# Working Together to Prevent AIDS!

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# —Malawi’s Countermeasures to Infection: Partnership Makes a Difference—

“I don’t want other people to have to suffer what I’m suffering.” These are the words we often hear from HIV-infected people in Malawi. The threat of the HIV/AIDS epidemic is surging in Malawi in southeast Africa, with 930,000 people believed to be infected. $ ^{1} $ This represents around 7% of Malawi’s population, a strikingly high rate by global standards. The HIV/AIDS epidemic in Malawi is an extremely serious issue for the country’s sustainable development. The Government of Malawi is taking countermeasures to halt the epidemic, including setting up testing centers and healthcare centers. However, these countermeasures are not always within reach of rural areas. Against this backdrop, the national and local governments of Malawi, the Government of Japan, Malawians, Japanese and local non-government organizations (NGOs), and HIV-infected people, among others, are joining together to put their efforts into overcoming

A support group performs a traditional dance as part of AIDS outreach activities (Source: World Vision)

this issue. World Vision Japan (WVJ) is a Japanese NGO that has been participating in this initiative from the beginning.

To improve the serious state of HIV infections in rural areas, WVJ has set up AIDS Voluntary Counseling and Testing (VCT) centers with the financial assistance of the Government of Japan. $ ^{2} $ It has also carried out human resource development so that the centers can be run by Malawian people themselves. $ ^{3} $

Ms. Yuki Nakamura of WVJ has been working on this project as a coordinator since May 2007. "WVJ puts a strong emphasis on assistance for children. Our focus was on the impact the epidemic has on children in the rural areas, where the government's measures are not necessarily within their reach. We felt that we really had to do something when we saw young children losing their parents to AIDS," says Ms. Nakamura, looking back over the early phase of the project.

To make up for the shortfall in testing centers set up by the Government of Malawi, WVJ has set up 13 VCT centers nationwide with facilities and equipments essential to their running. Meanwhile, the Malawian Ministry of Health was responsible for providing viral testing kits and securing counselors to run the centers, and the Malawi Aids Counseling and Resource Organization (MACRO), a local NGO, was in charge of training counselors.

As to where to set up the VCT centers, WVJ chose places with a potential for having a large number of HIV infections, such as alongside highways, or where the number of people infected with HIV is increasing. To secure the land for the centers, WVJ talked with health authorities of local governments and residents' organizations such as chiefs of local ethnic groups. "Working on this project, we had to negotiate with many different people concerned. There were some occasions where the involvement of Japanese people—who are outsiders—helped smooth negotiations," says Ms. Nakamura.

WVJ is also conducting outreach activities on HIV/AIDS and viral testing, using posters and textbooks. Yet, merely urging people “Come and get an antibody test! They’re so important!” is not enough by itself. This is because for many Malawians, fear of a diagnosis of HIV infection is not only the fear of death, but also the fear of harsh discrimination from the people around them, even including their own families. To counter this situation, infected people themselves have formed HIV patients’ groups at the VCT centers, and begun outreach activities which stress the importance of antibody testing to the general public. With Malawian songs and dance, the unique rhythm reaches into people’s hearts. These outreach activities, conducted through the seemingly never-ending dances and songs, have had an unexpected result: they help those infected with HIV to maintain their physical strength. The HIV patients’ groups are an indispensable part of outreach activities for the general population in Malawi.

The cooperation of many people helped gradually increase the number of people visiting the VCT centers for HIV/AIDS testing and consultation. One such center saw more than 420 people in one month in July 2008.

Ms. Yuki Nakamura (far right) with a counselor and healthcare center staff in front of a VCT center (Source: World Vision)

WVJ places a strong emphasis on ownership of projects by recipient countries. It handed the VCT centers over to the Malawian Ministry in September 2008, entrusting the running of the centers to Malawian people. Through the partnerships of various people concerned, Malawi is now beginning to bring back the “light”—the meaning of the name “Malawi”—to its people.