In the absence of a cure for HIV, for the past 30 years this question has been the center of debate. For those of us who have dedicated our lives to the fight against AIDS, recent research has given us a glimmer of hope—and may have finally ended this debate.

In May, the University of North Carolina at Chapel Hill released results from the HPTN 052 study which indicate that putting an HIV-positive person on treatment as soon as HIV infection was detected reduced the risk of them transmitting the virus to their sexual partners by 96%. Ninety-six percent. The evidence was so compelling that the trial was actually ended early and results published years before expected. For anyone who has worked in the uncertainty of research, this just doesn’t happen.

EFA’s beneficiaries have experienced these benefits first-hand. Since receiving treatment, their improved health status has empowered them to become HIV advocates, peer educators, and leaders in their communities, gaining the respect of those who once stigmatized them.

Today is World AIDS Day

Today, on World AIDS Day 2011, over 50 EFA peer educators are conducting community-wide education events in over ten communities. Some members are sitting down with local religious and traditional leaders to explain how they can help achieve an AIDS-free generation. Others are going door-to-door, encouraging people to get tested for HIV at the local health center, and describing why an AIDS-free generation is important to their community.

We have the technology. For the first time ever we can actually see the way forward. We can envision an AIDS-free generation. Not a generation free of HIV, but free of AIDS.

Treatment IS prevention

So, forget the debate—treatment IS prevention. Putting people living with HIV on treatment early will not only extend their lives, but will also prevent new HIV infections among their HIV-negative sexual partners.

The tragedy is that this innovative and groundbreaking research comes at a time of declining levels of funding for HIV, of donor “fatigue” for financing national HIV programs, and of re-shifting priorities away from HIV strategies and towards broader health sector initiatives.

The United States government has taken a significant step. During a speech delivered by Secretary Clinton at the National Institutes of Health in November, she re-committed the U.S. government’s development efforts towards supporting the global AIDS response in achieving an AIDS-free generation. It is time for other governments to meet this call.

Education, empowerment, and enterprise

Since 2005, EFA has supported children, youth, and families in Cameroon. Our Youth Empowerment Network supports HIV positive youth in nine communities in northern Cameroon and provides ongoing support through education, empowerment, and enterprise.

Through our Peer Education program our members learn the tools they need to stay healthy, live positively, and they receive education on antiretroviral drug adherence and strategies. Our peer education program trains members to go out into their communities and educate others about the basics of HIV transmission and prevention, and the importance of getting tested.

In 2011, our peer educators provided basic HIV education to over 20,000 people, and over 5,000 people were referred to their local health center to get an HIV test.

We empower our members to advocate for their rights. In September, when all of the public hospitals in northern Cameroon hit six months without the laboratory reagents necessary for monitoring the efficacy of their treatment regimens, members of the Youth Empowerment Network visited a private hospital in the area and negotiated that all members of EFA’s network would be able to access these important monitoring tests at the private clinic, while paying the normal public facility costs.

We promote enterprise through collective and individual income-generating activities. Our members work together to create employment opportunities for themselves and other association members, so that they may financially provide for their own medical needs and for their families.

We can do this together

We are proud of our work and proud of the accomplishments of our HIV-positive beneficiaries. We have turned a new page in the HIV response. Today, on World AIDS Day 2011, it is time for us to look back at all we have accomplished and look to the future. Look towards an AIDS-free generation. We can do it. We can reach that goal through our collective efforts. We can do this together.

EFA is doing its part and we would like to graciously thank you for the support you’ve given us over the past six years. We wouldn’t have made it this far without you, but we’ve still got a long way to go and count on your continued support.

We are together. Nous sommes ensemble,

Andrew Koleros
Co-Founder and Member, Board of Directors
EFA International

Irene* is petite, with almond-shaped eyes and a brillant smile. She is married with one child and an eighth grade education. Irène is HIV-epositive. These facts alone are enough to make her story brave, exceptional. Many women in northern Cameroon are told than an HIV diagnosis is a death sentence and are rejected by their families.

In 2006, Irène connected with EFA International, where she met with other HIV-positive individuals and learned how to stay healthy and live positively. She underwent EFA’s comprehensive 6-month peer education training and now teaches her village about the importance of HIV prevention. That they can protect their children and families from the scourges of AIDS in a country where one in 20 adults has HIV. That they too can defy stigma and face an ominous diagnosis to manage what has become chronic disease: requiring daily awareness, discipline, and resources, but something that does not keep them from following and fulfilling their dreams.

Then I learned that Irène was suffering from a uterine tumor. The unmonitored tumor had grown to such extent that she could feel its presence by pressing on her abdomen. If Irène was not operated on immediately, then she would not survive. She did not have the money to receive the operation. Could we step in to save the life of a woman in whom we had invested so much, and who had given so much in return?

Some colleagues warned that if EFA officially stepped in, it would open a floodgate of medical requests. Most of EFA’s youth empowerment network members do not have the luxury of insurance or extra income to cover health emergencies and rely on family and friends. But I could not stop thinking about Irène’s smile, her energy and willingness to give back to something greater.

