Expanding & doubling our impact for mother to child HIV prevention!

GAIA currently funds HIV testing of all pregnant women seen for prenatal care at the Community clinic in Sikoro: our longstanding “Chez Rosalie, Mother to Child Transmission Prevention Program”. This month we have some exciting news!

Thanks to your support, we are expanding our successful program to a second community clinic located in the neighborhood of Banconi (next to Sikoro).

Here’s the thing about the Community clinic of Banconi (ASACOBA): Although classified as a community clinic it’s actually a very spacious and well-designed center that serves a large population. Banconi is, in fact, the most populous neighborhood in the city. In terms of treatment, ASACOBA serves almost as many patients as the local reference hospital. However, this also means that they routinely run out of HIV testing supplies for their prenatal care program. Over a 6-month period, they may only have enough testing supplies for 3 months, which means hundreds of pregnant women each month might miss an opportunity to get tested. 

So, what’s exciting about GAIA’s new partnership?

  • GAIA can increase our reach and visibility for our oldest and most successful prevention programs.
  • We can support HIV testing for pregnant women among a large population and help the clinic reach 100%
  • We can brainstorm with clinic staff to increase patient follow-up and adherence to treatment programs.
  • We can share our experiences in Sikoro, where, over the years, our HIV patient base has coalesced into an association (Hope Association of Sikoro) for the promotion of anti-stigmatization activities.

With your help, we can ensure that ASACOBA midwives never run out of testing supplies and they can keep their testing rates at 100% of pregnant women, and all babies can be born HIV free!

The picture above is from the Banconi clinic during our recent trip to Bamako: GAIA’s founder, Dr. Annie is flanked by a midwife and a community health worker who were both part of GAIA’s cervical cancer screening program. The Banconi physician director, Dr. Mariko is in the middle, with GAIA Director Dr. Karamoko and Kotou to the right.

The picture above is from the Banconi clinic during our recent trip to Bamako: GAIA’s founder, Dr. Annie is flanked by a midwife and a community health worker who were both part of GAIA’s cervical cancer screening program. The Banconi physician director, Dr. Mariko is in the middle, with GAIA Director Dr. Karamoko and Kotou to the right.

Courtyard at the Banconi clinic

Courtyard at the Banconi clinic



Meals that provide more than just food

Our nutrition and peer support program continues to be a regular part of clinic life in Sikoro. Every Tuesday and Friday, the HIV+ women’s group can be found busily preparing food purchased that morning from the Sikoro market. Each meal features a different menu and new delicious smells: Fish and veggies with rice, beef sauce with potatoes, meatballs and manioc… Some of our HIV+ patients say that it’s the best meal that they and their children get all week.

It’s true that we may not have the greatest environment; even after adding a roof over the cooking area, it continues to be cramped and not terribly well adapted to cooking and sharing a meal together. However, the community makes the most of the available space, and their hard work and regularity have built a framework for support and exchange among newly diagnosed patients.

Fatim, the new president of the HIV+ women’s association, is a dedicated leader with a strong vision for the group, which now has 50 members. Fatim is enrolling the women in a microfinance program that encourages entrepreneurial activities. This type of activity is crucial for many of the women who are the sole providers for their children.

Fatim keeps the group closely linked with the national organizations for people living with HIV/AIDS, and another of her initiatives is to start “peer learning groups” for the Sikoro HIV+ community. Sharing experiences and listening to others will help people who struggle to follow their treatment plans, and encourage the community as a whole to combat the social stigmatization that they face in their daily lives.

The funding that GAIA provides to keep the nutrition program going is just a small part of this larger whole. Thanks to the efforts of the dedicated women involved, this simple program fosters a world of support for people facing daily challenges due to their HIV diagnosis, social stigmatization, or poverty and food insecurity.

We need to keep this program running, but it’s entirely funded by individual donations. Please spread the word and contribute what you can to help fund this simple action: just a meal, twice a week, shared among friends and strangers that creates a community of support and opportunity for those who are struggling.


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Collaboration with HC3 for maternal health in Guinea

We’ve come a long way since we launched our initiative for Ebola Virus prevention during the height of the Ebola outbreak. While the panic of that moment has subsided, the need for improved healthcare services in the Ebola-affected countries is still urgent. In fact, the tragic death of Liberian Ebola survivor Salomé Karwah during childbirth highlighted to just what extent the fear of Ebola still affects women’s health; preventing them from accessing life-saving care when they are most at risk.

In Guinea, West Africa, 70% of women give birth at home. The statistic itself may not be shocking, but Guinea’s maternal and child health indicators are among the lowest in the world. Since the 2014-2015 Ebola Virus epidemic that ravaged West Africa, global attention has turned to strengthening the affected countries’ healthcare systems, yet the mistrust and lack of confidence felt by the population cannot be patched by infrastructure alone.

The Health Communication Capacity Collaborative (HC3) is a USAID program for social and behavior change communication. One of the main focuses of this global program was the Ebola emergency response and the post-Ebola recovery response among the most severely impacted West African communities.

