West Africa AIDS Project /AIDS 2
(1995-2001)

The credibility of the second phase of the West Africa AIDS Project, better known as AIDS 2, has been proven. In the fall of 2000, UNAIDS acknowledged this health project among its Best International Practices, for the quality of its design and management, an expertise at CCISD.

This five-year project has proved its effectiveness to specialists in the field. The following major observations were made on completion of activities:

• the syndromic approach to STI treatment within the framework of specialized and structured support for Primary health care, whether they are public or private, is applicable. In certain countries AIDS 2 has also demonstrated that it is possible to develop and efficiently provide proper care specifically targeting STI patients, high risk groups such as sex workers and their clients, and other groups, such as workers in the agricultural and industrial centres in Cote d'Ivoire, dockers and military personnel in Benin, and gold workers in Burkina Faso.
• the large scale utilization of anti-STI generic drugs is possible in Africa. Despite numerous supply and distribution problems which still persist, the market for generic drugs is rapidly taking hold in African health services. It has also been possible to observe that users are willing to pay part of the cost of health services.
• the mobilization and support of community groups operating among groups at risk are approaches that are interesting and cannot be ignored and which must be pursued. The innovative aspect of these approaches is that the emphasis is placed on the complementarity of health services and community initiatives. Support activities for community participation led to better use of health services by STI patients, although this result could not be measured as appropriately as project workers would have liked. The general approach to mobilization also led to organizing preventive and educational activities for several groups of prostitutes in both structured and spontaneous contexts. Community groups contributed to providing health education more effectively than the public sector. They led communities in taking change of reproductive health and in reflecting on the vulnerability of men and women to STIs and AIDS. Community organizations also played a role in analyzing the quality of health services, especially in terms of service provided to the most vulnerable groups.
• women are more vulnerable to STIs and HIV. This situation increases their exposure to risk and limits their access to information, prevention and protection and to health services for themselves and their children.
• isolated training activities without accompanying measures (supervision, management of drugs, etc.), have little impact since the individuals gradually forget their training and their skills cannot be used later.
• operational research is a necessary activity and the credibility of the project is based on maintaining high visibility in West Africa as well as internationally.

These observations provided inspiration for the direction given to the West Africa AIDS Project/AIDS 3.