre- and post-test counseling, lab tests) and provides treatment for more than 850 patients. In addition to providing medicines and home-based primary care, the organization insures psychological support and spiritual guidance. La Bergerie is also involved in access to ARVs: financial aid to help pay for treatment, medical and psychosocial followup, education / information on ARVs.

The need for treatment is considerable. Many of the people cared for have reached the end of their lives. Forty people are currently receiving ARV treatment.

BURKINA FASO CICDoc • CENTRE D’INFORMATION, DE CONSEIL

Last Updated: April 2004

ET DE DOCUMENTATION SUR LE SIDA ET LA TUBERCULOSE (The Center of Information, Counseling and Documentation on AIDS and TB) Tel: 226 36 96 90 / 21 05 84 [email protected] Contact: Pascal Antoine Niamba Started: 1999 City: Ouagadougou Country: Burkina Faso

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

The CICdoc in Ouagadougou networks people and organizations involved in the struggle against AIDS. As a resource center, it organizes informational workshops, and a variety of meetings, including a monthly meeting between doctors and organizations. They run a documentation center which serves as a point of entry for mobilization, and they do community work and testing as well (due to an agreement with St. Camille Hospital). CICdoc is starting to directly support specific projects within organizations in the area of care and/or helping with the structure of organizations through a project called, “development of medical networks of PLWHAs.” At the present time the CICDoc involves around 100 individual members (health professionals, lawyers, social science researchers, students, etc.) and around 50 communitsy based organizations in 18 different provinces. The network includes, among others: The AAS, ALAVI, AJPO, the Bergerie, SOS SIDA, AMMIE, ADIPS, and REV+. It contributes to the improvement of care and support given to PLWHAs and their families on the social, psychological and legal levels.

19

BURUNDI ANSS

Last Updated: June 2004

ASSOCIATION NATIONALE DE SOUTIEN AUX SEROPOSITIFS ET SIDEENS (ORGANIZATION FOR THE SUPPORT OF HIV POSITIVE PEOPLE AND PEOPLE WITH AIDS) Tel: 257 249 199 Fax: 257 241 501 [email protected] Contact: Dr Mbuzenakamwe Marie-José Web Site: www.anss.bi Started: 1993 City: Bujumbura Country: Burundi

Within the organization: Patients receiving care: 3 000 Patients on ARVs: 1200 Doctors and medical assistants: 6 Nurses and caregivers: 5

ANSS was created in 1993. The founding members and the great majority of the members are people living with HIV. The first open testimonies of PLHIV in Burundi came from ANSS members. The “TURIHO” center was created in 1999 to provide comprehensive care to PLHIV. Since May 2000 this receives PLHIV suffering from minor complications, that don’t require complicated and expensive hospitalization. The hospital has 3 beds, is equipped for simple surgical

operations and has a small laboratory allowing some routine examinations. The TURIHO center is now recognized for its expertise in providing medical care for patients who are under combination therapy. Throughout the course of the first semester of 2003, nearly 7,000 people have presented themselves, 3,123 people have been tested, and 4,256 free medical consultatations have been executed, all thanks to two full-time doctors and six other part time physicians; one of which is a pediatrician. This is in addition to the over 1000 nurse consultations and 117 hospitalizations. Globally, the ANSS ensures the medical follow-up of close to 3,000 people, of which 1,200 are on antiretrolvirals! The majority of the patients pay for their ARV treatments, but nearly 300 benefit from a complete subsidization of their costs. ANSS has conceived the idea of a solidarity cash box for savings, supplied by small voluntary subscriptions provided by active members and by the participation fees that cover the medicines costs paid by the persons who benefit. This fund benefits also from enrichment by backers (SIDACTION, Global Fund) and allows now for a greater access to generic medicines.

21

Finally, a strong action of advocacy for the rights of PLWHAS, supported by the solidarity and advocacy on the international level, remains the strong area of the work carried out by the ANSS. ANSS members have widely contributed to the editing of texts on PLWHAS rights that were submitted to the National Assembly Vote. The advocacy of the access to combination therapy triggered the government’s decision to create a Fund for Therapeutic Aid allowing the access to ARV for a cost varying between 50,000 and 90,000 Burundi francs per month (about $65 to $116,5). ANSS then negociated with the generic manufacturer CIPLA for the provision of generic ARVs. As a result, the price of a monthly triple therapy combination which ranged between $ 112 and $215 was reduced to $30/$60.

BURUNDI SWAA Burundi

Last Updated: July 2004

Tel: 257 241 533 / 248 709 Fax: 257 421 533 [email protected] Contact: Thérèse Ntahompagaze Website: http://www.web-africa.org/swaa-burundi/ Started: 1992 City: Bujumbura Country: Burundi

Within the organization: Patients receiving care: 16 424 Patients on ARVs: 200 Doctors and medical assistants: 10 Nurses and caregivers: 12

"SWAA Burundi is particularly concerned with women as mothers, wives, educators and the backbone of the Burundian family. The SWAA also cares for orphans, youth and in particular young women who often have a hard time obtaining information that they need to protect them against HIV/AIDS."

Created in 1992 SWAA Burundi is the independent and local branch of International SWAA. The activities of SWAA Burundi are divided among four principal activities: – Getting women involved in education and information activities in the fight against HIV/AIDS: by reaching out to both those who are infected as well as those who do not know their HIV status, SWAA Burundi prioritizes experience-sharing and consciousness-raising so as to encourage those who are infected to seek care and to encourage others to adopt safe behavior and to test for HIV. – MEDICAL ASSISTANCE: to infected and/or destitute women: SWAA Burundi provides medical consultation, access to medicine, outpatient and home-based care, in combination with substantial psychosocial support in which nutritional support is central in a country where certain populations suffer from malnutrition. – DEVELOPMENT of income-generating activities: through promoting the involvement of HIV+ women in micro-credit projects; 76 participated in this program last year. SWAA Burundi conducts counseling and HIV-testing activities and organizes free medical consultations as well as homebased care every day of the week. Treatments for the most common opportunistic infections are available and free of charge. SWAA personnel have been prescribing ARVs since the end of 2002, along with training sessions on the effects of ARVs. Financial aid for clients to help pay for ARVs has begun but the need is great. "In our organization, 100 people are on a waiting list for ARVs, 50 of whom meet the criteria for emergency treatment. If treatment was accessible for everyone we could follow 600 people on ARVs. We project placing 400 people on ARVs in 2004 in our center in Bujumbura. Recently, the organization set up a trust fund to which each person contributes 300 à 500 Fbu per month. This fund can be accessed if a problem arises."

22

BURUNDI APECOS

Last Updated: Sept. 2004

ASSOCIATION DE PRISE EN CHARGE DES ORPHELINS DU SIDA (Organization for the Complete care of Orphans with AIDS) Tel: 257 215 989 Fax: 257 213 354 [email protected] Contact: Janvier Uwihaye Website: http://www.orphelins-sida.org/Documents/ presentationapecos.ppt Started: 1993 City: Bujumbura Country: Burundi

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and care givers:

300 45 1 10

APECOS was created in 1993. From the start it supported AIDS orphans and other children at risk. The organization is responsible for 320 orphans in Bujumbura who receive school support (ie: uniforms, school fees, tutoring) food support, medical assistance, help in finding foster families, psychological assistance (via a counseling centre) and extracurricular activities including sports and cultural activities. Currently APECOS is expanding their work to include more of the interior of the country reaching over 545 children in the KIRUNDO, BUBANZA and CIBITOKE provinces. The children are housed either with foster families or at one of the two orphanages. The girls’ orphanage for example includes 18 children, 8 of whom are living with HIV/AIDS. Of these 8, 5 are already sick and often are stricken by opportunistic illnesses. Five have yet to take an HIV test. For all of these children healthcare is guaranteed. Those who need anti-retroviral medicines will get them thanks to a number of benefactors. Children needing special diets are provided them. In addition to HIV tests, and the counseling that goes along with it, the organization’s personnel have been prescribing ARV treatment since 1999. Despite their efforts to get more funding for ARVs, 70 people urgently need ARV treatment. Additionally, APECOS conducts educational workshops on prevention and treatment.

"Because many children are infected or affected by HIV/AIDS they are provided with both prevention and medical follow-up. The children are given balanced meals twice a day in order to help them grow. Medical care for all these children is provided. APECOS has an agreement with the hospital so that hospital care is provided as well, and 25 others who are also HIV+ are given ARVs and care and follow-up and we imagine that the number of children on ARVs will increase in years to come because APECOS takes this commitment very seriously."

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CAMEROON AFASO • ASSOCIATION DES FEMMES ACTIVES ET SOLIDAIRES (Organization of Active Women in Solidarity) Tel: 237 98672 56 / 231 15 01 Fax: 237 221 74 39 [email protected] Contact: Pauline Mounton Started: 2000 City: Yaoundé Country: Cameroon

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

0 30 0 0

AFASO is an organization of women living with HIV/AIDS that started in July 2000 with the general goal of helping and supporting HIV+ people and AIDS orphans; their objectives are to create a support system around people infected and affected by HIV/AIDS; to promote the rights and physical, economic and mental well-being of women living with HIV/AIDS; to sensitize the various decision-makers on their situation. Members of the organization insure that there is always someone at the day clinic: conducting pre- and post-test counseling and communicating the results. They organize home visits and visits to the hospital to mutually support one another, and to better manage their anxieties and difficulties in relation to their health and to their economic situations, with few resources; Additionally, the organization offers psychosocial follow-up on ARVs and conducts education and information sessions on treatment. Thirty of the clients are currently on ARVs. Getting more involved in providing treatment would need funding of ARVs, additional personnel, and training.

AFSU • ASSOCIATION DES FRERES ET SŒURS UNIS

Last Updated: April 2004

(Organization of Brothers and Sisters United) Tel: 237 221 42 06 / 955 00 94 Fax: 237 222 62 58 [email protected] / [email protected] Contact: Antoine Fofou Website: http://www.survivreausida.net/a3293 Started: 1994 City: Yaoundé Country: Cameroon

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

0 25 4 2

Started in 1994, the AFSU gave itself the mission of being a spokesperson of people living with HIV /AIDS in Cameroon. In terms of care their main activities are the following: • Medical and nutritional assistance • Comprehensive psychological care of people are HIV- infected or affected; • Home visits to PLHWAs and families; Among AFSU members, 25 are currently on ARVs

"In our organization, 20 men, 40 women and 15 children are in urgent need of being placed on ARV therapy immediately."

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CAMEROON COLIBRI Tel: 237 344 13 44 Fax: 237 344 13 44 [email protected] Contact: Jean Jules Kamgue Started: 2000 City: Bafoussam Country: Cameroon

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

32 12 1 1

Colibri brings together those infected and affected by HIV with the goal of insuring psychosocial care, promoting nutritional education and prioritizing access to treatment. It also aims at supporting people living with HIV/AIDS with integration in their socio-professional settings and defending those who are the object of discrimination because of their HIV status; COLIBRI conducts comprehensive care including: - Counseling in hospitals and in prisons, - Home-based care, - Support with compliance to ARV medicines in particular by showing films about treatment side effects and appropriate nutritional diets.

Thirty-two people are receiving medical and psychosocial care. Twelve or them are on ARV treatment.

REDS • Réseau Ethique, Droit et Sida (Ethics Network, Law and AIDS) Tel: 237 220 68 59 / 995 96 13 Fax: 237 220 53 65 [email protected] Contact: J.M. Talom Started: 1988 City: Yaoundé Country: Cameroon

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

14 2 4 1

The Network on Law and AIDS started out originally as a group defending the rights of HIV+ people. While their work mostly deals with legal issues they also offer some financial support for medical services to PLWHAs. In 2003, 31 were able to qualify for “multifaceted” support (including financial and/or medical aid and social assistance) in addition to legal counsel. REDS is also well known for computer and educational skills, especially in the management of care-giving personnel or in legal settings. During the first semester of 2003 REDS conducted sensitivity training on ethic and the rights of PLWHAs with approximately 280 health professionals in 6 health centers. They were able to hire three coordinators in the provinces and to conduct sensitivity-training to two hospital directors during the course of their field trips to rural areas. As a result, they received requests to do training seminars from 37 health districts and 6 private health facilities. In addition, a collaboration MSF Switzerland (Doctors without Borders) has given REDS the opportunity to work more on the legal and ethical aspects of placing people on antiretroviral medicine.

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CAMEROON INTER CARE / NJINIKOM PROJECT HOPE

Last Updated: April 2004

CATHOLIC HEALTH SERVICES Tel: 237 79 80 911 [email protected] Contact: Kenneth Muko Website: www.njinikomhospital.com Started: 2000 City: Njinikom Country: Cameroon

Within the organization: Patients receiving care: 1 650 Patients on ARVs: 88 Doctors and medical assistants: 8 Nurses and caregivers: 18

Inter Care / Njinikom Project Hope is the local affiliate of Inter Care UK, a British NGO. The organization conducts HIV testing (pre-and post-test counseling and on-site blood tests) and treatment and care of people with HIV. Medical consultation with a general practitioner costs 3 times less ($0.70) here than it does at the closest public health facility ($2.00). For the past three years this organization has been involved in the prescription of ARVS and have gained some experience. Unfortunately, they are not able to distribute the drugs free of charge or at low costs. Drugs are purchased based on availability, not price. Those who are selected to receive ARV treatment are selected mainly on their availability to pay for the drugs. The organization offers them medical and psychological follow-up and conducts education and information sessions on ARVs. Finding a way to treat all of their clients becomes more and more difficult because every day they have an increasing amount of positive cases. In 2003, of the 3680 that were tested, 846 were positive. Unlike other organizations, Inter Care Njinikom Project Hope also has several programs targeted towards children. They provide the necessary, be it educational, health, spiritual or psychological. Orphans that have been out of school for more than one year are trained in income generating activities. They also treat non-orphaned infected children. They find that they have difficulty treating children because the parents of these infected children do not believe that treatment is a priority, mainly because they cannot afford it. Finally, in 2003, 847 women benefited from program on the reduction of mother to child transmission (nevirapine), which included counseling, medical follow-up and free baby milk formula.

"Of our members, 768 men and 822 women are in emergency need of ARV treatment. The organization could follow up 1 200 people on ARVs. Currently we follow only 88. The potential and the skills are not being exploited only because we do not have the drugs."

AFSUPES • ASS. DES FRÈRES ET SŒURS UNIS POUR L’ESPOIR ET LA SOLIDARITÉ Last Updated: April 2004 (Organization of Brothers and Sisters United for Hope and Solidarity) Tel: 237 985 99 06 Fax: 237 343 33 60 [email protected] Contact: Solange Evodo Started: 1996 City: Douala Country: Cameroon

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and care givers:

50 0 6 10

AFSUPES conducts testing and counseling and provides comprehensive care to people with HIV.

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The organization provides basic medicines for treating opportunistic infections at a reduced price, gives financial aid for members to buy medicines and proposes psychological follow-up to patients as well as conducting information workshops on ARVs. Seven members are currently on ARVs.

CAMEROON SUNAIDS Tel: 237 343 92 99 / 985 99 05 Fax: 237 343 87 38 [email protected] Contact: Hélène Essome Sengue Website: http://www.cameroun-plus.com/s52/sunaids/ association.htm Started: 2000 City: Douala Country: Cameroon

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and nurse’s aides:

0 7 1 0

Started in 2000, SunAids is a PLWHA organization that came together to get informed and support people living with HIV in the region of Douala. This small group is "professionalizing" its support work: SunAids counselors hold positions in hospitals to follow patients on treatment, the director of SunAids has started a documentation center and an HIV hot-line, medical consultations are routinely suggested to members. Quite involved in the comprehensive care network in Douala (Hôpital Laquintinie, SWAA, MSF, etc), SunAids is in a position to start an effective lobby representing the HIV+ people of Douala and to contribute to their empowerment in the years to come. The stated goals are: - Sensitization of the community and comprehensive care for PLWHAs; - Reaching out to members so as to give them the opportunity to break out of the isolation and emotional marginalization to which they often feel confined; - To get informed and keep its members informed and updated on new developments in scientific research and treatment of HIV through contacts with national and international organizations and institutions and participating in seminars and conferences; - To research the ways and means to insure comprehensive medical, psychological and physical/financial care as well as better societal and familial integration for people living with HIV/AIDS; - To develop a lobby confronting the various decision-makers with the goal of obtaining grants from international organisms to pay for up-to-date therapies (Antiretrovirals); The organization operates in three hospitals in Douala where a team of 8 counselors conducts counseling and proposes “educational conversations,” particularly in the case of reducing the transmission of the virus from mother to child. These counseling activities reached close to 700 people for pre-test counseling and 550 for post-test counseling in 2003. In addition, the organization is currently giving psychosocial follow up on an as-needed basis to its 7 employees currently on ARV treatment, and conducts treatment literacy on ARVs. The organization is currently looking for a partner to establish a community fund in order to fund lab tests and medical care for those who are very poor.

Difficulties encountered in relation to ARVs: - Un-guaranteed delivery - Inability to satisfy the demand of patients, a majority of whom are waiting for donations.

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CAMEROON SWAA LITTORAL

Last Updated: April 2004

Tel: 237 342 32 46 [email protected] Contact: Dr Siewe Pulcherie / Dr Sanga Margaret Website: http://www.sidacameroun.org/Lieux/ Lieuxf_d.php?codeu_lieu=8 Started: 1990 City: Douala Country: Cameroon

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

80 20 1 2

The work of this organization revolves traditionally around psychosocial and medical care for the poorest people but they also conduct prevention work, with one project in the New Bell prison in Douala. This provincial branch of SWAA Cameroon ran the AIDES Pavillion until 2002-- a comprehensive care center for people living with HIV situated inside the Hôpital Laquintinie. But since the start of the antiretroviral access program, DARVIR, the center was taken over by the hospital management to transform it into an outpatient clinic. In June 2002, SWAA Littoral opened a comprehensive care center in the Akwa neighborhood in Douala. A full-time psychosocial counselor re-orients the most destitute to the new center where they receive free care. Comprehensive care includes: - Counseling by experienced and trained counselors. - Direct help to resolve problems (rent, transportation, food, funeral costs, hospitalization costs, financial support for orphans, etc.). - Home visits. - Medical care for close to 80 people, with free consultations and essential medicines. - Nutritional supplementation. - Activities in reducing transmission of the virus from mother to child: the organization cared for 15 women in 2003 by giving free baby formula, counseling and workshops on infant nutrition. SWAA’s medical personnel has prescribed ARVs since 2001, and conducts educational workshops on ARVs. The project of setting up support groups to help with compliance is currently in progress. 20 people are currently on ARVs.

"In the organization, at least 100 people are in emergency need of ARVs some of whom already started therapy and stopped due to lack of funds. If treatment was accessible to all, we would be able to follow an additional 100 people on ARVs, possibly more if we had additional free-lance general practitioners."

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CENTRAL AFRICAN REPUBLIC AMIS D'AFRIQUE • (FRIENDS FROM AFRICA) Tel: 236 61 31 29 / 50 58 04 Fax: 236 61 31 29 [email protected] / [email protected] Contact: Honorat Maurice Dabanga Started: 1993 CIty: Bangui Country: Central African Republic

Last Updated: April 2004

Within the organization: Patients receiving care: 1300 Patients on ARVs: 140 Doctors and medical assistants: 4 Nurses and caregivers: 17

Amis d'Afrique (Friends from Africa) is by far the largest; perhaps the only comprehensive care organization for patients on ARVs in the country. Set up in Bangui in 1993, this organization supported in large part by the Japanese Cooperation is advantageously placed inside the medical facility of the Boy-Rabe neighborhood. It develops several divisions of activities: • Medical follow-up: A well-equipped laboratory makes it possible to do a variety of lab work on site. A pharmacy is regularly supplied with essential generic medicines as well as those used to treat opportunistic infections. Close to 140 people are on ARVs in the organization. Triomune is the medicine that is most commonly prescribed. Ever other month patients are required to pay for their own medicines. The alternating month’s medicines are paid for by the organization. So patients’ medicines are subsidized by 50%. The staff of Amis d'Afrique is composed of 4 doctors, 1 dermatologist and 17 nurses and caregivers. A medical team composed of a doctor, a nurse and a sociologist consults with patients at home. Amis d'Afrique receives additional help from World Food Program to give food support to patients who are visited. • Information and education activities: - Outreach and awareness campaigns on the community and family level - Monthly patient education/awareness workshop: this awareness workshop is exclusively for HIV+ patients registered at the Center. Various issues such as AIDS and opportunistic infections are discussed. • Training: Training and peer education for members of community organizations who then become instructors in their respective communities. In 2003, 102 people graduated from these training sessions.