Working closely with Guinea’s Ministry of Health, as well as the Maternal & Child Survival Project (MCSP), the HC3 project launched a rebranding of the healthcare system with the “Gold Star Clinic” logo. Once healthcare facilities met certain criteria, the quality logo would be prominently displayed to inspire trust among the population served and encourage residents to participate in programs and services. HC3 worked in depth with the quality clinics that earned the Gold Star recognition logo to help them promote their services.

In early 2017, GAIA developed the “Gold Star Clinics” cloth pattern in close collaboration with the HC3 team in Guinea to generate a more widespread recognition of the Gold Star branded health centers. The team’s goal was to significantly impact maternal, neonatal, and child health outcomes by encouraging women to attend pre- and postnatal care visits and give birth at a Gold Star clinic. The pattern tells the story of a pregnant couple that leaves home to visit their community clinic for prenatal care and delivery. Pathways between homes and clinics symbolize the countrywide network of Gold Star clinics. Fabric was given out to 500 women who completed prenatal care visits and gave birth in a maternity ward at one of the Gold Star facilities. They are encouraged to wear the cloth and share their experiences with friends and neighbors. These femmes phares, or “exemplary women” will be the initial momentum for a wave of change to create a new social norm of using health centers for prenatal and maternity services creating a very important improvement in maternal health. 

Thanks to donor support, GAIA was able to create a “story-telling cloth” to rebuild trust in the healthcare system post-Ebola. These 500 women are all proud and healthy new moms to healthy babies.

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A novel approach to HIV care for teens



llustration development for teen HIV book

llustration development for teen HIV book

 “What problems do you see among your community?” we asked our young, HIV+ friend.

Her answer: “The problem is that young people don’t know enough about HIV, and they don't want to talk about it. Even when they have received some education, they still don’t want to take their medication, and they consider their diagnosis a death sentence”

We need more tools to help adolescent educators broach the subject of HIV with their peers.

What would be the best format? We settled on a book, because, although it may seem old fashioned in the world of swiftly developing technology, graphic novels are extremely popular in Bamako, and the shared experience of flipping through a book together will give our peer educators the opportunity to open up about this complex topic.

Now, how do we make a book for teens? First, we had to put together the ideal teen team!

Koura is our project advisor. As a high schooler in Bamako, she sees first hand how much her classmates avoid the topic of HIV and the tragic health consequences when an HIV+ friend stops taking their medication.

Ella is our writer. A high schooler in Providence, RI, she is developing the text of the story and getting feedback from HIV doctors to make sure all the information is accurate. Faced with endless information on the virus and symptoms, she is working hard to create an honest and uplifting story that will inspire other teens to care for themselves and regain hope.

Lynnette is our illustrator. Soon to graduate from the Rhode Island School of Design, she’s a recent teen (although teen no longer!) who will be putting the life and action into the story. We’ve included some examples of Lynnette’s sketches as she works on developing the characters, and more of her dynamic and colorful art can be found on her linked website.

Excited for the final product? So are we! And we’re excited to get this book into the hands of our teen educators in Bamako.

Your support can help fund printing costs for the graphic novel, and we’ll keep you updated on our progress!

Illustration development for teen HIV book

Illustration development for teen HIV book

Illustration development for teen HIV book

Illustration development for teen HIV book

Illustration development for teen HIV book

Illustration development for teen HIV book

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Call to Action: Vaccinate 7,981 girls against cervical cancer

We are thrilled to be back in Bamako, and we’re writing you with a special request:

We met with our “Story-telling Cloth" collaborators to go over the results of the Community Education & Cervical Cancer Screening Campaign. When we met with the director of the National Immunization Program, she was very impressed with our report on high levels of HPV vaccination acceptance and extensive training of healthcare personnel for increased screening. We screened 3,271 women in 6 months.

She informed us that there are leftover doses from the HPV Vaccine pilot program and they need to use them before they expire. She is wondering if she could do a campaign with the doses in the district of Bamako where we already educated the population with the “story telling cloth” program.  This is the perfect opportunity to pilot a “Mother-Daughter Cervical Cancer Prevention” program so that moms can get screened and girls can get vaccinated in the same clinic appointment.

There are 7,981 leftover doses from her pilot project that they could give out in Bamako. These doses expire in November, and they need to get the doses out quickly. If we could get the vaccine to the community clinics we work with, then they will apply for the 2nd dose in 6 months so that all girls are fully protected against infection.

Here’s what we need to mobilize healthcare personnel and get those vaccine doses to girls in our community:

  • Weeklong census activity to register 10 year old, vaccine-eligible, girls in the district. ($2,000 would cover daily stipends and transportation for the census staff)
  • Supervision of the team of vaccinators deployed to clinics and community sites on vaccine campaign days. ($2,000 for daily stipends and transportation for the supervision staff)
  • Vaccinators’ salaries are already covered in the National Program budget.
  • Training for census staff, vaccinators and supervisors would take place in partnership with the Bamako public health office ($10,000 for a 2 week training event with the different teams).

With just $14,000, we could get 7,981 girls vaccinated against HPV. Breaking down the cost per girl, that’s only $1.75 to get a child a vaccine that would otherwise go to waste.

 So, what do you say? Can we make this happen?

 Please join us to help protect girls from cervical cancer in Mali!

