As we enter 2013, it‟s time to reflect on a year that brought renewed energy, collaboration, and innovation to the fight against HIV in Côte d‟Ivoire. As 2012 progressed, so did efforts to reform and support the Central Medical Stores (PSP) and improve donor coordination for health and HIV-specific interventions.

Gathering and using quality data for decision-making was a priority, marked by a strong national HIV-commodities quan-tification, a major data quality assessment for the OVC pro-gram, more than 100 visits to monitor PEPFAR-supported sites, the extension of new HMIS software to more dis-tricts and sites, and the comple-tion of the national Demograph-ic and Health Survey, with final results (including HIV preva-lence data) to be released soon.

Together we made significant progress in strengthening the national blood supply system and laboratory network, with the opening of CNTS branches and a P3 biosafety lab at Insti-tute Pasteur. New ART proto-cols began to roll out, and ser-vice provision reached farther through new or rehabilitated sites, including a new pediatric treatment center at CHU Yopougon and a home for the InfoSIDA national hotline.

We bade farewell to longtime colleagues and welcomed new collaborators – not only within the larger PEPFAR family but also at PNPEC, UNAIDS, the CCM, and the EU, to cite a few. The end-of-year change in lead-ership at the Ministry of Health and AIDS certainly means a period of transition but also presents an opportunity to renew mutual engagement and transparency and to work to-gether to meet Washington‟s new “PEPFAR Blueprint: Creat-ing an AIDS-free Generation” and President Ouattara‟s chal-lenge of making 2013 “The Year of Health.”

Jennifer Walsh PEPFAR Country Coordinator

No. 21, January 2013

News you can use

from PEPFAR Côte d’Ivoire

A fter her husband‟s death in 2008, Amina-ta Soro found herself struggling to man-age her HIV care and feed her four

daughters. Meeting an AVSI Foundation social worker seemed like a good chance to ask for a sack of rice and some cooking oil.

“Their polite refusal was kind of a shock,” the 45-year-old recalls. “I thought, „This is just another one of those NGOs that arrive, give you their spiel, and then disappear after having benefitted financially from your suffering.‟ But I was wrong.”

Instead of a handout, the Soro family found a hand up. As part of a USAID/PEPFAR

project that in FY 2012 provided

care and support for 15,710 orphans and vulner-able children and 11,612 adult family members in Côte d‟Ivoire, AVSI emphasizes building on ex-isting community resources to move families toward autonomy.

Based on its assessment of the family‟s re-sources and priority needs, AVSI has provided health care, education, and psychosocial support for the daughters, who have also been tested HIV-negative. Looking ahead, the project also

provided tools, seeds, and training in hydroponic techniques to help the family put its shared back yard, in Abidjan‟s high-density Abobo quarter, to use growing vegetables.

During Côte d‟Ivoire‟s civil war flare-up in 2010-2011, “those vegetables saved my life and the lives of my neighbors, at a time when it was almost impossible to get to the mar-ket,” Aminata says. In addition to feeding her family, she has managed to sell 20 kg of toma-toes and eggplants, which has helped her take over paying school costs for one of her children. This year she‟s joining with three other HIV-positive wid-

ows to expand into truck farming and raising chickens.

“Now I realize that if AVSI had just given me some rice to eat, I wouldn‟t have discovered all the value and richness that are in me and around me,” Aminata says. “I was complaining about being hungry when I was perfectly capable of producing food. … With AVSI‟s support, we‟ve gotten to work, and our shared will to get ahead gives us the strength to believe in a better future for our children.”

Not a handout, but a hand up PEPFAR support helps families grow for the long run

Success Story

Aminata Soro works in the vegetable garden in Abobo that is helping sup-port her family and secure her future.

Coordinator’s Corner

Happy 2013! Dear partners, friends, colleagues,

Thank you for your dedication, hard work, and personal sacrifices, which allowed

the PEPFAR Côte d‟Ivoire program to recover fully and reach new heights in 2012.

May you return from a joyous, restful holiday with renewed strength to carry on the

fight. From the PEPFAR Côte d‟Ivoire team, best wishes to you and your loved ones

for a healthy, prosperous, productive, and peaceful new year.

Inside

World AIDS Day: Public HIV tests for U.S. Ambas-sador, left, and new Minister of Health and AIDS highlight national observance: Page 2. PEPFAR CI results: Continued expansion of antiretroviral treatment (at right), PMTCT, and OVC care are among FY 2012 achievements: Page 3. Center of excellence for pediatric treatment opens in Yopougon: Page 3.

