5) Description of health product/service offering: The present project follows a process that has been running for seven years with a regular tendency toward the improvement of multiple benefits that the association offers on the psychological, social, economic, medical and institutional plan. In relation to this vision, it’s all about reinforcing the capacities of the accompanying and existing medical staff, but also to get new people to these teams, including new intervening parties skilled in the area, on one hand, and on the other hand, reinforcing our assets in all aspects in order to offer people living with HIV/AIDS (PLHIV) and Orphan Vulnerable Children (OVC), a place of welcome, of meeting, of advice, of orientation, of information, of medical and psychosocial support. In its operational phase, the project takes into account the backing of screening test activities, medical follow- up in all aspects (ARV Treatment, biomedical tests, therapeutic education, opportunist infections treatment, prevention of mother-child transmission), and the opening of an observance house for people having difficulties with taking their medicines, organizing actions for food support, holding meetings of self-support, organizing a community pharmacy that helps the PLHIVs on the material, human and promotional plan, to encourage people living with HIV/AIDS to take responsibility for themselves. In 1998, the opening of the first center for people living with HIV in Ouagadougou, and the introduction of treatment with ARV have permitted the PLHIVs to unhide themselves. From 50 people attended in 1998, we had 1857 PLHIVs in the OASIS Center by the end of 2005.

6) Description of innovation: Being myself a person living with HIV, I decided from my own experience to fight so that the majority of people living with HIV have access to ARVs in order to change the look of society regarding AIDS. It was about mobilizing the international solidarity, and local volunteers from all sectors to come up with a center for the benefit of these people living with HIV, our leitmotif was “to preach by example”, to show that it is possible to treat with Anti Retroviral the PLHIVs living in countries of the SOUTH like those of the NORTH because we are also citizens of the world. The strategy was to create a network in France and in Canada to collect medicines that were returned from hospitals and send them to us. To be able to reassure our friends of the north, we succeeded in getting a scholarship for a Burkina physician for the prescription of ARV, and we created a mutual cooperative to solve the problems of shortage and transportation expenses. Our experience demonstrated that treating PLHIVs with ARV is less expensive to the entire society. Beyond the preconceived ideas, Africans can also be observing a lifetime and coercive treatment. From 12 people who were treated with ARVs, we currently have 390 PLHIVs under ARV treatment by typically private initiatives with a strong commitment of concerned communities. We also have contributed to the international advocacy for the decrease of ARVs price of the order of 90%, and we were the first in Burkina to order generics from India to demonstrate that they were as efficient as those of the big pharmaceutical firms of the north.

7) Operational model: In order to reach the highest number of people at the international level, I was committed from the beginning in the creation of AIDSETI (AIDS Empowerment and Treatment International www.aidesti.org). It regroups 22 organizations that fight against AIDS in 14 countries. In Burkina, as the administrator of AIDSETI, I created AIDSETI Burkina that regroups six (6) associations of responsibility. Currently, we have 1174 people throughout the network who have been treated in three Burkina cities: Ouagadougou, Bobo-Dioulasso, and Ouahigouya.

8) Human resources: The staff is made up of physicians, a pharmacist, pharmacy saleswomen, social workers, a psychologist, nurses, advisors, social animators and administrators. We have a total of 29 permanent staff and 27 temporary ones.

9) Key operational partnerships: AAS has put together several networks at the international level: AIDSETI: network of associations of people living with HIV for access to ARV treatments. AIDSET allowed us to order generic ARV medicines directly from India AFRICA 2000 Network: Consisted of the French NGO AIDES and 17 African associations of 8 countries, this network has permitted an exchange of South experience and specialized training in the prescription and delivery of ARV treatments. AAS is also a member of the network at national level CICDOC: Center of information, Counseling and Documentation on AIDS and Tuberculosis. This network has allowed us to develop an information circuit with physicians at national level. AIDSETI-Burkina: From the OASIS center example, we have developed initiatives to take care of PLHIVs in conjunction with 5 other associations with a financing of the World Bank. Partner NGOs: SIDACTION France: Technical financial support to take care of PLHIVs SOLIDARITY AIDS France: Technical financial support to take care of PLHIVs AIDS Alliance international U.K : Technical financial support to take care of PLHIVs

