FOCUS on multi-agency HIV/AIDS initiative

In response to the HIV/AIDS pandemic in the Republic of Congo (ROC) - described by the World Food Programme (WFP) as a "looming national catastrophe" - United Nations agencies and the ROC government, together with other implementing agencies, have set up a nutrition project for people living with HIV/AIDS, and their families, that is proving to be a life-saver. The pilot phase of this emergency response project was launched in November last year in the capital, Brazzaville, and Pointe Noire in the southwest, WFP said in its strategy paper on supporting the UN/government plan to fight HIV/AIDS in ROC. Whereas WFP had planned initially to assist some 5,000 people living with HIV/AIDS, and their families, the pilot project is now catering for more than 17,350 people, comprising both patients and their families. "To this day, about 1,735 people living with HIV/AIDS are participating in the project in our region," Dr Jean Pierre Nkouendolo, head of the government regional programme against HIV/AIDS in ROC's southwestern region of Kouilou/Pointe Noire, told IRIN. "The average [number of members] per household according to our investigation is between seven to 13, meaning [an average of] around 10 people per family. One can affirm without being mistaken that our project concerns more than 17,350 people affected with HIV/AIDS, including patients and their families," he said. A study carried out by UN agencies in the ROC last year revealed an HIV/AIDS-infection rate of between 10 and 12 percent of a population of 2,864,000. "AIDS is the main cause of deaths amongst people between 15 and 49 years old," WFP said. The country has suffered three outbreaks of civil conflict within the last five years. These displaced over 800,000 people in the southern regions of Pool, Bouenza, Lekoumou and Niari, and prompted tens of thousands to flee into neighbouring Gabon and the Democratic Republic of the Congo. The large displacement of people led to the near collapse of the public health-care system, and exacerbated the spread of HIV and other sexually transmitted infections, WFP, which initiated the strategy, added. According to Nkouendolo, the project has had a big impact on individuals living with HIV/AIDS as well as on their families, but also, "it is a new strategy that will improve our system of surveillance of the epidemic". "Our province is one of the areas severely affected by the disease," he added. "Our assistance is a psychosocial and nutritional one. We work with 45 social workers spread out in different hospital services and neighbourhoods," Nkouendolo said. "The population is very enthusiastic about the project, and they believe it is a life-saver to the family and the community in general. Some families say that the only time feeding of the sick took place was during the colonial period," he added. According to Nkouendolo, the project has helped fight stigma about the disease, and has helped infected people come out of their "refuge or hiding", which is often the church or bizinga - the therapeutic centres. They sometimes brought along documents revealing their HIV status, he said, adding that patients were now seen in a different light, "because they are the ones who feed their families". In Pointe Noire, there are future plans to increase the monthly ration for each beneficiary, and to expand the project to other localities of the province. It is hoped that other programmes on the prevention of AIDS in schools, prevention of maternal transmission of HIV/AIDS, treatment of sexually transmitted infections and the provision of retroviral drugs at a low cost will also be initiated. "We have received reports that the project is making a difference in the lives of people living with HIV/AIDS and their families," WFP Country Director Sory Ouane confirmed to IRIN recently, adding, however, that it was a bit early to give an impact assessment. He noted that some 52.5 kg of rice, 18 kg of pulses, 4.5 kg of oil and 0.75 kg of salt were given per person, per a month. He said WFP was involved in the implementation and monitoring of the project. In Brazzaville, WFP provides assistance to AIDS patients in hospitals through caretakers, who are usually family members. "The caretaker is responsible for providing daily assistance and comfort to their patient and preparing their meals as prescribed by doctors for easy digestion and strengthening of the immune system," WFP said. In turn, the caretaker is given a family ration of food to make sure that the family is well fed and that the assistance provided to the patient is not interrupted. "WFP, with the support from the nongovernmental organisations, local church groups and the International Rescue Committee, also provides food aid to bedridden patients at home," the agency added. The agency is working with the United Nations Children's Fund (UNICEF) to ensure that all orphans receiving treatment for AIDS are given food assistance; however, orphans in general are also catered for. In the future, WFP hoped to invest food resources for awareness training in collaboration with the World Health Organisation and the United Nations Population Fund, it said. It hopes to start food-for-work programmes with the objective of improving the dilapidated health-care infrastructure. It would also provide food aid to workers assisting in the rehabilitation of hospitals and clinics, while other UN agencies such as UNICEF and the United Nations Development Programme would provide non-food items, WFP said. In the second phase of the project, which is envisaged hopefully to start six to eight months after the completion of the first phase, WFP will provide assistance to those enrolled in the government's antiviral medication programme. "Giving assistance to those enrolled in the programme provides food security to his or her family. With the money saved on food purchases, patients will be able to purchase the antiviral cocktail," the report said. It also noted that the antiviral cocktail would be sold at a fraction of its real cost, "thanks to an agreement that will be reached before the end of August between large pharmaceutical companies and the government". "The pharmaceutical companies have agreed in principle to sell the antiviral cocktail to the government at cost price, and the government has agreed to go one step further by subsidising the cost, making it even more affordable for the most vulnerable patients," the report added. The UN Country Team, together with the government, hopes that people will come forward to be screened, knowing that, if infected, proper health-care resources will be available. "WFP will follow the plan drawn up by the UN team, and commence implementing both phases of the project in the southern part of the country, where the best medical facilities are located and where over 60 percent of the country's population lives," the report said, adding that, after completing implementation in the south, WFP would move north.