The organization has various projects that it hopes to develop, if funding were available, namely a project of orphan care, and a project of decentralization of activities in several provinces of the country.

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CENTRAL AFRICAN REPUBLIC ASSOMESCA • Association pour les Œuvres Médicales des Eglises

Last Updated: April 2004

en Centrafrique (Organization of Church Medical Charities in Central Africa) Tel: 236 04 38 54 Fax: [email protected] Contact: Sœur June Started: City: Bangui Country: Central African Republic

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

Assomesca is a Catholic organization which runs several health centers in Bangui and throughout the country: 6 private health centers, one of which is a maternity clinic, 2 nutritional centers, 2 centers for disabled people, 9 smaller health offices managed by Caritas, 3 hospitals in Bangui, 1 old age home, run by the Missionnaires de la Charité. One of the centers run by Assomesca, the Centre de Santé Notre Dame de Fatima, is situated in a working-class neighborhood. The parish of Notre Dame de Fatima, which is next door to the healthcare center, conducts counseling sessions every Wednesday from 4-6pm and promotes voluntary testing. A group of 60 women has been created from these sessions 40 of who are HIV+; 31 of whom are on cotrimoxazole. The center provides medical consultations for adults and children Patients pay a flat rate, which includes the price of the consultation, and any medicines that may have to be prescribed. Finally, the health center provides home-based care with the help of a mobile team. A prevention of transmission of the virus from mother to child has begun. Twelve women are currently enrolled.

RECAPEV • Réseau Centrafricain des Personnes vivant avec le VIH

Last Updated: April 2004

(Central African Network of People Living with HIV) Tel: 236 04 63 93 / 236 61 10 89 [email protected] Contact: Luc N'Vendo-Mozialo Started: 1994 City: Bangui Country: Central African Republic

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

RECAPEV is The Central African Network of People Living with HIV/AIDS. It was created in 1994 at the PLWHAs and under the direction of the Minister of Health. Seven organizations are currently members of RECAPEV: - The National Caucus of Young HIV+ (CNJFV+); - The Comité centrafricain des PvVIH (COCAPEV) (Central African Committee of PLWHAs); - Réveil Action Centrafrique + (RAC +) (Awake Action Central Africa); - l'Association des Hommes Vivant avec le VIH (AHVV) (Organization of Men Living with HIV); - International Community of Women against Aids (ICW); - The Groupement d'Aide Sociale (GAS)(Social Assistance Group); - The Association des Femmes Vivant avec le VIH (Organization of Women Living with HIV). In addition the network works in collaboration with the organization of blood donors. In total, 3 000 members are united under the umbrella of RECAPEV. The goals of the network are to coordinate activities for member organizations and to develop communication and awareness activities. RECAPEV is a signee of the agreement between UNDP and the Global Fund and participated in validating the sites of voluntary testing for the Global Fund.

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CHAD CEDIAM Tel: 235 51 48 01 / 235 53 54 54 [email protected] Contact: Rémi Alkoa / Emanuela Sbriscia Started: 1999 City: N’Djamena Country: Chad

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

100 23 1 1

CEDIAM conducts testing activities and medical follow up. The Center currently follows around 100 patients, for whom basic medicines are provided. CEDIAM prescribes antiretrovirals for patients who can afford to pay for them. Currently the organization is trying to figure out financially and logistically how to subsidize these medicines and to thereby increase the number of patients who take them. Twenty-three people are currently taking ARVs and are followed by the Diocesan Center.

RNTP+ • RESEAU NATIONAL TCHADIEN DES PVVIH (National Chadian Network of PLWHAs) Tel: 235 25 24 00 [email protected] Contact: Baba Denis Tatola Started: 2003 City: N’Djamena Country: Chad

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

145 7 7 0

The organization conducts pre- and post-test counseling, offers medical and psychosocial follow up for patients and dispenses information and ARVs. In addition the organization lobbies the country’s health minister to increase the number of patients eligible for free access to ARVs.

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CONGO ESPOIR • (HOPE) Last Updated: April 2004 ESPACE SEROPOSITIFS ET AUTRES PERSONNES ORGANISEES POUR UN INTERET REEL (A Place for HIV+ People and Others Organized for a Real Interest) Tel: 242 290 642 Fax: 242 82 22 07 [email protected] Contact: Ulrich Makaya Mabiala Started: 1999 City: Pointe noire Country: Congo

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

100 50 4 5

HOPE conducts comprehensive care for people living with HIV/AIDS. Around 100 benefit from medical follow-up of opportunistic infections including home visits. The organization has a small community pharmacy. While not directly prescribing ARVs the organization does medical and psychosocial follow-up on 50 patients who are currently on ARVs.

"In our organization, 10 women and 5 men are in emergency need of being placed on ARVs. If treatment was accessible to everyone the organization could follow an additional 100 people."

FEMMES PLUS DU CONGO • (AFPC)

Last Updated: April 2004

(Positive Women of Congo) Tel: 242 75 07 45 Fax: 242 82 22 07 [email protected] Contact: Dianzeka Elisabeth Started: 2002 City: Brazzaville Country: Congo

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

0 10 0 0

The Organization Women + of the Congo is made up of HIV+ women who conduct mainly psychosocial support and do pre- and post-test counselling.

JEUNES POSITIFS DU CONGO

Last Updated: April 2004

(Organization of Young Positives of the Congo) Tel: 242 77 27 22 Fax: 242 82 22 07 [email protected] Contact: Esmo-Valérie Mouellet Started: 2003 City: Brazzaville Country: Congo

35

Main activities related to HIV/AIDS care: - Pre and post-test counselling - Medical and psychosocial follow-up - Informational workshops on treatment

Within the organization: Patients receiving medical care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

20 16 1 4

CONGO VIVRE PLUS CONGO

Last Updated: April 2004

(AVPC) • (Live +, the Congo) Tel: 242 21 30 36 Fax: 242 82 22 07 [email protected] Contact: Ambroise Mamona Started: 1996 City: Brazzaville Country: Congo

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and care givers:

50 0 6 10

The organization conducts comprehensive care activities of people living with HIV/AIDS ranging from pre and post-test counseling to psychosocial and medical follow-up for around 50 people. Treatments for opportunistic infections are given at a subsidized rate. 8 members are currently on ARV treatment. "Once a week we organize educational workshops on ARV treatment access using as a guide the comprehensive care booklet produced by AIDS. But we must recognize that we lack educational support in this activity."

36

DEMOCRATIC REPUBLIC OF THE CONGO APICOM

Last Updated: April 2004

ASSOCIATION POUR LA PROMOTION DES INITIATIVES COMMUNAUTAIRES (Organization for the Promotion of Community Initiatives) Fax: 001 509 984 2485 [email protected] Contact: Sam Lelo Nsakala Started: 1995 City: Mbanza, Ngungu, Bas-Congo Country: Democratic Republic of the Congo

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

87 0 5 9

The mission of this organization is the rehabilitation, education and support of homeless children who were displaced by war. They started a project that provides medical care and HIV testing. Eighty-seven patients are currently receiving medical care and medicines for the treatment of opportunistic infections. APICOM is not yet involved in access to ARVs, but hopes to begin such a project in 2004. The needs in order to be able to accomplish this are great. They are, principally, funding of ARVs, the training of existing staff and acquisition of equipment.

FONDATION FEMME PLUS • (Foundation Woman +) Tel: 243 99 11 162 [email protected] / [email protected] Contact: Thecla Marie Bernadette Mulelebwe Issiki Website: www.enda.sn/africaso.org/fondationfemmes.html Started: 1994 City: Kinshasa Country: Democratic Republic of Congo

Last Updated: April 2004

Within the organization: Patients receiving care: 5 000 Patients on ARVs: 30 Doctors and medical assistants: 5 Nurses and caregivers: 5

Fondation Femmes Plus is an NGO that specializes in psychosocial follow-up for people living with HIV and those who are otherwise affected. It’s stated goals are: empowerment of people living with HIV so that they are able to advocate for themselves, providing socio-economic support for members, teaching HIV prevention to the population at large, educating community members, antiretroviral treatment. In addition to a testing/counseling service, the Foundation provides psychosocial and medical follow up to a significant number of HIV+ patients through home and hospital visits and giving medicines and food support. When they conduct home visits they teach family and community members about treatment and care. The organization has medicines to treat the most common opportunistic infections, which are mostly donated. Thirty patients are currently on ARVs.

GROUPE ANTI SIDA DE BUTEMBO • (Anti-AIDS Group of Butembo) Tel: 243 98 38 36 56 E mail: [email protected] Contact: Kakule Mulengya Samson Started: 1992 City: Butembo Country: Democratic Republic of Congo

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

30 30 0 3

37 Starting in 1992, a group of volunteers got together to bring awareness and information about HIV/AIDS to the residents of Butembo. Now this same group is set up to do HIV tests and provides basic care for people who are HIV+. Among the center’s clients around 30 are on ARVs.

DEMOCRATIC REPUBLIC OF THE CONGO FONDATION TULIZA Tel: 250 08 48 32 95 [email protected] Contact: Martin Kadaku Started: 2003 City: Goma Country: Democratic Republic of Congo

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

0 0 0 0

The TULIZA Foundation operates in the Northern province of Kivu and its headquarters are in Goma. Founded in February 2003 to help children and women victims of war, AIDS and other disasters, the TULIZA Foundation takes its name from the Swahili verb "Kutuliza" which means to console. It is not directly involved in medical follow-up of PLWHAs but gives itself as mission to “to provide the bare necessities to keep children and women victims of HIV/AIDS and war alive ".

“We teach awareness and promote voluntary testing to clients. We accompany those who live close by to the testing center and the pay lab fees for the test. We give clients the means to start small projects and with the profits from these projects they can buy ARVs but often it is not easy because there are not very many ARVs in our country and they are consequently more expensive while clients’ revenue is meager. Throughout the country and especially in our region organizations do not have access to ARVS due to lack of funders. While it stands to reasons that community organizations are best placed to attract the majority of those in need of ARVs we are not yet effective in this area. All AIDS organization are committed to access to ARVs and see it as an irrefutable priority but are unable to realize this dream for lack of means. This is why you will find ARVs only in certain public institutions and only the rich have access. Orphans and widows will be among the first to die for lack of access.”

SIDAACCESS • (AIDSACCESS) Tel: 243 98 38 60 73 Fax: 00871 762 523 410 [email protected] Contact: Dr. Jean Paul Mundama Witende Started: 1989 City: Butembo Country: Democratic Republic of Congo

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

20 15 8 20

Sidaaccess offers pre and post test counseling services and follows around 20 people living with HIV/AIDS. While the organization supplies medicines to treat the most common opportunistic infections they are not in continuous supply. The care giving staff prescribes ARVs to those who can afford, offers medical and psychosocial follow-up to patients and conducts educational/informational workshops on ARVs. Fifteen people in the organization are currently on ARVs.

"We don’t see many HIV patients in the hospitals—but at home these people are dying in an environment of neglect and extreme poverty while all around them people talk of their human rights and dignity. Orphans who lost their parents to AIDS are further hurt by a society whose charity ends with the end of life: by paying for the coffins in which to bury the dead with dignity."

38

ERITREA BIDHO • ASSOCIATION OF PEOPLE LIVING WITH HIV/AIDS Tel: 291 1202 772 e-mail: [email protected] / [email protected] Contact: Amanuel Tesfamichael Started: 2002 City: Asmara Country: Eritrea

Last Updated: April 2004

Within the organization: Patients receiving care: 5000 Patients on ARVs: 50 Doctors and medical assistants: 31 Nurses and caregivers: 10

BIDHO is a community organization of People Living With HIV/AIDS that has a unique approach to AIDS support and treatment. BIDHO is not a clinic although they provide on-site consultation, home consultation, and outpatient care. They conduct psychological support, prevention campaigns by Positive People, research against stigma and discrimination, and lobbying. Because of their unique and experienced perspective on the disease, HIV positive people counsel clients at BIDHO. ARVs are just now being introduced into the country and BIDHO can help provide important guidance and counseling associated with the taking of these drugs to ensure that they are correctly administered. They estimate that 10% of those enrolled in their association in one form or another are in need of ARVs. Eritrea is in the process of setting up a national ARV program. Medical personnel from larger hospitals are currently receiving training from experts outside of the country.

BIDHO believes that if the people of Eritrea had free access to ARV treatment, they would be able to provide treatment adherence counseling and social support for up to 2000 clients.

39

ETHIOPIA FGAE • FAMILY GUIDANCE ASSOCIATION OF ETHIOPIA Tel: 251 151 4111 Fax: 251 151 2192 E-mail: [email protected] Contact: ATO Amare Bedada Started: 1966 City: Addis Ababa Country: Ethiopia

Last Updated: April 2004

Within the organization: Patients receiving care: 7359 Patients on ARVs: 0 Doctors and medical assistants: 12 Nurses and caregivers: 65

The Family Guidance Association of Ethiopia (FGAE) is the largest NGO working in the area of Sexual and Reproductive Health in Ethiopia. At present FGAE is implementing 24 large-scale Sexual and Reproductive Health projects in partnership with various international donors, the Ethiopian Government, NGO and the community at large. HIV/AIDS prevention is a primary issue amongst all projects being implemented. Presently, FGAE is playing its part to control HIV/AIDS from every angle: including providing information and counseling. FGAE is also planning to promote “care and support” intervention that will include home-based care. In addition, FGAE is giving emphasis to integrate PMTCT (prevention of mother to child transmission) into their program. Although FGAE does not provide access to ARV treatment themselves they have established a referral network among other NGOs in the area so that HIV positive clients who need treatment can be referred elsewhere.

As for providing ARV treatment, FGAE would like to see an expansion in their ARV services in the near future. FGAE would then need help in providing adequate training for its health care workers so that they may be able to handle ARV services. They also need to find funding for ARV drugs purchase and arranging the necessary laboratory services.

41

GHANA GATAG • GHANA AIDS TREATMENT ACCESS GROUP Tel: 233 21 718419, 233 27 770 3559 Fax: 233 718419 E-mail: [email protected], [email protected] Contact: Started: 2002 City: Accra Country: Ghana

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

0 385

GATAG is a recently formed organization providing a comprehensive treatment service to HIV+ clients. GATAG is a resource for the treatment of common opportunistic infections, counseling, and medical follow-up for those undergoing ARV treatment. It is one of their primary objectives to launch an ARV program within the year, but they currently lack the funds to do so. Addressing the issue of stigmatization and discrimination of PLWHAs through treatment literacy is one of GATAG’s top priorities. They organize treatment education workshops for PLWHAs, care givers, youth, workers, scientists, lawyers, economists, politicians. “Knowledge that effective treatments exist will help alleviate the fear and stigmas associated with AIDS and encourage people to learn the facts about HIV and to utilize voluntary counseling, testing and care”. GATAG needs help in training current PLWHAs counselors. They have to help with numerous amount of patients that need pre and post treatment counseling on ARVs. They also definitely need to enlarge the number of volunteers to serve people in need nation-wide.

“Treating people living with HIV virus will offer us hope and by offering hope we dispel the notion that AIDS spells doom. Treatment has irreversibly broken the equation between AIDS and death, it allows us to begin to undo the social stigmas and phobias that make prevention so difficult to talk about frankly and to practice effectively, hence we announce to ALL “Treat the people NOW!!!” “This is a tremendous task that must be done, so a young group like GATAG needs a lot of assistance. When helpless mothers and children need the necessities of life, their needs are met because people care, this gives them the assurance that when they suffer, “They really have a shoulder to lean on”. GATAG encourages all to contribute to a worthy course, even if it is just a letter of encouragement, it can go a long way. This Work needs desperate financial support.“

43

GUINEA ASFEGMASSI

Last Updated: April 2004

Association des femmes de Guinée pour la lutte contre les MST et le Sida (Guinea Women’s Organization against STDs and AIDS) Tel: 224 21 75 60 / 26 18 52 / 29 36 70 / 29 89 82 [email protected] Contact: Dr Bintou Bamba Website: www.reseauafrique2000.org/guinee/asfegmassi.html Started: 1990 City: Conakry Pays: Guinea

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

130 16 20 10

ASFEGMASSI is an organization composed mainly of women living with HIV, affiliated with the pan-African organization of women in the fight against AIDS (SWAA). The organization provides counseling and testing, care, psychosocial support and advocacy in favor of broadening access to treatment. ASFEGMASSI runs a counseling center, and 25 community workers have been trained to give home based care to women living with HIV. They divide their visits across 5 communities. The mobile care giving team was formed in the first trimester of 2003. 65 PLWHAs (48 women and 17 men) have received home-based care including nutritional support and administering of medicines. Several doctors from local healthcare facilities refer HIV positive people to the head office where a nurse provides care; the organization also runs a community pharmacy and dispenses generic medicines at low prices to treat the most common opportunistic infections. Medical consultations are free and the staff is trained to manage ARVs. The doctors who are closest to the ASFEGMASSI have been prescribing ARVs since 2001. Patients on ARV therapy are medically followed up at the head office and informational workshops on ARVs take place regularly: PLWHAs get together for “therapeutic week-ends” where they talk about problems they encounter during the course of treatment. 16 people are currently on ARVs in the organization. Available at the pharmacy hospital, treatment is expensive and not very accessible. The organization can give financial aid generated by the AGR inside the organization but aid remains limited.

“In our organization, 50 people are in emergency need of being placed on ARV therapy."

FONDATION ESPOIR GUINEE (FEG) • HOPE FOUNDATION, GUINEA Tel: 224 67 88 81 / 29 92 87 [email protected] Contact: Abdoul Rahim Diallo Website: http://www.vihinternet.org/asso/fge/ Started: 1997 City: Conakry Country: Guinea

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

76 14 6 2

The Hope Foundation is an organization that brings together people living with HIV, those close to them and the caregiving staff. The organization dispenses medicines, which are procured largely through donations, to treat the most common opportunistic infections. The care-giving staff prescribes ARVs and provides psychosocial and medical follow-up to 76 patients 14 of whom are currently on treatment.

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GUINEA-BISSAU ASSOCIATION GUINEENNE D’ETUDES ET ALTERNATIVES

Last Updated: April 2004

Centre d’Information, Dépistage, Conseil et appui en sida Guinean Organization of Studies and Alternatives-Information Center, Testing Counseling and support for AIDS Tel: 224 21 75 60 / 26 18 52 / 29 36 70 / 29 89 82 [email protected] Contact: Dr Bintou Bamba Website: www.reseauafrique2000.org/guinee/asfegmassi.html Started: City: Bissau Country: Guinea-Bissau

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and nurse’s aides:

The organization conducts testing and counseling activities as well as follow-up for opportunistic infections. It provides as much financial support as possible to clients to help pay for ARV treatment and advocates on behalf of HIV positive people to the government treatment providers in order to facilitate access to treatment.

47

IVORY COAST ACONDA-VS-CI

Last Updated: April 2004

Tel: 225 23 52 52 53 / 07 07 20 39 Fax: 225 23 52 52 53 [email protected] Contact: Dr Touré Siaka Started: 2002 City: Abidjan Country: Côte d’Ivoire

Within the organization: Patients receiving care: 1 500 Patients on ARVs: 250 Doctors and medical assistants: 7 Nurses and caregivers: 3

ACONDA is run by health professionals working in public health centers of Abidjan. Because they were the first to get involved in HIV care, they aim at teaching others good medical practices. The training program run by ACONDA-VS focuses their activities on the employees of the Urban Healthcare Institution of Yopougon. Beyond building the capacities of the care-giving teams, the training program tries to encourage more pregnant women and general patients of the health centers to take an HIV test. Half of the training sessions deal with teaching best practices in counseling and testing and the other half is spent on teaching clinical care. ACONDA also works with the “Child Project” of Yopougon: their members insure the medical follow-up of the children of CHIGATA as well as that of their parents.