10) Financial Sustainability

          • Fees charged to clients?: Yes

          • How do you assure affordability?: Yes, in the beginning, we bring a subsidy and the patients supported the rest: male patients contributed 50% and female patients contributed 25% of the expenses of services that are not found at the OASIS center. It was mostly for specialty medicines in city pharmacies. Now we adopt the politics of universal access to cares and screening tests. Currently all our services are free and it is what guaranteed the involvement of women in our activities. Currently, our ARV recipients consist of 67% of women, 31% of men and 2% of children.

          • Earned incomes as a percentage of operating costs: 0

          • Other funding sources: Currently, the contribution of the international community is sufficient to take people in charge. But within the context of our politics of Great Implication of People Living with AIDS (GIPA), we use self-support as a fundamental strategy. And a lot of recipients dedicate their times to come with others.

          • Strategy for long-term sustainability:  The durability of our initiative depends especially on an effort that must be made to reduce the costs of ARVs of first and second line. Our strategy on the subject rests on advocacy and international solidarity. It is not acceptable that tuberculosis treatment is free in our countries, and that of AIDS is paying and at a costing price. We sustain and actively participate in different initiatives for the universal access to treatment and care for all PLHIVs in all countries of the world. In this context, making our actions visible and showing the benefit for society to treat the PLHIVs, is fundamental.

11) Current and Future Impact

          • Total number of clients: 1857

          • Clients in the past year: 414 new

          • Percentage of low-income clients: 90

          • Impact: More than 90% of our recipients are people without incomes, ruined by the disease or victims of discrimination of which they lost their jobs. Treating someone that lives with HIV is to give hope; it mostly contributes to family balance. A person, who cannot work anymore because of the disease, will be able to start a new life and become again the pillar of the family widely speaking as we live it in Africa. The impact to society is the reduction of deaths due to AIDS. We see children are better observed and start going back to school. AAS experience with the OASIS center allowed the government to understand the contribution of communities to medical actions. The OASIS center is the first community center of struggle against AIDS in Burkina to have a medical center accreditation.

          • Overall "market": . According to the report of UNAIDS/WHO of November 21st, 2005, 25.8 millions of people live with HIV/AIDS of which 3.2 millions (4.3-6.6 millions) of recorded new cases. This report says that less a million of people is treated. Our action appears in community commitment and especially in actions to take ourselves in charge because we are also people living with HIV. All African countries and other continents will be able to take advantage of the initiative of universal access to ARVs. A lot of efforts must be made to reduce meaningfully the number of 2.4 millions deaths due to the HIV/AIDS in Africa, at the south of Sahara. Community commitment will be the solution and the results will be more visible.

12) Scaling up strategy

          • Stage of the initiative: Scaling Up stage.

          • Expansion plan: Our plan by 2008 is to serve 3,000 PLWHIV and 3,000 vulnerable children, from respectively 1,000 and 1,500 in 2006.

13) Policy change: We will be able to reach these objectives only if Burkina adopts the politics of universal access to care and other services for PLHIVs. The national Council of struggle against HIV/AIDS, of which I am a member, understands the problems. Because, beyond treating the PLHIVs, there is the challenge to decentralize health services in order to reach the maximum of Burkina be.

14) Origin of the initiative: Being myself a person living with HIV, and being under treatment since 1997 thanks to the mobilization of the communities, I decided from my own experience to fight so that the majority of people living with HIV have access to ARVs in order to change the look of society regarding AIDS. It was all about mobilizing volunteers from all sectors to come up with a center for the benefit of people living with HIV. Our leitmotif was “to preach by example”, to show that it is possible to treat the PLHIVs living in countries of the SOUTH like those of the NORTH because we are also citizens of the world.

Contact Information:
Issoufou  Tiendrebeogo
Président
Association African Solidarité (AAS)
(ONG)
01 B.P. 2831 Ouagadougou 01
Burkina Faso
Tel: +22670212150
Fax: +22650304822
Email: issoufou@aasbf.org
Website: www.aasbf.org