International Federation of Red Cross and Red Cresent Societies - 15 December 2003
Christopher Black in Dakar

The Conference brought together more than 2,000 people, including representatives of each regional Red Cross Red Crescent HIV/AIDS network. Twenty Red Cross Red Crescent international participants were joined by hundreds of volunteers from the Senegalese Red Cross.

At the opening of the conference, Senegalese President Abdoulaye Wade received a round of applause when he called for a greater political engagement in the fight against HIV/AIDS and declared that from January 2004, there would be free access to anti-retroviral treatment for those living with HIV/AIDS in Senegal. He highlighted the need for coordination and solidarity access to Anti-retrovirals. "African governments must take responsibilily and allocated budgets on a sustainable basis."

Held for the first time in Africa, the conference focused on increasing access to HIV/AIDS care and treatment, mobilizing leadership in the fight against HIV/AIDS related stigma and discrimination, as well as on the importance of real involvement of people living with HIV/AIDS.

Strategic partnerships

"What came across here is the role of the Red Cross Red Crescent globally in strategic partnerships," said Alyson Lewis, the federation's sub-regional health delegate, based in Lagos. "There was recognition of the strengths of the Red Cross Red Crescent network, which includes a tremendous human resource, its strong volunteer base, vital for both anti-stigma and home based care work."

Different elements of HIV/AIDS response are stronger in different countries. In West Africa, there exist exchange programmes between different National Societies to share knowledge, experience and ideas. The Nigerian Red Cross, for example, has a long experience in care activities, while the Togolese Red Cross has developed a strong peer education programme. Ghana has the innovative mothers' clubs, which combine income generation activities and peer education, with the future hope of branching out into home based care.

At the conference, similar exchanges of information occurred between different Red Cross Red Crescent Societies. Grover Yepez Chacon distributed a large quantity of HIV/AIDS prevention material which was produced by the Bolivian Red Cross working with a large number of partners across the South American country. The Bolivian Red Cross uses all communication avenues - radio, television and print media - to pass messages on HIV/AIDS prevention.

"We have found that HIV/AIDS prevention activities are an efficient way to address stigma and discrimination," says Chacon. Chacon hopes to build on their experience in working with young people and adults and with the involvement of people living with HIV/AIDS to create an integrated programme which combines prevention, advocacy and care. The Bolivian Red Cross has a small home-based care programme which it hopes to expand. "I learned at this conference the importance of involving families in all aspects of care activities."

Similarly, Kathleen Fergusson Steward, HIV/AIDS Officer in the Federation sub-regional office in Trinidad. came to the conference to learn from others about scaling up home-based care programmes. Some National Societies in the Caribbean Red Cross AIDS Network (CARAN) have well established HIV/AIDS prevention programmes with an emphasis on youth, along with traditional Red Cross activities such as Disaster Preparedness and Response and social work. However it is only recently that some of them û in Jamaica, for example û have become involved in home-based care work.

Building on strengths

"In the past, some programmes have expanded without thought to what expansion really means. We are here to look for tools to prepare the CARAN network to expand in a way that is practical, sustainable, efficient and comprehensive," says Steward.

By the next home-based care conference in two year's time, Steward hopes to have six HBC programmes up and running on different islands in the Caribbean. She sees the opportunities to build on traditional Red Cross strengths and involve key players, especially those living with HIV/AIDS, along with a group which has often been left out of the HIV/AIDS equation: the elderly. "There is an important role for older volunteers. HIV/AIDS is not a disease that affects only the young," she says.

She wants to see a cadre of trainers across the Caribbean, enhancing in-country programmes and complementing the work of other organizations. She sees a role for the Red Cross in creating programmes that, rather than dependency, empowers those involved, specifically through their association with groups of people living with HIV/AIDS.

One of the major obstacles to overcome is the lack of funding, "People need to see beyond the traditional views of the Caribbean as only sex, sea and sand. They need to see the reality - that this region is heavily affected, second to sub-Saharan Africa in terms of prevalence and needs a new aggressive and integrated approach if we are to make an impact."

This integrated approach also drew Dr. Habiibullah Choudhury from the Bangladesh Red Crescent Society to Dakar. The Red Crescent recently began an information and education campaign targeting youth in slum areas, as well as a national anti-stigma campaign. With religious and social taboos rife, the Red Crescent has also opened a volunteer-run telephone, voicemail and email counselling centre for people to receive information and assistance anonymously.

Stigma in health profession

The Bangladesh Red Crescent is well equipped to move beyond prevention into care and support. With 300,000 volunteers nationally and an impressive health structure consisting of 64 maternity health clinics, five general hospitals, five maternity hospitals, eight outdoor clinics, one medical college, four nursing colleges and five blood banks, the natural progression would seem to be towards care. Yet, in beginning care activities, the Red Crescent chose to address HIV/AIDS related stigma that exists in the health profession.

"If doctors and nurses come forward and are open, it will create a positive environment for people living with HIV/AIDS. Then we will work with NGOs working in this field and with associations of people living with HIV/AIDS. We are new to this, we can learn a lot from them," Choudhury explains.

The voice of Red Cross and Red Crescent volunteers was also present at the conference. Nemani, a volunteer who has been working in the Fiji Red Cross health and care programme for two years, shared his experience in working in peer education with young people and with prison populations.

He highlighted the courage of HIV-positive volunteers in reaching out to community leaders at the biannual gathering of chiefs.

"Before, it was very difficult to talk to villagers about sex education. When they came to know about the dangers of HIV, they saw there was no need for such taboos. Once the chiefs understood the problem, and accepted the volunteers as part of the solution, they became very supportive. They heard the cry of the nations and listened," Namani says.

Now, when the volunteers take their puppet show to hard- to- reach village, sometimes travelling for days by road, on horseback and on foot, communities are much more open to receiving their messages on HIV/AIDS prevention.

3x5 initiative

Much discussed at the conference was the contribution of local communities and volunteers in the World Health Organisation and UNAIDS "3x5" initiative, which aims to provide anti-retroviral treatment to 3 million people living with HIV/AIDS in developing and transitional countries by 2005.

For the International Federation, anti-stigma work is crucial to making this a success. By overcoming stigma, people are more likely to come forward for testing.

"People need to understand the whole picture of what will be involved in making 3x5 a reality. Traditional Red Cross Red Crescent community work is an essential compliment to clinical care. There seems to be a broader appreciation emerging of the elements which are needed beyond the clinic to make antiretroviral treatment work," says Bernard Gardiner, head of the Federation's global HIV/AIDS programme.
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