Total Control of the Epidemic

The Application
In the month of February year 2001 the board of the Foundation received an application, which made an impression, not so much because of its monetary size, but because of its subject. The application came from The Federation for Associations connected to the International HUMANA People to People Movement, which the Foundation previously has donated grants to. The application asked for an amount of 800,000 Dkr for additional initiatives to a unique program for combating HIV/AIDS in Africa - the program TCE - Total Control of the Epidemic.

The overall Background for the Application
The Foundation has since 1996, when the Federation applied for a grant to HOPE Centers in four countries of southern Africa, followed at a closer range how explosively and catastrophically HIV and AIDS develop in this part of the world. Over 25 million of the 36 million people of the world living with HIV/AIDS live in this region where poverty, diseases and social problems already make it one of the most difficult situations in the world. Today the continent's HIV/AIDS crisis has developed to such an extent that it exerts a markedly negative influence on all sectors of society, not least the economy, to such a degree that it in many countries has been declared a national catastrophe.

About the TCE Program
In the countryside and in the towns of southern Africa a drama is played out - the population is under sweeping influence of the slow killer, HIV - a virus which weakens and destroys the immune system, and which after a number of years leads to AIDS and the thereby associated pathological picture with death as a result. HIV has to a large degree been acting during the past 15 years in this region, but without attracting great attention - but now the time has come when a large and still growing number of people die from the disease every year. And now is the final call for stopping its raging.

If you take a walk around in Zimbabwe or Botswana - or the other countries of the region - just a single afternoon, you might not notice anything, but if you stay a day or two in a bit closer contact with the people, you will see the effects of the deadly disease on both high and low, and in the functions of society as such. The funerals take place every day, people in their best age waste away, die and leave families without breadwinners, enterprises close, children loose their home and their parents, schools loose their teachers, the poverty increases as a result of disease and death among the productive part of the population, the health system is overburdened and lacks both funds and training to be able to intervene - and the mood among people darkens, because it is difficult to see what one can do.

TCE is a program which has set itself the task of fighting HIV/AIDS in southern Africa. TCE means Total Control of the Epidemic and has been created and implemented by the international development organization Humana People to People. The program is based on the philosophy that only people themselves can take control of the HIV infection and start addressing the pathological consequences which the infection has for the already infected.

TCE organizes the countries systematically in geographical TCE areas, each with a population of 100,000 people. A TCE area is again divided into 50 TCE fields, each with 2,000 people. TCE employs a TCE Field Officer in each field. So the Field Officer is responsible for 2,000 people in his area. The Field Officer seeks out and informs every person in his field, and mobilizes all people in an all out war against HIV/AIDS. The Field Officer is employed for three years - the idea is that after this time every person in the field and in the area, as well as the field and the area itself, must live up to the demands of TCE - that is in practice be in full control of the HIV/AIDS epidemic.

The TCE program exerts itself at the time of writing, June 2001, in eight areas in Zimbabwe, Mozambique and Botswana - and thus covers 800,000 people. Many more areas are being planned in these countries and in a number of other countries, hereunder Angola, Zambia, Malawi, Lesotho and Tanzania. The program is, as can be seen from the above, systematically organized, and shows mobilizing and disciplined roads forward to combat this modern plague. In Botswana and Mozambique the TCE programs have been made part of the country's national plans for fighting HIV/AIDS.

In November 2000 the TCE program won the 1^st prize in a competition instituted by AGFUND - Arab Gulf Fund for United Nations Development Organization - as the best community mobilizing program for fighting HIV/AIDS. In April 2001 the TCE program was presented to all the African heads of state at an OAU meeting in Abuja in Nigeria. The interest for the program is growing - unfortunately because the problem of HIV/AIDS is growing at a rate which is surprising even alarmists in the region and in the whole world.

TCE Mobilizes every Person in every Nook
The TCE Field Officer has as his task to seek out every person in his field, talk with all of them about HIV/AIDS and about how they can prevent getting infected - and how they can live a healthy and good life even if they have been infected. The TCE Field Officer teaches prevention and the use of condoms, and encourages people to change their sexual behavior, and educates them concretely in how to lead a sexual life, which secures them against infection.

TCE spreads Information about the Infection and the Disease
TCE publishes a number of publications as tools in the work of informing, mobilizing and instructing people to take their situation into their own hands. The publications explain in simple words and in local languages about HIV/AIDS and about issues connected to this.

