Cote d'Ivoire: Reaching Out: Extending the Community-Based Approach (August 2006)

In a generalized HIV/AIDS epidemic like Cote d'Ivoire's, challenges are everywhere, but fortunately, so are solutions. With HIV services concentrated in the economic capital, beyond the reach of many of the country's 510,000 HIV-infected people and 310,000 orphans and vulnerable children, the need for decentralized, community-based HIV/AIDS services is great.

In April 2004, the U.S. President's Emergency Plan for AIDS Relief (Emergency Plan/PEPFAR) began work to support and reinforce community action to address the HIV/AIDS epidemic in Cote d'Ivoire. A transparent selection mechanism with an external selection committee was put into place, and three rounds of calls were issued for proposals from local non-governmental, community-based and faith-based organizations to provide HIV/AIDS services in underserved areas of the country. From hundreds of proposals, 73 grants of approximately US$5,000 to US$40,000 each were awarded to projects providing HIV prevention, care and support services. Projects included services for orphans and other vulnerable populations.

The scale-up of a counseling and testing model, hailed for its sustainable combination of local ownership and national and international support, is a shining example of the community-based approach at work. Named for the site of its successful pilot project, Port Bouet, the model leverages the local mayor's buildings, amenities and support staff; the Ivorian government's HIV tests and health workers; and Emergency Plan funds for equipment, minor renovations, training and management, and monitoring and evaluation. With Emergency Plan support, the International AIDS Alliance awarded 12 grants to support three existing and nine new counseling and testing centers based on the Port Bouet model. The projects are expected to provide counseling and testing to 20,000 people in their first year, with a special emphasis on prevention for people living with HIV/AIDS, discordant couples and young people.

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