Dawn of hope in Ethiopia

Addis Ababa - He returned to work and continued to live a normal life, until 2001 when his CD4 (T-cell) count dropped to a dangerously low level, and he became extremely weak. Though Sileshi wanted to start on antiretroviral medications, he could not afford the drugs then available in Ethiopia. He refers to this period of his life as “the disaster time.”

A year later, Sileshi learned about Dawn of Hope – a local nongovernmental organization in Ethiopia that supports people infected and affected by HIV. He decided to join them, and work on the advocacy campaign to get public provision of free anti-retroviral treatment (ART). During this period he received drugs for opportunistic infections through Dawn of Hope – financed by the Ethiopia MAP. This enabled him to manage his health well enough to keep going, and to get married. His wife is also HIV-positive.

As an activist, Sileshi and others lobbied the government as well as officials from UNAIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria. In 2004 Ethiopia's ART program was launched, with money from the Global Fund.

After 18 months on treatment, Sileshi's CD4 count improved and he felt strong enough to start a second university degree in management. Seeing a future for themselves, Sileshi and his wife began a family. Today, Sileshi is a leader in the Ethiopian AIDS community, representing people living with HIV on the National AIDS Council and the National AIDS Committee Management Board. He is also the proud father of an 18 month-old son, who is HIV-negative, thanks to treatment to prevent transmission from mother-to-child. While it is access to free antiretroviral drugs that is keeping him and his wife healthy today, Sileshi says that they and many other Ethiopians with the virus would not have survived if not for the free drugs to fight opportunistic infections, financed by the World Bank's Multi-Sectoral AIDS Program.

“The MAP made a big difference in people's lives,” Sileshi says.  “Before treatment, people were dying of opportunistic infections. The MAP enabled us to arrive at the era of antiretroviral treatment.”. He also points out that counseling and home-based care provided through the MAP were essential. “Without counseling, there is no positive living, there is no hope.”

Supporting 6,000 communities to help themselves

In 2000, Ethiopia committed to developing a participatory, community-driven response to HIV and AIDS. The initiative was funded with a US$60 million grant from the World Bank's International Development Association (IDA) through the Ethiopia Multi-Sectoral AIDS Program (Ethiopia MAP). The program which closed on December 30, 2006, funded about 6,000 community and NGO initiatives including those described in this article.

The Ethiopia MAP has provided the only systematic support to civil society organizations working on AIDS in Ethiopia and helped to establish the decentralized local response system that is in place today. The project has funded local activities that have had a positive impact on attitudes about people living with HIV and about the importance of knowing one's status. It has financed home-based care, care of AIDS orphans, treatment for minor opportunistic infections, food for needy people with HIV, and income-generating activities.

Without the project's support for life-saving drugs for opportunistic infections, many HIV-positive Ethiopians would have died before anti-retroviral treatment became available in 2004. One of the lessons learned is that food is an overarching basic need for many HIV-positive people in Ethiopia, since most Ethiopians living with HIV are very poor and undernourished.

Especially for those on ART, lack of sufficient and nutritious food makes it impossible to regain or maintain their health.

Article courtesy of The World Bank