The U.S. President's Emergency Plan for AIDS Relief - January 2010 Newsletter

In December, Ambassador Eric Goosby, U.S. Global AIDS Coordinator, travelled to Malawi to visit Government of the Republic of Malawi officials and civil society members and observe programs supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR).

While in Malawi, he also attended the Third Southern Africa Regional Meeting of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) with Professor Michel Kazatchkine, Executive Director of the Global Fund.

"The progress I observed on my visit was very encouraging," said Ambassador Goosby.

"With support from PEPFAR and the Global Fund, Malawi provided life-saving antiretroviral therapy to over 170,000 Malawians, and supported HIV counseling and testing services for over 300,000 pregnant women. ... The country is continually increasing access to HIV/AIDS prevention, treatment and care in areas in need of services," he said.

In addition to these results, Ambassador Goosby noted that the number of centers providing HIV/AIDS services in Malawi has increased from only nine in 2004 to 300 at the end of 2009.

"It is clear after my time in Malawi that the country is in a position to make large strides towards defeating their epidemic. The Malawian Government's leadership in the fight against HIV/AIDS is a real example for others in the region," he said.

During this visit, Ambassador Goosby joined the United States Ambassador to Malawi Peter W. Bodde at the dedication of the new HIV and AIDS Department of the Malawian Ministry of Health. The new state-of-theart building, which was supported by the United States Government in response to a request from the Ministry, will strengthen the country's HIV/AIDS prevention, care, and treatment efforts. The HIV and AIDS Department will also now house the national data repository, which will allow national data collected from all districts to be analyzed in a timely manner and to produce information that will guide data-driven national health policy development.

"The facility is a product of the growing partnership between our two countries, embodied by the Partnership Framework that we entered into earlier this year," said Ambassador Goosby.

In Malawi, Ambassador Goosby also joined Professor Kazatchkine to meet with Government officials and to visit programs jointly supported by the Malawian Government, PEPFAR, the Global Fund, and other partners.

"The Global Fund is a critical funding vehicle in the fight against HIV/AIDS, and the U.S. Government is committed to continuing to work through the Global Fund and U.S. bilateral programs to support the people of Malawi in defeating this disease," said Ambassador Goosby.

Ambassador Goosby also emphasized that PEPFAR is working with Malawi and other countries around the world to transition their HIV/AIDS response from an emergency response to a sustainable one. He noted that the Global Fund will be a key ally in Malawi, as it is in the other countries where PEPFAR is working, during this transition.

"Professor Kazatchkine and I are committed to continuing to coordinate PEPFAR and Global Fund activities to ensure that resources are used efficiently and effectively," said Ambassador Goosby. "We will work together to develop and support country-level leadership, scale up proven HIV/AIDS interventions, strengthen health systems, and expand the integration of HIV/ AIDS programs through linkages with other activities supported by the U.S. Government and other partners."

To date, PEPFAR and the Global Fund have supported countries as they placed more than 3.7 million people on antiretroviral treatment and delivered prevention interventions to millions more.

When Moses Mubala and Peace Corps volunteer Jessica Dyer started their demonstration farm last year, they had a small piece of land and high hopes to support orphans and vulnerable children (OVC) through an income-generating project that breeds pigs and goats.

With a small grant supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), these hopes are now a completed demonstration farm where animals are breeding and OVCs are learning how to care for them.

This project is helping provide 55 OVC - 40 of whom are HIV-positive - with a source of income to pay for school fees, healthcare and food.

The overall goal of the demonstration farm is to generate enough money to pay for health, education and other costs for the OVCs, and to produce more pigs and goats.

U.S. Mission Small Grants paid for the construction of the four animal houses used for the farm and an onsite office to manage it. The grant also supports veterinary care and training and paid for the first stock of goats and pigs. This month, the OVC will receive their first male and female pig, except for Muslim children who will receive goats. All participants receive free training and veterinary care to improve profitability and productivity, and OVCs are encouraged to return to the veterinarian for consultations as needed.

To date, the profits generated from the demonstration farm have allowed these OVCs to pay for their current healthcare and school fees. But the income generated by this program has done more than just provide funds - it has given hope for an independent and selfreliant future.

"They've been encouraged to start something of their own because they are dependent and vulnerable. Being productive is a meaningful way of being self-reliant," said Moses. With income from their pigs and goats, he says, "they will access basic needs in life."

Building on this success, the Peace Corps will continue to monitor this income generation project and also develop a grassroots HIV testing and health education campaign.