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Teen Peer Education update!

When I was in Bamako shortly after World AIDS day in December, our peer educator Socrates pulled me aside to talk about the Teen Peer Education program.

The program has been running for over a year now, with a total of 1,041 participating teens in 2015, and the majority of our participants are teen girls between 14 and 18 years old. Socrates pointed out that a large percentage of the population is living on the outskirts of the city where they don't easily access educational events or health services. His idea is to expand the program to these areas and start helping the teens run the sessions. 

The benefits of this plan is that, first of all, teens themselves would be stepping into leadership positions. Secondly, we would be increasing our impact 5-fold if we expanded to 4 new neighborhoods. In areas where teens have less access to information, they become more at-risk for sexually transmitted diseases or unplanned pregnancies.

We want to fully support Socrates' initiative to grow this program and put teens in leadership positions.

Please join us is promoting teen health and education in Bamako!



Keeping the ball rolling in the fight against cervical cancer

Our 6-month cervical cancer screening campaign in Mali ended in October. We are proud to say that over 3,000 women were screened and rates increased 6-fold since the previous year!

Good news for HPV vaccination: 92% of 200 women who answered questionnaires wanted the HPV vaccine to be available in Mali.

Our HPV "Story-telling cloth" was a big hit at the 5 clinics, and both midwives and patients are all still wearing their stylish new fashion. The pattern includes a slogan in French; “I protect myself, I care for myself, and I get vaccinated” as well as a local proverb in Bambara; “ It’s better to prevent than cure”. By connecting this commonly known proverb with the information about HPV, CC, screening and vaccination, women were encouraged to take preventative measures. When asked if they would get their daughter vaccinated, 89% of women said yes, and when asked why, many specifically mentioned “prevention” or “protection”.

Now, even though the study is over, women are still coming to the clinic for screenings, and the midwives are making every effort to ensure that all women get screened (even the night staff have been doing some screening!) However, the last of the supplies are running low, and if they are not re-stocked, women will have to be turned away. News travels fast through the grapevine in Mali, and women won’t waste their time coming to the clinic if they hear that the supplies ran out.

That is why it’s of utmost importance to find a way to keep these cheap and basic supplies in the clinic. With only a liter of acetic acid (concentrated vinegar) and iodine, over 200 women can be screened each month. 

The cost for one clinic is only $160: to get 200 women screened.

Let’s keep our midwives busy!



A word from our founder on World AIDS Day 2015

Human contact instills hope.

Last Sunday, in honor of World AIDS Day, I spoke at Providence's Beneficent Church about fear, and stigma, and Shorty Boy. Also known as Alicia Sanchez, Shorty Boy was one of my many patients who died of AIDS before medicine found ways to keep them alive.

Many AIDS patients died back then, in the 1980s and '90s (many are still dying where access to life-saving medicine is limited). Not only patients, but also friends, and friends of friends, artists, musicians -- a whole generation -- disappeared.

There was stigma and fear of AIDS -- fear of touching, fear of breathing the same air, terror of the unknown. Health-care practitioners had to re-learn the power of touch -- the incredibly powerful act of putting one hand on another hand, or shoulder, that could shatter stigma and fear.

Shorty Boy was one of my patients in the 1980s at the Framingham Institution for Women, a place where 13 percent of the women who were incarcerated were HIV infected. Shorty Boy was a boisterous, strong, Latina lesbian, proud and loud, but also terrified to say the name of the disease that would eventually kill her.

On one World AIDS Day many years ago, she "performed" in the role of an AIDS patient in a skit at the prison. When I heard she had done so, I knew that Shorty Boy had conquered her own fear and stigma, and had come to peace with herself.

Even though she embraced her disease at the very end, when she died of AIDS, her family refused to take her ashes. So staff members, former inmates, activists and friends took Shorty Boy’s ashes to Boston and buried her under the lilacs at the Arnold Arboretum.

We did that so that, on every Mother’s Day, when the lilacs bloom, thousands of mothers and their children would embrace and celebrate the fragrance that Shorty Boy has become. She is not forgotten. Even though, these many years later, AIDS, like diabetes and heart disease, has been tamed, for those who can access medicine, I remember her.

I called out Shorty Boy’s name at the service. I spoke her name so that she would not be forgotten. I am writing her story now, so that we will all remember the fear that could be cured with a simple touch -- that we can remember that human contact can cure the fear of the "other."

Whether the "other" is a lesbian like me, or a person of color, a transgender individual, an immigrant, refugee or AIDS patient, human contact can conquer fear and stigma, and instill hope.

As we celebrate World AIDS Day, I wish that each one of us will remember that reaching out can be the best medicine -- for the one who reaches out to connect, and for the one who lives in fear. With touch, with contact, with hope, we can fight the terror of the unknown.

 Annie De Groot, M.D., is CEO and CSO of EpiVax, in Providence. She is also one of the founders and the Scientific Director of GAIA Vaccine Foundation, an organization that does HIV / AIDS care, prevention, education and training in West Africa. She is a professor and director of the Institute for Immunology and Informatics at the University of Rhode Island. She is volunteer medical director of the Clinica Esperanza/Hope Clinic.