Patients on ART with PEPFAR support

Page 2

With PEPFAR support, three

Ministry of Health and AIDS offi-

cials joined 200 logisticians and

supply-chain experts from around

the world to share experiences

and lessons at the 2012 Global

Health Supply Chain Summit in

November in Kigali,

Rwanda. Dr. Olivier

Yayo, director of the

National Pharmaceuti-

cal Development Pro-

gram; Dr. Carine Co-

do, coordinator of the

ARVs Management

Section at the Central Medical

Stores (PSP); and Dr. Nina Ehou-

lan-Oka, pharmacist for the Co-

cody-Bingerville Health District,

said they particularly valued the

networking with global supply

chain expertise at the summit,

which covered a variety of

themes relevant to Côte d‟Ivoire,

including measuring and optimiz-

ing supply chain performance,

improving data visibility, and un-

derstanding and managing supply

chain risks and internal controls

to minimize drugs lost between

port and patient.

“We learned a lot and feel

inspired to become supply chain

champions for Côte d‟Ivoire,”

said Dr. Yayo, who has

already taken action to

launch a local associa-

tion of public health

logisticians. “It is vital

for us to make use of

new experiences and

innovations in the sup-

ply chain technical area, to ad-

dress challenges that we encoun-

ter in our efforts to increase

availability of lifesaving health

products.

“Decision-makers and supply-

chain practitioners in the public

health sector have to share a

common vision and work toward

a stronger supply chain system,

which is critical for the success of

health programs.”

G overnment commitment and individual

responsibility in the fight against HIV/

AIDS were themes of a PEPFAR news

conference, an “in-reach” program for U.S.

Embassy staff, and a national World AIDS Day

2012 celebration that included

public HIV testing for the U.S.

Ambassador and the new Min-

ister of Health and AIDS.

Culminating a week of activities, the Dec. 1

national observance in Abobo featured re-

marks by newly appointed Minister of Health

and AIDS Dr. Raymonde Goudou-Coffie and

U.S. Ambassador Phillip Carter, who presented

elements of the new “PEPFAR Blueprint” for

creating an AIDS-free generation, underscored

America‟s continued role as a leader in the

international fight against HIV/AIDS, and called

upon Ivoirian leaders to increase their owner-

ship and funding of the national

response. Both demonstrated

the importance of knowing

one‟s sero-status by being

tested and counseled during the ceremony by

CDC/PEPFAR partner PSI staff.

While many PEPFAR partners promoted the

national “Zero Deaths Due to HIV/AIDS”

theme with outreach activities in their inter-

vention zones, USAID/PEPFAR partner Geneva

Global and local subpartner Lumière Action

assisted at the national observance to provide

HIV testing and counseling; among 219 women

and 309 men tested, 16 women and six men

were diagnosed as HIV-positive and referred to local health facilities for care.

Ambassador Carter and four Ivoirian minis-

tries joined PEPFAR CI in kicking off the week

with a news conference to outline the U.S.

government‟s contributions in the fight against

HIV/AIDS in Côte d‟Ivoire and underline the

importance of strong inter-governmental part-

nerships. In addition to highlighting prevention,

care, and treatment results for FY 2012 (see

related story on Page 3), PEPFAR‟s support for

systems strengthening was highlighted in

presentations by the Ministry of Health and

AIDS (focusing on elimination of mother-to-

child HIV transmission); the Ministry of Em-

ployment, Social Affairs, and Professional Train-

ing (integration of HIV/AIDS modules in train-

ing curricula for social workers); the Ministry

of Education and Technical Instruction

(integration of life skills in public school curric-

ula); and the Ministry of Solidarity, Families,

Women, and Children (care and support for

orphans and vulnerable children).

Embassy staff were the target of an “in-

reach” day, under the theme of “Working

Together for an AIDS-Free Generation,” that

focused on teaching parents skills to speak with their children about sexuality and introducing

strategies to live positively with HIV. PEPFAR

staff and implementing partners provided pre-

vention kits and led discussions about practical

applications of “Families Matter” strategies for

parent-child communication. A sero-discordant

couple shared their experiences with discover-

ing the husband‟s HIV, providing mutual sup-

port, and living positively. The Embassy Health

Unit collaborated with the Port Bouet HIV

Counseling and Testing Center and CDC/

Retro-CI laboratory to provide free testing and

counseling for Embassy staff and families.

