Djibouti

Zarah Ali (not her real name) remembers how things changed for the better. “In 2014, I received a loan of 40 000 Djiboutian francs (US$ 250) that I used to develop and improve my garment business. I was also trained in business entrepreneurship, including marketing and customer satisfaction. I import clothes from Dubai and Somaliland and earn a decent income that helps me support my 25-year-old son, my 16-year-old daughter in secondary school and my three-year-old adopted son. I am able to pay for my rent, electricity and water and have decent meals.”

Ms Ali’s loan came from an income-generation programme established by the World Food Programme in collaboration with the United Nations Development Programme, UNAIDS and the national network of people living with HIV in Djibouti (RNDP+). The programme supports the long-term empowerment of, and provides regular incomes to, women living with HIV in Djibouti City. It helps them to achieve financial security and have access to food and improves their access to health-care services. Income-generating activities such as those supported by the programme have a powerful potential to help people living with HIV adhere to antiretroviral therapy and optimize health outcomes. 

The loans, ranging from US$ 141 to US$ 438 per person, are for starting or building retail businesses. The beneficiaries, who are selected from among two networks of people living with HIV affiliated to RNDP+ (ARREY and Oui à la Vie – Yes to Life), also receive training on how to run their business. Government support in the form of favourable policies and legislation has been vital to the success of the programme. 

Dekah Mohammed (not her real name) now lives a fulfilling life after receiving help from the income-generation programme. Ms Mohammed, who lost her husband to AIDS, lives with six children. After she lost her job in the hospitality sector owing to her deteriorating health and to stigma and discrimination, she started her own clothing business and received a loan of 50 000 Djiboutian francs (US$ 313) to expand her business. The loan was repaid within 10 months. Her business has since expanded into furniture and electronics and she has recruited an employee. “I am no longer a desperate woman. I make enough to take care of my family and dependants,” she said. 

The programme has improved the quality of life of many Djiboutian women, allowing them to regain dignity and ensure their financial security. It empowers women and girls to protect themselves from HIV, make decisions about their health, live free from violence and be financially independent. 

Building on the belief that empowering women living with HIV and their households to be financially independent strengthens adherence to treatment and leads to more fulfilling and dignified lives, the programme contributes to the World Food Programme’s broader strategic contribution towards ending AIDS as a public health threat by 2030.

The Parliament of Djibouti has adopted a new plan to Fast-Track the end of the AIDS epidemic and increase protection for people living with HIV and key populations.  

The new strategy was formulated during a workshop attended by deputies as part of Djibouti’s national week of action against HIV. Opened by the Minister of Health and the Speaker of the National Assembly, the event brought parliamentarians together with people living with HIV and representatives of civil society organizations, the national AIDS, tuberculosis and malaria council and the United Nations. The workshop was an opportunity for parliamentarians to hear directly from people living with HIV about the social and legal challenges they face, including stigma and discrimination.  

The participants welcomed recent progress in the response to HIV in Djibouti, especially the decrease in HIV prevalence from 3% in 2000 to 1.6% at the end of 2014 and legislation introduced to strengthen the protection of people living with HIV and other vulnerable groups. The workshop also reviewed critical challenges to the HIV response, including the limited uptake of services to prevent mother-to-child transmission of HIV and pervasive stigma, discrimination and other human rights violations towards people living with HIV and key populations.

In drawing up the new plan, parliamentarians said better coordination across government was required to implement the non-discrimination provisions of existing legislation. They also called for a public meeting at parliament with the National Network of People Living with HIV to raise awareness about stigma and discrimination. 

During his visit to Djibouti, UNAIDS Executive Director Michel Sidibé met President Ismail Omar Guelleh to discuss the country’s ongoing response to the AIDS epidemic.

During his three-day visit, Mr Sidibé took part in an event held to mark the acceleration of a campaign to prevent mother-to-child transmission of HIV. He also participated in a round-table discussion to explore ways of securing sustainable financing for the country’s AIDS response.

