The U.S. President's Emergency Plan for AIDS Relief - May 2009 Newsletter

In April, Tanzanian President Jakaya Kikwete launched Angaza Zaidi, a 5-year, $13.5 million HIV counseling and testing program. With support of the U.S. President?s Emergency Plan for AIDS Relief (PEPFAR,) the program will provide urban and rural communities in Tanzania with HIV counseling and testing services, post-test support groups, and referrals for HIV-positive individuals to care and treatment facilities.

Angaza Zaidi builds on lessons learned from the highly successful 7-year Angaza program, Tanzania?s oldest and largest HIV counseling and testing initiative.

In conjunction with Angaza Zaidi, four Area Support Offices have been established to strengthen coordination between implementing partners and the Ministry of Health at the Regional and District levels and to build the capacity of community-based sub-partners.

At the launch of Angaza Zaidi, President Kikwete praised this new decentralized approach, as well as the mobile units that will bring quality services to remote and hard-to-reach areas.

?This is a commendable achievement in the fight against AIDS?Angaza Zaidi will have experts in the regions so that even people in the villages can easily reach them and benefit from their services,? he said.

After learning his HIV status in 1998, Mtepa says that he didn?t know where to go.

?I had lost direction in my life. I thought I was likely to die soon, but when I found people with same health status like myself I felt happy to share life experiences with them,? said Mtepa.

Mtepa joined a post-test club, started volunteering in his community, and later took courses to become a qualified counselor.

Today, he is an Angaza Zaidi counselor and is proactively involving other people living with HIV/AIDS in HIV prevention, treatment, and care.

?Finding employment was empowering for me. I began to share my experiences of positive living with other people who came for services. The work enabled me to earn a salary which helps me fulfill my dreams.?

Recently, the Public Diplomacy section at the U.S. Embassy in Maseru, Lesotho teamed up with the U.S. President?s Emergency Plan for AIDS Relief (PEPFAR) country team to bring Dr. Amita Gupta, Deputy Director of the Johns Hopkins University Center for Clinical Global Health Education, to Lesotho for an HIV/AIDS road show.

While in Lesotho, Dr. Gupta traveled to universities, clinics, and communities across the nation to speak about HIV/AIDS. Her presentations focused on her experiences in the United States and India, as well as the other countries where she has worked.

At National University, Dr. Gupta spoke to over 100 faculty and students at the school?s new Faculty of Health Sciences. Her lecture focused on prevention of mother-to-child transmission of HIV (PMTCT) and the benefits of early treatment initiation. Following her talk, staff and students engaged her in a lively discussion about the issue of breastfeeding for HIV-positive mothers, a continuous conversation in Lesotho.

While visiting the Sea Point Support Group, Dr. Gupta spoke with the all-woman group that provides HIV counseling and testing and invests in income generating projects such as egg production, beadwork, and porridge bottling and supply, about their experiences working with HIV-positive individuals. Here, Dr. Gupta listened to the everyday issues these women face including abject poverty, alcohol and drug abuse, teen pregnancy, stigma, and high mortality rates due to AIDS. She encouraged the women to continue to contribute to the fight against HIV/AIDS.

During her time in Lesotho, Dr. Gupta also spoke to the National AIDS Commission

While her presentations varied depending on her audience, Dr. Gupta always stressed the importance of treatment and its impact on survival rates for HIV-positive individuals. Throughout the tour she continually urged people living with HIV/AIDS to initiate treatment early.

As a result of this road trip, PEPFAR Lesotho reached a large audience with HIV/AIDS messaging through television, newspaper, and live radio interviews. Many groups requested Dr. Gupta?s return and at the same time thanked the U.S. Government for their continuing support in the fight against HIV/AIDS.

?We are appreciative as a country for the U.S. Government?s efforts to bring speakers like Dr. Gupta to share experiences that the Government of Lesotho can learn from,? said the NAC?s Director of Policy Strategy and Communication. ?It makes people aware that we are all grappling with the same issues,? he said.

Twenty-eight year old Shanti* and her husband were diagnosed with HIV seven years ago. While they are in good health and adhere to regular antiretroviral therapy, they worry about their economic security and the futures of their two children.

To combat this doubt, the couple joined a program supported by the U.S. President?s Emergency Plan for AIDS Relief (PEPFAR) that works to enhance the income of its HIV-positive beneficiaries. The program partners with a private telecommunications company to provide public telephone call booth facilities to people living with HIV/AIDS at a subsidized rate. This partnership came to be known as the ?Coin Box Scheme? because the telephone instruments provided by the company have a usage charge of one rupee.

With the income Shanti and her husband earned from their farming business, they purchased a ?Coin Box? telephone facility and had it installed near a milk depot close to her house. This PEPFAR-supported endeavor has earned Shanti and many other families an additional monthly income of 800-1,000 rupees per month ($20 ? $25).

This amount has improved the quality of their life, she said.

?Coming to [the program] has not only improved our physical health, but it has also helped us to earn and save some money. I have even made new friends in this process,? said Shanti.

*Name has been changed.

Health at Home/Kenya, a public-private partnership that provides home-based HIV counseling and testing, aims to reach two million people in western Kenya with their services over the next two years.

Launched in January 2009, this groundbreaking initiative is supported by the Government of Kenya; the Global Business Coalition on HIV/AIDS, TB and Malaria (GBC); and the U.S. President?s Emergency Plan for AIDS Relief (PEPFAR).

Health at Home/Kenya works to bring HIV counseling and testing, TB screening, and malaria bed nets to remote households in western Kenya that have difficulties accessing health care.

In order to ensure success, Health at Home/Kenya nurses and counselors enter homes with hand-held devices that they use to enter data regarding the family?s health, record test results, and document the physical location of the household to guarantee education, counseling and data collection follow-up. Any person identified as HIV-positive during counseling and testing will immediately be given an appointment for follow-up clinical care.

In addition to reaching HIV-positive individuals and connecting them with the appropriate services, the program also helps those who test negative for HIV by teaching them about HIV/AIDS prevention and encouraging them to implement practices that will allow them to remain HIV-free.

With as many as 70 percent of Kenyans unaware of their HIV status, program implementers hope this initiative will play a large role in increasing the number of individuals that know their status.

?This initiative will result in hundreds of thousands of people being successfully tested for HIV and, if positive, being immediately referred into care and treatment,? said Dr. Sylvester N. Kimaiyo, a program manager for the Health at Home/Kenya initiative. ?We will not win the AIDS battle by waiting for people to come to our clinics, but only by taking HIV testing to people?s homes in Africa. This same model can effectively test and treat millions throughout Africa.?

The U.S. Mission in Kenya also has high hopes for this initiative.

?Our PEPFAR program is honored to support this work that will contribute so directly both to the Government of Kenya priority of universal knowledge of HIV status as well as enrolling people in care far earlier in the disease process so they stay healthier longer,? said Michael E. Ranneberger, U.S. Ambassador to Kenya.

HIV/AIDS implementers from around the world will gather in Windhoek, Namibia, from June 10-14 for the 2009 HIV/AIDS Implementers? Meeting. The theme of the meeting is ?Optimizing the Response: Partnerships for Sustainability.?

Information about the meeting is available online at: http://www.hivimplementers.com.