Lack of access to care for HIV positive people has been well documented on the African continent. Many initiatives strive to show that things could improve with collective effort, and among them is the Drug Resource Enhancement against AIDS and Malnutrition (DREAM) program.

DREAM was created in 2002 by the Sant'Egidio Community in Mozambique, and takes a comprehensive approach to fighting HIV/AIDS. Cristina Cannelli, leader of the Guinea DREAM program, explains the special relationship [it] with the African continent, especially Mozambique:

"Free care here". Image by Sant'Egidio photo service.

La Comunità di Sant'Egidio è profondamente legata all'Africa, anche perchè la Comunità stessa è una realtà africana. Esistono Comunità di Sant'Egidio in 26 paesi  del continente con più di 20.000 membri africani. Un legame particolare con il Mozambico, dove nel 1992 fu firmata la pace che pose termine ad una terribile guerra civile grazie alla mediazione della Comunità, condusse a scegliere il Mozambico qualeprimo paese in cui lanciare il programma DREAM.

Today DREAM is present in Malawi, Tanzania, Kenya, Guinea (Conakry), Guinea (Bissau), Nigeria, Angola, the Democratic Republic of Congo and Cameroon. The basic philosophy of the program is:

… DREAM has been created to achieve excellence: excellence in treatment and diagnostics, in computerization. DREAM demands that western standards be adopted in Africa too; the programme routinely uses viral load assessment, and has introduced Highly Active Anti-Retroviral Therapy (HAART)

A DREAM success

The sheer numbers of the DREAM activity throughout the continent are impressive: 150,000 people have been treated of which 25,000 were aged 15 years or younger,  65,000 patients have benefited from anti-retroviral therapy of which 6,000 were children. DREAM also successfully interrupted vertical mother-to-child HIV transmission for 14,000 births from HIV positive mothers.

Since the beginning of the program more than 1,000,000 people have benefited from the DREAM program via health education, water filtration, food supplies, mosquito nets, prevention programmes on television, radio and the workplace.  In total, the DREAM centers have performed 1,300,000 medical consultations, 276,000 viral load tests and 540,000 CD4 tests.

Celebrating the good health of the children at the mother-to-child HIV transmission prevention centers. Image courtesy of the Sant'Egidio community.

For such a large organisation to run properly in so many countries with many different spoken languages, qualified personnel is a must, which is why the community has organized 18 workshops throughout the continent for 4,000 health professionals. Mobile teams travel to reach the most isolated patients.

In order to engage the local institutions, DREAM states that:

Some of these structures are operational thanks to collaboration and agreements reached with local health centres that have replicated the programme.

However, patients also are actively contributing by committing to actively fight the HIV pandemic by becoming volunteers:

In each and every DREAM centre, medical and paramedical personnel are flanked by local men and women who have decided to commit themselves to working for patients who come to our centres. They decided to do so when their own lives were remarkably transformed after they came in contact with our services.
There are relatively large groups of such people and they constitute an indispensable resource for the success of the programme. Most, but not all, of them are sick. They are our “campaigners”.