On the occasion of a trip to Côte d’Ivoire, a delegation of French parliamentarians, accompanied by Dr Philippe Duneton, Deputy Executive Director of Unitaid, devoted the morning of 2 July to the ATLAS Project. Marion Lenne, Jean-Francois Mbaye, Sira Sylla and Valérie Thomas[1] were present in Côte d’Ivoire at the invitation of Unitaid, in order to learn about the benefits of French investments in global health.
They had the opportunity to discover the Clinique Confiance de Biétry and the Centre d’Accompagnement et de Soins en Addictologie (CASA), one of the implementing partners of the ATLAS project, the NGO Espace Confiance[2] which has been working since 1994 to raise awareness, screening and medical and psychosocial care for key populations.
Inaugurated in October 2004, the clinic is a site for the prevention and management of STIs and HIV/AIDS in key populations, as presented by Drs Anoma and Fofana, respectively Director of Espace Confiance and Director of the Clinic.
Positioning its action on the principles of non-judgment, gratuity and discretion, the staff of the Cliniques Confiance (4 in total), including 12 doctors, 4 nurses, 110 community counsellors and peer educators, offer services in fixed and advanced strategy, which made it possible to reach more than 20,000 beneficiaries in 2018, including more than 10% at the Biétry site.
The visit then continued at CASA, where Dr. Zahoui, site manager, presented this structure dedicated to the care of drug users (DU).
In Côte d’Ivoire, according to a study carried out in 2017 by Médecins du Monde, which accompanied the establishment of the centre, the prevalence of HIV/AIDS is 5.64% among IDUs, and that of tuberculosis is 9.8%[3], which is higher than the national average, in a context of low access to healthcare, high stigmatization and repression.
CASA was therefore born out of the need to provide a community care centre for DUs, where information, awareness, testing, primary health care and HIV and tuberculosis care are provided in a non-judgmental environment.
After less than a year of operation, CASA has already welcomed more than 730 people, 11% of them women, with the arrival of more than 70 new DUs each month. Of these, 2.3% are HIV-positive and 4.1% have tuberculosis. The CASA team has also organized 34 screening outings since its opening.
These two sites are partners of the ATLAS Project, and will provide HIV self-testing, in advanced strategy for the Confidence Clinic in Biétry and in fixed strategy for the CASA.
[1] Marion Lenne, LREM deputy for Haute-Savoie, Jean-François Mbaye, LREM deputy for Val-de-Marne, Sira Sylla, LREM deputy for Seine-Maritime and Valérie Thomas, LREM deputy for Puy-de-Dôme, sit on the French National Assembly’s Foreign Affairs Committee.
With the ATLAS project in Mali, a major innovation as close to the field as possible to achieve the global target for HIV testing by 2020
Bamako, June, 19th 2019 – The HIV self-test will be introduced more widely and promoted in Mali so that people most at risk of contracting the virus can access their HIV status discreetly and be connected to health care or prevention services.
The ATLAS Project was officially launched today in Bamako in the presence of Michel Hamala Sidibé, Minister of Health and Social Affairs, Professor Moussa MAIGA, Executive Secretary of the High National AIDS Council, Félicité Nsabimana Ndimira, UNAIDS Country Director, Clémence Doumenc-Aïdara, ATLAS Project Director, Laurent Vidal, IRD Representative in Mali, and Odé Kanku Kabemba, ATLAS Project Manager in Mali.
Supported and funded by Unitaid, the project is implemented by the Consortium Solthis (Solidarité thérapeutique et initiatives pour la santé) and the French Research Institute for Development (IRD), in partnership with the Malian Ministry of Health and Social Affairs, the Executive Secretariat of the High National AIDS Council, the Sectoral AIDS Control Committee, AKS, Amprode Sahel, ARCAD Sida, Danaya So, PSI and Soutoura.
Over a period of 3.5 years, ATLAS will not only enable the distribution of 150,000 HIV self-test kits in Mali, but will also lay the foundations for the large-scale deployment of this testing strategy by the government and other partners, with the support of institutional, community and research partners.
