5) Description of health product/service offering: Our actions are primarily aimed at the fight against HIV/AIDS. Our main beneficiaries are those infected and affected by HIV/AIDS, as well as AIDS orphans and vulnerable children. The services we introduced include:  A voluntary testing centre  Psychosocial support  Home visits  The treatment of opportunistic infections by a doctor from the organisation  A community pharmacy  Financial aid for buying antiretroviral drugs  Contributions towards the purchase of medical prescriptions  Nutritional support through the distribution of food kits and the preparation of communal meals  Economic support through revenue generating activities  Educational and psychosocial support for people living with HIV/AIDS It has had a great impact on low-income populations: Access to all these services is free: A person living with HIV needs to live with a positive outlook. The distress caused by the knowledge that s/he is infected and the inability to accept her/his condition, often leads to a rapid progression of the disease and to death; therefore psychosocial support enables her/him to receive some advice and to find some answers to her/his worries. Medical support (the community pharmacy; financial help with the purchase of antiretroviral drugs; the treatment of opportunistic infections) has a direct impact on the health of beneficiaries. Nutrition is a very real problem for people with a low income living with HIV; these people need a rich and balanced diet, but unfortunately they are often unable to meet their dietary needs. Therefore, by making the food kits available to them and by preparing communal meals, we manage to meet their nutritional needs. Revenue generating activities enable the beneficiaries to undertake an activity that enables them to provide for their basic needs.

6) Description of innovation: Our approach is different because it takes into account all the aspects of supporting people living with HIV. Rather than being confined to one aspect of support, we have diversified our approach to include all the areas that infection affects. In the Cote d’Ivoire, Lumière Action has been for a long time the only community based organisation with a voluntary testing centre. It is not common for an organisation to set up a testing unit, but, as you well know, testing is the first stage in providing support, therefore testing is the key point of entry for an intervention. Furthermore, the fact that it is free makes the centre accessible to populations who are not going to be confronted with a problem. Today there is another centre at the Croix Bleue which is a treatment and support centre for alcoholics and drug addicts: this centre permits us to support these vulnerable populations, who are under the effect of drugs and alcohol.

7) Operational model: We mainly focus on voluntary testing and on psychological and social support. For these populations we have a psychosocial and legal unit. The psychosocial unit is responsible for making social enquiries and for psychological and social follow-ups within a framework of continuing care. The legal unit defends the rights of infected and affected people.

8) Human resources: The team is made up of an executive board, a (female) executive director, and volunteers. More than 35 people work on the health initiative. In the main, they are volunteers who have received training as community counsellors, and from instructors in all areas of HIV support, from lawyers, doctors, psychologists and nurses.

9) Key operational partnerships: We have established a partnership with Villages des enfants SOS, which is a social organisation for the support of orphans and for the support of families striving for the wellbeing of children. Our main partners are SIDACTION and SOLIDARITE SIDA; these two French partners are traditional partners. Occasional partners are: UNICEF; HIV AIDS ALLIANCE; PNPEC; LEMINISTERE DE LA LUTTE CONTRE LE SIDA; Le projet Corridor. We submit financing proposals to these various donor organisations. Some of them also provide us with technical support. As well as being strategic, these partnerships are very important for our initiative.

10) Financial Sustainability

          • Fees charged to clients?: No

          • How do you assure affordability?: N/A

          • Earned incomes as a percentage of operating costs: 0%

          • Other funding sources: The initiative is neither profitable nor financially self sustaining. Funds are received primarily from our sponsors.

          • Strategy for long-term sustainability: The search for additional resources from other partners and the involvement of the state if possible

11) Current and Future Impact

          • Total number of clients: 2,500+

          • Clients in the past year: 700+

          • Percentage of low-income clients: 75%

          • Impact: The impact in terms of behaviour change is that those who benefit from the advice and information are beginning to change their behaviour; in addition there is an heightened level of consciousness in the surrounding area.

          • Overall "market": • The potential order of magnitude is the completion of the community all-round support centre with a budget of 100 million francs, and the successful establishment of two other voluntary testing centers. Countries of Africa, Asia and America and the Caribbean could benefit from it, benefiting more than 10 000.

12) Scaling up strategy

          • Stage of the initiative: Scaling Up stage.

          • Expansion plan: ACTIVITIES YEAR A1 A2 A3 Opening of a community support centre X Increase in the number of voluntary project staff X X X Opening of two voluntary testing centres in the towns of Aboisso and at the ‘village d’enfants SOS’ X X Building and strengthening of paid and voluntary staff capabilities X X X Building and strengthening of the capabilities of the community pharmacy and other support activities X X X Creation of an accredited medical follow-up centre X Raising of resources/funds X X X

13) Policy change: State institutions must not only encourage initiatives, but also consistently support them financially and in addition become involved in organisations’ initiatives.

14) Origin of the initiative: The initiative started with the establishment of an association of people living with HIV, the organisation of home visits, and by having someone available in health centres for people living with HIV. Several people were behind the idea and took part in the initiative. They are Feu Dominique Esmel, Jeanne Kouamé ,Ettienne Tapé Bi. These people were the founders of the organisation; they were all people living with HIV: DOMINIQUE ESMEL: was the first president of the organisation; JEANNE KOUAME: the second president; ETTIENNE TAPE BI: the first secretary general.

Contact Information:
NATHALIE  SADIA
Executive Director
LUMIERE ACTION
(NGO)
14 BP 2101 ABIDJAN 14
Cote d'Ivoire
Tel: 225 24 39 73 12/225 05 97 85 12
Email: nathalie_sadia@yahoo.fr
Website: N/A