World AIDS Day highlights political, personal action

U.S. Ambassador Phillip Carter and new Minister of Health and AIDS Dr. Raymonde Goudou-Coffie (second and third from left) lead the charge for “Zero Deaths Due to HIV/AIDS” at the national World AIDS Day observance.

W ith support from First

Lady Dominique Ouattara,

the Ministry of Health and AIDS

and its partners in November

launched a national plan to elimi-

nate mother-to-

child HIV transmis-

sion (eMTCT) by

2015, at an estimat-

ed cost of $186.3

million.

The plan aims to

reduce the num-

ber of new HIV

infections among

women of child-

bearing age by

50%, to ensure that all women‟s

family-planning needs are met, to

reduce vertical HIV transmission to below 5%, and to reduce HIV-

related maternal, neonatal, and

child mortality by 90%.

Planned actions will focus on

primary HIV prevention among

women, prevention of undesired

pregnancies among HIV-positive

women, ARV prophylaxis for HIV-

positive pregnant women, care

and treatment for HIV-positive

women and their families, govern-

ance, and evaluation and research.

Expected results include that

80% of women and their partners

eliminate high-risk behaviors, 95%

of pregnant women and their

partners know their HIV status,

90% of women use family-planning

services, 90% of pregnant HIV-

positive women and 90% of their

newborns receive ARV prophy-

laxis, 100% of infants born to HIV-

positive women on ART are test-

ed for HIV, and 80% of identified HIV-positive children remain alive.

Main challenges include funding

and shared ownership and re-

sponsibility by all stakeholders.

World AIDS Day

2012

Zibo Jean-Claude Debo and Madeleine Konan share their ex-periences as a sero-discordant couple dur-ing an Embassy World AIDS Day program.

First Lady Dominique Ouattara

National eMTCT plan aims to end vertical HIV transmission by 2015

Drs. Codo, left, Ehoulan-Oka, and Yayo

Supply chain champions Summit stimulates global exchange, networking

FY 2012 was a year of rapid post-

crisis recovery and significant

growth for PEPFAR Côte d‟Ivoire, with

particular successes in expanding antiretro-

viral therapy, prevention of mother-to-

child HIV transmission, and care and sup-

port for orphans and vulnerable children.

Other notable achievements with PEP-

FAR support include opening the country‟s

first biosecurity Level 3 laboratory at the

Pasteur Institute in Abidjan and renovating

and equipping a Pediatric Treatment Cen-

ter at the University Teaching Hospital

(CHU) of Yopougon.

“Our implementing partners are hitting

their stride again after the disruptions of

2011,” said PEPFAR Country Coordinator

Jennifer Walsh. “New leadership from the

Ivoirian government and better coordina-

tion with other donors will help us to fur-

ther extend and consolidate these gains.”

PEPFAR, the largest commitment by any

nation in history to combat a single dis-

ease, is by far the largest donor for Côte

d‟Ivoire‟s national HIV/AIDS response.

Worldwide, PEPFAR was directly sup-

porting life-saving ART for more than 5

million men, women, and children as of

Sept. 30, 2012, up from 3.9 million in 2011.

PEPFAR also directly supported ARV

prophylaxis to prevent mother-to-child

HIV transmission for almost 750,000 HIV-

positive pregnant women in FY 2012, al-

lowing 230,000 infants to be born HIV-

free; care and support for 15 million peo-

ple, including 4.5 million orphans and vul-

nerable children; and HIV testing and

counseling for 49 million people.

PEPFAR 2012 results: HIV services reach farther

Page 3

C ôte d‟Ivoire‟s campaign to eliminate pediat-

ric HIV/AIDS took a step forward in Octo-

ber with the inauguration of the Pediatric

Treatment Center (CTAP) of the University

Teaching Hospital (CHU) of Yopougon in Abidjan.

The center is the culmination of three years of

collaborative efforts by PEPFAR and its Ivoirian

implementing partner ACONDA VS with the

CHU of Yopougon and the Mairie de Paris work-

ing through the Panafrican Organization to Fight

HIV/AIDS. PEPFAR‟s $400,000 investment helped

renovate and equip the new national reference

center for the diagnosis, treatment, and care of

pediatric HIV/AIDS, as well as a training center

upgraded to international standards.