« ATLAS is part of Unitaid’s broader investment strategy to promote HIV self-testing in Africa, including West and Central Africa, as a way to achieve high rates of HIV testing, and thus help reverse the epidemic. » said Lelio Marmora, Executive Director of Unitaid.
Knowing your HIV status : an essential step in ending the epidemic
At a time when UNAIDS is advocating for universal access to HIV testing to defeat the epidemic by 2030, the stakes are high because in Mali, only just over 40% of people living with HIV know their status[1]. Stigma and discrimination against people living with HIV are major barriers to achieving the global goal of testing[2]. It is therefore essential to innovate to diversify the supply of screening and thus be able to reverse the course of the epidemic.
Although the rate of HIV infection remains moderate in West and Central Africa, the HIV epidemic is concentrated in certain population groups such as sex workers and men who have sex with men. ATLAS will provide a complementary screening offer strategy, allowing, through self-testing, to reach populations at high risk of contracting the virus who do not access existing screening services.
The ATLAS project, at the crossroads of technological and societal innovation
By targeting at-risk populations, ATLAS offers people who have never been tested before or whose practices require frequent testing, the opportunity and a tool to know their status and refer to appropriate prevention or care services. The self-test, an oral device for detecting HIV antibodies that consists of passing a spatula on the gums and then immersing it in a reagent, allows for simple and rapid screening in complete discretion, and strengthens the ability of each person to be an actor in their own health.
The project will help to create the conditions for the introduction and large-scale deployment of HIV self-testing and generate the necessary demand for self-testing among these target populations.
Finally, the ATLAS project includes a scientific component involving the IRD, pilot of the research and evaluation component, the London School of Hygiene and Tropical Medicine and the Imperial College of London. Five studies will be conducted to document the impact of HIV self-testing as an essential complementary testing strategy and determine the most cost-effective distribution models. The results of the studies will be shared with countries in the region to facilitate the adoption of the screening self-test and its widespread deployment.
By 2015, Unitaid had taken a pioneering role in promoting HIV self-testing with the STAR project implemented by Population Services International (PSI) and its partners in six southern African countries. To date, nearly 30 countries have integrated HIV self-testing into their testing programs.
[1] National Strategic Framework for HIV and AIDS (CSN 2017-2021)
[2] UNAIDS ’90-90-90′ goals set for 2020 : 90% of HIV-positive people know their status, 90% of people tested positive for HIV are on antiretroviral therapy, 90% of people on treatment have a viral load Undetectable.
« Carnets de santé », a project of the Presidential Council for Africa (CPA) and the NGO Action Global Health, aimed at highlighting African innovations to make health accessible to all, made a stopover in Senegal from 20 to 25 May 2019. Led by Dr Yvonne Mburu, immunologist and member of the CPA, the delegation visited two partner structures implementing the ATLAS Project. In Dakar, first of all, Dr Bâ, Technical Coordinator, presented CEPIAD, the Dakar Integrated Addiction Care Centre, which will participate in the distribution of HIV self-test kits as part of the implementation of the project. At the origin of the creation of the Centre, explains Dr Ba, « a 2011 survey that shows a very high vulnerability of drug users to HIV, with a prevalence of 9.4%, and to HCV, with 23%. » CEPIAD, the first specialized unit in West Africa, now has « an active line of 500 users, 275 of whom are on methadone ». This unit of the psychiatry department of Fann Hospital also offers community and advanced strategy activities. Ousmane, community mediator, recalls that « risk reduction (RoR) is one of the centre’s priorities, as is advocacy with the security forces and advanced strategy screening. »
Dr Diallo, from the ATLAS Project, presents the oral self-assessment kit for HIV
The delegation also went to Ziguinchor, to the health centre, formerly Silence Hospital, where it was welcomed by Dr Jean-Jacques Malomar, Chief District Physician. Dr Sanata Diallo, Head of the ATLAS Project in Senegal, then presented the project and its innovations, together with Dr Boubacar Diouf, Enda Santé’s representative on site and implementing partner. Stressing that « the end of the epidemic begins at the front door, testing », Dr. Diallo introduced participants to the oral HIV self-test device that will be provided as part of the project. Meetings were held with the beneficiaries, including a group of sex workers from the Diamorane association. Sokhna Rokhaya, mediator, stressed in particular the need for them to be tested every three months. « The conditions are so difficult that we have to accept many things », she explained, half acknowledging that she and her sisters often had to accept to practice their profession without protection. « I didn’t want to test myself first. But the talks and awareness convince us, the “official” sex workers as well as the informal or hidden », she explains, adding that « the self-test perfectly meets the needs of our profession. »
Another innovation of the ATLAS Project is that secondary distribution will make it possible to provide HIV self-assessment kits to key populations for distribution to those targets who do not wish to travel to health centres, particularly because of the strong stigma that still prevails in Senegal.