A week passed. I received an update from EFA’s regional office. Irène’s community, family and friends had collected the money she needed for the operation. EFA saved Irène because its programs had empowered her. Her village valued the hope and knowledge that Irene was giving to young people. Irène is more than her HIV status. She is a change agent within her community.

Unfortunately, we cannot pay the hospital bills of each individual. Our Circle of Love project has just been launched on GlobalGiving to fill financial gaps so HIV-positive individuals can afford medical tests. But EFA’s peer education empowers HIV-positive individuals to mobilize and know how, when, and where to seek medical care. By staying healthy and practice safe behaviors, they are less likely to transmit HIV within their communities. This positive prevention is one of EFA’s core values.

* Name has been changed to protect individual’s privacy.

EFA Peer Educators at gender training in Maroua

My husband died from a disease that we didn’t understand; after medical exams, the results showed that we had been infected [with HIV]. This was a huge shock for me; in addition my husband’s family began to treat me bad, insulting me, refusing to talk to me just because I was infected. I was not even allowed to eat with them anymore. To them, I had killed their son.

My husband’s family went as far as to forbid me to share and drink next to them, I could no longer use the same eating utensils as before – all this from fear that they would be infected. My life became impossible.

There was a young neighbor who had pity on me and defended me in front of my family in regards to this torture that I was living. He introduced me to a man who gave counseling, this man gave me a lot of advice and also showed me that I was not alone in this situation. He suggested that I leave my husband’s family to live with my parents.

I was extremely afraid of my parent’s reaction, but my father understood my situation and gave me a lot of examples of people in my condition that had been living for many years with this disease. He told me that I could live like the others.

Miss Oumarou, a medical counselor, talked to me about associations of people living with HIV and AIDS, at the time associations were typically for adults, but an association for youth had just been created by EFA. Thanks to EFA, I became a member of this association of youth living with HIV and AIDS. With AJEPS Mokolo [the association], I became a new person, like the others. Then the members of my association chose me to attend training on this disease and to become a peer educator. I had the taste of living a new life and I met a lot of other people living with HIV who lived in peace and at ease.

Thanks to my association I had the chance in my life to travel, eat well, and all while surrounded by a group of people who were HIV-positive and some people who were not. I even was able to sleep at a hotel during the training, this I could never have imagined; I was happy!

… After returning from the training, I became an active member of my association where I had the responsibility to buy and sell eggs for an income generating activity. Others in my association like me also bought and sold peanuts, which would help us enormously to balance our lives, to buy our medicines and to become healthy like the others.

Thanks to all these efforts, I could talk with people openly, I could even talk about my disease at church and explain to people in my local language the myths, realities and other things related to HIV and AIDS.

One day, my friend from training, Therese Pehlem, talked to me about a man in Maroua who was interested in me and who was also infected with HIV. I went to his house and I stayed there throughout all of his sickness. We still felt a lot of hope thanks to our associations, but unfortunately he did not survive. After his death the members of AJEPS Maroua [an EFA association in Maroua] asked me to integrate into their association; I was truly honored and I accepted.

Today, I am respected, I have friends, I manage the selling of water which is the income generating activity of my new association, I sleep well, I eat well and I can even help people who are in need, either for advice or for support.

The greatest thing that has touched me to this day is the exchange of ideas, the dialogue, and the friendship within the associations and during the trainings. This gives us more than hope; we have found again the will to live.

My wish today, is to see EFA International continue what they have started and with us help to save the other people who are in my situation. My last words to say are thank you to all who have had the courage to help us and to help those that we have helped.

To date, EFA International has helped create 10 associations (with another 2 currently in development) of youth infected and affected by HIV and AIDS throughout the Far North region of Cameroon. Through education, empowerment and enterprise, EFA International strives to improve the condition of life for these youth and their families. Though positive living and positive prevention, EFA International and our associations work to reduce stigma and discrimination, help others living with HIV or AIDS, and promote the prevention of HIV infection within their communities.

Djingui, one of the EFA Peer Educators, approached me and said that the night before, he was out in town and hopped on a moto to go home.  Somehow he and the moto driver struck up a conversation about HIV.  The driver told Djingui that he was concerned about his sister who was bed-ridden at home.  He described the fairly typical AIDS-symptoms—supreme fatigue, weight-loss, and the list continues—to Djingui.  Djingui convinced him to take his sister to get tested for HIV the next day.

Sure enough, the test came back positive.  But, then, the moto driver realized to take action to get his sister healthy again, which they believed WAS possible because of Djingui’s testimonials about his own HIV+ status, he needed more money than he had available—moto drivers can usuallyexpect to make $2-3 a day in Maroua.

Djingui brought the moto driver and his sister to us at EFA . . . and through the Circle of Love, she got a CD4 test (a test used to measure the strength of the immune system), chest x-rays (she has suspected TB, too), and we paid for her stay at the hospital.

I find this little story remarkable on so many levels . . .

Djingui’s bravery to disclose his own status is remarkable.  His commitment to these strangers is remarkable.

The moto driver’s dedication to his sister is remarkable, when so many families here reject their kids/sisters/brothers upon learning that they are HIV+.

The sister is remarkable for not losing hope as this all got figured out (the health care system is not as transparent as it ought to be!).

