The path to ending AIDS runs through communities. From connecting people to the treatment, services and support they need. Through AJAN collaboration with grass root centers, we get to support all those on the frontlines of the battle against AIDS by placing community leadership at the center of HIV plans, programs, interventions, and monitoring efforts.

The Context Today in Madagascar

Despite the low HIV prevalence of 0.30% in Madagascar according to the Spectrum projection tool, the number of new infections over the past five years has increased significantly, mainly affecting young people aged 15 to 49. In addition, the epidemic remains concentrated among key populations. Due to lack of funding, the last HIV seroprevalence survey among pregnant women was conducted in 2019, among HCPs and CDIs in 2016, and among MSM in 2014. This year, the seroprevalence and biobehavioral survey of these key populations was carried out, the results of which are currently being validated. A few sentinel surveillance sites for pregnant women are being set up and will be operational. Faced with this situation, new strategies have been adopted in the new National Strategic Plan 2023-2028, whose interventions tend towards the improvement of the three 95 and towards the elimination of HIV by 2030. Thus, the dissemination of messages remains essential to strengthen information, awareness and advocacy among the respective targets. The first of December is the date set aside to celebrate the fight against HIV/AIDS, and serves as a setting for the demonstration of support for PLHIVs: a platform for them to talk about the important challenges in their lives and to raise awareness, to remind everyone that HIV/AIDS still exists in our country,  and that everyone’s commitment and increased awareness of the impact of HIV and the fight against stigma and discrimination with the improvement of the quality of life of people living with HIV remain essential.

D-Day

For this year, the national celebration of Worlds AIDS Day on December 1 took place in Antananarivo, aligning with the global theme “Entrusting leadership to communities”, a message that was at the heart of the respective activities of each entity working in this struggle for the entire month of December. Because of the electric pre- and post-election atmosphere, all the stakeholders for the celebration were unanimous for a ceremony behind closed doors with only 150 people from organizations working with HIV/AIDS among other international and national organizations: UNFPA, UNAIDS, UNICEF, WHO, UNDP, LINFPA, ILO, PSI, CRS, ASOS,  … the Executive Secretariat of the National Committee for the Fight against AIDS (SECNLS), the National Programme for the Control of Communicable Infections (PNLIST) of the Ministry of Public Health, associations for the care of PLHIV and key persons (PS, LGBT, CDI), religious organizations (Reformed, Catholic, Roman, Lutheran Churches) and the Arrupe CA MDG Centre.

The day was preceded by a renovation of the HIV/AIDS stele in the city centre, a symbol to raise awareness that HIV and AIDS still exists. At the national and regional levels, HIV testing sessions have taken place despite the lack of reagents, which are reserved only for key people for a few years. However, the State is being asked to provide more reagents for young people in the new national policy that is being adopted.

The celebration of December 1st began with an ecumenical service led by Pastor Vololona RANDRIAMITANDRINA of OMASAVE, which was followed with the worship program that was led by the SAVE/INERELA organization. This was followed by a series of speeches by some state representatives including the Ministry of Health, the National Committee for the Fight against HIV, international representatives such as the representative of UNAIDS, and an association of PLHIV represented by MAD’AIDS. Certificates of recognition were distributed to 30 public and private actors combating HIV, including the Catholic Church represented by the MDG Board of Directors, including communication personnel and Eglise Catholique Apostoliques Romaine (ECAR) (Roman Apostolic Catholic Church) , thanks to prevention and awareness-raising activities within the framework of the L’émission Education à la Vie et à l’Amour (EVA) (The programme of Education in Life and Love) and AJAN HIV/AIDS Prevention Program for the Youth (AHAPPY).

We shared our best practice as follows:

Promotion of education for the integral development of man

• EVA adapted to the age group.
• EVA as part of the school subject
• AHAPPY with young people in Catholic chaplaincies, universities, associations, etc.

Education, awareness-raising, referral, and networking

•  With the various existing entities within ECAR (parishes, health facilities, media, rural and urban development, schools, associations, the Society of Jesus and other Religious Congregations…)
• With entities in public services (CSB, Hospital, Miscellaneous Centre, SECNLS, Ministries, etc.)
• Avec OMASAVE/INERELA dans le cadre du programme SAVE (Safety practices, Access to treatment, Voluntary, confidential, and regular counselling and testing- VCT, Empowerment)
•  With the African Jesuit Aids Network (AJAN) as part of the AJAN HIV/AIDS PREVENTION PROGRAM for the YOUTH (AHAPPY)

Development of Document and IEC tools

• Collaboration between 4 fundamental episcopal commissions (EC Family, EC Health, EC Education, EC Catechetical and Biblical)

Broadcasting and sharing 

• Collaboration between 3 other Episcopal Commissions (EC Social Communication, ECLAC – Pastoral Care of the Laity, EC Consecrated Life.)

Targets for different set of groups and types of activities

• Students: Compulsory courses on Sex Education, Awareness of STIs/HIV/AIDS in the subject EVA (Education for Life and Love) in primary and secondary classes of Catholic schools
• Parents: Conferences on Sex Education, Awareness of STIs/HIV/AIDS in EVA- Parents of Catholic Schools
• Teachers, facilitators: EVA and AHAPPY Training of Trainers on Sex Education and Awareness on STI/HIV/AIDS
• Conferences and talks in parishes, in associations, in universities, in companies, in chaplaincies on AHAPPY.
• General population:  Regular EVA and AHAPPY broadcasts with Radio Don Bosco, (listeners: 3,600,000)
• Catholic health facilities: Talks with communication personal, STI/HIV/TB testing and Medical and psychosocial care (STI) or referral (HIV/AIDS)

However, we have some challenges to overcome in some areas, such as:

• To ensure the proper assimilation of the education given to pupils which should lead them to a positive behavior change that is necessary against the transmission of HIV, discrimination of infected and affected persons.
• Ensuring good mastery of HIV courses and training for EVA and AHAPPY teachers and trainers
•  The problem of the lack of reagents for HIV testing at the level of Catholic health facilities at the PNLIST or other sites
•  The establishment of listening and psychosocial care centres for people who have tested positive by religious leaders, parish associations, schools, and health facilities.

Conclusion

The day was closed with a candlelight moment in memory of the victims of HIV and AIDS. Candles were lit to pay tribute to them. Several participants had the opportunity to testify or share emotions about loved ones who have died because of the scourge; Various interpellations were also shared.

To conclude, the celebration was a day rich in activities demonstrating first the solidarity and unity of all the different entities in the fight against HIV/AIDS in Madagascar. All the stands, roll-ups and various Information, Education and Communication (IEC) tools were all displayed around the room, demonstrating the strength and willingness to unify the actions to be taken for the years to come. In addition, a special place was given to us young people who animated the whole day with artistic presentations and traditional dances. In short, everyone has their place and responsibility in this fight!

Par la Pastorale Santé et Famille dans la lutte contre le VIH/SIDA team,

Centre Arrupe Madagascar (CA MDG)