Ruhengeri Program Summary

GHF’s current project, the subject of this grant proposal, is the development and implementation of a comprehensive community-based PMTCT and related HIV/AIDS prevention and treatment program in Ruhengeri, Rwanda. Ruhengeri is the second largest region in the trilingual African nation (Kinyarwanda, French and English) still recovering from the genocide events of 1994 during which nearly one million men, women and children were slaughtered. Specific problems in Ruhengeri are the 1) relatively high prevalence of HIV/AIDS and mother-to-child transmission; 2) lack of outpatient services to HIV/AIDS patients; 3) lack of medicines and resources to treat opportunistic infections; and 4) lack of awareness of the risks of HIV/AIDS among the general population and more particularly, among the young people of the region. The HIV rate among Rwandan women, estimated to be between 11-25%, has been exacerbated in part by the widespread number of rapes committed during and after the genocide events of 1994.

The first component of PMTCT program in Ruhengeri consisting of nevirapine therapy and rapid HIV testing was launched in October 2001 because of support from the Global Hope Foundation and generous donations by the Dorothy Ann Foundation, Roxane Laboratories (a subsidiary of Boehringer Ingelheim Corp.) and Orasure Technologies. This program expands upon and facilitates the initial PMTCT program in Ruhengeri and includes related HIV/AIDS services (the “Ruhengeri Program”) has been planned and coordinated with the medical staff at l'Hôpital de Ruhengeri ("Ruhengeri Hospital"), the Ruhengeri Provincial AIDS Commission (Commission Provincale de Lutte Contre Le SIDA De Ruhengeri or "CPLS") and the Rwandan Ministry of Health’s Treatment and Research AIDS Center ("TRAC"). Input also came from consultations with the Centers for Disease Prevention and Control ("CDC") in Atlanta and select NGO’s operating in Rwanda.

The Ruhengeri Program is initially a twenty-four (24) month program (albeit with the view for perpetual sustainability) that will:

• PMTCT: Provide rapid HIV tests (with voluntary counseling indicated below) to screen pregnant women for nevirapine treatment and supply reagents for ELISA confirmatory HIV tests.
  
• Establish pre- and post-test VCT (voluntary counseling and testing) services with the guidance of Family Health International for local Ruhengeri medical and social workers.
  
• Provide assistance in obtaining and sustaining a supply of drugs to prevent and treat opportunistic infections.
  
• Support the Association Des Jeunes Scolarisés Contre Le SIDA (Association of Young Students Against AIDS, or the "Jeunes Scolarisés") in educating young people about the risks of HIV/AIDS and publicizing the services offered by through the Ruhengeri Program.

On a far more reaching scale, the Ruhengeri Program will:

• Combine the respective skills and experiences of all of the actors/institutions involved in the prevention and treatment of HIV/AIDS the Rwanda by coordinating their activities;
  
• Maintain dynamic interactions among the actors which will permit them to share their respective experiences, reach a consensus on the approach, efficiently develop further capacities and adapt new innovations to the current reality of the Ruhengeri province (i.e. taking into account the impact of the genocide within communities);
  
• Serve as a model for future programs developed and implemented by GHF in other parts of sub-Saharan Africa, Eastern Europe and developing regions of the globe; and
  
• Serve as a model of how small grassroots NGO's can partner with local community members and institutions in developing nations to develop and implement public health programs.

The CPLS and the medical staff of Ruhengeri Hospital will administer the Ruhengeri Program with an annual audit by GHF. The hospital has been operating with general technical support from Coopération Française, but to date has received no support specifically targeted for HIV/AIDS prevention and treatment. The goals of the Ruhengeri Program include the 1) reduction of perinatal HIV transmission in the region, 2) facilitation of outpatient care and support services, and 3) amelioration of the AIDS burden on the resources of the province’s primary hospitals.