U.S. Ambassador Phillip Carter joined the minis-

ters of Health and AIDS and of Women, Families,

and Children in noting the center‟s importance in

moving Côte d‟Ivoire toward the elimination of

pediatric HIV/AIDS. Only about one-fourth of the

country‟s estimated 61,000 children living with

HIV have been diagnosed.

The ambassador also took the opportunity to

encourage national authorities to pursue the

scale-up and integration of pediatric care and

treatment into all maternal, neonatal, and health

care centers, with linkages to social-sector care

and support.

“Without strong government leadership and

coordination across the health and social sectors,

tens of thousands of children will remain undiag-

nosed, untreated, and needlessly at risk,” Carter

said.

An emotional highlight was the announcement

that the center would be named after Prof. Mar-

guerite Timité Konan, a pioneering clinician and

activist who helped establish the country‟s first

pediatric antiretroviral treatment site at CHU

Yopougon and served as mentor to many of the

country‟s experts in pediatric HIV/AIDS.

PEPFAR in Côte d’Ivoire FY

2004 FY

2009 FY

2010 FY

2011 FY 2012

PMTCT sites 26 414 541 506 573

HIV-positive pregnant women receiving ARV prophylaxis

1,840 7,757 10,993 9,000 11,022

HIV testing & counseling sites 18 450 737 708 712

Persons tested, given results 45,527 646,738 836,670 726,800 894,938

People with HIV receiving clinical care

26,950 105,530 105,999 114,400 129,601

Orphans/vulnerable children receiving care and support

1,137 95,875 110,095 101,600 125,748

ART sites 16 258 326 351 358

Persons receiving ART 4,536 49,697 61,203 64,800 81,437

0

200000

400000

600000

800000

1000000

FY04 FY06 FY08 FY10 FY12

Orphans and vulnerable children receiving care and support

Persons tested and counseled

Joy reigned at the inauguration of the Pediatric Treatment Center in Yopougon, which then-Minister of Health and AIDS Prof. Thérèse N’dri-Yoman, left, announced will be named for Chief of Pediatrics Prof. Marguerite Timité Konan, right.

Pediatric HIV/AIDS center opens in Yopougon

Dr. Amani Lokossue, new ARV ser-vices technical adviser, CDC/PEPFAR

Sabine Gabriel, new USAID/ PEPFAR senior acquisition and assistance spe-cialist

Page 4

P EPFAR and its partners provided tech-nical and financial support for coordina-tion meetings in November-December

that allowed the Ministry of Health and AIDS (MSLS) to bring together all of its regional and departmental directors to share experiences and hear messages about improv-ing accountability, data manage-ment, and program performance.

Central ministry officials and 20 regional directors met in Daoukro to take stock of achievements and challenges of the past 12 months. „‟The purpose was to en-gage regional health directors in the Ministry‟s vision to improve governance and accountabil-ity within the health system,” said General Director for Health Prof. Allou Assa. “We all need to strengthen our health information system and above all improve the use of health data if we are to improve the quality of ser-vices that we deliver to patients.”

All 82 departmental directors gathered in Yamoussoukro described as “indispensable” the opportunity to exchange experiences and harmonize approaches to supply chain, data

management, and other issues. Based on identi-fied challenges, the regional and departmental directors de-fined strategies and formulated

recommendations to strengthen resource man-agement and improve the performance of their health programs.

“Through these sessions, we wanted to take stock of our activities and remobilize and en-courage our regional leaders to work with greater ardor to confront the enormous chal-lenges we face,” said Dr. Zamblé Koffi, the ministry‟s deputy director for health.

Youth2Youth communication Two songs, two projects, and an essay – all created by young people and designed to reach more young people with effective messages about HIV prevention, testing, and health care services – are the fruits of contests conducted

by USAID/PEPFAR Johns Hopkins University Center for Communi-cation Programs (JHU.CCP) in collaboration with the U.S. Embas-sy. Reggae star Tiken Jah is com-

posing two songs based on win-ning lyrics submitted by students. Two project proposals (one using new information technologies such as SMS and social networks, the other radio programs on intergenerational sex, PMTCT, and stigma) and an essay on targeting bars, video parlors and other high-risk zones were also selected as winners.

Strategic communication Thirty-three HIV/AIDS professionals in Côte

d‟Ivoire received training in leadership and innovative approaches in strategic communica-tion during a two-week course in October organized by USAID/PEPFAR partner JHU.CCP in collaboration with the Information, Commu-nication, and Arts Department of the Universi-ty of Abidjan.