BOUAKE – EVEIL • (Bouake awake) Tel: 225 31 64 03 90 / 05 88 08 44 / 31 63 79 91 [email protected] Contact: Brahima Sidibe Started: 2001 City: Bouaké Pays: Côte d’Ivoire

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

180 27 0 0

Started in March 2001, Bouaké Eveil used to be called Lumière Action Bouaké, from 1996 to 2001. Bouaké Eveil is an organization of people infected and affected by HIV who are involved in the struggle against AIDS in the Bandama Valley region. The organization has around 100 members most of whom are HIV+. The majority of them has no resources and lives in precarious situations. They do home visits, give Assistance in hospital to those who are sick and provide sensitivity training in numerous settings in Bouake City Until the outset of the crisis in September, 2002, new activities had begun with posttest counseling for those who had tested positive and were guided towards Bouake Eveil by others within the local network of health structures. Members of the organization have begun to find one another again at the SAS Center (with Bouake Eveil still not being safe). During the course of the first semester activities have resumed impressively given the circumstances (around 1800 home visits have taken place, full-time staff are working at the SAS Center, St. Camille, at the pediatric unit of the University Hospital). The group has organized a training seminar on comprehensive psychosocial care as well as supportgroup meetings.

49

In the first semester of 2003, 183 PLWHAs, 10 of whom are orphans, received psychological support and social support at home conducted by the organizations 15 counselors. They also received counseling on prevention, hygiene and nutrition. Twenty-seven people in the organization are currently receiving ARV treatment.

IVORY COAST CHIGATA Tel: 225 07 81 50 64 [email protected] Contact: Rose Dossou Started: 2001 City: Abidjan Country: Côte d’Ivoire

Last Updated: April 2004

Within the organization: Patients receiving care: 50 to 100 Patients on ARVs: 15 Doctors and medical assistants: 0 Nurses and caregivers: 2 In the local language CHIGATA means: "As long as there is life there is hope". CHIGATA fights for the well being of children affected by the HIV/AIDS epidemic. The organization is comprised of people who are infected or affected by HIV/AIDS, volunteers, and children.

The “House of CHIGATA" in Yopougon, where the comprehensive care of children takes place, is near the pediatric unit of the University Hospital of Yopougon. It is a large facility with a backyard and provides all kinds of support including medical care for families and children. Families who come to the center will always find a sympathtic ear of someone who is him or herself also HIV+ and will then steer them to the appropriate resources and facilities. Chigata provides classes for children at different levels (preparatory, elementary school and middle school levels) for around 10 children. Clothes, toys and food are distributed to the neediest families. A group of adolescents meets monthly. This support group is made up of 7 to 10 HIV+ children all aware of their status who are 11 to 17 years old. A second group will start soon comprised of 7-10 year olds. Families of HIV+ children attend monthly meetings. A restaurant was started in December 2002 as a way of generating income and delivers around 100 meals a day. Other programs have recently started such as a day care center for small kids. This kind of support provides an important service to women living with HIV as well as to the families in the organization. Another project in progress is reaching out to other for kids to organize a play center and summer camp for the children. "This whole comprehensive project for children and their families relies on a network of community groups and organizations, to provide care and support in a systemic manner: CHIGATA works in close relations with an HIV + women’s organization (Amepouh), a medical care and training organization (ACONDA VS CI), with a comprehensive care program for HIV+ children, “The Yopougon Children’s Program” that is housed by the hospital of Yopougon. In October 2000 this program opened an outpatient clinic for HIV+ children (consultation with a nurse, dispensing of medicines, bandages, care, taking blood). The center also provides para-medical care such as motor and respiratory kinesytherapy three times a week and follows 300 children of CHIGATA, 250 of whom are on ARVs. There is also an adult care program with a relationship with hospital services. Parents and families are very involved in the day-to-day functioning of the House of Chigata, alongside the volunteers of the organization.

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IVORY COAST SOLIDARITE ACTION SOCIALE

Last Updated: April 2004

Centre SAS) • (Solidarity and Social Action Center) Tel: 225 31 63 79 91 / 31 63 79 92 [email protected] Contact: Diagola Toure Penda Started: 1995 City: Bouaké Country: Ivory Coast

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

400 27 1 1

The SAS of Bouaké was started in 1995 with funds from the Coopération française. Because of the psychosocial support they provided and the role they played as a intermediary between the community and the healthcare facilities, the Solidarity and Social Action Center quickly became a critical link in the fight against AIDS in Bouaké. The organization worked in perfect collaboration with other local organizations until 2002: the Secours project and the House of Transit of Renaissance Santé Bouaké, and for a long time housed the local PLH organization Bouaké Eveil. The Coup attempt, and then the partitioning of the country considerably changed the community group landscape: stockouts of medicines, closing the outpatient clinic of Bouake and the HIV test center, difficulties in traveling to Abidjan for medical tests… The SAS Center is the only HIV organization that has been able to maintain the whole of its activities. In order to accommodate increasing demand it had to keep up with the needs of families when Bouake was cut off from the rest of the country. Two hundred and thirty people receive medical follow-up on site or at home. Medicines for treating the most common opportunistic infections are available even if there aren’t enough in supply. Additionally, the organization coordinates food support for families hardest hit by the crisis. The organization also conducts pre- and post-test counseling and onsite HIV tests. Close to 600 families currently benefit from the services provided by the SAS Center throughout the course of a year. With a greater involvement when it comes to AIDS orphans. While the Center waits for administrative permission to prescribe ARVs, the fact that the organization has relationships with prescribers is of help to the patients. Those who are enrolled in the National program receive financial support to help pay their monthly fees and transportation costs. They also offer informational workshops on ARVs. 27 members of the organization are currently on ARVs

"Do you have the capacity to insure medical follow-up to an increased number of patients on ARVs? - Yes, it is much easier to follow patients on ARVs than to follow patients who are not on treatment. Within the organization around 100 people are in emergency need of starting ARV therapy. "

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IVORY COAST LUMIERE ACTION • (LIGHT ACTION) Tel: 225 24 39 73 12 Fax: 225 24 39 73 12 [email protected] Contact: Konan N’Gra

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

Started: 1994 City: Abidjan Country: Ivory Coast

100 150 1 2

Three HIV positive people started Lumière Action in 1994. This was the first community-based organization that gave visibility to the epidemic and to HIV+ people in Ivory Coast. Members of Lumière Action contributed, by talking about their experiences, to fighting against the popular misconceptions and prejudices about AIDS. This organization also initiated networking and lobbying locally and throughout Africa as well as on the international level. As a pioneer organization in West Africa in defending the rights of people living with HIV, they have gradually taken on providing psychosocial and medical care. They are the main AIDS organization in the working-class Abobo neighborhood. The organization runs an anonymous and voluntary testing site which performs around 10 tests a day. The student population is one of the main targets: Lumière Action’s staff regularly conducts sensitivity training and advocates voluntary HIV testing in the Universities in Abobo. But Lumière Action is the victim of the success of its HIV-test center and has a hard time providing the care and support to all its clients who come to the organization seeking care. People who test positive are guided immediately to the heart of the organization or towards hospitals of good standing for medical care. Emergency interventions, sponsorships are also offered to PLWHAs and to AIDS orphans, as are educational workshops on ARVs and nutrition. One hundred and fifty clients are currently on ARVs as part of the national Ivorian program. Space is limited.

RENAISSANCE SANTE BOUAKE • (RENAISSANCE HEALTH BOUAKE) Tel: 225 05 64 42 36 / 31 63 80 83 Fax: 225 31 63 05 40 [email protected] / [email protected] Contact: Ouohi Diomande Started: 1993 City: Bouaké / Yamoussoukro Country: Ivory Coast

Last Updated: April 2004

Within the organization: Patients receiving care: 250 Patients on ARVs: 10 to 20 Doctors and medical assistants: 2 Nurses and caregivers: 9

This organization composed essentially of healthcare professionals was once the pillar of a collective dynamic for prevention and care for HIV+ people. It ceased all activity because of the dispersion of its members throughout the country. Until 2002, RSB ran two main projects: “Transit House” housing for PLWHAs who in need of temporary housing or who were rejected or isolated and the “Secours” project, a home-based care program run by a multidisciplinary team (nurse’s aides, doctors, psychotherapists, PLWHAs, etc). The fact that these two programs came to a halt is a loss for Bouaké although the “Secours” Project started again in 2004. As a result, the organization has lost track of many of the patients it used to follow. Activities are slowly starting up again: a doctor has been reruited to coordinate the organization’s different projects particularly the medical allowances. Before the onset of the war, between 10 and 20 patients were on ARVs.

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IVORY COAST RUBAN ROUGE COTE D’IVOIRE • (RED RIBBON IVORY COAST) Tel: 225 23 45 35 10 / 05 63 21 50 Fax: 225 23 45 35 08 [email protected] Contact: Marius Raoul Boka Website: http://www.vihinternet.org/asso/ruban-rouge/ Started: 1994 City: Abidjan Country: Ivory Coast

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

545 170 1 3

RUBAN ROUGE was started in June 1994. This volunteer organization in the struggle against AIDS was one of the first to get involved in care and treatment of PLWHAs in the 90s through two main projects: CDIS, a center providing documentation, sensitivity training and information, and Centre Plus, a center providing medical and social follow-up. These two facilities are located in the working-class neighborhood of Yopougon. Centre Plus provides free or low-cost medical and para-medical care, essential medicines, psychological help and massage therapy. RActivity slowed down during the Coup attempt and then took off again during the phase of returning to normal. The partitioning of the country meant that many people moved around a lot and as a result greater demand was placed on all of the AIDS organizations. The active file of Centre Plus is large: care and treatment for PLWHAs reaches about 545 people free consultation, on site, at home or in the outpatient clinic. The center registers 60 consultations per month at the center and around 30 consultations at home for those who are very sick. Centre Plus is a registered care provider in the Ivorian national antiretroviral access program and insures medical care for many who are on ARVs.

53

KENYA NEW LIFE HOME TRUST Tel: 254 020 564743 Fax: 254 020 574955 Contact: Clive and Mary Beckenham E-mail: [email protected] Web Site: http://www.newlifehometrust.org Started: 1994 City: Nairobi Country: Kenya

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

20 8 5 6

New Life Home Trust (NLHT) is a faith-based organization, which provides a home for abandoned HIV+ babies, accepting infants from birth to the age of 6 months and caring for them until they are adopted. They provide testing, medical follow-up, on-site prescription of treatments, including ARVs that are ordered in bulk.

Among babies who test positive, presently 40% are given ARV treatment. NLHT is still searching for funds to put babies who are currently on prophylactics on ARVs. They are one of the very few organizations that deal with HIV+ infants, especially those abandoned.

PENDEKEZO LETU Tel: 067 25057 or 0733 296525 Fax: E-mail: [email protected] Contact: Nicola Clarke Web Site: Started: 1997 City: Nairobi Country: Kenya

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

0 0 0 0

Pendekezo Letu is an organization whose main function is to care for street girls in Nairobi and their families. Many of these street girls have been forced onto the streets because their parents have died or aids and they are obligated to care for the families. Pendekezo does not yet have an ARV program in place for the street girls that have been infected by HIV/AIDS. They facilitate access to ARVs by providing treatment literacy and referring clients to organizations where treatment is available. “We work with street children and their families and will help them access ARVs. Many of our clients however do not access treatments as they cannot afford them. Therefore we are actively lobbying government to supply ARVs free to impoverished street families. We would welcome the opportunity to provide ARVs. We would need Funding to purchase the drugs, training of our staff (we are not a medical NGO), if required we could employ a trained professional nurse. Working in the 5 main slum areas of Nairobi it would be very easy for us to network with other organisations in order to provide ARVs to impoverished people living either on the streets or within the slums. If funding was available perhaps a van/car could be purchased and therefore a mobile clinic could travel around all of the 5 slums in order to give the drugs to the most impoverished Kenyans.”

55

KENYA YOUTH EMPOWERED TO SUCCEED PROJECT Tel: 254 5744371 Fax: 2545722684 E-mail: [email protected] Contact: Martin Opondo Obwar Started: 2002 City: Kisumu Country: Kenya

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

72 0 3 0

Youth Empowered to Succeed Project is a medical center, staffed by 3 doctors, which cares for 72 clients living with HIV/AIDS. They provide medication for most opportunistic infections, but are not yet involved in ARVs.

“Providing ARV drugs to our client has been our interest but lack of adequate funds and technical support to give ARV drugs have been our biggest challenge. Secondly most of our clients are young people who have just learned of their positive status. Thirdly the cost of CD4 machines is so prohibitively high. If this, together with support to get the drugs, can be put in place then we see our selves starting provision of these services soon.”

AFRICAN MEDICAL AND RESEARCH FOUDATION Tel: 254 20 602190 Fax: 254 20 602531 E-mail: [email protected] Contact: Dr Festus Ilako, heads of programs, KCO Web Site: http://www.amref.org/ Started: 1957 City: Nairobi Country: Kenya

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

350 120 16 12

The African Medical Research Foundation (AMREF) in Nairobi provides medical follow-up, counseling and access to ARV treatment. AMREF is an independent non-profit, non-governmental organization (NGO) whose mission is to improve the health of disadvantaged people in Africa as a means for them to escape poverty and improve the quality of their lives. AMREF defines the disadvantaged as people who suffer from high prevalence and severe impact of major health problems like HIV/AIDS, lack of information about adolescent and reproductive health, and poor access to health care. At their center in Nairobi, clients are treated for common opportunistic infections. On-site blood tests are conducted along with available pre and post test counseling. AMREF is also greatly involved in facilitating access to ARVs. AMREF prescribes ARV medication on site. ARV medication is also ordered in bulk so as to lower its price. Patients are ensured medical and psychosocial follow-up in addition to treatment literacy on ARVs. AMREF also provides “Adherence support and nutritional supplementation during the first three months of ARV treatment, public education and social mobilization.”

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KENYA WOFAK • WOMEN FIGHTING AIDS IN KENYA Tel: 254 020 2725455 / 254 020 2725455 Contact: Ms. Dorothy Onyango E-mail: [email protected] Web Site: www.wofak.or.ke Started: 1993 City: Nairobi Country: Kenya

Last Updated: April 2004

Within the organization: Patients receiving care: 500+ Patients on ARVs: 25 Doctors and medical assistants: 4 Nurses and caregivers: 25

WOFAK was founded by a group of women who were mostly all HIV+, and came together to support each other because they had experienced rejection, stigmatization and discrimination as a result of their HIV status. This program, which was originally intended as a resource for women suffering from the aftermath of AIDS, has now expanded its influence throughout Kenya, focusing mainly on women and children. WOFAK is involved in testing, care, psychological support, prevention, lobbying, representation, drug distribution, nutritional support, vocational training for children infected and affected, treatment literacy, and ART adherence counseling. Despite the many difficulties associated with the treatment of children, it is notable that WOFAK continues to make efforts towards child counseling. Counseling for children remains as one of their greater challenges also because they find that it is difficult to minimize the trauma caused to children when their parents die from AIDS. WOFAK is very interested in providing ARV prescriptions yet they lack the funding to do so. Two of their trained officers specialized in ARV treatment, which indicates that they will be able to expand as soon as they are given adequate resources. Through the help of well-wisher donors who buy and send drugs to their organization along with strengthened political support for ARV programs, the prices for ARVs are decreasing. However, most of WOFAK’s clients can barely afford a meal, much less ARVs: WOFAK are strong advocates of the free access to ARV.

WOFAK claims that among their clientele there are 200 men and 900 women who are in urgent need of ARVs but do not have access. If they were granted more technical support and human resources they could put an additional 200 people under ARV treatment at each of their branches in Kenya (Homa Bay, Kisumu, Mombasa). The lack of ARVs is becoming increasingly more serious.

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KENYA CAFS • CAMPAIGNERS FOR AN AIDS FREE SOCIETY E-mail: [email protected] Contact: PO Box 5019 00200 Nairobi Kenya Started: 2000 City: Nairobi Country: Kenya

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

30 5 2 2

CAFS is a community youth based organization composed of people who are positively living with HIV and AIDS. They do a lot of advocacy work aimed at reducing stigma and discrimination associated with HIV and AIDS by sharing real life experiences, coping mechanisms, how to live with infected and affected, ARVS, nutrition, orphans, acceptance, disclosure and advocating for the rights of the less disadvantaged in the society. They promote a Greater Involvement Of People Living with HIV and AIDS (GIPA) at the work place, public places, schools, institutions, churches etc. “CAFS accommodates all ages and our youngest campaigner is 5 years old. We target the youth who are most vulnerable to HIV and AIDS and strive for an AIDS Free Society ".

CAFS provides counseling, medical follow-up and basic treatments for opportunistic infections. Most medication is donated to the organization, so patients don’t pay full price. ARV medication is prescribed on site at their medical facilities to those who can afford, and CAFS provides financial assistance to clients as much as they can. In addition, patients are ensured medical and psychosocial follow-up as well as treatment literacy on ARVs. The expansion of their current ARV program has become the primary goal of the Campaigners for an AIDS Free Society.

KENYA AIDS NGOs CONSORIUM • (KANCO) Tel: 2717664 Fax: 2714837 E-mail: [email protected] Contact: Allan Ragi Web site: www.kanco.org Started: 1990 City: Nairobi Country: Kenya

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

Kenya Aids NGOs Consortium (KANCO) works through their member NGOs and CBOs to advance their interests. They are particularly involved in the fight for access to ARVs. They describe their main activities as “advocacy and lobbying for ARV policies in Kenya as well as sensitisation on access to ARVs”.

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KENYA LAIKIPIA HIV/AIDS CONTROL ORGANIZATION Tel: 065 32237 Mobile: 722 681685 Contact: Peter G. Gitau- Program Manager E-mail: [email protected] Started: 1998 City: Nyahururu Country: Kenya

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

480 32 4 2

The Laikipia HIV/AIDS Control Organization (LAHACO) is a Kenyan NGO which provides testing, care and psychological support to HIV+ people. This organization, which is one of the few testing centers in the region, deals with an astounding amount of positive clients. In 2003 alone, of the 618 people that were tested, 240 were found to be positive, averaging out to an astounding 38.8% rate of infection.

In order to treat the numerous patients LAHACO provides a comprehensive program of on-site consultation, home consultation, and outpatient care. For the past 14 months, LAHACO has begun to build up their program of ARV treatment, which at present treats 32 people. There is still, however, a lack of resources when it comes to the access to drugs. LAHACO claims to have 72 women and 38 men who are in urgent need of ARVs but do not have access. Although their facility is relatively new, their staff has been well trained in the field of ARVs and their nurses attend courses specific to ARV treatment. The nonavailability and the bureaucracy involved in getting the drugs seem to be the biggest obstacle to overcome. LAHACO’s standard charge on the drugs is the least expensive in the region but it is still far from free. To keep prices down, LAHACO is constantly involved in negotiations with the government. If patients absolutely cannot afford the treatment they sometimes reduce the cost or provide free medication, but they do not have the resources to do this for everyone. Among the organization’s several goals for the future is the desire to purchase a new project vehicle to facilitate their home-based care programs. The have applied twice for aid from the Global Fund but have been rejected, sighting the technicalities of the application as being too intricate for them. LAHACO believes strongly in a greater access to ARV treatment. The majority of infected Kenyans cannot afford treatment due to the poverty levels: according to them, drugs should be given feely in order to save lives.

LIVERPOOL VCT & CARE Tel: 254 020 2714590 e-mail: [email protected] Contact: Dr. Colin Speight Web site: http://www.liverpoolvct.org/ Started: 2002 City: Nairobi Country: Kenya

Last Updated: April 2004

Within the organization: Patients receiving care: 1000 Patients on ARVs: 70 Doctors and medical assistants: 2 Nurses and caregivers: 3

Liverpool VCT & Care (LVCT) is an NGO that encompasses three different clinics in Kenya. It is a recognized non-profit organization involved in giving technical assistance to those wishing to start Voluntary Counseling and Testing (VCT) services in public health care settings. The staff implements their VCT projects by working through existing government facilities. LVCT has a well-established reputation for providing high quality care and training sessions.

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The overall objective at LVCT is to increase life expectancy and improve the quality of life of those infected. They also wish to compliment and enhance other HIV/AIDS prevention and support programs in order to reduce the unnecessary stigma surrounding this disease. They believe that if people are aware that high quality care is available, they will be encouraged to go for VCT. LVCT is involved in facilitating access to ARVs. ARVs are prescribed on-site and are made more available through financial purchasing support and reduction in prices attributed to buying the drugs in bulk. LVCT will also provide medical and psychosocial follow-up, as well as treatment literacy on ARVs.

“We are in the process of securing funds to expand access to ARVs to those that cannot afford them- at present, all of our patients on ARV’s are either paying full cost or are 50% subsidized.”