Our story-telling cloth for HPV and cervical cancer education is everywhere! From the beaches of RI to the streets of Bamako, everyone is showing off their GAIA style!

Along with the distribution of fabric at the 5 participating health clinics in Bamako, we have been offering free cervical cancer screening for all women since April 2015. Screening rates have increase up to 6 fold at some of the clinics thanks to the amazing efforts of our story-telling-cloth-wearing peer educators, fantastic radio programming, and conscientious team of doctors and midwives. When a woman tests positive for precancerous lesions, GAIA is covering the cost of her biopsy and she will receive free treatment with Pr. Teguété, top specialist on cervical cancer. 

Check out the great variety of story-telling cloth styles, and consider supporting GAIA to help us continue this program!

You can create your own GAIA style as well, click here!



The Story-Telling-Cloth – Or how we use Textiles as Social Media to improve Vaccine Uptake

GAIA Vaccine Foundation’s Story-Telling Cloth receives “Grand Challenges Explorations Grant” Award For West African-Style “Social Media” Cervical Cancer Prevention Campaign

Providence, Rhode Island, 04 November 2014. The Bill and Melinda Gates Foundation awarded $100,000 to GAIA Vaccine Foundation to test whether dissemination of a printed cloth that tells the story of HPV, coupled with a media campaign led by influential women musicians, will improve HPV knowledge and incite women to be screened for cervical cancer and (when vaccine is available) to vaccinate their daughters against HPV in West Africa. Cervical cancer is one of the most common and lethal cancers (67% mortality) among women in Africa, with rates that are approximately 5 fold higher than in the US. Nine out of ten (87%) cervical cancer deaths occur in less developed regions of the world, like Mali. This exceptionally high rate of cervical cancer is almost entirely due to lack of knowledge about HPV, since at least in Mali, cervical cancer screens are free and available at every health center.

GAIA Vaccine Foundation Executive Director, Eliza Squibb, with Mme Rokia Sangare and Madame Fatoumata Diarra showing off the HPV “story-telling cloth” design at the Hope Clinic, a project funded by the foundation in Bamako, Mali.

GAIA Vaccine Foundation Executive Director, Eliza Squibb, with Mme Rokia Sangare and Madame Fatoumata Diarra showing off the HPV “story-telling cloth” design at the Hope Clinic, a project funded by the foundation in Bamako, Mali.

Gates Foundation is funding the innovative idea that story-telling pagnes, a traditional cloth worn by most women in West Africa, can motivate women to be screened for cancer while making use of fashion to disseminate cervical cancer education. Previous research by GAIA Vaccine Foundation uncovered a very low rate of knowledge about the association between HPV and cervical cancer in Mali []: less than 3 in 100 persons were aware of the connection between HPV and cervical cancer, and cervical cancer testing rates were extremely low. “If you don’t know the connection, you have no motivation to get tested” said Annie De Groot MD, GAIA Vaccine Foundation’s Scientific Director. And you certainly won’t vaccinate your daughter against HPV infection, which has been shown to prevent cervical cancer. “These life-saving tests and vaccines are already available in the US and Europe, and it is about time that they were available to West African women too”. De Groot is also known as an award-winning “Vaccine Influencer” (one of the top 50 vaccinologists in the world, according to a recent poll):

New Ebola-Story-Telling Cloth Design for Ebola – this one and two others are being considered. Vote for your preferred design on the GAIA VF website:

New Ebola-Story-Telling Cloth Design for Ebola – this one and two others are being considered. Vote for your preferred design on the GAIA VF website:

A few years ago, De Groot had a flash of inspiration about using brightly printed cloth or pagnes, which are worn throughout Sub Saharan Africa, to tell the about the connection between HPV and preventing cervical cancer. A creative student at Rhode Island School of Design (RISD), Eliza Squibb, contributed the eye-catching design, and the result is West African ‘pagne’ (colorful printed cloth) that tells the story of HPV-associated cervical cancer, its transmission, HPV vaccination, and how getting screened for cervical cancer could prevent death from the disease. Dr. De Groot stated: “We are extremely grateful to the Bill and Melinda Gates Foundation for funding this project. We plan to follow expand the distribution of this cloth throughout West Africa. Producing it locally will create jobs for local businesses and tailors in Mali, and the fashion ‘buzz’ about the cloth will successfully transmit this message to women at risk of cervical cancer”.

At a recent focus group in West Africa Eliza Squibb, the artist who is now the GAIA Vaccine Foundation Executive Director, met with enthusiastic women and men who were all ready to wear the cloth. One man made the cloth into a shirt by the next day! Squibb said that designs are in the works for Ebola, HIV and TB.  To donate to GAIA VF and support this project, and others like it, interested persons are invited to visit GAIA’s Story-Telling Cloth© In West Africa, textiles have traditionally served as a medium of communication, and a method of storytelling.

