HIV Care for the poorest of the poor

February 2, 2009. HIV Care at the village level.
GAIA Vaccine Foundation has received permission from the Malian
national AIDS agencies to establish the first HIV care TB/HIV outreach
program in a village clinic, located in Sikoro Mali. The new “Project Hope” HIV care center will open its doors on February 2, 2009.

for HIV and TB in peri-urban Mali, West Africa is constrained by
extreme poverty and limited access to health care. Even though
treatment for TB and antiretrovirals is free or low cost, few
individuals are aware of the importance of treatment and even fewer
have access to the centers where these lifesaving medications are
distributed. Currently, only 18,000 of the estimated 180,000 Malians
living with HIV infection have access to HIV care.

The GAIA HIV Care center is based in one such village “CSCOM”. This CSCOM,
located in Sikoro, a village on the outskirts of Bamako that houses
40,000 of the region’s poorest citizens. Doctors at GAIA’s Hope Center
Clinic is currently following 120 HIV patients from the village, and an
estimated 1,000 more such villagers need HIV care. Until this week,
those patients had to travel by bus or taxi to another hospital to get
their medications. Most Malians cannot afford transportation, and as a
result, only a handful of the patients at the clinic routinely obtained
HIV care. GAIA built a new HIV care center called the “Hope Center
Clinic” (finished in June, 2008) with the help of Gilead Foundation,
Keep a Child Alive, Textron, and local Rhode Island donors. The “Hope
Center Clinic” will be the first CSCOM to offer HIV care in West Africa.

CSCOMS are ideal for this type of CSCOM-based HIV care and HIV/TB
outreach program because they usually serve higher risk populations and
because they are organized in “communes” centered around satellite
infirmary-style clinics (CSCOMs), several of which are linked to a
larger “Centre de Soins de Référence” (CS Réf) for supervision and
management of complicated cases.