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Drug Resource Enhancement against AIDS and Malnutrition (DREAM)

A program of the Community of St Egidio

The Community of Sant'Egidio began in Rome in 1968, following the Second Vatican Council. Today it is a movement of lay people with more than 50,000 members, dedicated to evangelisation and charity, in Rome, Italy, and in more than 70 countries throughout the world. DREAM, the acronym for Drug Resource Enhancement against AIDS and Malnutrition, is a programme based on a holistic approach of treating AIDS in Africa, launched in February 2002 by the Community of St Egidio. Today, the programme is present in Mozambique, Malawi, Tanzania, Kenya, the Republic of Guinea, Guinea Bissau, Nigeria, Angola, the Democratic Republic of Congo, and Cameroon.

The programme is the child of a dream. This is where its name comes from. A dream of fighting the AIDS epidemic in the African continent in a new, more effective way. A dream of fostering equality between the North and the South of the world.

DREAM is, above all, a different approach to Africa; it is a perception that speaks of confidence and of hope in the continent, representing a choice to break free from the chains of afro-pessimism and from the minimalism too often applied to Africa. It is the desire to reaffirm the right to treatment for all, no matter where they were born, so that millions of African children will also have the prospect of a long life before them, the same right we would want our own children to enjoy.

In fact, the aim of DREAM was to combine prevention and pharmacological treatment of AIDS in sub-Saharan Africa too, as happens in the West.

For many years, intervention models acting against HIV infection in Africa were nearly wholly preventive. But prevention alone, alas, did not work. The progression of the epidemic throughout the continent is proof of this. It is not by mere chance that in the North of the world, prevention and treatment go hand in hand. DREAM was born precisely with the aim of uniting these two types of intervention south of the Sahara too, in the conviction that it is necessary to look after the lives of the African people, apart from preserving them.

In the same perspective, DREAM has been created to achieve excellence: excellence in treatment, in diagnostics, in computerization. DREAM demands that western standards be adopted in Africa too; the programme routinely uses viral load assessment, and has introduced Highly Active Anti-Retroviral Therapy (HAART), the current golden standard in the treatment of HIV infection, giving it to all patients who need it. The Community of Sant’Egidio operates according to that simple and ancient saying: do unto others as you would have them to do unto you. And who would not want excellence for himself?

DREAM is free of charge. It is crucial that all health services provided – from diagnostics to nutritional support, to health education and conventional treatment of opportunistic infections – be offered free of charge. It is impossible to ask people who don’t even have enough money to buy food for themselves and their families to pay for medicines.

The whole point is not to distance sick people, but rather to attract them. In Africa, one pressing problem to be overcome is that it is extremely difficult for people to access health centres, especially in rural areas. And this is precisely the third criterion of DREAM which cannot be renounced: accessibility.

DREAM does not strive merely to welcome those who come to ask for treatment, but also to encourage adherence by offering adequate nutritional support and an apposite “home care” service, which reaches in their very homes those patients who are at risk of being lost.

More about the DREAM program.

More about the DREAM approach.

About the experience of DREAM in Mozambique.

About the February 2009 14th Panafrican Training Course..

About DREAM as a replicable model in other African settings.

Adapted with permission from the DREAM website, February 2009.