Abidjan, May 7th, 2019 – Supported and funded by Unitaid, the ATLAS and MTV Shuga : Babi projects officially launched today in Abidjan.
MTV Shuga : Babi is a television series and multimedia campaign aimed at raising awareness of HIV/AIDS among young people in French-speaking Africa.
The ATLAS project will provide HIV self-tests kits in Côte d’Ivoire.
ATLAS and MTV Shuga : Babi, both supported by Unitaid, are two complementary projects in the fight against HIV/AIDS, with a particular focus on West and Central Africa.
The event was attended by the Deputy Director General of Health and Public Hygiene, in charge of the Health System, representing the Minister of Health and Public Hygiene, Dr Jean Anouan N’Guessan, and the French Regional Advisor for Global Health, Saran Branchi Fadiga, representing His Excellency the Ambassador of France to Côte d’Ivoire, Mr. Gilles Huberson, the Deputy Executive Director of Unitaid, Dr. Philippe Duneton, the Deputy Executive Director of the MTV Staying Alive Foundation, Ms. Sara Piot, and the Director General of Solthis, Dr. Louis Pizarro.
Knowing your HIV status : a critical step in ending the epidemic
The ATLAS project will provide more than 500,000 HIV self-test kits, including more than 300,000 in Côte d’Ivoire, over a period of 3.5 years. The ATLAS project is being implemented in Côte d’Ivoire, Mali and Senegal jointly by the consortium formed by Solidarité thérapeutique et initiatives pour la santé (Solthis) and the Institut de Recherche pour le Développement (IRD), a French research organisation.
The project targets at-risk populations, including sex workers and their clients, men who have sex with men, drug users and patients with sexually transmitted diseases. This project brings together IRD, which will lead research and evaluation activities, and PACCI, the London School of Hygiene and Tropical Medicine and Imperial College London. Five studies will be conducted to document the impact of HIV self-testing as a complementary testing strategy, and to determine the most cost-effective distribution models. The ATLAS project will lay the foundation for the large-scale deployment of its screening strategy by governments, with the support of partner institutions, associations and research organizations.
Prevention, an essential approach to contain contagion
MTV Shuga is a popular television series about the lives of young people living in Africa. Seven seasons have already been broadcast and reached 720 million people. The series tells powerful stories with sexual health messages to influence viewers’ attitudes and behaviours. An independent study conducted in Nigeria by the World Bank showed that MTV Shuga has the power to influence behaviour : twice as many people who watched the series at community screenings were tested for HIV within six months.
MTV Shuga : Babi is the first version of the series adapted to the audience of French-speaking Africa. The campaign will also include a radio series, digital and social media content and local events. The first season will be broadcast in the last quarter of 2019 and will present basic knowledge about HIV, including condom use, sex work and discrimination against people living with HIV in Côte d’Ivoire. The London School of Hygiene and Tropical Medicine will evaluate the campaign.
Unitaid plays a major role in promoting HIV self-testing. It funded the HIV Self-Testing Africa, STAR (HIV Self-test for Africa) project implemented in six southern African countries by Population Services International and partners. To date, nearly 30 countries have integrated HIV self-testing into their testing programs.
With the ATLAS project in West Africa, a major innovation as close as possible to the field to achieve the global HIV testing target by 2020.
Knowing your HIV status remains an essential step in accessing treatment and ending the epidemic
On Tuesday 29 January in Dakar, Solthis in partnership with Unitaid, the Institut de Recherche pour le Développement (IRD) and in collaboration with the Ministries of Health of Senegal, Mali and Côte d’Ivoire officially launched the ATLAS project « HIV SelfTest, Free to Access its Status » to reduce HIV-related morbidity and mortality in West Africa.
