In February 2013 the Malawian National Committee Against AIDS (NAC) approved a program prepared and submitted by the DREAM program of the Community of Sant'Egidio, for the implementation in four districts of the country of an innovative plan for the treatment, care and support of the women under the national program for the prevention of vertical transmission (PMTCT) of the HIV virus.
As it is well known, Malawi has made some important and courageous choices to combat HIV adopting Option B + which involves the administration of antiretroviral drugs for life to HIV positive pregnant women, regardless of their clinical conditions. This protocol allows to break down the number of infections among newborns, and we hope that quickly it will help to reduce the spread of the virus in the country.
The DREAM program was the first to start this protocol in Africa and has been chosen by the government to work together, to address the challenges that arise in this new phase of the fight against the pandemic. Today, the main objective is to be able to retain women in care for life and begin early treatment in children who are born HIV-positive.
With this program, the long experience of DREAM is at the service of the country, organizing the logistics for the collection and transport of samples for early diagnosis in infants (DBS) from four districts. The samples will be analyzed in the laboratory of the DREAM Center in Blantyre that, within a week will send the results to the health centers, to be delivered to the mothers of the newborn.
Explaining to the women the importance of subjecting the infant to the test, having an efficient laboratory and making sure that mothers receive the results, is still an open challenge. To use an example, only in the Blantyre district, one of the largest in number of inhabitants and prevalence of infected people, in 2012 only 5 over the 100 children exposed (5%) were able to make the test for early diagnosis.
One of the key points of the program is the involvement of expert clients (activists), who are patients under treatment, aware of the importance of adherence and that, after receiving proper training, commit to act as mediators between the health center and the local population encouraging women and supporting them in the care of the newborn.
The project, in a first preparatory phase, organized meetings in the districts to raise awareness of the program's objectives to the political authorities and regional health and social authorities.
The next step was to visit the involved maternities and the organization of the logistics for the collection of samples and the transport of blood samples.
In the same months two training courses for expert clients were organized, respectively in the district of Balaka and Blantyre, and those who will be employed in the maternity have been selected among the participants, to support the work of the medical staff.
The program has officially started on July 15 and is expected to be fully operational by mid-October.
The first meeting with the medical staff of the maternity (nurses and counselors), to evaluate together the progress of the program, analyze the problems encountered and identify shared solutions, was held on September 7 2013.
The achievement of the expected results is facilitated by the medical staff of DREAM, committed in the support and monthly supervision visits.
After about two months of the beginning of the program, nearly 1,000 blood samples have been analyzed and the answers delivered to mothers at health centers.
With this program, funded by the Government of Malawi, DREAM is helping the country to chart a way to provide more efficient services and especially services that are closer to the people. The treatment of AIDS is becoming a chance to work together and build a health care system that is more human, more accessible and closer to sick people.