Eliza Squibb with Socrates, GAIA's Peer Educator at the Hope Center Clinic in Bamako, Mali

Eliza Squibb with Socrates, GAIA's Peer Educator at the Hope Center Clinic in Bamako, Mali

Created by artist Eliza Squibb, who is also GAIA Vaccine Foundation’s Executive Director, GAIA’s pattern tells the story of strong, educated women who proclaim, “I protect myself, I take care of myself, and I immunize myself”, a mantra written as a banner across the image of flowering, healthy cervixes. Nearly disguised in the beautifully vivid print are the images of fallopian tubes and uteruses surrounding a near-invasion of HPV viruses embedded in abnormal cancerous cells. These are banners serve to remind women about ways to keep the virus out of the healthy cervixes, a reminder of the importance of being an educated, vaccinated woman. Under separate GAIA Vaccine Foundation funding, each woman who receives the HPV vaccine will receive a pagne, the traditional length of printed fabric for dress-making, so that she might pass on the story of prevention and vaccination, and take on a personal role in preventing cervical cancer. A pilot project to introduce HPV vaccines to Mali is underway, funded by GAVI.

Cervical Cancer caused by HPV in West Africa

The link between HPV and cervical cancer is well known and well documented. Merck and GSK have developed vaccines to prevent cervical cancer; these vaccines are already preventing the disease in the US and in Europe. Access to cervical cancer detection “pap” smears is practically nonexistent in West Africa, where the vaccine-preventable disease is the number one cause of cancer death among women. HPV vaccination will begin in many sub Saharan countries in the next few years, but vaccine acceptance will require education. Thus in preparation for the vaccine campaign in hardest hit areas of the world, GAIA Vaccine Foundation is promoting awareness through a fashionable print that is an effective and culturally appropriate way of joyfully transmitting information about an important pubic health campaign. For information on HPV in West Africa, see: For more information, on GAIA Vaccine Foundation see For information about Eliza Squibb, artist and designer of the Story Telling Cloth, see For information about Annie De Groot MD, please see either the article about De Groot on the Smith College website or De Groot at EpiVax.



Ebola and GAIA VF: What we are doing to focus on the real problem: Access to healthcare in West Africa


At the eighth annual Vaccine Renaissance conference in Providence, Rhode Island on October 13th-16th, many different diseases were discussed, but the press only wanted to talk about Ebola.  It has become very easy for the news media to twist the words of any rational specialist speaking on the topic of the Ebola virus outbreak into the hysteria that has become status quo.

Annie De Groot, founder of GAIA VF and director of iCubed, a vaccine research institute located on the University of Rhode Island’s Providence campus, reiterated the importance of treating the outbreak at its source and sending all possible resources to support the West African health care system. 

Many others have pointed out the urgency of sending resources to West Africa with quotes like these:

"The Ebola outbreak in West Africa has exposed major gaps in development aid, prompting a rethink of the balance between building health systems and tackling specific diseases like AIDS, malaria and tuberculosis."

And Jim Yong Kim, the head of the World Bank, who pointed out the short-sightedness of stopping flights from affected countries.

"It's like you're in your room and the house is on fire, and your approach is to put wet towels under the door. That might work for a while, but unless you put the fire out, you're still in trouble."

With many important things being said, the news media still refuses to hear anything other than a misconstrued quote from De Groot that "The U.S. is ripe for Ebola outbreak".

Here at GAIA, we have been working for twelve years to increase access to healthcare in West Africa. The Ebola virus outbreak has renewed our sense of urgency, but it is important not to lose sight of the most important goals of training personnel, increasing access to care, and providing resources wherever necessary.

List of corresponding articles:



One case of Ebola is no time to panic

Yes, the CDC confirmed the first case of ebola diagnosed in the US. The next day, the cover of the Providence Journal looked like this, with the headline of "Ebola Outbreak":

Yes, we need to send as much support to those countries that are suffering from this virus, and yes, we need to lay in supplies to prepare for cases in the US or Mali, BUT it is important to remember that there are many other dangerous diseases that we cannot ignore that are quietly killing far more people than the Ebola virus. As Douglas Boyd posted (@douglasjayboyd)

"The West African #EbolaOutbreak took .005% the number of lives heart disease takes annually in the US alone."

You can support our initiatives to protect health workers from Ebola in Mali, but don't forget about the important issues. Here at GAIA VF we are still fighting killers like HIV and cervical cancer.



Our Founder, Annie De Groot, named most influential!

Annie de Groot, GAIA's founder and scientific director was name the most influential person in the vaccine industry !

"She joins Microsoft founder Bill Gates and Dr. Bruce Aylward, who is currently directing the Ebola response in West Africa for the World Heath Organization, on the organization’s list of 50 vaccine “influencers.” Those selected were voted on in an international poll conducted by VaccineNation."



GAIA stands in solidarity against Ebola

While it is terrifying to watch the spread of Ebola virus in West Africa, it is important to remember that there are logical and appropriate actions that can be taken to prevent the disease. So far, there have been no reported cases in Mali, and our collaborators are well prepared to test and treat any possible occurrences. 

Unfortunately, the risk is great due to the impermeability of borders in this region, and we need to be vigilant and responsive. We are currently collecting donations to purchase safety materials such as gloves and masks for our clinic, and we are greatly in need of your support. 

As Jeffery Sachs so eloquently states in this article, action is crucial in this moment, for the safety of all.