There were around 9900 people living with HIV in Djibouti at the end of 2014 and HIV prevalence among adults aged 15–49 years old was 1.6%. Fewer than one in five has access to antiretroviral medicines.

The First Lady of Djibouti, Kadra Mahamoud Haid, and the Executive Director of UNAIDS, Michel Sidibé, have taken part in an event to announce a further acceleration of the country’s campaign to eliminate mother-to-child transmission of HIV.

At the event, the Djibouti Minister of Health, Kassim Issak Osman, said that projects to prevent mother-to child-transmission of HIV had shown clear benefits and would be expanded to allow more pregnant women and new mothers to access them.           

At the end of 2014, about one in five pregnant women living with HIV in Djibouti were accessing antiretroviral medicines to keep them healthy and prevent them from transmitting the virus to their children.

During a visit to Djibouti, UNAIDS Executive Director Michel Sidibé has met a group of volunteers involved in an innovative public-private partnership between the Ministry of Health, the BE Health Association and the Kempinski Hotel Group.

Since September 2014, BE Health has trained 24 employees of the Djibouti Palace Kempinski Hotel to become peer health educators. Since June 2015, these volunteers have reached out to more than 300 people a month in six community health centres across Djibouti-Ville. They have also identified 15 tuberculosis patients who had interrupted their treatment and guided them back on to medication.

BE Health, an independent Swiss non-profit health association that aims to prevent the spread of infectious diseases, is expanding its collaboration with the health authorities in Djibouti to foster and facilitate screening campaigns for tuberculosis and HIV.     

H.E. Ismail Omar Guelleh, President of the Republic of Djibouti together with Mr Michel Sidibé, UNAIDS Executive Director. Credit: UNAIDS/P.Virot

Each year, there are more than 200 million people on the move. The UN estimates that between 20 and 30 million are migrants in irregular situations and that wars and conflicts have caused the displacement of 16 million refugees. 

Many countries around the Red Sea and Gulf of Aden are affected by intense poverty and violent internal conflicts. This has resulted in large numbers of migrants living in and around the ports. There is also a large community of mobile populations, including truck drivers, dock workers, port staff, security staff, ships crews and sex workers who can be at higher risk of exposure to HIV.

Poverty, social exclusion; separation from families and communities, loneliness, fear and marginalization can make mobile populations and migrants particularly vulnerable to HIV. The situation can also be aggravated by lack of access to HIV prevention, treatment and care services.

“It is essential that mobile and migrant populations living in and transiting through ports have access to HIV services and are included in national HIV plans,” said Michel Sidibé, Executive Director, of the Joint United Nations Programme on HIV/AIDS (UNAIDS). “Achieving universal access goals means making sure all sectors of society are reached, particularly people most vulnerable to infection.”

The Government of Djibouti, in close collaboration with UNAIDS, the International Organization of Migration, the Inter-Governmental Authority on Development (IGAD), and other partners, convened a meeting from 26-29 September 2010, which brought together leaders from Red Sea countries and other countries across Africa to address the issue of key populations at higher risk of HIV infection along the Red Sea and the Gulf of Aden ports.

“For us, this conference has been extremely instructive, we have learnt a lot from the experts, but particularly from people living with HIV who have come forward to tell us their stories,” said His Excellency Abdallah Abdillihi Miguel, Minister of Health of Djibouti. “This meeting has reinforced my conviction that we have to continue to work towards universal access to HIV prevention, treatment, care and support and make sure that everyone in need, even those most marginalised and vulnerable, has access to services.”

The experts and leaders agreed to take concrete actions to strengthen advocacy and leadership on HIV and mobility; integrate HIV and mobility into national strategic plans; ensure improved planning; enhance the capacity of civil society and partnerships with the private sector; and develop a common communication strategy with particular emphasis on human rights.