In keeping with our efforts to build local capacity at all levels, technical, administrative, fundraising, and program-related, WE-ACTx has assisted our Rwandan staff in establishing a local Rwandan affiliate organization, WE-ACTx for Hope, through which some of our non-clinical programs are currently operating, and through which all non-clinical WE-ACTx programs will be administered as local capacity permits. Currently, three of our programs are operating through WE-ACTx for Hope.
In January 2005, WE-ACTx developed a longitudinal cohort study , enrolling nearly 1000 women in the Rwanda Women’s Interassociation Study and Assessment (RWISA). With the approval of the Rwandan government Ethics Committee and the Institutional Review Board of the Montefiore Medical Center in the Bronx, NY, RWISA is the largest research study in Rwanda, led by both US and Rwandan investigators. RWISA follows 936 Rwandan women, 710 HIV+ and treatment naïve at study enrollment, and 226 HIV-negative. Most of the HIV+ women have initiated antiretroviral treatment, and by participating in the study to help assess the effectiveness and toxicity of ART in treatment naïve women, assess the influence of post-traumatic stress symptoms on wellness and treatment adherence, and the impact of nutrition on HIV disease progression and response to therapy. RWISA staff are integrated into grassroots partner organizations, to ensure follow-up and study retention, and to provide psychosocial support.
Following the success of the Rwandan “Know Your Rights! Community Handbook on Health-Care Rights and Other Laws for Rwandan” in 2008, our local affiliate organization, WE-ACTx for Hope, will soon be releasing a new handbook specifically addressing health-care rights and available legal resources for children in Rwanda.
Watch here for the English and Kinyarwandan versions of the Children’s Health Rights handbook in spring of 2010. We will make both versions available for on our website. Download the Know Your Rights! Handbook for adults in English or Kinyarwandan.
Congratulations to INEZA on its recent approval from the Rwandan government of its legal status as a Rwandan business cooperative. The women who make up the cooperative, many of whom were some of WE-ACTx’s earliest patients, have worked hard to build their cooperative. WE-ACTx continues to support INEZA through subsidies and technical assistance/capacity building. We are proud of their many achievements thus far!
Some of INEZA’s many well-crafted products can be purchased on-line at Manos de Madres. Manos de Madres continues its instrumental role in developing INEZA’s potential. You can also purchase hand-woven items produced by another of WE-ACTx’s grassroots partner associations, Solidarite’ at the Manos de Madres . If you are in Rwanda, please visit Ineza’s shop in the Remera district of Kigali.
Download the PowerPoint slideshow here:
Slide Show – WE-ACTx in Rwanda
Mardge H. Cohen, MD
Anne-Christine d’Adesky, MS
Kathryn Anastos, MD
Knowing that when we are sick with AIDS, we have no shelter on our head and no school fees for our children, that is what kills us.
Laurence Mukamurangwa
Rwandan Women’s Network
June 7, 2005
IN 2003, RWANDAN WOMEN’S ASSOCIATIONS ISSUED AN international call to aid women who had been raped and
infected with human immunodeficiency virus (HIV) during the genocide, and who were becoming sick and dying.
As difficult as it was for the world to comprehend the tragedy of the 1994 events, it was even more incomprehensible
that while women with HIV were not receiving antiretroviral medications, alleged perpetrators were receiving treatment in prison.
Read the full article here: Another World Is Possible (PDF)
Document Downloads: Overlapping Epidemics
– Short Report (PDF)
– Full Report (PDF)
US Office
3345 22nd street
San Francisco, CA 94110
(415) 648-1728
Rwanda Office
Box 5141
Kigali, Rwanda
(+250) 0830 2089
Contact: Anne-christine d’Adesky
(415) 690-6199 cell
PRESS RELEASE
December 1, 2006
New Report Highlights Challenges of Integrating
Food into HIV Programs
More holistic global model of care & new development partnerships with focus on poverty needed to respond to urgent demand for food by millions with HIV and AIDS in hard-hit regions.
San Francisco-A new report entitled “Overlapping Epidemics: Challenges and Strategies for Integrating Nutrition and HIV Programs” – Grassroots Perspectives on a Global Problem” is being issued today by the Women’s Equity in Access to Care and Treatment (WE-ACTx). WE-ACTx is an international nonprofit AIDS program that began working in Rwanda in 2004 to provide HIV care and antiretroviral (ARV) treatment access to genocide and rape survivors, in partnership with the Rwandan government and local NGOs. WE-ACTx runs two clinics in Kigali serving ~ 5000 clients.
The new report examines the challenges facing grassroots AIDS groups and provider NGOs globally who are facing a rising demand for food that experts say may soon eclipse antiretroviral medicine. The report summarizes the views and ‘best practice’ ideas of representatives in international and local agencies working across the fields of HIV/AIDS, nutrition and development. Research for the report was supported by a grant from Keep a Child Alive (KCA) in New York.