Responding to Ebola    

Jeffrey D. Sachs     

August 11 2014

NEW YORK – The horrific Ebola epidemic in at least four West African countries (Guinea, Liberia, Sierra Leone, and Nigeria) demands not only an emergency response to halt the outbreak; it also calls for re-thinking some basic assumptions of global public health. We live in an age of emerging and re-emerging infectious diseases that can spread quickly through global networks. We therefore need a global disease-control system commensurate with that reality. Fortunately, such a system is within reach if we invest appropriately.

Ebola is the latest of many recent epidemics, also including AIDS, SARS, H1N1 flu, H7N9 flu, and others. AIDS is the deadliest of these killers, claiming nearly 36 million lives since 1981.

Of course, even larger and more sudden epidemics are possible, such as the 1918 influenza during World War I, which claimed 50-100 million lives (far more than the war itself). And, though the 2003 SARS outbreak was contained, causing fewer than 1,000 deaths, the disease was on the verge of deeply disrupting several East Asian economies including China’s.

There are four crucial facts to understand about Ebola and the other epidemics. First, most emerging infectious diseases are zoonoses, meaning that they start in animal populations, sometimes with a genetic mutation that enables the jump to humans. Ebola may have been transmitted from bats; HIV/AIDS emerged from chimpanzees; SARS most likely came from civets traded in animal markets in southern China; and influenza strains such as H1N1 and H7N9 arose from genetic re-combinations of viruses among wild and farm animals. New zoonotic diseases are inevitable as humanity pushes into new ecosystems (such as formerly remote forest regions); the food industry creates more conditions for genetic recombination; and climate change scrambles natural habitats and species interactions. 

Second, once a new infectious disease appears, its spread through airlines, ships, megacities, and trade in animal products is likely to be extremely rapid. These epidemic diseases are new markers of globalization, revealing through their chain of death how vulnerable the world has become from the pervasive movement of people and goods.

Third, the poor are the first to suffer and the worst affected. The rural poor live closest to the infected animals that first transmit the disease. They often hunt and eat bushmeat, leaving them vulnerable to infection. Poor, often illiterate, individuals are generally unaware of how infectious diseases – especially unfamiliar diseases – are transmitted, making them much more likely to become infected and to infect others. Moreover, given poor nutrition and lack of access to basic health services, their weakened immune systems are easily overcome by infections that better nourished and treated individuals can survive. And “de-medicalized” conditions – with few if any professional health workers to ensure an appropriate public-health response to an epidemic (such as isolation of infected individuals, tracing of contacts, surveillance, and so forth) – make initial outbreaks more severe. 

Finally, the required medical responses, including diagnostic tools and effective medications and vaccines, inevitably lag behind the emerging diseases. In any event, such tools must be continually replenished. This requires cutting-edge biotechnology, immunology, and ultimately bioengineering to create large-scale industrial responses (such as millions of doses of vaccines or medicines in the case of large epidemics).

The AIDS crisis, for example, called forth tens of billions of dollars for research and development – and similarly substantial commitments by the pharmaceutical industry – to produce lifesaving antiretroviral drugs at global scale. Yet each breakthrough inevitably leads to the pathogen’s mutation, rendering previous treatments less effective. There is no ultimate victory, only a constant arms race between humanity and disease-causing agents.

So, is the world ready for Ebola, a newly lethal influenza, a mutation of HIV that could speed the transfer of the disease, or the development of new multi-drug-resistant strains of malaria or other pathogens? The answer is no.

Though investment in public health increased significantly after 2000, leading to notable successes in the fights against AIDS, tuberculosis, and malaria, there has recently been a marked shortfall in global spending on public health relative to need. Donor countries, failing to anticipate and respond adequately to new and ongoing challenges, have subjected the World Health Organization to a debilitating budget squeeze, while funding for the Global Fund to Fight AIDS, Tuberculosis, and Malaria has fallen far short of the sums needed to win the war against these diseases.

Here is a shortlist of what urgently needs to be done. First, the United States, the European Union, the Gulf countries, and East Asian states should establish a flexible fund under WHO leadership to combat the current Ebola epidemic, probably at an initial level of $50-$100 million, pending further developments. This would allow a rapid public-health response that is commensurate to the immediate challenge.

Second, donor countries should quickly expand both the Global Fund’s budget and mandate, so that it becomes a global health fund for low-income countries. The main goal would be to help the poorest countries establish basic health systems in every slum and rural community, a concept known as Universal Health Coverage (UHC). The 

greatest urgency lies in Sub-Saharan Africa and South Asia, where health conditions and extreme poverty are worst, and preventable and controllable infectious diseases continue to rage.

In particular, these regions should train and deploy a new cadre of community health workers, trained to recognize disease symptoms, provide surveillance, and administer diagnoses and appropriate treatments. At a cost of just $5 billion per year, it would be possible to ensure that well-trained health workers are present in every African community to provide lifesaving interventions and respond effectively to health emergencies like Ebola.

Finally, high-income countries must continue to invest adequately in global disease surveillance, the WHO’s outreach capacities, and life-saving biomedical research, which has consistently delivered massive benefits for humanity during the past century. Despite tight national budgets, it would be reckless to put our very survival on the fiscal chopping block.