KENYA MORCAO • MOTHER’S RURAL CARE FOR AIDS ORPHANS Tel: 254 733 474489 / 254 722 792839 Fax: 254 57 23230 E-mail: [email protected] / [email protected] Contact: Jenipher Otieno Started: 1999 City: Nairobi Country: Kenya

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

650 4 6 40

Mothers’ Rural Care for AIDS Orphans (MORCAO) is a local community based organization based in Kenya. MORCAO has an integrated approach to Family-Based Care for the orphans in various homes within East Karachuonyo Division, Rachuonyo District, Kenya. MORCAO’s main activity is to place orphans into families, or identify caregivers willing to look after orphans in their natural environment. MORCAO also currently has 4 children placed on ARV treatment. They are one of the very few organizations which provides medical follow-up for children on ARVs. They could like to expand their involvement in ARVs in the near future. Before they can begin an ARV program, the organization needs “funding ARV drug purchase, hiring 4 more nurses and 5 counsellors, training volunteers on administering ARVs, a vehicle to help move patients who cannot walk, and a nutrition program for the people taking ARVs”.

MMAAK • MOVEMENT OF MEN AGAINST AIDS IN KENYA Tel: 254-020-790282/6 extension 130/254/733753954 Fax: 254-020-788140 E-mail: [email protected] ; [email protected] Contact: Michael Onyango Started: 2000 City: Nairobi Country: Kenya

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

20 10 2 10

Movement of Men Against AIDS in Kenya (MMAAK) provides medical care, testing and treatments for most common opportunistic infections at reduced price. MMAAK prescribes ARV medication on site. ARV medication is regularly ordered in bulk for clients, so as to ensure its availability. Patients on ARVs are ensured medical and psychosocial follow-up as well as treatment literacy. There are currently 10 patients on ARVs through the MMAAK program.

Before they can begin an ARV program, the organization needs “funding ARV drug purchase, hiring 4 more nurses and 5 counsellors, training volunteers on administering ARVs, a vehicle to help move patients who cannot walk, and a nutrition program for the people taking ARVs”.

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LESOTHO LESOTHO CATHOLIC BISHOP’S CONFERENCE Tel: 09266 22312750 Fax: 0926622312751 E-mail: [email protected] Contact: Mamello Makoae Started: 1976 City: Maseru Country: Lesotho

Last Updated: April 2004

Within the organization: Patients receiving care: 1150 Patients on ARVs: 50 Doctors and medical assistants: 14 Nurses and caregivers: 460

The Lesotho Catholic Bishop’s Conference has 4 hospitals and 55 health centers in Lesotho and therefore a huge potential to reach HIV/AIDS infected people nationwide. They currently have 50 patients undergoing ARV treatment, but have the potential to treat far more. As of yet, their ARV program has not been very developed. Lesotho Catholic Bishop’s Conference does not have the means to provide financial assistance to their patients who search ARVs in other associations. Access to treatment becomes a matter of economics; those who can afford treatment will receive it. Lesotho Catholic Bishop’s Conference will then provide both medical and psychosocial follow-up, as well as treatment literacy on ARVs.

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LIBERIA SAIL • STOP AIDS IN LIBERIA Tel: 011 377 47 55 17 82 / 011 399 47 53 99 47 Fax: 231 22 7838 E-mail: [email protected] / [email protected] Contact: Stephen K. McGill Started: 1998 City: Monrovia Country: Liberia

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

50 20 2 6

Stop AIDS in Liberia is a source for medical follow-up and treatment of common opportunistic infections in Liberia. Stop Aids has not yet established an ARV program but they do provide medical and psychosocial follow-up for clients on ARVs as well as treatment literacy. Currently, Stop AIDS cares for 20 patients on ARVs. They would like to expand their influence in the realm of ARVs in the coming year.

“We are doing advocacy for PLWHAS to get treatment. Treatment education is important at the moment because there are so many people waiting to get the right treatment. Now that the War is over. We are hoping that the government of Liberia is going to be put in place facility to administer ARVs. In order to launch such a project our organization must find funding for ARVs drug purchase, the training of current members and hiring one or two more Medical Doctors.”

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MADAGASCAR FIFAFI • FINOANA – FANANTENANA – FITIAVANA Foi – Espoir – Amour (Faith-Hope-Love) Tel: 261 331 160 161 [email protected] Contact: Started: 2003 City: Antananarivo Country: Madagascar

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

0 6 0 0

FIFAFI provides psychosocial follow-up to patients living with HIV and conducts informational workshops on ARVs. Six members of the organization are currently on ARV therapy.

ASSOCIATION PHILADELPHIE Tel: 033 11 150 10 / 020 22 282 81 [email protected] Contact: Pastor Gilbert Ralison Started: 2003 City: Antananarivo Country: Madagascar

Main activities related to HIV/AIDS care: - Pre- and post-test counseling - Income-generating activities - Psychosocial follow-up - Support groups - Sensitivity-training with families of PLWHAs

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Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

0 0 0 0

MALAWI CHRISTIAN HEALTH ASSOCIATION OF MALAWI Tel: 265 775 404 / 265 775 180 Fax: 265 775 406 E-mail: [email protected], [email protected] Contact: Sr. Nympha Que Started: 1965 City: Lilongwe Country: Malawi

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and care givers:

10 50

The Christian Health Association of Malawi (CHAM) is responsible for 37% of the healthcare in nationwide. They have 4 different hospitals spread throughout Malawi in which they are involved in the prescription of ARV medication. This distribution of ARV treatment is then backed up by medical and psychosocial follow-up and education on treatment. Currently, there is a plan in motion for the scaling up of Antiretroviral Treatment among all the Christian Health Association of Malawi hospitals with functioning VCT centers by the month of July 2004. The treatment will be available free of charge thanks to funding from the Global Fund. This upgrade is pertinent nation-wide: two other hospitals will also provide free ARVs and an additional two will begin an ARV program but the drugs will not be free of charge.

DAPP • DEVELOPMENT AID FROM PEOPLE TO PEOPLE Tel: 265 9 950889 / 265 9 960306 Fax: 265 1 676927 E-mail: [email protected] / [email protected] Contact: Jennie Munthall / Lisabeth Thomsen Started: 1995 City: Blantyre Country: Malawi

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and care givers:

100 25 0 5

The Development Aid from People to People (DAPP) is a testing and medical follow-up centre situated in Blantyre, Malawi. DAPP’s main activities include testing along with pre and post counselling, and also the basic medical follow up of people living with HIV/AIDS. Patients are provided treatment for the most common opportunistic infections and medication is given for free when available. DAPP does not provide ARV medication but they do ensure the psychosocial support of patients undergoing ARV treatment. “We also offer positive living courses focusing on nutrition, exercise and clean water as complimentary efforts. We have post test supportive services including group therapy, individual counselling, as well as advocacy groups.”

PARTNERS IN HOPE Tel: 265 1 762 207 Fax: 265 1 761 743 E-mail: [email protected] Contact: Perry A . Jansen, MD Web Site: http://www.partnersinhope.info/ Started: 2001 City: Lilongwe Country: Malawi

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Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

150 120 3 4

Partners in Hope is a Christian faith based association which is involved in providing testing services, medical follow-up and facilitating access to ARV treatment. The team of 3 doctors and 4 nurses care for the association’s 300 clients, 150 of which are currently accessing medical care through Partners in Hope. Patients are given essential treatment for most common opportunistic infections and some ARV medication. Partners in Hope provides financial assistance towards the purchase of these drugs. Patients undergoing ARV treatment are ensured medical and psychosocial follow-up as well as treatment literacy on ARVs. “Private patients pay the full cost of ARV medication. 1/3 of the patients are subsidized and 10% receive treatment for free.”

MALI ARCAD SIDA MALI / CESAC • ARCAD AIDS MALI/CESAC Tel: 223 221 72 59 Fax: 223 221 49 13 [email protected] Contact: Dr Alliou Sylla Started: 1996 City: Bamako Country: Mali

Last Updated: November 2004

Within the organization: Patients receiving care: 6 000 Patients on ARVs: 1200 Doctors and medical assistants: 10 Nurses and caregivers: 3

ARCAD AIDS is comprised of medical professionals, people living with HIV/AIDS and volunteers. Started in 1994, the organization set up the “Listening Center” of Care Activity and Counseling (CESAC) in collaboration with the Coopération française and the Malian government. Because of its experience with HIV+ people in Bamako, CESAC has become a model AIDS care and treatment program in Mali. A permanent multidisciplinary staff provides medical, social and psychological services. Its success is clear: the center is the leader in access to antiretrovirals in the country. It is an integrated health facility open to the city, unique in its overall approach to the patient. The organization’s activities are countless and respond to the myriad of needs felt by PLWHAs: counseling/testing, medical care (diagnostic and treatment of opportunistic infections, follow-up of patients on ARVs, home-based care, outpatient clinic…), psychological (individual psychotherapy, group therapy, support groups, occupational therapy, fashion show “well-being in the body, well-being in the mind", compliance clubs), social (family visits; hospital visits; nutritional support; emergency support: rent, transportation, facilitation of complementary lab work), cooking workshops, incomegenerating activities, tuition support. Care is integrated with prevention by way of an information center. Information is disseminated in a number of ways: at the reception desk, over the phone, through documents/publications, debate and conversation, film screenings at the CESAC, distribution of condoms and advocacy around the female condom. This center of excellence plays a significant role in training medical and community workers throughout the country. Since 2002, an emphasis has been placed on training for people in the struggle against AIDS: along with other Malian AIDS organizations, ARCAD has designed a training program for its most active staff and volunteers. More specialized training for example in home-based care and training for instructors has increased the sharing of skills. The active patient list amounts to around 6000-- 1200 of whom are on antiretrovirals (Doctors have been prescribing ARVs since 1997). CESAC was identified as one of the 3 first sites of prescription and dispensation of antiretrovirals within the Malian Initiative of Access to Antiretrovirals. Now a resource for community initiatives, similar centers have opened in Kenedougou and Mopti.

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“In your organization (among clients and members), how many people are in emergency need of ARVs but do not have access? - There are 5000 people waiting, 75% of whom qualify (a CD4 count of less than 200), so less than 10% have access! Close to 3000 should be on ARVs."

MALI KENEDOUGOU SOLIDARITE Tel: 223 262 14 33 / 262 10 33 / 672 20 57 Fax: 223 262 14 33 [email protected] / [email protected] Contact: Mohamed Alassane Toure Website: www.reseauafrique2000.org/mali/kenedougou.html Started: 1999 City: Sikasso Country: Mali

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

500 8 2 1

Started by former members of CESAC in Bamako, this Malian organization is located in Sikasso, in the Kénédougou region, where HIV prevalence around 5% higher than it is in the rest of the country. The organization runs the CERKES, a reference center for care and treatment of people with AIDS that opened in May, 1998. In 2002, the organization finally received support from the Malian government. The organization has been taking on more and more care and treatment activities that take place outside the hospital in a difficult environment. Their activities include: information and prevention, HIV testing, comprehensive care, and fighting against the kind of discrimination typically faced by families affected by HIV/AIDS. CERKES’ staff comprises an administrator, a doctor, two psychologists, a laboratory assistant, a nurse, a social worker, a secretary/accountant, two PLWHA support group facilitators, and a community pharmacy manager. All of them participate regularly in training seminars. CERKES has a laboratory and a community pharmacy. The medicines to treat opportunistic infections are free. During the first semester of 2003, CERKES conducted 526 HIV tests, 1 404 counseling sessions and 558 home care or hospital care visits. Cooking demonstrations involved 328 people. Tuition and clothing support was provided for about 100 children. During the same period, 862 adults received medical consultations and 166 children received consultations. Medical activity centered on care and treatment of sexually transmitted diseases and opportunistic infections and more and more care and treatment of people taking antiretrovirals. Eight people are currently on ARVs in the organization. These people must get their prescriptions in Bamako, however, as KENEDOUGOU SOLIDARITE waits for the national program to become decentralized.

“Of the secondary cities, Sikasso is first line to obtain government authorization. We strongly hope to become a prescribing center. Once patients are on ARVs, they no longer come to the center for treatment of opportunistic infections. It is harder to provide care for people who are not on ARVs than it is for those who are. “ “Around 200 people in our organization are in emergency need of ARV therapy. Only three facilities currently (one public and one community-based) are authorized by the Malian Initiative of Acces to ARVs to prescribe ARVs in Mali. They are all based in Bamako. "

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MALI WALE ACTION SANTE POPULATION Tel: 223 2 32 12 97 / 6 72 43 04 Fax: 223 2 32 05 27 [email protected] Contact: Aly Soumountera Website: www.promali.org/ong/wale/index.htm et http://wale.segou.net/ Started: 1997 City: Segou Country: Mali

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

120 13 4 2

WALE’s goals in the Ségou region are: fighting sexually transmitted diseases, (prevention/information seminars in various places, including schools) and improving the socio-economic condition of women. The organization has conducted research (studies on prostitution and HIV/AIDS) and has opened a drop-in center for people living with HIV/AIDS. Since 1999, WALE decided to integrate care and support of PLWHAs into its other activities. The first to participate received diverse kinds of support such as cereal, clothes and medicine. As the need grew, WALE hired a psychologist and a doctor to improve the quality of care. The psychologist refers patients to the doctor in the medical unit who will then help with opportunistic infections and other treatment issues. As the only facility providing medical care to people who are infected by HIV, WALE can testify to the increasing need for treatment of opportunistic infections everyday. The organization has free treatments for the most common opportunistic infections at its disposal. Thirteen of their 120 patients are on ARVs. The care-giving staff prescribes ARVs, suggests medical and psychosocial follow up to patients and conducts education/information sessions on ARVS. WALE has also substantially contributed to the establishment of PLWHA organization called KENEYATON. This organization, which has 36 to 40 members, conducts sensitivity training to the population on different aspects of infection.

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MAURITANIA AMALUTS • Association Mauritanienne de Lutte Contre le Sida (Mauritianian Organization against AIDS) Tel: 222 63 27 180 Fax: 222 52 52 801 [email protected] [email protected] Contact: Sinna Boly

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses aides and caregivers:

Started: 1996 City: Nouakchott Country: Mauritania

12 3 2 2

AMALUTS provides testing and counseling services, and follows around a dozen patients while obtaining for them some medicines to treat opportunistic infections. Among the members of the organization, 3 people are currently on ARVs.

SWAA Mauritanie

Last Updated: April 2004

Tel: 222 630 00 56 / 630 24 51 Fax: 222 525 05 25 [email protected] Contact: Sana Abass / Lo Yéro http://www.maurifemme.mr/ONG/swaa.html Started: 1992 City: Nouakchott Country: Mauritania

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

200 20 8 15

SWAA-Mauritania is undoubtedly the oldest AIDS organization in the country. Founded in 1992 by a group of 12 women, SWAA began by organizing several sensitivitytraining sessions for large groups including focus groups moderated by various doctors (heads of health centers). The organization produced a series of videos that were broadcast on national television to make citizens more aware of the need for voluntary testing, and then conducted a study in 1999 on the establishment of a of treatment and care center for PLWHAs. The organization now conducts comprehensive care activities for around 200 people. Treatments for opportunistic infections are available at minimal cost and patients receive financial support to pay for ARV therapy. Twenty people are currently on ARVs and they are given both psychological and medical support at the organization’s office. Workshops on ARVs are offered.

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MAURITIUS PILS • PREVENTION, INFORMATION ET LUTTE CONTRE LE SIDA (Prevention, Information and Struggle against AIDS) Tel: 230 210 70 75 / 47 Fax: 230 210 70 34 [email protected] Contact: Juliette François / Nicolas Ritter Started: 1996 City: Port-Louis Country: Mauritius

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

5 25 1 0

Created in the mid- 90s, PILS is the only AIDS organization in this little country. Essentially involved in the areas of information, communication, prevention and support to people living with HIV/AIDS, the organization is particularly militant when it comes to the issue of patients’ rights. Their advocacy work has resulted in women having access to ARVs to reduce the incidence of transmission of HIV from mother to child, ARVs for HIV-infected children and, finally, the payment of antiretroviral medicine the patients. In 2002, the organization participated in the creation of a network involving all the other islands in the Indian Ocean. CADI (AIDS Documentation and information Center) serves as the offices headquarters. In 2004, the first residential rehabilitation center for women for detoxification of drug addicts and alcoholics will open on the West Coast of the island. PILS, which belongs to the same network, receives these women to help them help each other and to encourage them with the collaboration of the Minister of the Woman and the European Union, to create their own businesses.

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MOROCCO ALCS • ASSOCIATION DE LUTTE CONTRE LE SIDA (Organization of the Struggle against AIDS) Tel: 212 22 99 42 42 / 43 Fax: 212 22 99 42 44 [email protected] Contact: Pr Hakima Himmich Started: 1988 City: Casablanca Country: Morocco

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

677 340 13 16

The first AIDS organization in North Africa and the Middle East, the ALCS started in 1988 when a group of doctors decided to convene because they were very concerned about the seriousness of AIDS and the risks of it spreading even further. Starting out as a medical facility, the ALCS evolved into a community organization centered on the needs and skills of its members. The ALCS defines itself as “a place for the struggle for the rights of people affected by HIV /AIDS." The ALCS is now the only NGO that provides care and treatment to People Living with HIV/AIDS in Morocco. The organization has never stopped fighting to broaden access to antiretroviral treatment namely fighting to obtain lower prices. The ALCS is a leader in comprehensive care for people affected by HIV in Morocco. They are involved on a national level as they have 10 active regional divisions in addition to the main office in Casablanca. From the beginning, the ALCS has fought the idea that access to treatment can’t be a priority in countries where HIVprevalence is low. Their actions brought results: since 1999, funding institutions and the government subsidize the purchase of triple therapies in this sovereignty for a limited number of patients. ALCS activities contribute equally to the success of these initiatives. In Casablanca, the “care and treatment” division of the organization comes to the help of patients in the most desperate situations: a community trust ensures that help reaches those who are in difficulty, for example, by covering their transportation costs to and from the hospital or by buying them food-- the volunteers manage a pharmacy and they visit patients who cannot come to them such as patients who are incarcerated. The ALCS plays the role of mediator between the pharmaceutical laboratories and those who pay for their own treatments, those whose employers pay for their medical care, or those who have medical insurance. The organizations full-time volunteers at the Ibn Rochd Hospital ensure continuity between the hospital assistance and the follow-up that takes place outside the hospital for the PLWHAs of Casablanca. Three hundred and sixty five people are currently on ARVs in the ALCS.

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MOROCCO ALCS Marrakech • ASSOCIATION DE LUTTE CONTRE LE SIDA - Marrakech (Organization of the Struggle against AIDS) Tel: 212 22 99 42 42 / 43 Fax: 212 22 99 42 44 [email protected] Contact: Pr Hakima Himmich Started: 1992 City: Marrakech Pays: Morocco

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

Founded in 1992, this division manages the only CIDAG (Center for Information and Anonymous and Free Testing) in the city, and provides free consultation on STDs for populations at risk, particularly sex workers and men who have sex with men. The ALCS in Marrakech is becoming increasingly involved in psychosocial and material care and legal support for people living with the virus. The organization mediates between the patients and the prescribing doctors in coordination with the CHU (University Hospital) of Casablanca and the Service of Infectious Diseases of Marrakech. Hospital patients are referred to the ALCS for care and psychosocial follow-up; help with making with hospital appointments, the purchase of medicines for opportunistic infections, and getting ARVs through the mail. 41% of the people cared for at the ALCS in Marrakech are not yet in treatment. Volunteers provide services three times a week at the hospital including counseling and support to patients on antiretroviral treatment to assist them in correctly taking their medicine and managing side effects. The care division works mostly with the help of volunteers and the services that the ALCS Marrakech provides are made possible solely through the generosity of private donors and special grants. As the number of people reached continues to grow so do the needs for care. The ALCS Marrakech recently established a training program on therapeutic education for 37 nurses and 10 doctors in the areas of prevention and treatment of opportunistic infections, the handling of antiretroviral medicines and the prevention of risk of exposure through blood as well as training in assisting with compliance and ethics.