TCE - The Passionates and their Movement
As close partners to the TCE Field Officers, one finds in each field 'The Passionates', who are organized in The Passion for People Movement. These are warmhearted people in the field, who volunteer for a profusion of efforts in the fight of HIV/AIDS. In this way they support the TCE Field Officer in his or her work and show real passion for other people and their lot.

TCE gets People Tested for whether they are HIV Positive or Negative
The TCE Field Officer and the Passionates - the volunteer helpers - mobilize people in their field to become tested, so they know their own HIV status - which is crucial for ensuring that the HIV negative can continue to be negative and avoid being infected, just as well as it is crucial for the HIV positive being taught how they can live longer and healthier and get the most out of the time and their life.

TCE makes Clubs for many different kinds of People
The TCE Field Officer establishes and runs popular clubs, which contribute to fighting HIV/AIDS. They start clubs in the schools, sport clubs for young people, Positive Living Clubs - just to mention a few. Besides this they gather people for larger arrangements, celebrations, informative meetings and courses.

These activities contribute to breaking down the prejudices which exist among people towards the infection and the disease, and contribute to people being able to speak more freely with each other about the conditions and about what they themselves can and must do with regards to the infection, the disease and the consequences thereof.

TCE furthers the Care of the sick in their Homes
The TCE Field Officer educates and holds courses in home based care, a humanizing effort, which is part of getting people to understand that they themselves can remedy the consequences of the disease and gain influence on how it concerns the individual, the family and the society.

TCE has many Activities going on
The TCE Field Officer contributes to the community's possibilities by acquiring funds and helping to organizing the start up of income generating activities, which finance and grow vitamin rich food for sick people as well as the many children, who have become orphans because of AIDS.

It is also on the agenda of the Field Officers to start soy restaurants, which make inexpensive and healthy food and give valuable boosting of people's immune system. The TCE Field Officer furthermore works together with a number of forces in the community to find solutions for the upbringing and the schooling of orphans.

TCE - also via the TCE staff - works on acquiring funds, donations or cooperation partners for a number of research trials and efforts within health, medicine and treatment in the TCE areas. The TCE program encounters in its practical operations - which until now is only about one year old - constantly new necessities and is therefore incessantly working on improving and expanding its activities. This takes place at the Federation's headquarters in Zimbabwe.

The TCE Field Officers are crucial in the TCE program
The TCE Field Officer is employed as a wage earner for the three years it takes to carry out Total Control of the Epidemic. As such he or she is a very central person and becomes the pivotal point, around which a people to people effort against the disease turns. The TCE Field Officer is educated throughout the three years it takes. The work is described in instructive manuals. Every Friday, the 50 Field Officer of the area meet, exchange experiences, educate themselves, and are inspired to new methods and actions for the coming period. Every Field Officer is qualified as an HIV/AIDS counselor with a diploma - with regard to getting people tested and getting help to how they should conduct themselves. More diploma qualifications will follow as the program develops.

In General.....
The TCE program has already during this short span of time proven to be effective in loosening up the tight atmosphere that HIV/AIDS creates in a society which is under hard pressure from the disease and its consequences. The program has been well received by the population in the areas where it is taking place. It has shown to have a profound and humanizing effect in the fight against this threat towards mankind. One of the program's more striking, visible and immediate effects is that it brings the whole question about the epidemic into the open, gets people to a much larger extent to acknowledge its presence, understand its consequences and make it a personal issue to act so as to get control over all the conditions surrounding it.

Also governments and international institutions have shown great interest in TCE. If TCE could be expanded extensively and come to encompass and cover all the 1,200 areas which southern Africa consists of, this would contribute comprehensively to curb HIV/AIDS.

The Specific Background for the Application for Funds for Additional Initiatives to TCE.
The TCE program is built up area by area - each area with 100,000 people. Every area costs 100,000 USD - about 800,000 Dkr - for one year, that is 2,4 million Dkr for a three year program. These expenses cover only the area itself - that is, employing 50 Field Officer at a salary of about 100 USD/month, as well as the most necessary tools for their work, which is basically a bicycle for each field officer, so they can come around, educational material and expenses for meetings, transport, etc.

This means that when there will be many more TCE areas, and therefore also a more urgent need for an organizational and service-providing superstructure - activities which today are taking place from the headquarters of the Federation - there will not be enough funds in the above mentioned budget of 800,000 Dkr.