“WE-ACTx is facing the urgent challenge that most groups working in the field of AIDS in poor countries are dealing with today, which is hunger and poverty that are root causes of the epidemic,” said Anne-christine d’Adesky, co- author of the report, and Executive Co-Director of WE-ACTx. She is also author of the 2004 global AIDS book, ‘Moving Mountains,’ which profiled challenges and successful efforts of early pioneers introducing HIV treatment around the world.
“Food remains the number one need of many of our clients, alongside antiretrovirals,” said d’Adesky. “Without food, people are often reluctant to start ARVs, which may be difficult to take without food, or they struggle to maintain good health if they lose access to food. We need global AIDS policies and more holistic, practical guidelines that address the link of HIV to food insecurity and poverty and gender inequity — and their impact on each other.”
WE-ACTx has been working with Rwandan NGO partners to identify and implement innovative solutions that support sustainable food access for HIV clients. “We particularly wanted to identify best practice approaches that can be shared with other grassroots groups,” said d’Adesky.
Among the findings of the report:
- Malnutrition, food insecurity and poverty remain critically overlooked factors in the global HIV pandemic. According to the UN World Food Programme, 13.8 million people will need access to HIV/AIDS care by 2008, and 6.4 million of them will need nutritional support. Out of 6.6 million also needing access to ARVs, 0.9 million will need food aid. The demand for food will increase as more people access ART based on present trends.
- The devastating impact of AIDS on the rural agricultural sector is greatly increasing food insecurity and especialy. threatens women who make up the majority of smallholder farmers in hardest-hit southern Africa. One analyst warned in 2003 that, in extremis, AIDS could produce a new ‘variant famine’ targeting rural Africans.
- Extreme poverty threatens to blunt the benefit of HIV therapy for severely malnourished individuals, who are six times more likely to die than those on ART who are not malnourished. Malnutrition decreases one’s ability to absorb HIV medicine and cope with drug side effects, and prolongs the length of recovery to natural immunity.
- Globally a more holistic model of HIV care that integrates nutrition and nutrition education, and sustainable food security and livelihood strategies is needed to address the root issue of poverty. Field providers call upon the World Health Organization to move faster to quickly develop and disseminate practical holistic field guidelines to help guide those implementing programs at the grassroots level.
- A multisector “partnership” approach can bring together groups working HIV and AIDS with those working in sustainable development fields. The private sector has an important role to play, helping to manufacture food, providing business resources to local NGOs, and opening markets for products made by their HIV clients.
- Nutrition is not specifically mentioned in the global ‘Three Ones’ principles adopted in 2001 as a framework for harmonizing national HIV programs.
- Funding for nutrition must be included in funding mechanisms to scale-up global access to HIV treatment. Experts estimate the global cost of providing nutrition to HIV-positive individuals for the next two years to be $1.1 billion — just 2% of $55 billion required to tackle the pandemic by 2008.
- A household vs. individual approach to nutrition, food access and security, and HIV is best to address the dynamic impact of overlapping illness and chronic poverty that affects families with HIV-affected members.
- Gender inequity contributes to a higher degree of poverty, malnutrition and vulnerability to HIV in women and requires specific strategies aimed at empowering women. Securing property and inheritance rights for women and children is an essential part of battling poverty.
- A range of nutrition interventions should be considered within a continuum of HIV care model, with a range of entry and exit points for interventions at different stages of malnutrition, illness and HIV status. Short-term food aid is a lifesaving intervention for severely malnourished HIV-positive individuals and needed by many starting ART, but should be linked to sustainable food security or income generation programs.
- The nutritional needs of HIV-positive refugees requires better coordination by humanitarian, refugee affairs, and public health providers with local community groups, and benefits from input by refugees into program design.
This report will be available at the WE-ACTx and KCA websites (www.we-actx.org | www.keepachildalive.org).
PRESS RELEASE
Contact: Anne-christine d’Adesky
(415) 690-6199 cell
December 1, 2006
New Report Highlights Challenges of Integrating Food into HIV ProgramsMore holistic global model of care & new development partnerships with focus on poverty are needed to respond to urgent demand for food by millions with HIV and AIDS in hard-hit regions.
