Arias against the scourge: the DREAM program
May 8, 2015
Deutsche Welle: The Opera Gala in Bonn is a benefit concert, the proceeds go to the German AIDS Foundation, which also supports charitable projects in Africa, including the DREAM program. Could you tell me what that is?
Noorjehan A. Majid: In ten countries, DREAM exists to help, treat and follow-up on patients. Since it was founded in 2002, about 260,000 patients have benefited from the program, and as a result of our efforts, about 28,000 babies of HIV-positive mothers have been born HIV-negative. Apart from treatment with antiretroviral drugs during pregnancy, mothers receive all kinds of help and advice, resulting in a 99 percent success rate in preventing transmission of the virus from mother to child.
In terms of the finances involved, could you give me some figures?
Dieter Wenderlein: To protect one baby costs around 500 euros, which in purely economic terms isn't very much, if you consider the long-term cost savings; for one thing, these children will not need later treatment. Currently, about 60,000 patients are in the antiretroviral program. 75 to 80 percent of the funds come from private donors, including the German AIDS Foundation, which has been supporting the program for ten years, including directly funding the running costs of three treatment sites in Mozambique.
What about support from governments and public institutions?
Wenderlein: It could be better. African governments, who in turn are supported by global funds, give us the antiretroviral drugs free of charge. These global funds come from a variety of sources, including a big effort launched by the administration of former US President George W. Bush. Unfortunately, those funds have been declining in recent years.
Ulrich Heide: Keep in mind that this disease requires life-long treatment. It's an ethical question; if you start with such a program you have to do everything you can to continue. We have a moral responsibility there. The German AIDS Foundation began about 30 years ago with a national reach. Then people sought help from us who were living in Germany but came from abroad. So about halfway into our history, with rates of new infection stable or declining in Germany, we decided to extend our reach. We looked towards southern Africa, which has the highest infection rates. We encountered the DREAM program in 2005. I visited Mozambique two years later and had a very good impression of it - particularly since people participate in it who are themselves HIV-positive or have AIDS. You cannot do a good job in this effort without having them involved.
Can you give me an idea of the current situation of the epidemic in Africa?
Heide: Even if you look at those countries that have been extremely challenged by Ebola, HIV is a more serious problem there. And the infection rate is lower in Liberia than in Estonia! In the last ten years, tremendous progress has been made in Africa; many more people now have access to treatment - about 35 to 40 percent of those who need it. But that also means that more than 60 percent have no access. So the situation is improving - and the DREAM program is part of that - but we are not where we should be yet. In fact, there's reason for concern that donors might be reducing their support.
I would imagine that in your profession, there are encouraging moments, but also sad moments…
Majid: We laugh a lot. Every time an HIV-negative baby is born, we have a big party. But when a child loses its mother, or when a grandmother can't afford a birthday present for an orphaned child - yes, there are sad moments too, every day.
And the long-term perspective?
Wenderlein: We talk about sustainability: apart from ethics, the long term economic benefits of a child born HIV-free are enormous. It's a crucial period from a global point of view. Rates of new infection are decreasing in Africa, as is the death rate. We can have an AIDS-free generation of babies in Africa. That is an attainable goal - although it might take 40 to 50 years to achieve it.
One thing that strikes me about your efforts, then, is their accountability…
Wenderlein: You're totally right. We're at a crossroads. If you consider that in 2013, two million people died of complications from AIDS, the epidemic is still a catastrophe, a horrific worldwide scourge. On the other side, the epidemic is beginning to appear manageable. We just have to work to manage it.
Dr. Ulrich Heide is Head of the German AIDS-Foundation. Dr. Noorjehan A. Majid heads the DREAM program in Africa, and Dr. Dieter Wenderlein is project coordinator of the Sant’Egidio Society for Mozambique.