OPALS-MAROC • ORGANISATION PANAFRICAINE Last Updated: April 2004 DE LUTTE CONTRE LE SIDA (Pan-African Organization in the Struggle against AIDS) Tel: 212 37 65 71 21 Fax: 212 37 65 31 08 [email protected] Contact: Dr Nadia Bezad, Dr Saida Semmar Started: 1994 City: Rabat Country: Morocco

Within the organization: People receiving care: People on ARVs: Doctors and medical assistants: Nurses and caregivers:

25 25 18 13

OPALS – Morocco is connected to the national ARV access program and works in partnership with various public health services and NGOs. Besides a comprehensive HIV-testing service OPALS also provides free medical consultations and follows 25 PLWHAs, all of whom are on antiretrovirals. The health personnel is specifically trained in the management of ARVs and 9 people are followed closely by the medical personnel who provide comprehensive care: a listening center, training workshops, awareness training on methods of care, side effects, lab tests, financial support and management of ordering medicines. “AIDS has to be seen as being like other chronic illnesses and should be treated generally and impartially. The patient should find the answers to all his needs: listening, testing, counseling, treatment and prevention, comprehensive services.” OPALS is equally involved in a rights collective as well as advocacy of generic medicines and lobbies for free access in the country.

“ARVs must be free for all patients-- medicines are expensive, medicines which are free of charge encourage compliance.”

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MOZAMBIQUE TCHAVELELO Tel: 258 082622516 Contact: Algina Betuel Bombe Started: 2002 City: Manjacaze Country: Mozambique

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and care givers:

40 0 1 20

Tchavelo is a small organization which treats 54 clients living with HIV/AIDS. Basic medical care is allotted to clients in need, but there is not yet an established ARV program. Despite their lack of ARV treatment, it is one of their primary objectives to establish such a program. In that respect, they would need funding for a laboratory, to hire a doctor, get government authorization and find a consistent source of funding to ensure the sustainability of the project.

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NAMIBIA CATHOLIC HEALTH SERVICES Tel: 264 61 225 265 Fax: 264 61 248 126 Contact: Sr. Dr. Raphaela Händler E-mail: [email protected] Started: 2001 City: Windhoek Country: Namibia

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and care givers:

250 88 4 12

The Catholic Health Services (CHS) provides healthcare for the underserved and poor communities of Namibia through their 4 district hospitals, 5 health centers, and 7 clinics: all people have access to CHS. In a country where 22% of the population is infected, CHS is using all its resources to provide adequate care. Of those who have been tested in one of their 4 hospitals, the prevalence rate is 27%, 22%, 21%, 10%. CHS provides on-site consultation, outpatient care, inpatient hospitalization, pre and post test counseling. CHS is closely involved with other actors such as the ministry of health and social services, FBO’s like Catholic AIDS Action and Lutheran ELCAP, Family Health International and John Hopkins University. Greater access to ARVs is another domain in which CHS would like to expand. They currently treat 88 people, but could potentially handle even more. Their problem is not one of a lack of money, but rather a lack of human resources. The CHS staff is fully equipped to prescribe medication and have received special training specific to ARVs. Three of their doctors have even completed a full month course in Kampala. The existing staff is competent but in order to treat more people, CHS needs to find more staff members. One of CHS’ 4 district hospitals already provides full access to ARVs and the remaining 3 are expected to provide full access by July of 2004. An upscale of their current facilities shall take place within the year 2004 with the expectation of having fully operational VCT centers, PMTCT and PMTCT+, and free access to HAART without any payment on the part of the client. Overall, CHS supports the idea that ARV treatment should be made available to all those in need of it.

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NIGER MVS • MIEUX VIVRE AVEC LE SIDA

Last Updated: April 2004

(Living Better with AIDS) Tel: 227 96 24 09 / 72 40 94 / 73 26 65 Fax: 227 73 49 82 Contact: Idrissa Sabbou [email protected] / [email protected] Started: 1994 City: Niamey Country: Niger

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

100 30 3 6

The organization, “Mieux Vivre avec le Sida” runs the only voluntary and free testing center in Niger, CEDAV. The organization established specialized medical consultation, the CESIC (a drop-in, care, information and counseling center) to compensate for doctors’ lack of involvement in the care and support of patients with AIDS. The CESIC occupies two consultation cubicles in Niamey’s hospital. The first room is a consultation office and the second room contains a large closet full of medicines as well as two beds and serves as a kind of ad hoc “outpatient clinic” for patients who need care. Few organizations have committed themselves to the care and treatment of PLWHAs. Of nearly 170 NGOs who have an AIDS division, only 5 of them actually provide care or support to PLWAs. MVS is the pioneer. Medical services provided in terms of care and support include a large prevention and treatment of opportunistic infections component which unfortunately cannot meet the demand especially when there is no formal structure in care and treatment for PLWHAs in the public sector. A Mobile Treatment Unit has just been established but their capacity to provide services could soon be overwhelmed. Around 150 patients are regularly followed at the CESIC. The active patient list has grown progressively over the last three years. The number of monthly consultations varies between 150 and 200. Consultation with a General Practitioner is free while it costs around $6 at the National Hospital and $2 at the CTA. The organization runs a community pharmacy and dispenses free medicines for treating opportunistic infections. ARVs are not free and they remain costly. CESIC has been prescribing ARVs since 1998. It is recognized as an authorized prescription center for ARVs and will function as such in the national ARV access program, which hasn’t yet started, INAARV (Initiative Nigérienne d'Accès aux ARV). MVS handles all stages of care and support: from the preparation for treatment to the management of undesirable effects of ARVs, to prescription, to clinical and laboratory follow-up, to providing assistance with compliance, and nutritional counseling. Around 30 patients are on ARVs half of whom work for two uranium mining companies whose employers pay for their treatment. The others pay for their own treatment themselves. In 2003, MVS set up a system for supplying antiretroviral medicines: Generics were imported from India by a local pharmacist and other antiretrovirals like efavirenz and lamivudine were purchased from Burkina Faso by the organization Association African Solidarité (AAS-African Solidarity). The drugs are re-sold to the patients at cost. The monthly price of a triple therapy is between 76 and 122 euros. Only privileged minorities can afford to buy them. Around 40 women and 20 men are in emergency need of ARVs. In addition, MVS developed income-generating activities for HIV+ women, most of whom are widows. They have startup funds in the form of loans, which are paid back. A revolving health fund has been set up to help them pay for the costs of their medical care. Finally, the organization supports around 30 orphans through tuition and food support. To respond better to the needs of the patients, MVS needs a pharmacy which is better stocked with medicines for opportunistic infections, more medical and paramedical personnel trained in the care and treatment of opportunistic infections and ARV prescription, social workers and PLWHAs trained in support and care of patients, nutritional aide and home-based care.

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"If treatment were accessible to all, we could follow up to 100 patients with our current staff. With more staff we could follow more patients. We are fighting for treatment to be free of charge because the majority of PLWHAs live in poverty. We do not agree with the idea that people will be less likely to take their ARVs if they are free because this is a question of survival and our patients who are on free ARVs are no less compliant than the others. It is all a question of the doctor-patient relationship. In the North, has free treatment altered the level of compliance? "

NIGERIA ACTION FAMILY NETWORK Tel: 234 14 725137 Contact: Dr. E.I.B. Ohechukwu E-mail: [email protected] Web site: http://www.aicug.org/ Started: 2000 City: Lagos Country: Nigeria

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

15 10 2 3

The Action Family Network (AFN) is a community-based Christian NGO working in the areas of family life, health, and community development. It deals with family-related issues such as nutrition interventions, disease control, prevention of teen pregnancy, reduction of abortion-related deaths, and youth and adult criminality. While primarily involved in family planning, and advocates of abstinence, they conduct a number of Aids related activities: Advocacy and intervention activities include efforts to empower families with culturally sensitive preventive information and behavior change models. For those already infected or affected by HIV/AIDS, AFN seeks to motivate and equip the family with necessary capabilities to cope with challenges. Strategies include counseling, advocacy campaigns, and care and support - including home-based care for people living with HIV/AIDS.

“The Action Family Networks finds funds to pay part of the ARV costs for indigent patients who cannot pay themselves and provides clinical care for those in crisis in our base clinic. We would like to scale up coverage and recruit more patients if we access funding for ARVs, training current employees and volunteers, and provide VCT services in our Community Health Facility”

AIDS ALLIANCE IN NIGERIA Tel: 234 1 2600047 Fax: 234 1 2600029 [email protected] [email protected] Contact: Mohammed Farouk Auwalu Web site: http://www.aidsallianceinnigeria.org Started: 1999 City: Lagos Country: Nigeria

Last Updated: April 2004

Within the organization: Patients receiving care: 1967 Patients on ARVs: 980 Doctors and medical assistants: 4 Nurses and caregivers: 8

AIDS Alliance was formed by a group of people living with HIV who were the first to be open about their positive status. It is one of the most active organizations in the area of AIDS in Nigeria. Its mission is “To restore hope to PLWHA in living positively in Nigeria by advocating legal and policy reforms, institutionalizing sustainable treatment services and empowering members to get more involved in HIV and AIDS activities.” It provides care and support for PLWHAs in Lagos, including home based care, life skill training, and formation of support groups in the South-South, Northeast and Middle Belt zones. They are also involved in training of PLWHA as counsellors. Close to 1000 of their members have already begun treatment, mostly through the national treatment access program. For those who were shut out of the government-subsidized ARVs due to lack of space, AIDS Alliance Nigeria orders ARVs in bulk and provides medical and psychosocial follow-up together with treatment literacy. During the last shortage of drugs in the National Program they formed partnerships in order to obtain generic brands of ARVs at reduced prices.

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NIGERIA CRH • CENTER FOR THE RIGHT TO HEALTH Tel: 234 1 4979467 Fax: 234 1 7743816 E-mail: [email protected] / [email protected] Contact: Bede Eziefule Website: www.crhonline.org Started: 1999 City: Abuja and Lagos Country: Nigeria

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

500 10 4 4

“Patients are given drugs with the label peeled off, necessary education about the drugs denied them, leading sometimes to adverse drug reactions and death. Youths and women seeking reproductive health care are treated with scorn and disdain depending on the disposition of the health care provider. They are rarely consulted about their diagnosis or in making decisions about their treatment. This is more so for vulnerable groups such as the uneducated, the poor, women, children and patients with stigmatizing diseases like HIV/AIDS. Most often, violation of rights in healthcare institutions, leads to violation of other rights such as the right to life, work, housing and education among others.” The Center for the Right to Health (CRH) is dedicated to addressing these issues in the most concrete manners, ranging from providing direct social support to victims of discrimination to educating lawyers and bringing cases to trial. They are also active in the area of medical care: a mini clinic has been established within the CRH where testing and counseling is carried out, as well as limited provision of direct medical cares by trained volunteer doctors and nurses. The team provides for a total of 1000 clients who receive treatment for most common opportunistic infections. CRH has also been able to provide anti-retroviral drugs at reduced price to ten of its members.

“Our organization would like to launch into full time ARV administration. To launch fully we would need to hire full time doctors, funding ARV drug purchase and training for medical and nursing staff.”

NEPWHAN • NETWORK OF PEOPLE LIVING WITH HIV/AIDS IN NIGERIA Tel: 234 9 2349281 Fax: 234 9 2345238 E-mail: [email protected], [email protected] Contact: Dr. Pat O Matemilola Web Site: www.nepwhan.com Started: 1997 City: Abuja Country: Nigeria

Last Updated: April 2004

Within the organization: Patients receiving care: 2000 Patients on ARVs: 1000 Doctors and medical assistants: 10 Nurses and caregivers: 500

Objectives (as stated by Nepwhan) are: to defend and advocate for the rights of PLWHA, to promote cooperation and collaboration within member support groups, to facilitate involvement and representation of PLWHA in decision making, policy formulation, implementation, monitoring and evaluation of programs on HIV/AIDS. They also try to facilitate formation of support groups where none exist and assist government to realize its objective of controlling the spread of HIV. They serve as information resource centre on HIV/AIDS, providing capacity building cessions for support groups. The Network of people living with HIV/AIDS in Nigeria is also an organization of infected people. They provide direct home-based care for those who are confined to their homes. They offer vitamin supplements for healthy members and assist others to access ARVs, but they do not follow them up medically “as this is usually done by hospital staff”. “In order to commence full provision of ARV services within our network we need more training and funds to initiate purchase. We are already discussing with GSK and a few manufacturers of generic ARVs but still lack the necessary funds”

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NIGERIA LIFE LINE PLUS FOUNDATION NIGERIA Tel: 234 042 251547 234 803 4747806 E-mail: [email protected] Contact: Ms. Ijeoma Nnaji Started: 2001 City: Enugu Country: Nigeria

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

165 59 5 28

The foundation provides VCT, medical care, psychological support, orphans care and support, prevention, advocacy, drug literacy, drugs, research, home based care and palliative treatment.

“Community involvement and participation is very important because with training they can provide better services at a cheaper price. Also, clients are more likely to open up to their peers, helping to curb stigma and discrimination. We use trained persons living with HIV/AIDS in counselling and testing although we have many health personnel who are working as volunteers or in the Public Health Department of Council. Seeing this has inspired so many people to come in for testing...”

There are currently 59 members undergoing ARV treatment at the Life Line Plus Foundation. Life Line tries to provide CD4 counts and other necessary exams for those on ARVs about every 6 months “but it is often difficult as the cost is too expensive. 98 patients are bedridden in their homes in the communities who desperately need CD4 tests and nutritional aid in their states. If there was more help available, they could survive.” If ARV medication were available to all, Life Line Plus believes it has the capacity to medically follow-up all 165 of their current patients. They have 145 men and 175 women who are desperately in need of treatment. “We are trained to give ARVs to the PLWHAs whose CD4count is below 200, after doing other tests like Lft, Pcv, etc. Our handicap is finding access to the ARVs. Only the University teaching hospitals can access these drugs from the national drug store. We were trained in readiness or in preparation for the scaling up which we don’t know when will take off. As it is now, we will be very delighted to associate with any organization that will facilitate our access to ARVs. We lack the following: funding ARV, laboratory equipments, computers, HBC kit, Refrigerator, big screen television for presentation, videocassette, etc.” Life Line Plus also believes strongly in education and adherence education for those undergoing ARV treatment because they have seen the negative consequences associated with interrupted ARV treatment.

“There was a period when Nigeria ran out of ARVs and it was disastrous because some of our members started having OIS and lympho-adenopathy, etc. Some of them who survived that period started regaining their health when the ARVs were brought back into the governmental health centres.”

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NIGERIA LIVING HOPE ORGANIZATION Tel: 234 1223014 E-mail: [email protected] Contact: Jude Chidi Munaonye Web site: http://www.livinghopeorg.tk/ www.livinghopeorg.8m.com Started: 2000 City: Umuahia Country: Nigeria

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

600 3 7 4

‘We give hope to the hopeless’

“We give hope to the hopeless”

Living Hope Organization (LHO) is a nongovernmental, non-political, non-religious, non-for profit support group of people living with HIV/AIDS. The major goal of this support group is to help members live positively with the infection through awareness, education, and counselling, and help the members to play key roles in the prevention and control of the HIV/AIDS epidemic. The organization is still fairly unknown and they require assistance in order to elevate their reputation and gain credibility, especially for the education of positive members, counselor training for members, fund to establish a well equipped office, and assistance in getting Antiretroviral drugs.

In addition to providing a source of support to those infected by HIV/AIDS, Living Hope Organization provides medical follow-up, limited access to ARVs and testing services. Patients undergoing ARV treatment are ensured medical and psychosocial follow up as well as treatment literacy on ARVs. Living Hope Organization places great importance on their ARV program. They hope to expand their current capacity of ARV treatment, but are limited by such factors as finding available ARV medication for purchase, having enough funds to purchase them, and insufficient training of their personnel. Currently, they have 3 members undergoing ARV treatment, but they believe that is access to ARV were free, they could treat up to 20 people with their current resources.

Among those involved in the Living Hope Organization program, there are 743 men and 1235 women that are desperately in need of ARV treatment, but do not have access. They are currently on medication (such as prophylaxis) to prevent opportunistic infections.

CHAN • CHRISTIAN HEALTH ORGANIZATION OF NIGERIA Tel: 234 73 2808, 234 803 401 6905 Fax: 234 73 280974 e-mail: [email protected] Contact: Deacon Sule Abah Started: 1973 City: Jos Country: Nigeria

Last Updated: April 2004

Within the organization: Patients receiving care: 1000+ Patients on ARVs: 1000+ Doctors and medical assistants: 250 Nurses and caregivers: 1200

88 Christian Health Organization of Nigeria (CHAN) member institutions provide healthcare services to more than 40% of the 130 million Nigerians. Their member institutions are involved in access to basic health access as well as ARV therapy. ARVs come from local suppliers at a price that only a few patients can afford. There is a plan to commence a separate program on ARV distribution.

NIGERIA NNELA/PSC

Last Updated: April 2004

NETWORK ON ETHICS, LAW, HIV/AIDS PREVENTION, SUPPORT AND CARE Tel: 234-08033248532 Fax: 234-2-810951 E-mail: [email protected] ; [email protected] Contact: Prof Femi Soyinka Web Site: Started: 1994 City: Ibadan Country: Nigeria

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

102 25 2 4

The Nigerian Network on Ethics, Law, HIV/AIDS Prevention, Support and Care (NELA/PSC) provides legal, economical and social support together with medical follow-up and treatment literacy on ARVs to people living with HIV/AIDS in the second largest city of Nigeria. They organize workshops on all those issues and activities to empower local PLWHAs support groups. Their staff of 2 doctors and 4 nurses and caregivers allows them to treat 102 clients, 25 of which are on ARV treatment.

“NELA in collaboration with the teaching hospital (University College Hospital) Ibadan is providing ARV at a subsidised price of 1000 naira per month. Other clients purchased the ARV at a subsidised price from a phamaceutical company through special arrangement with the company by NELA. Despite these arrangements, not all the clients could afford to pay for the drugs. Other clients are basically on treatment of opportunistic infections and health promoting activities.”

PLAN • POSITIVE LIFE ASSOCIATION OF NIGERIA Tel: 234 8037190628 / 234 8033199849 Email: [email protected] / [email protected] Contact: Obatunde Oladapo Started: 2001 City: Ibadan Country: Nigeria

Last Updated: April 2004

Within the organization: Patients receiving care: 200/250 Patients on ARVs: 70 Doctors and medical assistants: Nurses and caregivers:

The Positive Life Association of Nigeria (PLAN) is a voluntary support group of people living with HIV/AIDS. Based in Ibadan, Oyo State, its membership cuts across age, sex, religion, educational attainment and social status. The mission of PLAN is to “advocate and work for the empowerment and capacity building for enhanced positive living of people living with HIV/AIDS. PLAN envisions a Nigeria where the rights, welfare and dignity of PLWHA are assured and the society is protected against the spread of HIV/AIDS. " They conducted a number of public enlightenment programs on HIV/AIDS Prevention and Care in Tertiary Educational Institutions; publish a Booklet titled "Staying Alive - Positive Living Strategies for PLWHA and All”and a 1-hour Television Program titled "Positive Talk". They are especially efficient in advocating for a better and cheaper access to medicines and laboratory exams through the public sector program.

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“Despite the fact that the 10,000 or more people living with HIV/AIDS on the Federal Government-subsidized ARV program are paying one thousand naira ($7) monthly for their ARV drugs, the high costs of laboratory investigations remains one of the most daunting problems affecting them and militating against the success of the program. But people undergoing ARV therapy at the University College Hospital of Ibadan can now heave a sigh of relief as the laboratory of the Virology Department is now conducting CD4 Count tests for them FREE OF CHARGE. This development is the result of advocacy activities by the Positive Life Association of Nigeria…”

Members of PLAN received training on HIV/AIDS Counseling, Care and Support organized by the Nigeria Network on Ethics, Law and HIV/AIDS (NNELA-PSC), They do pre and post test counseling and support their members in all possible ways, helping them buying drugs at the cheapest price, or referring them for ARV therapy at the University College Hospital. PLAN is a member of Treatment Action Movement (TAM) Nigeria, a coalition advocating for access to treatment and care for PLWHAs, and was very active in lobbying for a better management of the governmental program during the national ARV drug shortage.

NIGERIA SAVE THE WORLD ORGANIZATION Tel: 234 8033156139 E-mail: [email protected] Contact: John I. Ibekwe Started: 1998 City: Onitsha Country: Nigeria

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

300 92 30 8

The Save the World Foundation in Onitsha, Nigeria, provides medical assistance to over 60 clients a month. They provide medical follow-up to 300 patients living with HIV/AIDS. Their main activities include providing basic medical health care, such as treatment for common opportunistic infections, and they also facilitate access to ARV medication. The Save the World Foundation has not yet established a program of ARV prescription within their center. They do, however, ensure patients undergoing ARV medication easy access to medical and psychosocial treatment in addition to providing them with treatment literacy on ARVs. It is one of Save the World Organization’s primary objectives to expand its current activities in ARVs but they lack “technical support and funding”. For the moment, they help to facilitate patient’s access to ARVs by referring them to other hospitals where they can access the drugs.