Another big day

Une grande journée dans notre marathon de santé public qu'on est en train de faire pendant qu'on est a Bamako: Conference sur le HPV, un cours spécial avec Annie De Groot, discussion sur le pagne et l'éducation pair. Demain, reprenons!

Another big day in our public health marathon as we try to take advantage of every minute in Bamako: HPV conference, a special class taught by Annie, study group on the cloth project and peer education. Tomorrow we're back at it!


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Return to Bamako - Why this Matters

We have been waiting for the AQIM situation to calm down before returning to Bamako...not that things are super calm, but it just seemed to be the moment to return. Eliza Squibb, GAIA VF director, is meeting our collaborators and visiting the clinic for the first time. We'll be posting picture and brief updates, check back here...

Karamoko Tounkara, GAIA VF Mali Director, and Eliza Squibb, GAIA VF Executive Director, at the Loft, beginning of day 1.

There has been a bit of construction at the Hope clinic (our HIV clinic-within-a-clinic) in Sikoro - expansion of the lab to accomodate a CD4 T cell counter . . and... editing of the mural by Eduardo Pineda 

The well-deserved Ciwara of Gold that the ASACOMSI won for their excellent public health (and HIV "prise en charge") efforts in Sikoro.

Karamoko in the internal courtyard of the clinic - shrinking as the clinic grows.

The 'observation' room that we built with donations from GAIA supporters - equipped by the Adam Traore family. Buildng out a clinic takes a village...

Yssouf Kone, MD, Karamoko (checking his phone per usual) and Eliza in one of the exam rooms that we built 5 years ago at the Hope Clinic - used to take care of HIV patients in the first-ever "HIV clinic in an infirmary" in West Africa. Built with significant support from Gilead Foundation and our donors.

Dr. YssouffKone and Eliza take a look at the HPV Pagne with GAIA Mali Director, Dr. Karamoko Tounkara

Haby! Looking very well! in the Hope Clinic Pharmacy with Eliza Squibb.

Tounkar, Chief (of Sikoro) Niare, Eliza.

Our director is a kid-magnet

Koura Dicko, Dr. Dao, Dr. Tounkara, Eliza.

Koura, Kara, and Annie in front of FMPOS.

Koura and Eliza at the National Museum - for a break-fast..

Our Iftar today...

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Campagne pour la distribution du vaccin contre le Pappillomavirus en Afrique de l’Ouest

SITUATION: 33,000 doses de vaccin contre le VPH sont entrain de périr au Mali.

PROBLEME: En raison du conflit militaire au Mali, les fonds de l’Etat financent actuellement les interventions armées; Les vaccins ne peuvent donc pas être distribués !


INTERVENTION DE GAIA: En 2011, GAIA Vaccine Foundation a entamé une étude qui prouve que le vaccin est efficace et utilisable au Mali et que la population de la région de Bamako est favorable à l’introduction de ce vaccin. Nous avons sur place une équipe médicale prête à vacciner 11,000 adolescents – dans les conditions sanitaires requises bien sûr.

VOTRE INTERVENTION: Aidez-nous à vacciner ces adolescents! Notre vidéo vous endira plus long ! Aidez-nous à faire reculer le cancer de l’utérus au Mali !        Faites un don ici ! Merci.


GAIA VF a travaillé avec Eliza Squibb, une étudiante en art de la Rhode Island School of Design de Providence, pour la conception d’un bazin qui illustre la nécessité d’un vaccin contre le VPH et l’importance de se protéger contre le cancer du col. Le message “Je m’immunise, Je me protège, Je me soigne” est imprimé sur un dessin montrant des cellules saines à côté de trompes et cols sains également. L’équipe médicale en charge de vacciner les adolescents, portera ce tissu en l’honneur de la campagne de vaccination.

UN IMPACT IMMEDIAT: Avec votre aide, nous allons pouvoir vacciner 11,000 adolescents d’ici 3 mois ! Nous voulons les protéger du cancer et leur offrir un bel avenir.

S’IL VOUS PLAIT: Nous n’y arriverons pas sans votre aide ! Ces vaccins ne doivent pas rester entassés au fond d’un entrepôt. Quel gâchis ! Ils doivent être utilisés à bon escient ! 3 euros suffisent à vacciner une adolescente.  Imaginez les possibilités si vos dons atteignent 30 ou encore 300 euros.

IMPORTANT: Les vaccins sont périssables et le temps presse. Si nous ne les utilisons pas au plus vite ils seront perdus.

Vous trouverez des informations supplémentaires en première page de notre site web.

Un grand merci pour votre soutien !

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2012 World AIDS Day update

2012 is GAIA Vaccine Foundation’s 10th anniversary!  Please stand strong with GAIA VF and donate today.

10 years ago, we first set out to establish collaborations with Malian HIV researchers. GAIA VF was subsequently established to coordinate networking among HIV/AIDS governmental organizations, non-governmental organizations, and HIV care providers, as well as to tackle the problem of misinformation about HIV/AIDS treatment among clinicians and patients that could impair the ethical conduct of HIV vaccine trials in Mali.

