UNAIDS: The First 10 Years

Côte d’IvoireCôte d’Ivoire101In West Africa, Cote d’Ivoire has recorded the highest prevalences of HIV in theregion since the start of sentinel surveillance. In 1986 prevalence among pregnantwomen was found to be 3%, increasing to 14% in 1995, while a national surveyfound estimated prevalence of 9.5%. Among sex workers, the figures emerging fromcross-sectional studies have been particularly alarming, ranging from 27% in 1986 to89% in 1992-1993, decreasing to 28% in 2000. Currently (2007) national adult HIVprevalence is estimated at 7.1%.The coup d’état in December 1999 and the outbreak of civil conflict in September2002 resulted in Côte d’Ivoire’s mixed success in fighting its epidemic, and thesecircumstances have also posed challenges to the United Nations system.One intervention, the Drug Access Initiative, was launched in 1998 by the IvorianMinistry of Health in collaboration with UNAIDS, the United States Centers forDisease Control and Prevention RETRO-CI project, the Agence Nationale deRecherche sur le SIDA (National Agency for AIDS Research) and the InfectiousDisease Clinic of the Hôpital de Treichville. By March 2000, antiretroviral treatmentwas provided through six medical centres in Abidjan, prescribing treatment to 649people, while 2144 people in total had passed through the eligibility screening. Whilethese numbers were modest, the programme was the first to provide treatment inCôte d’Ivoire at that time. After the first two years, the programme was absorbed bythe Ministry of Health and now represents the main treatment programme in thecountry. Through the creation of a national solidarity fund ofUS$ 2.5 million in 1998, the government put in considerable national resources tosustain this treatment programme.The majority of people who had received treatment by November 2005, a total of17 600 out of an estimated 111 000 who would need it, accessed it through publicsector facilities spread over 33 out of 79 districts in the country. According to theWorld Health Organization’s 2005 Summary Country Profi le for HIV/AIDS TreatmentScale Up – Côte d’Ivoire, voluntary counselling and testing services are accessible in 95facilities, again mostly in the public sector.The National AIDS Programme, RETRO-CI project and the Antwerp Instituteof Tropical Medicine are also running a successful HIV prevention and supportprogramme with sex workers – initiated through the Clinique de Confiance launchedby Peter Ghys, now Manager of Epidemic and Impact Monitoring at UNAIDS.