WARO • WOMEN ACTION RESEARCH ORGANIZATION Tel: 234 042 259046 / 259275 Fax: 234 042 259046 [email protected] Contact: Started: 1996 City: Enugu Country: Nigeria

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses: Caregivers:

55 2 4 10

Women Action Research Organization (WARO) offers testing and medical care services to women with HIV. Essential treatment for the most common opportunistic infections is provided to those in need, and WARO regularly orders ARVs in bulk, providing patients on treatment the medical and psychosocial follow-up they require. An expansion of their ARV program is one of their main objectives, they hope to obtain “funding for ARV drug purchase and training of current employees” in order to do so.

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RWANDA AFXB - RWANDA • ASSOCIATION FRANCOIS-XAVIER BAGNOUD Tel: 250 562 780 Fax: 250 562 780 [email protected] Contact: J. Damascène Ndayisaba Website: www.fxb.org/action/rwanda/indexfr.html Started: 1995 City: Kigali Country: Rwanda

Last Updated: April 2004

Within the organization: Patients receiving care: 1 560 Patients on ARVs: 55 Doctors and medical assistants: 5 Nurses and caregivers: 12

Working with organizations and associations such as the Kigali Urban Social Office, the Medical Center of Bilyogo, The Widows Association of Icyuzuzo, FXB has established community-based programs to reach as many people as possible with the goal of not only providing emergency help, but also creating self-sustaining programs that allow the people of the community to improve their own well-being. Since July 2000, FXB has been operating support programs in Kigali for HIV-positive mothers and the host families of children with AIDS. FXB works directly with 240 families to help them develop income-generating activities for self-support, and obtain medical care and counseling to help them deal with their disease and the attendant problems. Since July 2002, this comprehensive program has been extended to Gitarama town, where the virus affects 15 % of the population. Here, two programs now reach 160 families comprising 960 people. The organization helps provide treatment for the many infections suffered by people living with aids, and instruct families in primary health care. Support is provided through community outreach clinics, home visits, palliative care and referrals of patients to other centers. In collaboration with government and other organizations, voluntary counseling and testing services are provided. In three months (end 2003), FXB helped a total of 102 adults and 126 children to obtain treatment in Kigali, and 112 adults and 92 children in Gitarama. FXB works with pharmacies and clinics such as Icyuzuzo, la Confiance, Ubuzime and la Concorde in Kigali, and with the Health Centers in Mbuye, Kabgayi and Gitarama.

Among a total of 1 560 people now benefiting from FXB services, 55 people are undergoing ARV treatment. This number could be much higher.

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SENEGAL SIDA SERVICE Tel: 221 835 34 07 / 644 42 66 Fax: 221 835 34 08 [email protected] [email protected] [email protected] Contact: Paul Sagna Started: 1992 City: Dakar Country: Senegal

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs:

120 13

Doctors and medical assistants:

7

Nurses and caregivers:

0

Sida Service is a Christian NGO. Paul Sagna, the executive secretary, says that his organization does not reject condom use as a way of preventing the transmission of AIDS but rather “recommends abstinence and faithfulness.” Sida Service is very involved in medical care. It is the only NGO to have started a free and anonymous HIV testing center in Senegal. A hundred and twenty people currently receive medical and laboratory follow up. The organization provides medicines to treat the most common opportunistic infections at low cost. At the present time those who need to be on ARV therapy are referred to the Mobile Treatment Center, the only facility authorized to prescribe them. The organization provides follow up and education/information sessions on ARVs.

SYNERGIE POUR L’ENFANCE Tel: 221 683 98 80 / 854 21 21 [email protected] [email protected] Contact: Ngagne Mbaye Website: www.mfsn.gouv.sn/dpesenegal/Program_projets/ synergie.htm Started: 1996 City: Pikine Country: Senegal

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

150 40 6 5

Synergie pour l'Enfance is based in Pikine, a suburb of Dakar. Its areas of involvement are: - Prevention of pediatric infection through the participation in the national program of prevention of mother to child transmission, - Medical follow up on HIV + children, nutritional assistance and psychosocial support of infected or affected children, whether or not they are orphans, - Development of an integrated center for the survival of children in a rural environment (Centre intégré pour la Survie de l'Enfant en Milieu Rural, CISERM). Synergie Pour l’Enfance provides testing and pre and post counseling services, and has a medical analyses laboratory on premises. The organization conducts medical and psychosocial follow up for 150 people 40 of which are on ARV treatment. Activities of care, prevention and advocacy for the health of the mother and child are conducted based on a participative community approach.

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SEYCHELLES FAHA • FAITH AND HOPE ASSOCIATION Tel: (248) 722504 Fax: (248) 224500 E-mail: [email protected], [email protected] Contact: Joseph Rath Started: 2001 City: Mahe Country: Seychelles

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

15 9 4 8

Faith and Hope Association (FAHA) is a small organization in Seychelles, involved in facilitating treatment for those patients undergoing ARV medication. They ensure medical and psychosocial follow-up as well as treatment literacy for patients receiving ARV treatment from the government. They do not intend to launch an ARV project themselves, but are more concerned with counseling and providing follow-up to those who have begun ARV treatment. “At present, with the situation in Seychelles, all ARV administration is managed by the central public hospital due to the limited number of individuals eligible for ARV treatment. Our association is mostly concerned with after care support, psychological support, supplementing nutritional demand as a result of ARV consumption, moral support and other socially associated assistances required by the client. The Communicable Diseases Control Unit at the hospital administers all medical aspects of ARV treatment. However, our association presently does not have an office space with which we could guarantee maximum access to ARV treatment particularly in relation to treatment literacy, and informing more people on the advantages of such treatment. An office space would ensure a fixed point whereby all those concerned can gather for information sharing, support groups facilitating, etc. by the association.”

95

SIERRA LEONE FLASK COMMUNITY DEVELOPMENT ORGANIZATION Tel: +232 30 214527 E-mail: [email protected] Contact: Adikali Kaba Sesay Started: 2000 City: Freetown Country: Sierra Leone

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

15 0 2 10

Members of Flask Community Development Organization provide counseling and medical follow-up to patients in need, and give them treatments for common opportunistic infections. They have a relatively small number of active patients, followed by 2 doctors and 10 caregivers. With greater resources, the Flask Community Development Organization could likely increase its patient load. Flask has not yet begun any involvement in ARVs due to lack of resources. They would like to be able to treat the patients in need and establish a program of ARV treatment in the near future.

“We as a very small community organization trying to provide the little we have to meet the basic medical requirement of patients especially those who are diagnosed HIV positive. It is a community based health center which does all it pre-testing and post testing at the central hospital. As a little organization we may need to get one more testing centre so that we may facilitate the effort of identifying victims. Also we need funding for ARV drug purchase, and training current employees. The organization requires capacity building materials like computers, a motor cycle or vehicle to be reaching people living in the suburbs.”

UMC KISSY HEALTH AND MATERNITY CENTER Tel: 232 22 222 616 232 22 234 785 Fax: n/a E-mail: [email protected] [email protected] [email protected] Contact: Dr. Dennis Marke • Sally F. Morris Started: 1973 City: Freetown- Kissy Country: Sierra Leone

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

66 3 3 6

The UMC Kissy Health and Maternity Center provides testing, medical follow-up and access to ARV treatment to their clients in Sierra Leone. The 3 doctors and 6 nurses and care givers care for 66 clients that undergoe basic medical treatment. Patients are treated for most common opportunistic infections. They currently have 3 of their 66 clients undergoing ARV treatment. They are ensured medical and psychosocial followup as well as treatment literacy on ARVs. UMC Kissy Health and Maternity Center would like to have the opportunity to expand their current ARV program. To them it is most important to “ensure the availability of ARV drugs” for their patients.

“We need to train our current employees and funding of ARV drug purchase.”

97

SOMALIA SDO • SAMO DEVELOPMENT ORGANIZATION Tel: 252 544 4808 / 252 543 4808 Fax: 1 309 276 0640 E-mail: [email protected] - [email protected] Contact: Dr. Abdinasir M. Abubakar Strated: 1999 City: Galkayo/Hargeisa Country: Somalia

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

15 10

“In Somalia, neither ARV nor counseling is available, even though more than 50,000 people are possible infected with HIV. Even regular blood testing is hard to find. Therefore, our organization helps those people who do not know where to find ARV or testing and provides regular support in referral hospitals. Due to low prevalence in the country and lack of functioning health system, people with AIDS are still hiding and Somalis are still in the denial stage. Nevertheless, our organization is to try to establish functioning counseling centers and so far we assisted on establishing three centers but they have not start functioning yet. Secondly, training counselors will be another important step. Then purchasing more ARV as well as HIV testing should follow. Making available for ARVs locally will be a good opportunity for those infected and also training the local staff on how to use it will be needed.”

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SOUTH AFRICA HIV/AIDS PREVENTION GROUP Tel: 014 736 3054, 072 473 8745 Fax: 014 736 3054 E-mail: [email protected] Contact: Cecile Manhaeve Started: 1996 City: Belabela Country: South Africa

Last Updated: April 2004

Within the organization: Patients receiving care: 200 monthly Patients on ARVs: 5 Doctors and medical assistants: 1 Nurses and caregivers: 20

HIV/AIDS Prevention Group is a seasoned organization that has been combating the negative effects of HIV/AIDS since 1996. Its team of 21 doctors, nurses and caregivers provide for their large amount of clientele. Currently, there are only 5 people, all employees of HIV/AIDS Prevention group, on ARV treatment. High costs and scarcity of the medicines has made access to treatment something very difficult to provide. They recognize the importance of establishing a wide spread ARV program and list it as one of their primary objectives. HIV/AIDS Prevention Group aims to put up to 300 clients on ARVs by April of 2006. This requires more than simply accessing ARVs. Money must also be allocated towards hiring more counselors, upgrading buildings, upgrading the current staff, administrative equipment, and provision of treatments for opportunistic infections.

THE KIDZPOSITIVE FAMILY FUND Tel: 27 21 404 3020 Fax: 27 21 406 6169 Contact: Paul Roux E-mail: [email protected] Started: 1987 City: Cape Town Country: South Africa

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

400 272 4 8

The Kidzpositive Family Fund is a singular case of an organization that has taken on the challenging task of treating children that are HIV+. Childcare requires intensive and committed health care with a mother, nurse, doctor and social worker all working together to provide the solidarity needed to battle this disease. The organization is there to support the bands of mothers who come together in support of one another when they themselves and their child are infected with HIV. Kidzpositive works under the belief that children with HIV infection can still live happily for several years if they have the proper care. They concentrate on children and also on funding mothers so as to avoid an increased rate of orphanage. Money is raised partially by projects, such as jewelry making. The beadwork project, for example, earns 70 mothers a modest monthly sum, which allows them to feed their children and continue living. They also help the mothers receive aid from the government. In addition to providing free access to ARV treatment for mother and child, Kidzpositive ensures that the basic needs of the families are met and that the mothers are self-sufficient. They are currently providing ARV treatment to 225 children and 100 mothers, but they believe they could handle up to 350 with the resources currently at their disposal if treatments were given for free. During there two years of experience with ARV treatment, The Kidzpositive Family Fund purchases the drugs (benefiting from a reduces rate) and distributes them for free.

101

“It is amazing to see what a sick child can get used to. You will not often see one of these children cry when they are being admitted yet again. Even though they know that someone will be taking blood or putting up an intravenous line, that there will be needles and that they will have to tolerate an oxygen tube at the nose for weeks on end. Even though they know their mothers will soon be going home and that they will be alone in the ward. They seem to know that feeling sick means an infection, an infection means hospital and a while in hospital will mean feeling better again.”

SOUTH AFRICA SINOSIZO HBC Tel: 27 31 9035722 Fax: 27 31 9035782 E-mail: [email protected] Contact: Liz Towell http://www.catholic-dbn.org.za/cadacc/ovc.htm Started: 1995 City: Durban Country: South Africa

Within the organization: Patients receiving care: 620 Patients on ARVs: 0 Doctors and medical assistants: 1 Nurses and caregivers: 3 nurses, 214 volunteers

A project of the AIDS Care Commission of the Catholic Archidiocese of Durban, Sinosizo (Zulu word for "we help") provides medical support and educational services to people affected by HIV/AIDS and tuberculosis living in townships and informal settlements in the Durban Metropolitan area. They are above all providing free palliative care service through the training of volunteers. Sinosizo’s mission is “to empower under resourced communities with sufficient skills and knowledge to enable them to provide an acceptable standard of holistic care to those affected by HIV/AIDS, sexually transmitted diseases (STD's) and TB.”

Sinosizo works within the guidelines of the Catholic Church. It provides: · Care and support to the sick, orphans and widows. · Prevention messages promoting abstinence outside of marriage and faithfulness within it. · Poverty alleviation and nutritional relief by linking to other Catholic organizations such as St Vincent De Paul.

Sinosizo also provides training to community-based volunteers, hospices, companies, and churches in all aspects of HIV/AIDS related issues: Nutrition, Training of Trainers, Peer Educators, Counselors for adults and children, bereavement counselling, wellness management, home based care, directly observed treatment for tuberculosis, stress management, strengthening the skills of child care givers and memory box facilitators. Courses are available both in the English and Zulu languages. Above all, Sinosizo has an organized ARV program underway: “ARV Therapy starts in March 2004 in our project. Training is currently underway. Our ARV project has employed a doctor, a nurse and a project manager in February 2004. We are currently preparing for the start of the screening of patients. Staff and potential patients have been educated about the ARV Therapy to be offered to our patients. The infrastructure is now in place and we hope to start with 25 patients initially, our aim is to have 100 patients on ARV's by the end of 2004. A further 200 patients in 2005, 400 patients in 2006 and so on. Our partner organisation iThemba Primary Care has started their ARV project and we are sharing information and resources. The ARV project manager has been employed to manage both Sinosizo and iThemba ARV projects for the first 3 months of 2004 thereafter iThemba will employ their own project manager.”

102

SOUTH AFRICA HOLY CROSS HOME • (FRAIL CARE AND HOSPICE) Tel: 012 3796067 / 083 4265403 Fax: 012 379 6067 E-mail: [email protected] Contact: South Africa Started: 1984 City: Pretoria Country: South Africa

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

15 6 1 7

Holy Cross Home is a hospice that provides housing and care for 75 people, 10 of which are terminally ill. The staff of one part time doctor and 7 nurses and caregivers, provide medical follow-up and treatment of most common opportunistic infections related to HIV/AIDS for 15 of their clients. The Holy Cross Home provides necessary medications at a reduced price for patients in need. Holy Cross Home is also involved in facilitating access to ARVs for their patients. ARVs are regularly ordered in bulk for their clients, and patients are ensured medical and psychosocial follow-up as well as treatment literacy on ARVs.

“We already monitor our own clients which are in our own community, as well as some TAC clients who come from all around the area. Now Holy Cross Home and Hospice has been approached by the SABC (South African Broadcast Center) or rather selected as one of their 12 sites for the rollout of ARVs. This hopefully will enable us to help our clients to access ARVs. At present, only those who are able to pay for ARVs are on this treatment but for some, the financial drain is beginning to show and we are very concerned.”

Given the overwhelming demand for ARV treatment, Holy Cross Home makes facilitating access to treatment one of its primary objectives. They intend to launch a more comprehensive project in the year to come but are lacking some resources they need: training staff members, provide education on ARVs to clients to prevent the onset of drug resistance, establish a network of referral community facilities…

TOPSY FOUNDATION Tel: 271777 Fax: 27177790647 E-mail: [email protected] Contact: Dr. Jana Oosthuizen Web Site: www.topsy.org.za Started: 2000 City: Grootvlei Country: South Africa

Last Updated: April 2004

Within the organization: Patients receiving care: 200 per month Patients on ARVs: 7 Doctors and medical assistants: 1 Nurses and caregivers: 22

The Topsy Foundation is specialized in caring for children. The focus of its Home-based Care and Community Outreach Program is to offer services to people in their own homes. The emphasis is on medical and social care, and the activities are co-managed by one doctor and one social worker, servicing to a monthly average of 1000 families from the area. The In-house Care Program operates at the Sanctuary. This program is a “last resort” for vulnerable children who no longer have access to food, shelter, clothing and schooling, providing them a safe haven and basic human rights. Children who are HIV+ are given antiretroviral medication, ensuring however that their status is not disclosed.

103

The Orphan Care Development Project focuses on this problem, by caring for orphans and their caregivers within their own environment. A social worker from Topsy assists families– some of whom are headed by children themselves – to obtain the relevant documentation and determines their needs. Free medical care is offered, as well as assistance with education. “The children get antiretroviral treatment in our sanctuary. The Topsy Foundation finds sponsors for all the children. The two adults we have on treatment are both sponsored by their employers.”

SOUTH AFRICA VUSABANTU Tel: 012 621 04 00 Fax: 012 661 03 87 [email protected] Contact: Caroline Maslo Started: 2003 City: Soweto Country: South Africa

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

Vusabantu was officially founded in July 2003 by a city council representative of Johannesburg. Its mission is to improve the overall treatment and care of PLWHAs in the townships surrounding Johannesburg, especially in Soweto. Their work takes place in a difficult context: the HIV infection rate in Gauteng Province is 14.7%; there is no specifically HIV-oriented healthcare facility in Soweto; the hospital is overcrowded and is therefore unable to provide hospitalization to those who desperately need it. Care, treatment and support is provided solely by a network of 14 neighborhood clinics which do: HIV testing, medical follow up for tuberculosis, and occasionally, prescription of prophylactic treatment for opportunistic infections. One clinic provides palliative care and is continually overwhelmed. Vusabantu's goal is to improve the quality of healthcare for PLWHAs in these community healthcare centers. The Javabu Clinic has been selected as the site for a year-long pilot project. A doctor and nurses have been hired for their team. Medical follow up of patients conducted in conforming to the standards defined by national or provincial authorities should enable improved treatment, care and support of HIV+ patients and also by emphasizing early detection of tuberculosis and uterine cancer. A home-based care unit is in charge of bringing nursing care to those patients who are bedridden. Finally, there will be ongoing training for everyone on the care-giving team as well as regular psychological support: this aspect will be provided by a hospital practitioner and by the freshly hired nurses. This pilot project is for one year with the purpose of showing the feasibility of decentralizing follow-up of people living with HIV/AIDS in primary healthcare facilities. Funding for this project which started in 2004 has been provided by SIDACTION, the City of Johannesburg, and by private resources donated in South Africa.

104

SUDAN PATIENTS HELPING FUND Tel: 12348312 E-mail: [email protected] Contact: Dr. Elwathigali Bellah Ali Started: 1986 City: Khartoum Country: Sudan

Last Updated: April 2004

Within the organization: Patients receiving care: 36,000 per year Patients on ARVs: Doctors and medical assistants: 22 Nurses and caregivers: 46

Patients Helping Fund is one of the few organizations in Sudan that provides cares for those living with HIV/AIDS. Their staff of 22 doctors and 46 nurses and caregivers cares for 36,000 annually. Patients Helping fund provides care for the most common opportunistic infections. At the moment, their involvement in ARV treatment is very limited. They are engaged in providing financial assistance to individuals for drug purchasing. In order to expand their involvement in ARVs they could need funds to pay for ARV purchase and they would need to train their current employees.

105

SWAZILAND SASO • SWAZILAND AIDS SUPPORT ORGANIZATION Tel: + 268 422 1640 Fax: + 268 422 0663 E-mail: [email protected] Started: 1993 City: Mbabane Country: Swaziland

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

620

Swaziland AIDS Support Organization provides primarily psycho-social and medical advises and support, together with nutritional care to its members. As most support groups of this size do, they are involved in treatment advocacy and awareness raising. 620 of them are undergoing ARV treatment

SWAZILAND HOSPICE AT HOME Tel: 268 5184485 Fax: 2685186405 Contact: Ms. Thulilie Dlamini-Msane E-mail: [email protected] Started: 1990 City: Matsapha Country: Swaziland

Last Updated: April 2004

Within the organization: Patients receiving care: 1300 Patients on ARVs: 50 Doctors and medical assistants: 1 Nurses and caregivers: 5 nurses, 20 caregivers

In the region of Matsapha, where Swaziland Hospice at Home is located, local medical staff believes that the rate of infection may be as high as 60%. In a country with an estimated population of 1 million, over 20,000 die from AIDS each year.