With your help, we have been able to support the treatment of HIV seropositive women and their families at the Hope Center Clinic and at “Chez Rosalie”, our successful mother-to-child HIV transmission prevention (MTCTP) program, since 2005! We have established strong local and regional partnerships in Mali, performed vaccine readiness research, and implemented a comprehensive HIV care program in anticipation of performing HIV vaccine trials. With approval from the Malian Ministry of Health, GAIA VF has addressed the issue of access to care by setting up a model village-based HIV care and treatment clinic. The Hope Center Clinic now features HIV case management, outreach to identify new patients, referral to care, and promotion of medication adherence. GAIA VF also partners with local organizations to improve access to specialty HIV care at the clinic. Our goal is to leverage innovative HIV management techniques, expand HIV treatment, and increase HIV knowledge in order to improve access and adherence to care, a model that could be implemented to expand village-level HIV care throughout West Africa.

Coup d’Etat in Mali

Unfortunately, 2012 was also the setting for a military coup, which took place in Mali in March. While there is ongoing civil unrest in the northern part of the country, our onsite director Dr. Karamoko Tounkara reports that all is calm in Mali’s capital of Bamako. Our patients and staff are safe, as are GAIA VF’s collaborating scientists.In spite of this unrest, we are still providing access to HIV testing, care, and prevention, as well as food for HIV-infected patients, at our clinic in Sikoro. While we have had to reduce the scope of our programs to cut costs, the current political crisis has had no other impact on our activities at the Hope Center Clinic.

Although circumstances have been hardenrollment in the MTCTP program has been steady over the past months. Voluntary HIV testing requests have skyrocketed in the past year, increasing from 226 in 2011 to 412 in 2012! This reflects not only GAIA VF’s resilience in keeping its programs open when other programs were forced to close due to the current political turmoil, but also an awareness and appreciation for the services provided by our clinic. We believe that continuing to operate our programs will instill hope in the citizens of Mali to sustain them through these difficult times. Our Malian collaborators are continuing the fight against AIDS, and we need to bolster their optimism that peace and prosperity will be restored. More than ever, GAIA VF, our staff, and our patients need our, and your, support.

HIV Care Program

Since the launch of our antiretroviral (ARV) access program in 2009, more than 200 patients have enrolled in care at the clinic. In the past 2 years, GAIA VF was able to reduce the cost to patients of HIV screening and provide supplies and material for HIV screening activities. We reinforced our staff to levels appropriate for management of persons living with HIV/AIDS and hired a full-time pharmacist (full-time) trained in the management of care for HIV-positive patients, as required by the government of Mali.


2011-2012 Hope Center Clinic Achievements

438     Voluntary HIV test requests

221     HIV-infected adults and children in care

42       HIV-infected children in care

118     New HIV-positive patients on treatment

1040   Meals distributed to our patients

MTCTP Program Evaluation

GAIA VF conducted a six-year retrospective assessment of its MTCTP program to evaluate its efficacy in preventing pediatric infections and providing services and support to HIV-positive women. Doctors and volunteers reviewed the maternity clinic’s patient charts to identify HIV-positive women enrolled in the MTCTP program for study participation. MTCTP acceptance, HIV transmission risk factors, and HIV seroprevalence among 150 babies born to mothers enrolled in the MTCTP program from 2005-2011 were evaluated by survey. The results of this evaluation were presented this year at the annual AIDS Vaccine Conference in Boston. GAIA counseled 9,379 women about HIV infection from 2005-2011 (average 145/month). An overwhelming majority (99.1%) of women agreed to HIV testing following counseling. 202 women (2.1%) were HIV positive, of whom 125 (61.9%) accepted MTCTP treatment. Notably, 100% of babies born at Chez Rosalie to MTCTP-adherent mothers were HIV free.

Hope is a Vaccine Award Dinner

Dr. Myron Cohen and Dr. Julio Montaner were awarded the 2012 International Hope is a Vaccine award for their ardent support of the “Treatment as Prevention” approach to ending AIDS, in the absence of an effective vaccine. The National Hope is a Vaccine award was given to Jon Cohen (correspondent with Science) for covering HIV/AIDS from every angle, and the Local Hope is a Vaccine award winner was Dr. Paul Loberti for his unfailingly devoted advocacy of HIV prevention as a means of addressing the HIV epidemic. Our 2012 awardees attended the World AIDS Conference in Washington DC and gathered for a friendly award dinner together with Congressman David Cicilline.

Treatment as prevention: “The new vaccine for AIDS?”


The GAIA Vaccine Foundation held a satellite session at the AIDS Vaccine Conference in Boston in September 2012. Guest speaker (and 2012 Hope is a Vaccine Award winner!) Dr. Myron Cohen discussed the potential for implementation of the “Treatment as Prevention” (TasP) approach to ending AIDS, in the absence of an effective vaccine. Dr. Zoumana Koty, our Malian HIV specialist, was the recipient of both a scholarship and a travel grant, enabling him to attend the conference and present his work on improving clinical outcomes for HIV-positive patients at the Hope Center Clinic in Mali.

December 1st is World AIDS Day! Your support for GAIA could not be more important than it is right now – we cannot continue without your help. Help us preserve our HIV care, treatment, and education programs in Mali! Please make a donation today.