Dakar, Senegal
March 17 - 22, 2002

Full Report of the STD Management Workshop
Full Report of the Antiretroviral Therapy Workshop

Summary Report

Sixty health care professionals from Nigeria, Senegal and the Harvard School of Public Health met in Dakar for a week in March 2002. The joint workshop on Sexually Transmitted Disease (STD) management and Anti-retroviral (ARV) therapy which was organized by the AIDS Prevention Initiative in Nigeria (APIN) provided lessons from the seventeen-year international cooperation between Harvard and Senegal and helped to strengthen the one year collaboration between Senegal and Nigeria. The Nigerian participants at the workshop included zonal coordinators of the Nigerian ARV program, STD physicians, laboratory scientists, pharmacists, APIN collaborators and HIV/AIDS program managers from the public and private sectors.

The two-track workshop witnessed exchange of ideas on ARV management in the two countries with insights from the United States. Issues examined included: an overview of access to ARV in Nigeria and Senegal; laboratory requirements for safe and effective ARV management; principles of ARV treatment and ARV drugs classes, drug indications and contraindications. Special attention was paid to ARV complications and management; adherence; ARV clinical trials- principles and ethical concerns; HIV perinatal transmission and the Senegalese MTCT program. Other issues included paediatric treatment, ARV monitoring and data management in a large scale ARV program.

The Nigerians benefited from the three-year successful experience of the Senegal national program on ARV therapy and one year experience of the national program on prevention of mother to child transmission of HIV (PMTCT). During the week, participants spent quality time at the various ARV centers in the teaching and military hospitals in Dakar. Special clinics and pharmacies were also visited including the clinic for registered commercial sex workers. Senegal has organized a public health STD/HIV program for registered commercial sex workers since 1970.

The STD group also learned how to implement a large scale and coordinated approach to clinical management of most relevant STDS. They also spent quality time in the various laboratories of the CHU Le Dantec where they improved their skills in the diagnostic methods for STDs.

The Nigerian participants observed the Senegal experience as an example of successful national ARV therapy program in a resource constrained country. It enabled the Nigerians to learn first hand practical issues on toxicity, adherence and drug-resistance and how strict monitoring determined the success or problems of the program. The Nigerians were also exposed to the use of less expensive and efficient technologies for determining viral load, CD4 count, PCR etc. These being laboratory tests required to provide critical clinical management of HIV infected patients on ARV therapy.

Participants learned that the success story of Senegal was based on political support at all levels of governance, more importantly the commitment, teamwork (camaraderie) and the skillfulness of the Senegalese prevention team. Other noted contributory factors were simple and well-maintained health infrastructures; a crop of well trained and articulate professionals; and long-standing and stable collaboration/cooperation with the Harvard School of Public Health spanning over 17 years.

As the south-south collaboration between Senegal and Nigeria (especially the APIN collaborators) enters its second year, a more structured interaction is being proposed to include regular exchanges, joint implementation of activities and periodic reviews of progress. APIN is committed to utilizing this strategy to continue to build capacities on both sides, in order to successfully fight the HIV/AIDS epidemics in the two countries.