The course, first offered here in 2010, is designed to equip senior-level health profes-sionals to play a leading role in the conception and implementation of innovative communica-tion strategies. Using the planning software SCOPE, the 17 women and 16 men designed communication interventions based on availa-ble data and country context. JHU.CCP is working with the university to devolve the course to the university.

Lab leadership Côte d‟Ivoire made a strong showing at the

first African Society of Laboratory Medicine

(ASLM) annual meeting in South Africa in De-cember, with a plenary presentation by MSLS Cabinet Director Prof. Antoine Amonkou on CI‟s national laboratory program and oral presentations by Institute Pasteur Director Prof. Mireille Dosso and CDC/Retro-CI Lab Branch Chief Dr. Christiane Adje on lab strengthening, quality improvement, and minis-try leadership in equipment maintenance, along with poster presentations. CRESAC Director Prof. Daniel Sess, ASLM ambassador for fran-cophone West Africa, led a symposium for French-speaking participants and will help or-ganize ASLM‟s first francophone meeting in Abidjan in July. The CI delegation also included former Minister Prof. Thérèse N‟dri-Yoman and other senior MSLS and Retro-CI staff.

HQ support for CI programs The PEPFAR Côte d‟Ivoire program is receiv-

ing significant technical assistance from CDC and USAID headquarters and the Office of the Global AIDS Coordinator (OGAC) in advance of COP preparation this year, with visits by technical experts to learn from CI‟s successes and recommend strategies for maximizing the performance of its program.

Overlapping reviews of the pediatric HIV/AIDS care and treatment and the orphans and vulnerable children programs in September and of health systems strengthening activities in October will be followed by visits in January to review the prevention of sexual transmission, antiretroviral treatment, and TB/HIV programs. In addition, PEPFAR CI‟s country support team lead, Allison Campbell, visited Abidjan in De-cember to share OGAC‟s appreciation for the CI team‟s efforts and Washington‟s vision for sustained, smart, and ultimately successful PEP-FAR support for the international fight against HIV – recently summarized in “PEPFAR Blue-print: Creating an AIDS-free Generation,” available at www.pepfar. gov/documents/organization/201386.pdf.

Regional health directors meet

to improve coordination.

Ministry gathers all regional, district health directors

Contribute to PEPtalk!

Tiken Jah

Send news items, story ideas, photos

to peptalk@ci.cdc.gov.

Contributors to No. 21: PEPFAR partners, Simplice Kamdem, Etien

Koua, Deborah N‟Guessan, Herve Deza, Wassia Assemien, Oumou Diabate-Cissoko, Thierry Oswald, Ernest Koffi, J.L. Njampo, B. Howard

After six years as director of Côte d‟Ivoire‟s Na-tional HIV/AIDS Care and Treatment Program (PNPEC), Dr. Virginie Ettiègne-Traoré left in November to lead FHI360‟s new HIV/AIDS preven-tion and care project in Ghana. Under her leadership, with support from PEPFAR and ministry collaborators, the PNPEC built national capacities and established itself as a critical link in the national HIV/AIDS strategy.

Achievements include elaboration and revision of a national care and treatment policy and normative docu-ments. up-to-date and simplified thera-peutic regimens, integrated training materials, training for at least 500 health-care providers per year, standards and proce-dures for STI care, revised national HIV indicators and data collection tools, and a national plan to elimi-nate mother-to-child HIV transmission. Dr. Traoré

led the PNPEC to closer collaboration with the Cen-tral Medical Stores (PSP) to ensure continuous sup-plies of ARVs and commodities, even at the height of the 2010-2011 political crisis in Côte d‟Ivoire.

Under a national expansion plan for decentralized HIV/AIDS services, she helped improve coordination of inter-ventions, contributing to increasing key national results, including the number of patients on antiretroviral treatment (93,065), PMTCT sites (809), HIV test-ing and counseling sites (847), care and treatment sites (497), TB/HIV sites (133), and laboratories with CD4 count capacity (97). Dr. Traoré also served as director

of CDC/PEPFAR‟s ongoing cooperative agreement with the Ministry of Health and AIDS and led the PNPEC‟s successful application for a Global Fund Round 9 grant.

Comings & Goings

PEPFAR

Potpourri

After 6 years, national HIV/AIDS director heads for the field