It is however the intention that the program shall spread to all 1,200 areas in southern Africa. The funds necessary for organizationally and administratively keeping all these areas going must be raised along the way.

The 800,000 Dkr for an area thus covers the Field Officer's work - all that he can achieve with his salary and the smaller operational expenses, and all which he can mobilize his volunteer Passionates to do. That is: to seek out each person, explain, educate, make lectures, start clubs for children, young and sick, reach out to especially vulnerable groups in his field, convince people to be tested, procure things, hold meetings and mass meetings.

The 800,000 Dkr does not cover the additional activities, which ought to be started and operated in each area, in order for the program to accomplish much MORE than inform, and in order to involve each single community member, and thus become of optimal benefit for the community.

Of course, much can be done on the spot - locally and nationally - which is part of the Field Officer's work. This is acquiring funds, materials, support and allied cooperation partners from many corners of the society - the traditional healers, the churches, the local business people, politicians and authorities nationally and locally, midwives, school teachers and school inspectors, hospital and health personnel, and other private associations and initiatives of every kind. The aim of the TCE program is, among others, exactly to join the forces of those who can or will give any kind of contribution in the fight against HIV/AIDS.

But when this is said, then there are naturally many expenses, which must be paid to streamline and strengthen and utilize to the utmost the TCE Field Officers' mobilizing achievements.

The condoms cost money - not many cents for each - but we are talking big numbers. To get tested costs money - an expense which most health systems in Africa do not have means of paying. To strengthen the immune systems of the infected costs money - whether this is done by cultivating vitamin rich vegetables or raising chickens, or by utilizing prophylactic medical products, or by starting up inexpensive restaurants so people can get proper food. To mass inform efficiently costs money - for example to produce simple materials in local languages so that every household has at its disposal easily understandable and instructive booklets about how they should conduct themselves. To take care of the sick costs money - for painkilling medicines, soothing measures, soap and hygiene, rubber gloves, cotton. To take care of the orphans' upbringing and education costs money - not the least considering the growing numbers. To be treated against opportunistic infections costs money - whether it is Kaposis' Sarcoma, tuberculosis, pneumonia, fungal infections or something completely different. To be treated against HIV itself costs MUCH money - triple combination therapy can not cure HIV/AIDS, but can hold it in check for many years - but it is so expensive, that people in Africa have no chance of getting anywhere near it.

It is on this background that Humana People to People applies for 800,000 Dkr for additional initiatives in the TCE areas, which are already operating.

Quote from the application: "Initiatives such as publications, research, development and experiments, production of educational material and transferal of information will further the effect of the programs already going on, and programs not yet started.

The Utilization of the Granted Funds
At the time of writing, the first 232,000 Dkr out of the 800,000 Dkr have been used to buy equipment for the printing of publications for all the ongoing - and, for that matter, the future - eight TCE areas.

As becomes evident from the above description - there are funds for educating the TCE Field Officers to a small degree within the normal TCE area budget. Money for a mass publication of TCE material, however, is not part of the area budget.

The intention is that funds for printing a small library of informative publications to each household in the TCE areas should be acquired from donors and printing shops internationally and nationally. This work of raising funds for the mass publication of TCE's publications is well under way, and at present the first publications are being printed on mass scale in Sweden. TCE however expects that this is a task, which will be going on for some time, and that the publications then will come out to everybody, as the funds eventually are found.

TCE however stands with an immediate need for printing for its eight areas. TCE has now started to establish - until the publications come out on a large scale - smaller libraries in all of its 400 fields, so that the 30 publications, which TCE until now has written and published, can be lent out to people via a system - TCE Information Service - in each field. This implies publication of relatively 'smaller' editions of publications and material, until the sufficiently covering mass publications have been secured financially. An investigation has shown that with a printing machine TCE is capable of printing these smaller, but still considerable, editions much cheaper itself than if the work was given to printing houses.

Therefore this is one of the additional initiatives, which TCE has given priority to.

Conclusion
No conclusion can as yet be made, since only about 1/3 of the grant has been used - and the account for the remaining 2/3 will only come at the end of 2001.

At its meeting in June, the board of the Foundation could, after having been presented for TCE's list of over 130 publications and a selection of the 30, which have been published, already express great approval of these publications, and in general of the people working with the TCE program. The board could only be extremely satisfied with the utilization of the first part of the grant.

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