Boston, November 6 – A new report entitled “Overlapping Epidemics: HIV/AIDS, Hunger and Poverty — Challenges and Strategies for Integrating Nutrition and HIV Programs,” is being issued today by the Women’s Equity in Access to Care and Treatment (WE-ACTx). WE-ACTx is an international nonprofit AIDS program that began working in Rwanda in 2004 to provide HIV care and antiretroviral (ARV) treatment access to genocide and rape survivors, in partnership with the Rwandan government and local NGOs. WE-ACTx runs two clinics in Kigali serving ~ 5000 clients. The new 140-page report examines the challenges facing grassroots AIDS groups and provider NGOs globally who are facing a rising demand for food that experts say may soon eclipse antiretroviral medicine. The report summarizes the views and ‘best practice’ ideas of representatives in international and local agencies working across the fields of HIV/AIDS, nutrition and development. Research for the report was supported by a grant from Keep a Child Alive (KCA) in New York. “WE-ACTx is facing the urgent challenge that most groups working in the field of AIDS in poor countries are dealing with today, which is hunger and poverty that are root causes of the epidemic,” said Anne-christine d’Adesky, primary author of the report, and Executive Co-Director of WE-ACTx. She is also author of the 2004 global AIDS book, ‘Moving Mountains,’ which profiled challenges and successful efforts of early pioneers introducing HIV treatment around the world.”Food remains the number one need of many of our clients, alongside antiretrovirals,” said d’Adesky. “Without food, people are often reluctant to start ARVs, which may be difficult to take without food, or they struggle to maintain good health if they lose access to food. We need global AIDS policies and more holistic, practical guidelines that address the link of HIV to food insecurity and poverty and their impact on each other.” WE-ACTx has been working with Rwandan NGO partners to identify and implement innovative solutions that support sustainable food access for HIV clients. “We particularly wanted to identify best practice approaches that can be shared with other grassroots groups,” said d’Adesky.
Among the findings of the report:
- Malnutrition, food insecurity and poverty remain critically overlooked factors in the global HIV pandemic. According to the UN World Food Programme, 13.8 million people will need access to HIV/AIDS care by 2008, and 6.4 million of them will need nutritional support. Out of 6.6 million also needing access to ARVs, 0.9 million will need food aid.
- Extreme poverty threatens to blunt the benefit of HIV therapy for severely malnourished individuals, who are six times more likely to die than those on ART who are not malnourished. Malnutrition decreases an HIV-positive person’s ability to absorb medicine and cope with drug side effects, and prolongs the length of recovery to natural immunity.
- Globally a more holistic model of HIV care that integrates nutrition and nutrition education, and sustainable food security and livelihood strategies is needed to address the root issue of poverty. Field providers call upon the World Health Organization to move faster to quickly develop and disseminate practical holistic field guidelines to help guide those implementing programs at the grassroots level.
- A multisector “partnership” approach can bring together groups working HIV and AIDS with those working in sustainable development fields. The private sector has an important role to play, helping to manufacture food, providing business resources to local NGOs, and opening markets for products made by their HIV clients.
- Nutrition is not specifically mentioned in the global ‘Three Ones’ principles adopted in 2001 as a framework for harmonizing national HIV programs.
- Funding for nutrition must be included in funding mechanisms to scale-up global access to HIV treatment. Experts estimate the global cost of providing nutrition to HIV-positive individuals for the next two years to be $1.1 billion — just 2% of $55 billion required to tackle the pandemic by 2008.
- A household vs. individual approach to nutrition, food access and security, and HIV is best to address the dynamic impact of overlapping illness and chronic poverty that affects families with HIV-affected members.
- Gender inequity contributes to a higher degree of poverty, malnutrition and vulnerability to HIV in women, including women-headed households, and girls, and requires specific strategies aimed at empowering women. Securing property and inheritance rights for women and children is an essential part of battling poverty.
- A range of nutrition interventions should be considered within a continuum of HIV care model, with a range of entry and exit points for interventions at different stages of malnutrition, illness and HIV status. Nutrition interventions aimed at malnourished pregnant women and orphans and vulnerable children with HIV are critical. Short-term food aid is a lifesaving intervention for severely malnourished HIV-positive individuals and needed by many starting ART, but should be linked to sustainable food security or income generation programs.
- The nutritional needs of HIV-positive refugees requires better coordination by humanitarian, refugee affairs, and public health providers with local community groups, and benefits from input by refugees into program design.
Throughout Liberia’s 14 years of civil war, the use of rape and sexual violence as a weapon of war was all too common. Although the war itself came to an end in August 2003 and the country has been disarmed since that time, sexual violence continues to affect Liberians. It is now estimated that 40 percent or more of women and girls in Liberia have experienced some form of sexual violence. In order to treat the overwhelming number of rape victims, Doctors Without Borders/Médecins Sans Frontières (MSF) set up treatment and counseling centers in three camps for internally displaced people north of the capital city of Monrovia as well as at Benson Hospital in the capital itself, where 60 percent of the Liberian population lives. Recently MSF teams in Nimba, a county northeast of the capital, have also begun work on issues pertaining to gender-based violence.Rebecca Singer is a nurse from Denver, Colorado, who has spent five months working with MSF to provide treatment and support for victims of rape and other forms of sexual violence at Benson Hospital’s Gender-Based Violence Clinic. Rebecca writes of her experiences thus far in Monrovia.
Women's Equity in Access to Care & Treatment