And our Circle of Love donors are remarkable! You literally saved a life,  And I am not being overly dramatic there.

And this is just the first story of MANY to come!

-By Caitlyn Bradburn, EFA HIV Technical Advisor

One meeting out of many that I attended, still stands out.  ASSYSGOD, the association in Godola, is about 20 extremely bumpy miles north of Maroua.  Alim, Amada, and I arrived to the warm greetings of several members of the association including Mairamou, the female president of the group and also a local community health worker.  After an orientation to the group’s activities and finances, I was invited to see their enterprise projects; onion fields and grain storage.

As we wound through the small town, our discussion was interrupted by many greetings to Mairamou, and also children scurrying to cower in shadows and doorways as we passed – her humorous explanation was, “They all know me as the nurse who comes to give vaccinations!”  We arrived at a field of blue, knee-high stalks as far as the eye could see…Onions galore! Then we went to a small barn, and Miramou threw open the doors so that I could count all 32 huge bags of grain being stored until the price rose for re-sale at a profit.  I was astounded and delighted!

This group of about 15 women and men had, in just a few years since their group’s formation by EFA, turned a small grant that enabled them to embark on a collective enterprise, into two income generating machines!  ASSYSGOD now manages several acres of various crops each season: onions, tomatoes, couscous, millet, etc., and they buy and sell grain at a profit.  From the small initial grant, the group established and continues to increase their savings account (used  as insurance to take care of members and their families who fall ill, and to reinvest in new enterprise projects) to the point that they are now self-sustaining and even dispensing small amounts of profits to each member!  Members use their income to send their children to school, buy medications and food – all things that would have been impossible before their membership in ASSYSGOD.

Another day, almost all 52 Peer Educators came to Maroua to give their feedback on the community health talks they had conducted in the previous three months through the Trust Africa grant focusing on Sexual & Gender Based Violence (S-GBV).  I was completely overwhelmed with the Peer Educators’ (PE’s) gratitude for the S-GBV training sessions (given by EFA staff and the Peace Corps volunteer) and the fresh message they were giving to their male dominated communities.  The PE’s found the theme empowering and refreshing – and no wonder!  For once the focus was on the value of women, and of creating more balanced and equal relationships between men and women.  PE’s reported that members of their communities wanted to learn more about gender equity and wanted repeat community talks on the same subject!

My time in Maroua was short, but I was once again honored to work with Alim and Amada, the Regional Director and Program Manager, and again witnessed how tirelessly these two work on behalf of EFA International.  Peace Corps Volunteer Gena Barnabee (like each of the PCV’s before her) truly serves EFA International and beneficiaries, with passion and enthusiasm.  These three spend long hours in the office and also attend meetings that are hours and hours along bumpy dirt roads in 100+ degree heat, sometimes spending the night in villages with no electricity and little food, and they do it all with a smile!  I felt like a weak and too privileged person in their presence.  They are genuinely knowledgeable, thoughtful, and invested in their guidance roles for EFA International and the Youth Empowerment network.

Education and enterprise truly do fight AIDs. It may not sound innovative, but when you witness (like I did) the simplicity of the EFA model of content delivery and support, EFA’s strong partnerships with local government and health centers, and the unparalleled positive outcomes, you easily understand that EFA International is a unique resource for those who need it most.  And you are proud to be a part of it all!

Thank you for helping EFA come so far! Did you see the 2010 Annual Report? Without friends like you, we wouldn’t see the results we have already attained.  Can you help us take this a step further today?  Could you consider becoming a regular monthly donor?  Spreading the word of EFA’s good work, and continuing your valuable support, will ensure that EFA International is able to continue to support African youth in their want and right, to live positively.    Please support EFA International in the best way you can, today!

Kathryn McKissick
Secretary, Board of Directors

EFA International, founded by Cameroon returned Peace Corps Volunteers and still partnering with the agency in the country, ensures individuals infected with and affected by HIV and AIDS have the proper support, whether emotional, educational or financial, they need to live positively. EFA International also won a PEPFAR grant in May 2010 to support its peer education trainings that year and acknowledges the importance of collaboration with existing agencies, like PEPFAR, to continue fighting the HIV and AIDS crisis.

The Peace Corps Cameroon 2010 Annual Report also cited PEPFAR’s increase of funds in the country as significant to building and continuing effective HIV and AIDS programs. The report noted EFA International projects, including Men as Partners, as well as former EFA International Technical Assistant, Caitlyn Bradburn, and current Maroua Regional Officer, Alim Ousmanou, for their collaboration with Peace Corps and its HIV and AIDS efforts. In the report, Ousmanou also said he sees infinite value in Peace Corps’ community-based approach to development:

“For me, Peace Corps remains the best organization working to improve the lives of Camerounians at the community-level. The most important lesson I learned is that Peace Corps Volunteers may not come with a bag of money to distribute but rather a multitude of ideas to share. When they resonate they can change lives.”

EFA International Cameroon Regional Officer, Alim Ousmanou, stands in front of a painting he did as part of EFA’s 2010 World AIDS Day activities. “VIH” translates to HIV and “SIDA” to AIDS.