500,000 HIV self-tests to be distributed to change the face of testing among most-at-risk populations.
Improving access to HIV testing through self-testing is an innovative approach to reaching key populations that are not being reached today but are most at risk and where the epidemic remains concentrated.
This strategy complements existing screening strategies to reach as many people as possible and accelerate the achievement of UNAIDS’ 90-90-90 goals, particularly the first one: « By 2020, 90% of people living with HIV know their HIV status » in a region where only half (48%) of people living with HIV know their status and therefore cannot access treatment.
« The #ProjetATLAS puts the diversification of self-test distribution channels at the heart of its project to reach key populations that are not being reached today. » President of Renapoc Mali #launch at #Dakar Cc @UNITAID @ird_fr @NGOSolthis
#P#ProjetATLAS#lancement#unitaid «The #HIV self-test is a technological and societal innovation. It is a tool for accessing treatment and prevention » @dunetonphilipp1
A more comprehensive investment strategy to promote HIV testing in Africa
« ATLAS is part of a more comprehensive investment strategy to promote HIV self-testing in Africa, including West and Central Africa, as a way to achieve high rates of HIV testing, and thus help reverse the epidemic. », said Lelio Marmora, Executive Director of Unitaid.
The 3.5-year ATLAS project will not only distribute 500,000 HIV self-test kits in Côte d’Ivoire, Mali and Senegal, but will also lay the foundations for the large-scale deployment of this testing strategy by governments and other partners, with the support of institutional, community and research partners.
Dakar, 3 December 2018 – On the occasion of the second edition of the Journées Scientifiques Sida au Sénégal (JSSS), which is being held from 3 to 5 December at the Centre International de Conférences Abdou Diouf (CICAD), the ATLAS project (Autotest VIH, Libre d’accéder A la connaissance de son Statut), opens up perspectives on self-screening as part of the symposium « HIV self-testing, an innovative tool to make available a screening offer tailored to vulnerable populations ».
Know your status
In a context where, in Senegal, more than a quarter of people living with HIV do not know their HIV status, it is essential to diversify the testing offer to achieve UNAIDS’ 90-90-90 targets (90% of HIV-positive people know their status, 90% of people who test positive for HIV have access to treatment, 90% of people on treatment have an undetectable viral load by 2020). As highlighted in the latest UNAIDS report, Knowledge is power, published on 22 November, the West and Central Africa region is lagging behind in screening, preventing rapid entry into care.
Implemented in Senegal by the consortium Therapeutic Solidarity and Health Initiatives (Solthis) – Institut de recherche pour le développement (IRD), in partnership with the Senegalese Ministry of Health and Social Action, the Conseil National de Lutte contre le Sida, the Division de lutte contre le Sida et les Infections sexuellement transmissibles, CEPIAD, CTA, ENDA Santé and SSD, the ATLAS Project is supported and financed by Unitaid for a period of 3.5 years and a budget of about 15 million dollars. It was developed to diversify the screening offer with an innovative solution for vulnerable populations that complements existing screening services.
The ATLAS project, at the crossroads of technological and societal innovation
By targeting vulnerable at-risk populations who do not identify themselves as such and by using secondary distribution channels, ATLAS provides a way for people who have never tested, often for reasons of stigma and confidentiality, to do so. The self-test (an oral device for detecting HIV antibodies that consists of passing a spatula on the gums and then immersing it in a reagent) makes it possible to demedicalize the act and strengthens everyone’s ability to be an actor in their health.
The project is also innovating by distributing the self-test to a larger average, which until now had only been tested in pilot programs. The ambition of the ATLAS Project is to prepare the transition to the sub-regional level as of now by supporting the implementation of the necessary legislative frameworks.
Finally, the ATLAS project is a research program involving the IRD, the Bouisson Bertrand Institute, the London School of Hygiene and Tropical Medicine and the Imperial College of London, among others. Five studies will be conducted from the end of 2018 to demonstrate the contribution of self-testing as a complementary screening strategy.
The ATLAS project is being implemented in Côte d’Ivoire, Mali and Senegal.
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