“In recent years the resources of the Hospice have been stretched thin by the increasing numbers of people that come in. We have seen a 60 to 70% increase in attendances of those needing medical attention and a 100% increase amongst those who wish to know their status. The demand for treatment is so high that people camp outside the hospital in hopes to be seen by doctors who treat up to 100 people per day in order to receive access to ARVs.” Swaziland Hospice at Home provides an attractive alternative to Government hospitals because of its holistic approach and more relaxed environment. The hospice provides home consultations and will even go to a person’s workplace upon request. However, the hospice is very limited by its lack of medical involvement. They have only one senior physician trained in ARVs who is present only on a weekly basis. The hospice currently has 50 patients undergoing ARV treatment from the national ARV program (ARV are provided at one government hospital only). For those they provide ongoing support. The current medical staff is competent enough to prescribe ARVs although currently they do not disperse ARVs through their pharmacy. The Swaziland Hospice at Home believes in the potential of ARV programs and wishes to play a role in the expansion of such programs. In the year 2003/2004, their income reached only 162,500 euro, a mere fraction of the budget in other prominent AIDS treatment centers in other African countries, even though they treat up to 1300 people. Swaziland Hospice at Home is an example of an organization with a great potential in extending access to ARVs.

107

SWAZILAND TASC • THE AIDS INFORMATION AND SUPPORT CENTER Tel: 288 6054790 / 288 6054752 Email: [email protected] Contact: Thandi Nhlengethwa Web site: www.tasc.org.sz Started: 1989 City: Manzini Country: Swaziland

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

65 20 1 12

The Aids Information and Support Center (TASC) is a community based NGO which is primarily involved in risk reduction counseling and HIV antibody testing. This organization has successfully initiated mobile outreach community HIV/AIDS VCT centers: to date these centers have reached 21 communities in 4 regions of the country. In 1995, TASC initiated the training of health professionals in the syndromic management of sexually transmitted diseases and HIV/AIDS. TASC was the first organization to form a group of people living with HIV/AIDS in Swaziland. TASC is involved in facilitating the access to ARVs to clients that are in need, as they ensure prescription as well as medical and psychosocial follow-up. TASC would like to expand its involvement in ARVs and treat more clients. In order to expand, TASC needs to hire “nurse practitioners specially trained in clinical care for HIV/AIDS patients, access to a constant supply of ARV drugs, and upgrading the HIV testing laboratory so that they can conduct such things as a CD4 cell count, viral load, full blood count, liver function tests, etc. It is also necessary to enhance the capacity of current employees in HIV treatment and care.”

FLAS • THE FAMILY LIFE ASSOCIATION OF SWAZILAND Tel: (268) 505 5851 Fax: (268) 505 3191 E-mail: [email protected] Contact: Cedric Musa Mgogo Web Site: http://www.flas.org.sz Started: 1979 City: Manzini Country: Swaziland

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

0 0 55

The Family Life Association of Swaziland (FLAS) is primarily a testing center that then refers its clients to other organizations that can suit for their medical needs. It is the largest and leading organization in the provision of innovative sexual and reproductive health (SRH) services. FLAS has two static adult clinics - Mbabane Clinic and Manzini Clinic. FLAS also has a Youth Friendly Center, established in 1998 at their headquarters to serve youth between the ages 10 - 24 years. They do provide treatment for the most common opportunistic infections, but since they are short of funds, clients are obligated to pay full price for medication. FLAS would also like to launch an ARV program in the coming year, if they are able to find adequate funding.

“(We need) funding of ARV drug purchases, to hire more employees (especially a medical doctor), train current employees, administrative authorization, and improvement of the two laboratories the association has through hiring a lab technician and purchasing lab equipment for conducting CD4 cell count.”

108

TANZANIA CHAWAVUMA Tel: 0744927477 E-mail: [email protected] Contact: Deogratias A. Mwacha Started: 2000 City: Moshi Kilimanjaro Country: Tanzania

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

20 0

Chawavuma is a counseling center that provides counseling and basic health care for people infected with HIV/AIDS. At the Chawavuma center, treatment is provided for the most essential opportunistic infections. Due to a lack of funding, patients are unfortunately obliged to pay for their medications at full price. Chawavuma does not yet have an established program for ARVs although it is one of their primary objectives to establish a program within the coming year. They find that their largest obstacle in establishing an ARV program is finding donors willing to support them financially.

TANOPHA • TANZANIA NETWORK OF ORGANIZATIONS FOR PLWHAs Tel: 255222773740 E-mail: [email protected] Contact: Program Manager Started: 2001 City: Dar Es Salaam Country: Tanzania

Last Updated: April 2004

Within the organization: Patients receiving care: 1000 Patients on ARVs: 10 Doctors and medical assistants: 14 Nurses and caregivers: 25

The Tanzania Network of Organizations for People Living with HIV/AIDS (TANOPHA) is a grouping of 25 Tanzanian health organizations. TANOPHA is not currently involved in the prescription of ARVs nor does it buy the medications in bulk so as to lower the price for its clients. They do, however, facilitate the access to ARV treatment in other ways. For example, TANOPHA associations ensure the medical and psychosocial follow-up of patients on ARVs. In addition they promote information sharing sessions amongst PLWHAs and their organizations. In addition they conduct psychosocial motivation in order to ensure that the ARVs are taken consistently. Establishing an ARV program remains one of TANOPHA’s main objectives. In order to succeed, they would require more employees, administrative authorization, networking, supervision, and organization’s capacity building.

TUMANI CENTER – HURUMA HOSPITAL Tel: 027 2757136 Fax: 255 027 2757341 E-mail: [email protected] Contact: Dr. Sr. S. Safari (PMO) City: Moshi- Rombo Country: Tanzania

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

257 0 3 15

The Tumani Center at Huruma Hospital provides testing facilities, treatments for opportunistic infections and medical follow-up to people living with HIV/AIDS.

109 “35 clients living with HIV/AIDS organize monthly meetings in order to share experience on how to cope with the problem, how to take care of themselves and others in the community.”

At this time, the Tumani Center- Huruma Hospital is not directly implicated in facilitating access to ARVs. They refer their AIDS infected clients in need of ARV treatment, especially pregnant women, to a neighboring hospital, the KCMC (Kilimanjaro Christian Medical Center). The Tumani Center would like to establish an ARV program within the coming year if they are able to access enough funding.

TANZANIA VUKA TANZANIA Tel: 255 22 2856345 Fax: 255 744 972842 E-mail: [email protected] / [email protected] Contact: Mr. Bartholemew Tarimo Started: avr-99 City: Dar es Salaam Country: Tanzania

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

132 16 6 21

VUKA Tanzania advocates strongly for the accessibility, availability, and affordability of ARVs for its clients but lacks the resources to provide the same. They essentially provide HIV and AIDS related treatment literacy and counseling to their clients. They currently have 16 members on ARV medication, they would like to expand their ARV program, and set up HIV testing units, including CD4 counting and viral load detecting machines.

WAMATA ARUSHA Tel: 0748688818 Fax: 027 2508416 E-mail: [email protected] Contact: Emmanuel Mawere Started: 2000 City: Arusha Country: Tanzania

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

11 1 3 3

Wamata is a small community based organization that provides social counselling (peer group counseling for students, youth and women’s groups), some treatment and care, and support for orphans.

WAVUMO Tel: 0744823839 E-mail: [email protected] Started: 2001 City: Morogoro Country: Tanzania

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

322 0 1 9

The WAVUMO centre is a source of counselling and medical follow-up in Tanzania. They provide medical follow-up and treatment of most common opportunistic infections amongst their 322 clients. They aid in facilitating access to ARVs by referring clients to other institutions that provide ARVs. Thy also “send applications to organizations which are in the position to empower (them)” in the hopes of obtaining funding for ARVs, and hope to be able to launch an ARV program within the coming year. They would need funding for ARV drug purchase, training for current employees, funding for HIV/AIDS education to the community, HIV/AIDS testing equipment and hiring more employees- especially a second doctor.

110

TOGO ESPOIR VIE TOGO • (Hope Life Togo) Tel: 228 251 46 56 Fax: 228 229 03 97 [email protected] Contact: Godefroy Laxson-Gaïzer Website: http://www.vihinternet.org/asso/espoir-vie-togo/ Started: 1995 City: Lomé Country: Togo

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

600 70 3 2

Espoir Vie Togo is a PLWHA organization founded in 1995, the first in all of Togo. Their activities in the areas of prevention, awareness and care are always developing. With the recent move to new premises the organization found renewed dynamism as well as an increase in its activities. This new center is perfectly adapted to house a wide range of services and assistance to patients: medical care and treatment takes place in the basement (where there is a consultation office and an observation room), administrative activities and meetings happen on the ground floor, the bedrooms on the first floor for patients who have been abandoned, nutritional assistance and social meetings in the garden. The large number of rooms facilitates confidentiality in counseling. Now the organization has 600 members and clients. Medical care and treatment is developing rapidly. In relation to 2002 the number of consultations has tripled currently hovering around 150 per month. The organization is trying to think of ways to restrict the number of new members for fear of not being able to provide the same level of care if the number continues to increase so rapidly. At the end of June 2003, 23 patients had access to a triple combination therapy financed by: Aides, Aidseti and SIDACTION. At the beginning of 2004, around 70 clients were on ARVs. Certain services in particular need to be reinforced in the upcoming months to maintain balanced development of the organization: a social worker is assigned to help people who are destitute but has no real emergency budget; while the center does not have a full-time doctor it does have the equivalent with two doctors sharing a full time position and a freelance medical assistant; the EVT’s pharmacy is almost empty sparsely stocked; it is restocked every three months but they run out long before that. EVT with great potential to develop but is financially fragile.

"Among the organization’s clients, 90 people are in emergency need of ARVs."

111

TOGO SAUVONS LA VIE • (Let’s Save Lives) Tel: 228 221 94 75 Fax: 228 220 30 11 [email protected] Contact: Eric Mathey Started: 1993 City: Lomé Pays: Togo

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

30 0 3 4

Located on rue des Filaos, in the oldest section of Lomé, SAUVONS LA VIE Center receives people every day who wish to get information about AIDS or wish to take a free and anonymous HIV test. The main objective of the organization and its president is clear: "We want to rid our country of AIDS. To do this we prioritize bringing information to the people. We began this activity with the help of Lome’s motorcycle-taxis, which number around 15,000. As the most common mode of transportation it reaches the city’s." At present 400 of them are “Messengers of hope” and have undergone training about AIDS. In addition to this division aimed at prevention, SAUVONS LA VIE has set up teams of two in partnership with the hospitals in Tokoin and Aktapamé to help PLWHAs. Psychosocial follow-up and medical and financial assistance are provided for the poorest people. As a part of this project, 30 people receive medical follow-up and free medicines to treat the most common opportunistic infections.

AIDES MEDICALES ET CHARITE Tel: 228 901 38 35 / 251 26 47 Fax: 228 251 26 57 [email protected] / [email protected] Contact: Eugène Novon Started: 1996 City: Lomé Country: Togo

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs in 2003: Doctors and medical assistants: Nurses and caregivers:

53 15

Founded in 1996, Aides Médicales et Charité (AMC) is an organization bringing together doctors, nurses and lab technicians. It’s headquartered at the CHU Campus, which lends them a room as well as a motorcycle to facilitate home visits. The organization is made up of around 40 members and seeks to develop its activities in the countryside, particularly in Kpalimé, 150 kilometers from Lomé. The AMC conducts prevention activities, including awareness sessions. They also provide mostly medical and some psychosocial follow-up providing in 2001 close to 1,200 medical consultations and 900 home visits. In 2002 they opened a care, treatment and counseling center called CISSA (Centre d’Information et de Soins de Santé Ambulatoire), located in a part of Lomé with few healthcare centers. The Center estimated that it would conduct 64 tests per month, but the demand went as high as 190 tests for certain months. It was estimated that during the course of the first year the center would follow 100 patients. Instead more than 150 were followed. At AMC, medical consultation is free while outside it costs 1,700 FCFA, (around $3) at the CHU Tokoin, and 4 500 FCFA, (around $9) at the CHU Campus. Since April 2002, the organization’s doctors have been prescribing ARVs. In 2002, 11 people were placed on ARV therapy, and 42 started ARV therapy in 2003. For 11 patients, treatment was paid for by the organization thanks to grants. The Central Medical Store or CAMEG made special credit arrangements with the other patients so as to avoid interruption of treatment. AMC provides as well as benefits from various kinds of training whether for the staff or for patients and their families. Nurses receive training in compliance and doctors receive training in prescriptions. The center organizes support groups and compliance consultation for patients and their families.

"At least 75 women, 40 men and 4 children in the organization are in emergency need of ARVs. If treatment were accessible for all we would be able to follow close to 500 patients on ARVs."

112

TOGO ACTION CONTRE LE SIDA • (Action Against AIDS) Tel: 228 271 01 54: 948 51 78 Fax: 228 271 01 54 [email protected] Contact: Michel Tevi Mensah Website: http://idong.free.fr/sidespoir/ACS/acs.htm

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

Started: 1998 City: Lomé Country: Togo

600 80 6 5

Action Contre le Sida was founded in July 1998. Since then the organization has evolved considerably. There are now 15 full time paid employees (among them 5 social workers) 6 permanent part-time employees (4 doctors, 1 medical assistant and 1 social aide), and 80 volunteers (35 trained to do psychological and social follow-up). Their main activities consist of awareness training, prevention, counseling (pre- and post-test, announcing of results) and medical follow up of people living with HIV/AIDS through the concept of “care and treatment information relay” or RISA. Around 600 patients receive follow-up and care through consultations on site, at home, or while hospitalized at the outpatient clinic. The organization manages a community pharmacy and dispenses free medicines to treat the most common opportunistic infections. Consultations are also free while the cost outside the center in the closest public facility ranges from (US) $1 – 5, or 500 and 2,500 FCFA. "Lab tests such as CD4 counts, various protein analyses, chest x-rays and many other lab tests are taken into account by the staff of the ACS. During the months of August and October 2003, CD4 counts were conducted for 18 patients, and for the other tests (transat, NFS, crea etc), to 15 people." The organization’s doctors have been prescribing ARVs since 2001.

"At least 75 women, 40 men and 4 children in the organization are in emergency need of ARVs. If treatment were accessible for all we would be able to follow close to 500 patients on ARVs."

113

TUNISIA ASSOCIATION TUNISIENNE DE LUTTE

Last Updated: April 2004

CONTRE LES MST ET LE SIDA-SFAX (Tunisian Organization in the Struggle Against AIDS and STDs-SFAX) Tel: 216 74 246 456 Fax: 216 74 242 627 [email protected] Contact: Pr Zahaf Abdelmajid Started: 1990 City: Sfax Country: Tunisia

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

5 0 3 0

The organization provides HIV testing as well as pre- and post-test counseling. They also provide care and support of people living with HIV/AIDS. Currently, 5 people are receiving medical care. The organization is also involved in ARV access. They provide psychosocial follow-up to patients on ARVs who receive them free of charge from the government.

“In a country like Tunisia, where ARVs are free, organisations have an important role to play when it comes to patient follow-up and care”.

115

UGANDA AFXB • ASSOCIATION FRANCOIS-XAVIER BAGNOUD Tel: 256 31263342 Fax: 256 31263343 E-mail: [email protected] Contact: Bekunda Remigious Started: 1989 City: Kampala Country: Uganda

Last Updated: April 2004

Within the organization: Patients receiving care (including testing): 290 Patients on ARVs: 3 Doctors and medical assistants: 1 Nurses and caregivers: 4

Association Francois Xavier Bagnoud (AFXB) provides medical care to 290 PLWHAs (People Living with HIV/AIDS). Although they themselves do not prescribe or provide ARV medication, they already ensure medical and psychosocial follow-up as well as treatment literacy for patients on ARVs. The AFXB is armed with a medical staff that is trained in ARV treatment and is capable of launching an ARV program of their own. Ideally they would like to begin such a project within the coming year, but they lack some of the resources to do so.

“We mainly provide treatment for opportunistic infections but a few patients get ARVs from other sources, so we assist to follow them up since our staff have skills in ARV management. We need funding for ARV drug purchase and more employees to work with the existing community based network of volunteers that follow-up clients on a daily basis to ensure adherence.”

117

UGANDA BUWAI • BUDIOPE WELFARE ACTION INITIATIVE Tel: 256-77-590246 Fax: C/O 256-41 349440 E-mail: [email protected] Contact: Namulondo Joyce Kadowe Web Site: Started: 1996 City: Kamuli (district town) Country: Uganda

Last Updated: April 2004

Within the organization: Patients receiving care (including testing):63 Patients on ARVs: 1 Doctors and medical assistants: 0 Nurses and caregivers: 0

“We sensitize and give information to community members, where we operate, on opportunities to access and availability of ARVs. We also promote VCT as a prerequisite to ARVs and PMTCT. We carry out basic counselling and home visits to encourage uptake and adherence. But since ARVs are not free in our community, because of poverty, people can not afford and this makes our awareness raising wanting. While it is not one of the primary objectives, as a CBO, we would like to participate in information dissemination, training community own resource persons to monitor those who may benefit in the near future, procurement of home care kits and to procure modest transport to facilitate home visiting.”

NACWOLA • NATIONAL ORGANIZATION OF WOMEN LIVING WITH HIV/AIDS IN UGANDA Tel: 256 41 510528 Fax: 256 41 510528 e-mail: nacwola@[email protected] Contact: Annet Biryetega Started: 1992 City: Kampala Country: Uganda

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

“One of our primary objectives is to improve the quality of life of people living with HIV/AIDS through providing care and support. We would like to start treatment activities but we do not have the capacity in order for us to take on this project we would like to hire professional medical staff and trained HIV/AIDS Counsellors. We have already acquired space for construction of a permanent structure to serve as a treatment clinic. Construction will begin in July this year. We would also like to access donors who will support our treatment activities.”

118

UGANDA REACH OUT MBUYA PARISH HIV/AIDS INITIATIVE Tel: 256-17259899 Fax: E-mail: [email protected] ; [email protected] Contact: Father Joseph Archetti & Dr Margrethe Juncker Started: City: Kampala Country: Uganda

Last Updated: April 2004

Within the organization: Patients receiving care:

929

Patients on ARVs:

128

Doctors and medical assistants: 11/2 Nurses and caregivers: 12 nurses and about 50 community heath workers

The aim of this project is to provide free holistic care for all HIV positive residents of Mbuya Parish via medical services, counseling, food provision and social support programs. A key objective is to show how a community-based health care program can be run for and by the community with only a minimum of funds. Project activities include a full-time medical clinic (4 days/week), weekly home-based visits by clinical staff and trained volunteers, a licensed pharmacy (4 days/week), counseling: pre-test, post-test and ongoing. It also includes food program for the chronically ill, several income generating activities, a school fees program for the children of clients, youth activities including education regarding health and life skills. These activities are supported by a strong and well-defined infrastructure run by both professional and non-professional volunteers many of whom are clients.

“We treat HIV/AIDS as a chronic disease with regular, scheduled follow-up visits of our clients. Services are provided for free, but we request and expect collaboration from our clients in term of adherence to scheduled visits, complying with the drugs prescribed, and support of fellow clients. In June we were able to start some of our clients on Antiretroviral drugs (ARVs) through a research programme with Joint Clinical Research Center (JCRC), and in addition we have raised sponsorships for ARV treatment for individual clients so that we now have 110 clients on ARVs We still have a big cry for ARVs for our clients.”

Currently, 128 clients have access to free ARV treatment, but Reach Out would like to be able to help more. With additional funding they could begin treatment of more of their nearly 1,000 members.

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UGANDA TASO • THE AIDS SUPPORT ORGANISATION Tel: 256-41-532580/1 Fax: 256-41-541288 E-mail: [email protected] Web Site: http://www.tasouganda.org/ Started: 1987 City: Kampala Country: Uganda

Last Updated: April 2004

Within the organization: Patients receiving care: 30000 Patients on ARVs: 60 Doctors and medical assistants: 35 Nurses and caregivers: 0

The AIDS Support Organization (TASO) is one of the very first community based organization that got involved in HIV care and support. Today they have ramifications in the whole country and see some 30,000 clients, providing treatment for common opportunistic infections, together with all needed services around care and support. TASO prescribes ARVs on site and provides financial support to individuals for ARV purchasing. Currently there are 60 people undergoing ARV treatment through the TASO ARV treatment program and they have plans to increase this number to 3000 people; still they would like to be able to treat even more people in need.

