Fighting HIV/AIDS in Rwanda

The adult prevalence of HIV is estimated to be greater than 13 percent, which distinguishes Rwanda as one of the 10 most affected countries in sub-Saharan Africa.

The majority of HIV-positive adults are women, and patients suffering from AIDS-related illnesses occupy more than 70 percent of the beds in major hospitals. Strong government commitment backs the principle of comprehensive services to fight HIV/AIDS, yet the country’s healthcare infrastructure is not adequate to manage the burden of this disease. Therefore the government of Rwanda has determined that strengthening its existing health-care system must be a priority that will serve as an important first step in halting the rapid spread of HIV.

A grant from the Global Fund of more than US$8 million, payable over a period of two years, will expand voluntary counseling and testing services to a minimum of three health centers within each of Rwanda’s 39 health districts. As part of a holistic model termed “integrated voluntary counseling and testing,” funds will also ensure that programs to prevent mother-to-child transmission of HIV are available in these 117 centers and reach 30 percent of all pregnant women. Thanks to support from the Global Fund, as many as 3,000 people will have access to antiretroviral therapy as well as treatment for HIV-related opportunistic infections, including tuberculosis. In addition, funding will underwrite training and skills-building programs for approximately 75 percent of the nation’s health-care workers. Additional staff will be recruited, and a corps of national and district-level trainers will be developed to sustain initiatives to build human resource capacity.

Recognizing that voluntary counseling and testing is a first step toward a wider range of care and support services, the Ministry of Health intends to develop complementary services and activities in and around the health centers. Ultimately the government aims to offer a comprehensive package of health services, with the infrastructure in place to support them. The training of three quarters of the nation’s health-care workers reflects the strategic vision of the country’s policy makers both to contain the spread of HIV nationwide and to do so in a way that supports the development of overall health systems. As part of this vision, the government will actively work with academic and non-governmental partners, including the Treatment and Research AIDS Center, the National University, the National Association for Supporting People Living with AIDS and the Rwanda National Youth Council.

Working in concert, these partners will use support from the Global Fund to benefit approximately 2.5 million people, including youth and military personnel, 200,000 people living with HIV/AIDS, 167,000 pregnant women and their children, and more than 5,000 health-care workers. Since receiving a quarter of the funds committed by the Global Fund, the Ministry of Health has started this training of its health-care workers, assessed clinical sites, developed criteria for the distribution of antiretrovirals and procured a large number of antiretrovirals and medicines to treat opportunistic infections.