The Botswana-based Media Institute of Southern Africa (MISA) is working with the Zambia Institute of Mass Communication Educational Trust (ZAMCOM) and the University of Kentucky School of Journalism and Telecommunications to implement the "Hearts and Minds" campaign.

This campaign is designed to improve public access to timely, high-quality information on HIV/ AIDS by strengthening mass media reporting on the epidemic. The innovative partnership is managed by the HIV/AIDS Twinning Center with support from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR).

"HIV and AIDS is continually evolving, affecting society in new ways. As a result, the media must become proactive and devise new ways to talk about the pandemic to help society fight it," said MISA Botswana National Director Thapelo Ndlovu. "Stigma is making people shy away from life-saving facilities and services. People hide their HIV status and live in denial because of the shame that would come if others knew they were living with the virus. This, and a whole host of other problems, represents just some of the challenges we face as a society."

The goal of the campaign is to improve the quality of HIV/AIDS reporting in Africa. To accomplish this, partners are working to motivate reporters, while at the same time engaging a broad range of non-governmental organizations, community and faith-based organizations, and international development agencies in a concerted effort to change the way people receive and react to information about HIV/AIDS. This includes providing training workshops for media professionals, as well as classes on how to effectively engage with journalists for other stakeholders.

Mwiika Malindima, a lecturer and HIV/AIDS and Gender Media Specialist at ZAMCOM, agreed with Ndlovu, and explained that the media has a huge role to play in the fight against HIV/AIDS.

"HIV and AIDS has been a presence in Africa for more than 25 years now and there is ever-increasing media fatigue in dealing with news related to the epidemic," Malindima said. "Reporters and editors feel there is nothing more to say about it, but this is at odds with the magnitude of the pandemic's impact on society, not to mention advances in medical treatment, which represent a source of exciting new material for journalists and hope for people living with HIV."

Beth Barnes, director of the University of Kentucky School of Journalism and Telecommunications concurred and noted that the media is needed to alter people's view of people living with HIV/AIDS.

"The Hearts and Minds Campaign is really all about changing people's perceptions, or hearts, by putting a human face on HIV by encouraging people living with the virus to share their stories. At the same time, there is still the need to provide accurate information to help overcome prevailing misconceptions and change people's mindset about HIV and AIDS. This combination of human-based informative reporting is a primary focus of Hearts and Minds."

Samuel Koutepo had been sick for years when HIV counseling and testing came to his village in Côte d'Ivoire. A local committee was promoting it, and Samuel was one of the first to accept.

For months, he spoke of this to no one in the village except Malobe Soumahoro, a volunteer community counselor, who offered Samuel support and helped him to seek care.

Malobe is part of an initiative by the National Agency for Rural Development (ANADER) that brings HIV prevention, mobile testing, and care services to rural areas of Côte d'Ivoire with support from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR).

"I was living under the weight of this secret, in anguish," Samuel said. "I was lonely."

When he finally told his family and friends that he was HIV-positive, they began avoiding him.

"I'd become the damned of the family," Samuel recalls. "I had lost all value in their eyes. For them, I was at the edge of the grave. I lost my taste for life. At times I thought about suicide."

But Malobe continued to support Samuel.

Working through village action committees and its own rural development agents in 146 villages in five regions of Côte d'Ivoire, last year, ANADER reached more than 230,000 people with HIV prevention activities, tested more than 29,000 people for HIV, and provided care and support for more than 3,000 people with HIV and more than 10,000 orphans and vulnerable children.

Along with delivering services, ANADER and the village committees are working to break down the stigma experienced by Samuel.

When Malobe started a support group for people living with HIV/AIDS in Grand-Zattry, Samuel initially refused to participate, fearing exposure.

"I didn't know there was anyone else like me in the village," he said. "People with HIV hide for fear of having fingers pointed at them as they pass."

After weeks of explanation and encouragement from Malobe, Samuel agreed to visit other people living with HIV/AIDS.

In March 2009, Samuel and four others met at Malobe's house to begin a support group, one of the 104 rural support groups initiated by ANADER. Along with meeting, these groups help distribute care, food, and school kits to people living with HIV/AIDS and orphans and vulnerable children. Some groups have also have started income-generating activities.

As the elected president of his group, Samuel now works to help members in need and is looking forward to beginning an income-generating activity in his village.

"We share in the group, and we help each other," he said. "All of us have regained the joy of living. We're no longer afraid of what others might say about us. We're united, and we're getting stronger every day."