“There has been a staff ART program where the organisation has contributed up to 80% of cost for the staff member only and not family. A drama group of 25 members benefited from a donation of ARVs since 2002 December and the experience has been used as a pilot to prepare TASO for a scaled up program. A total of 100 new multidisciplinary staff are to be recruited starting February to run the ART program. The ART program is just beginning 2004, with 3000 clients initially. Funding for ART program will be sourced through donors. Funding for the first 3000 has been approved and dispensing starts this year. As far as the ARV program is concerned, we have categorized our need as follows: Infrastructure- laboratories, consulting rooms, stores; Human Resource- we need more staff to handle the extra workload and specific new services; Training and capacity building for all the current and existing staff in ART; Vehicles and motorcycles; Training materials; Drugs and logistics; Technical support; Guidelines development; Advocacy for the program; Organisational development to incorporate a labor intensive new program into the system; documentation and research; Informatics, M&E systems development; Harmonization with National and Partner programs; Client involvement and training in ART literacy; Community mobilisation and sensitisation for ART; This is a long list but it is drawn out of the issues raised under the critical path analysis for successful ART program that the organisation has compiled. It is estimated that an additional 12,000 are currently in need of ARVs”.

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ZAMBIA CHINIKA HOUSE SACRED HEARTS SISTERS Tel: 260 264 0290 Fax: 260 264 0290 E-mail: [email protected] Contact: Sr. Elizabeth Mooney Started: 1992 City: Ndola Country: Zambia

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

873 0 2 104

Chinika House Sacred Hearts Sisters is an organization that works in shanty townships where the poverty levels are extremely low. There lack of funding has prevented them from providing any medical services which are more advanced than testing and basic health care. They have, however, established a large network of clientele, comprised of 873 people. In addition, they have an extensive number of nurses and care givers at there disposal, which allows them to treat a larger amount of people. The Chinika House Sacred Heart Sister’s association’s home care program has taken part in several studies to consider the possibility of providing treatment, but they do not have enough resources to commence an ARV program. Providing treatment is, however, one of the primary objectives of the Chinika House Sacred Hearts Sisters. Both funds and training are needed for the Chinika House to be able to expand its medical services.

CHAZ • CHURCHES HEALTH ASSOCIATION OF ZAMBIA Tel: 260 1229702/ 260 1 237993 Fax: 260 1 223297 e-mail: [email protected], [email protected], [email protected] Contact: Dr. Godfrey Biemba MD, Mr. Chipupu Kandeke Started: 1970 City: Lusaka Country: Zambia

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

3

“Though we shall start providing ART in 12 institutions with current funding, need far outweighs supply.”

Churches Health Association of Zambia (CHAZ) is a comprehensive medical force throughout Zambia, providing 50% of the rural and 30% or the national health services. They provide testing at their various hospitals and clinics throughout Zambia. In addition, they offer pre and/or post- test counseling and on-site blood tests. CHAZ also provides essential treatment for the most common opportunistic infections at a reduced price. Churches Health Association is an umbrella organization and does not directly provide ARV therapy, although some of their member institutions provide ARVs at a very minimal scale. CHAZ is on the verge of beginning its own ARV program, in 12 of the 116 member institutions located throughout rural Zambia, in an effort to complement programs already begun by the government, whose sites are currently only in towns and provincial hospitals. Though they are launching this ARV therapy programs, the existent need far outweighs the supply. There is a strong need for ARV therapy programs in other institutions. In order to extend the scale of their program, it would be necessary to find funding for training current employees and for recruiting new ones, funding for the purchase of ARVs and laboratory requisites, as well as funding for transportation in order to ensure a timely distribution.

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ZAMBIA FAITH ORPHANAGE HOSPITAL Tel: 260 222 0859 Fax: 260 223 0902 E-mail: [email protected] Contact: Bwalya Mubanga Web Site: http://www.geocities.com/fofsao/homepage Started: 1993 City: Kitwe Country: Zambia

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

45 4 3 20

The Faith Orphanage Hospital (FOH) is engaged in caring for orphaned children, most of whom have been orphaned as a direct result of the nation-wide HIV/AIDS crisis. There are presently 2 500 orphans being cared for by F O F. Rather than housing orphans in an institution, children registered with FOH are cared for by extended/foster families. FOH provides testing and counseling services. Infected patients receive treatment for most common opportunistic infections at a subsidized cost. There are currently only 4 patients on ARVs.

FAMILY HEALTH TRUST Tel: 260 1222834 Fax: 260 1222834 Contact: Mr. John N. Munsanje E-mail: [email protected] Web site: http://www.vihinternet.org/asso/fht/ Started: 1987 City: Lusaka Country: Zambia

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

600 60 0 200

With 600 patients undergoing medical follow-up and a medical staff of 200 people, Family Health Trust is one of the principle actors in the battle against AIDS in Zambia. The main services provided to their HIV+ clients include testing, psychological support, prevention, lobbying, research, drugs and representation. They specialize in on-site consultation, outpatient care and home consultation: they hope to be able to expand their home consultation program even further but they find that it is the most difficult to find funding for. In addition, they offer post-testing supportive programs in the form of food supplements, a referral system for ARVS and treatment for opportunistic infections. The actions of the organization, however, are becoming more and more limited due to scarce resources of drugs, transport and personnel.

“The organization’s medical staff has sufficient training to carry out the prescription of ARV but the problem lies in the unavailability of the drugs. At the moment, Family Health Trust claims to have 400 men and 647 women who are in dire need of ARV treatment but do not have access: for the moment all that FHT can do is refer them to another associations that may be able to help. Family Health Trust is able to provide some sort of follow-up to patients undergoing ARVs, but they cannot provide the drugs themselves.”

As members of the National Program for ARV access, they hope to expand their activities in the field of drug access. They feel that if they were given funding for better transport and they had access to ARVs that they could begin prescription and treatment for those in need. Given the desperate state of many of their patients, they believe in and strongly advocate the concept of a free and democratic access to ARV treatment.

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ZAMBIA HOMECARE SERVICES Tel: (260) 95 888482 Fax: (260) 1 239748 E-mail: [email protected] / [email protected] Contact: Amos Nota Started: 2001 City: Lusaka Country: Zambia

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

50 3 1 33

Homecare Services provides essential treatment of opportunistic infections, as well as medical and psychosocial followup to those that are infected with HIV/AIDS. They are trying to expand their involvement in the distribution of ARVs and all the components that compliment ARV therapy.

“We are trying to source for funding to go into treatment literacy and advocacy. This area is critical in the scale up of ARV's so as to ensure compliance and avoid problems of drug resistance. If we are to go into giving or access to ARV's, then we would require funding for ARV drug purchase, training current employees, establish Voluntary Counselling and Testing services and get administrative authorization from the Central Board of Health and National AIDS Council. We would also need to recruit a Doctor. This would require funding for staff. Mostly we have been meeting most of our running costs through self-help projects like car wash and hosting a weekly vegetable market. We encourage our clients to go to on the government cost sharing ARV program which is cheaper than doing it alone by buying ARV's on prescription. We can only embark on facilitating access to ARV's if the conditions stated before are put in place.”

LOLOMA E-mail: [email protected] Contact: Miss Marian Ronald Started: LMH-1957, LIHPP-1999, LAPP-1996 City: Manyinga Country: Zambia

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

600 0 2 15

The Loloma program incorporates a Mission Hospital, an Integrated Health Promotion program and an Aids Prevention Project. They currently have a clientele of 600 patients. ARVs have not yet been introduced into their medical domain. They are able to provide some drugs free of charge, but not all, and particularly do not have enough funding for ARVs.

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“We have not yet begun routine ARV treatment but are monitoring several patients with intent to initiate ARV when Lymphocyte counts reach appropriate levels. At this point we do not have sufficient access to ARVs to initiate widespread therapy. We have an active home-based care community and volunteer network which is ready to undertake activities related to ARVs. Our primary needs would be funding for ARVs and formal training for lab personnel (especially in haematology). Our only formally trained lab staff is needed as Program Manager for our Integrated Health Promotion Program which includes the AIDS prevention and home based care project. This takes most of his time. Our only other lab staffs are informally trained and need upgrading. We would like to send one for training as a lab assistant but it has been difficult to access training positions in the country. More staff would be helpful - but we are ready to initiate with current staff.”

ZIMBABWE BATSIRAI GROUP Tel: 263 67 24115 / 22398 E-mail: [email protected] or [email protected] or [email protected] Contact: Roora Clemence Mahachi Started: 1988 City: Chinhoyi Country: Zimbabwe

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

922 48 448

Batsirai Group was funded by a group of Chinhoyi community members in 1988 to prevent and mitigate the effects of HIV/AIDS in Chinhoyi town and surrounding areas. The organization has 28 staff members and 350 community volunteers. It promotes community awareness of HIV/AIDS, provides counseling, home-based care, orphan and support services. It has also gone into strategic partnership with Ministry of Health and Child Welfare establishing a two- way referral system with Chinhoyi Provincial Hospital, district and rural health centre for client referral. The community home based care run by Batsirai Group aims at empowering these individuals and families to deal with the effects of HIV and AIDS. The program assists people with essential drug to treat opportunistic infections. Patients are visited on a regular basis by Field Officers and or community volunteers. If they are found to be ill and needing medical care the program facilitates their referral to hospitals or clinics for physical examinations, diagnosis, prescription and treatment. However, in most cases the prescribed drugs are often out of stock at these facilities. In some cases when drugs are available the patients cannot afford to pay for them because of poverty. This is where Batsirai Group Home Based Care programs come in with provision of drugs. Positive aspects of the program are that 240 PLWHA from poor resource communities benefited from the program this year. They were treated for a variety of opportunistic infections resulting in improved quality of life. 170 of clients who benefited were females while 70 were males. The negative aspects of the program were experienced on procuring drugs because the provided funding was not adequate. As the cost of drugs continued to rise on almost quarterly basis there was no corresponding rise in allocation of funds hence the drugs purchased were not adequate to cover the needs of PLWHA. Although most clients expressed satisfaction with treatment of opportunistic infections a significant number is now demanding access to ARV therapy. Obviously, the program cannot afford to procure these due to prohibitive costs.

ZIMBABWE AIDS PREVENTION PROJECT Tel: 263 4 770610/1 Fax: 263 4 770170 E-mail: [email protected] Contact: 103/105 Rotten Row Rd Web Site: Started: 1992 City: Harare Country: Zimbabwe

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

400 75 8 10

Zimbabwe Aids Prevention Project started as a VCT centre and extended its mission to assessing the acceptability of short course AZT prevention regimen by HIV infected pregnant women, and whether VCT in the antenatal setting should be modified, and “the feasibility and acceptability by individuals and the community at large of ARVs”. “We involve PLWH/A in Therapeutic Counslling and the treatment literacy- these people are also taking ARVs”.

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Today Zimbabwe prescribes ARV medication on site and ensures medical and psychosocial follow-up as well as treatment literacy on ARVs. “The organization is offering ARVs, but this is for the purpose of study with a life span of five years. It is our primary objective to provide treatment beyond the study. What we would need most is funding for ARV drug purchase, maintaining and adding few more employees, fresher training for current employees, administrative authorization and other medicines for HIV/AIDS-related treatment, including nutritional support.”

ZIMBABWE FAMILY AIDS CARING TRUST Tel: (263) 20 63564 Fax: (263) 20 65281 E-mail: [email protected], [email protected] Contact: Jephias Mundondo Web Site: http://communities.msn.co.uk/thefactfamily/ Started: 1987 City: Mutare Country: Zimbabwe

Last Updated: April 2004

Within the organization: Patients receiving care: 1300 Patients on ARVs: 0 Doctors and medical assistants: 2 Nurses and caregivers: 28

In 1987, a pediatrician at the government hospital in Mutare witnessed some of the earliest cases of HIV/AIDS. Zimbabwe's limited government health services were fast becoming overwhelmed, while donor-driven AIDS prevention programs and office-based counseling for HIV-positive people were ineffective. Foreseeing an impending health catastrophe, he spearheaded FACT, Zimbabwe's first AIDS service organization. To be effective, he believed, AIDS organizations needed to work with local communities, develop culturally appropriate models of prevention and home care, address local religious beliefs on disease causation and decrease the stigma associated with AIDS. FACT began by engaging local church, political, health and business leaders and building up a broad volunteer and funding base within the community to openly discuss sexuality, female subordination and other taboo topics. FACT targeted programs to sex workers, single women, truckers, employees, youth, orphans, persons living with AIDS and people living in rural areas. In the 1990s, FACT began providing professional training and mentoring to hundreds of AIDS organizations emerging across Africa in response to the pandemic. Rather than setting up satellite offices, FACT’s approach was to strengthen existing organizations to respond to the epidemic. Where necessary, FACT worked with community groups to help establish new, locally-owned NGOs. FACT has also assisted other local NGOs to transition from service delivery into technical support organizations. FACT has become a regional organization with some 60 staff and over 500 volunteers, allowing allows access to testing, counselling and basic medical follow-up for 1300 PLWHA’S. They are able to provide essential treatment for common opportunistic infections through the donated medicines they receive. FACT is not involved in the prescription of ARVs but do, however, provide psychosocial follow-up to patients on ARVs and provide them with treatment literacy. They are currently in the process of launching an access to ARVs program, which they believe should be functioning by June 2004.

GALZ • GAYS AND LESBIANS OF ZIMBABWE Tel: 263 474 173 / 474 0614 Fax: 263 474 0614 E-mail: [email protected] Web Site: http://www.icon.co.za/stobbs/galz.htm Started: 1995 City: Harare Country: Zimbabwe

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

10 4 3 6

GALZ was first established in 1989 as a support group for the homosexual and lesbian community. It's aims were to try to provide services to the gay community such as counseling, access to literature and films, AIDS awareness, providing opportunities for the community to meet and to try to better the conditions under which they are forced to live. GALZ ultimately wanted to try to educate the public about the realities of gay life and explode some of the more damaging myths concerning homosexuals and lesbians. Presently GALZ' aim is to network broadly with other human rights organizations, the women’s movement, AIDS initiatives and regional associates. The objective is to increase awareness of gay rights in as broad a forum as possible thereby integrating these rights with the other basic human rights for which civil society is currently battling. Equal health opportunities to all lesbian, gay, bisexual and transgender people in Zimbabwe is one of those basic right that GALZ is fighting for. They provide pre and post test counseling along with basic medical follow-up. ¨Patients are treated for most common opportunistic infections and referred to “gay-friendly” doctors when necessary. There are currently 4 members undergoing ARV treatment at GALZ.

“We refer our clients to the Centre. We pay their medical insurance so that they can easily get treatment for opportunistic infections.”

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ZIMBABWE SOUL’S COMFORT Tel: 263 84 20834 / 263 88 480 / 263 023 251 270 E-mail: [email protected] Contact: Mpala Costain Started: 1997 City: Gwanda Country: Zimbabwe

Last Updated: April 2004

Within the organization: Patients receiving care: 1279 Patients on ARVs: 764 Doctors and medical assistants: 1 Nurses and caregivers: 5 nurses and 183 caregivers

Originally established as a counseling institute for the city of Gwanda, Soul’s Comfort has fully expanded into a treatment center providing Home Care services to the AIDS patients and other terminal ill patients in the rural communities through trained home caregivers. Soul’s comfort also supports AIDS Orphans and Children in Difficult Circumstances. Above all they now run a full ARV program: The organization received funding from one of its donors to purchase ARVs. At the same time it purchased drugs for the treatment of opportunistic infections for the AIDS patients it takes care of and the PLHWAs. The medical Doctor who supplied the drugs is a volunteer with this organisation. He conducts medical check-ups for free on patients without charging them consultation at all. He charges reduced prices for the ARVs he supplies the patients. The organisation pays the bill. The Home Care Program Officer in this organisation is a trained nurse that goes to the community with the Doctor, to meet the patients. Patients cannot afford transport costs to travel to Gwanda for the Doctor and to the hospital. Especially since in the hospital there is an acute shortage of medical staff and drugs. The organization uses its one old vehicle for these outreach programs in addition to others. “Nurses in the local rural clinics work with this nurse who is a Program Officer with Soul`s Comfort and with the Medical Doctor. They attend to the care of the patients”. Care givers ensure that this service is always available to the patients in the community. The medical doctor has scheduled dates when he goes travels to educate on the proper usage of the drugs given to the patients. This education is given to the caregivers and family members of the patients. The program officer checks on the patients and caregivers three times a week. As for psychosocial support, all the 183 caregivers have received specific training in this area. “They offer their services any time any family members are in need of it. Psychotherapy services are also offered the patients by the caregivers as they trained in this as well. Some family members have also been trained. This training shall always be an on-going activity.” Unfortunately, the partnership with the donors that has been supporting in this program is ending in February 2004.

YOUTH IN FOCUS Tel: (263) 23 268756 E-mail: [email protected] Contact: Roora Clemence Mahachi Started: 2002 City: Harare Country: Zimbabwe

127

Last Updated: April 2004

Within the organization: Patients receiving care: Patients on ARVs: Doctors and medical assistants: Nurses and caregivers:

50 20 10 15

Youth in Focus receives donated medicines that they then distribute. In addition, Youth in Focus orders ARVs in bulk so as to further lower the price for their clients. Although they do not prescribe ARVs themselves, they provide medical follow-up for its 20 patients that are on ARVs as well as treatment literacy. They would like to launch a full scale ARV program in the year to come.

ZIMBABWE THE CENTRE Telephone: +263-4-732966 Fax: +263-4-732965 E-mail: [email protected] Contact: Lynde Francis Web Site: www.kubatana.net Started: 1991 City: Harare Country: Zimbabwe

Last Updated: October 2004

Within the organization: Patients receiving care: 3446 atients on ARVs: 300 Doctors and medical assistants: 10 Nurses and caregivers: 20

The Centre was founded initially as a resource for women of the Zimbabwe community who were oppressed by the stigma of being infected by HIV/AIDS. It has become recognised as a model of best practice being the only service provider run exclusively by and for PLWHA. The motivation for this was to deal with the stigma surrounding HIV by demonstrating that PLWHA’s were uniquely and specially equipped to become providers of service to their communities, rather than consumers and victims. One of their core activities has long since been counseling sessions provided to their patients. The Centre provides pre and post-test counseling sessions and long term supportive counseling. In addition, information is given to both the infected and affected families in the community. Over 3000 have been counseled since the beginning of the project in 1992. The Centre also conducts training and capacity building sessions. These sessions aim to educate and empower the community on all aspects of long-term survival when struggling with the HIV virus. The sessions take place in the form of 5 days training sessions that cover HIV/AIDS information, nutritional intervention issues on disclosure, palliative ware and treatment literacy. In addition to their other programs, the Centre is involved in providing home-based care to their patients. Home-based care is an outlet for those who are too disabled to come to the center. The Centre has trained a Cadre of 20 HIV positive+ volunteers, themselves clients of The Centre, to follow up patients at their homes. They have received Red Cross Training in first aid and home based care, survival skills training, nutritional training, basic counseling skills and palliative care training. They are equipped with very basic inputs, like gloves, first aid kits and overalls and are able through a donor program to offer some basic nutritional support to patients. The Careers themselves come in to The Centre monthly for debriefing and feed back sessions and are supported with vitamins supplementation and medical insurance. However, they is a desperate need for more funding to increase their numbers and provide them with minimum allowances, uniforms, bicycles and consumables.

“Our aim is to put the HIV positive person back in control of their life and to take the virus down to size. We do this by giving people real, practical, down to earth information on what the virus is and do, making a special point of its weaknesses. We also explain how the immune systems works and what can be done to support it and keep it actively and aggressively controlling the virus.”

“Today at the Centre 861 patients are in urgent need of ARVs”.

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Authors Marie de Cenival, Sidaction – [email protected] Clémence Prunier-Duparge, Sidaction – [email protected]

Contributors Eric Fleutelot, Sidaction, France Julien Potet, Sidaction, France www.sidaction.org Delphine Floury, Solidarité Sida, France www.solidarite-sida.org

Translation Harriet Hirshorn Ana Lucia Villar

Acknowledgement Sidaction thanks Unaids for its financial support Françoise Renaud-Théry UNAIDS Secretariat www.unaids.org

SIDACTION 228, rue du Faubourg Saint-Martin 75010 Paris – FRANCE Tel: +33 (0)1 53 26 45 55 Fax: +33 (0)1 53 26 45 75 www.sidaction.org

Published: December 2004 Photograph (cover): Issouf Tiendrebreogo - AAS