Fellow Since 2000
This description of Issoufou Tiendrebeogo's work was prepared when Issoufou Tiendrebeogo was elected to the Ashoka Fellowship in 2000.
Issoufou Tiendrébéogo provides crucial medicine to AIDS patients by distributing unused anti-retroviral drugs from Europe and North America at a reduced cost to members of his education and support network
The New Idea
Issoufou has created a mutual cooperative to bridge the gap between Western medical advances and Burkinabe with Aids. His organization, Association African Solidarité (AAS), has created a network of doctors, individuals, and medical institutions in Europe and North America that supplies Burkinabe with anti-retroviral drugs that would otherwise be destroyed. The drugs are distributed at affordable prices through the mutual cooperative, the first of its kind, which gives poor people access to treatments that are usually available only to the rich. The cooperative will eventually grow to include the non-HIV-infected population and will move towards becoming a private insurance plan.
The devastating impact of Aids is now apparent across sub-Saharan Africa. Like other nations, Burkina Faso is particularly vulnerable to the effects of the epidemic due to its low level of development. For example, 45 percent of the nation's population lives below the poverty line and nearly 80 percent is illiterate. The internal and external migration of young men significantly affects the Burkinabe population, and the position of women and young girls in Burkinabe society is precarious. This situation is further exacerbated by the inability of medical workers to adequately care for people living with HIV. The age ranges most affected by the virus are adults between twenty-five to forty-nine years old and young girls from thirteen to twenty-four, for whom the rate of infection is between five and eight times higher than for boys of the same age.According to a 1997 UNAIDS report, there were nearly four hundred thousand people living with HIV and AIDS in Burkina Faso, making it the second most affected country in West Africa. In December 1998, the World Health Organization reported over thirteen thousand cases of AIDS in Burkina Faso. However, less than 10 percent of all cases are believed to be reported. By the end of the year 2000, the rate of infection among the general population was predicted to be nearly 10 percent.Anti-retroviral medicines are currently recognized as the most effective means of maintaining the health of HIV-infected patients and delaying the onset of full-blown AIDS. However, these drugs are out of reach for most Burkinabe with HIV. Anti-retrovirals are prohibitively expensive for many and insurance companies will not pay for them. Many people with HIV spend all their money on medicine. Because of the significant risks involved in taking the medicine, the option to begin the therapy must be accompanied by significant education about the drugs and the process of taking them. This discussion and counseling have been lacking from previous attempts to distribute these medications. Two major strategies have been initiated for distributing anti-retrovirals in Cote d'Ivoire and, to a lesser extent, in Senegal. In Cote d'Ivoire, there is a major initiative sponsored by UNAIDS to provide anti-retroviral drugs to HIV-infected people as a pilot initiative for West Africa. In Senegal, the government has taken an active role in a similar endeavor by providing start-up funds. In Burkina Faso, however, there have been no government or independent initiatives to respond to the dire need for AIDS medication.
The cooperative, which is run by people living with HIV and AIDS, supports patients of all ages and backgrounds and seeks assistance from doctors, pharmacists, and associations from Europe and North America. People involved in the cooperative include those who cannot afford to purchase the drugs at all, as well as wealthy patients who have been buying drugs abroad but who might still benefit from better prices and regular supply. One of the objectives in creating the cooperative was to channel donations of retroviral drugs from associations and individuals in Western countries. While Africa struggles to afford anti-retrovirals, the drugs are readily available in the West. In Western countries, HIV patients obtain their anti-retroviral medicine for a specific period of time. If a particular drug has severe side effects, they usually go back to the doctor for another type of therapy. They return the pills remaining in their original dosage to their doctors or pharmacists, who then dispose of them. Through the Internet, Issoufou and AAS have created networks of various doctors, pharmacists, and associations in France, Canada, and Belgium. This network allows AAS to access a regular supply of medications for Burkina Faso. Groupe Metis and Santé Sans Frontières in France, Europe Assistance in Belgium, and Medical Doctors Group at Montreal General Hospital in Canada have been AAS's first partners in this endeavor. After ensuring a stable reserve stock of 30 to 50 percent of the drugs donated, the cooperative manages the distribution of the donated medication in order to reduce the prices of anti-retrovirals available to HIV and AIDS infected people. AAS pays for the regular shipment of supplies. Those costs are easily compensated, given that the price of one anti-retroviral packet in Burkina Faso is almost twice the cost of shipping twenty packets. AAS has also negotiated with the government for tax-exempt status. Additionally, they have started lobbying the government on issues affecting the HIV-infected population in order to reaffirm that AIDS and all related issues are a public health issue and concrete solutions are needed. In 1999, the Burkinabe government granted a national award - Medaille de Chevalier de l'Ordre du Merite Burkinabe - to Issoufou and AAS for their achievements.New information technologies, particularly the Internet, play an instrumental role in this effort. Under the sponsorship of an organization named Planet Africa and other associations in Mali and Burkina Faso, AAS is part of an Internet network where it can exchange information on best practices and successful strategies. The lack of communication between francophone and anglophone organizations is an obstacle and Issoufou helps each community understand the importance of exchanging information and strategy. This email network is being enlarged to include other associations and organizations in other countries in West Africa, Europe and North America. Planet Africa initially provided the computers, modems, and email subscriptions to Issoufou and AAS members.To disseminate their ideas and promote their activities, Issoufou and AAS plan to take advantage of national and international AIDS conferences and events, which include the Bobo Dioulasso Health and Science Days, the International AIDS Conference, and the International Conference on Community Caring and Home Caring. In Ouagadougou, Issoufou targets the vulnerable youth population with community-based distribution of condoms, thus promoting youth reproductive health. Furthermore, Issoufou seeks to benefit from the relationship and exchange programs developed by AAS in other cities of Burkina Faso but also with other sub-regional associations in order to share their experiences and ideas.In 1997, Issoufou created the first center in Ouagadougou to provide intensive support for HIV and AIDS patients. He raised funds from the Dutch Cooperation in 1998 to provide psychosocial and medical support to HIV patients and their families. Since 1996, nineteen "health cafes" and twenty youth health clubs where young people can obtain vital health information have been set up in various areas of Ouagadougou and other cities such as Bobo Dioulasso. Twenty jobs for young girls who were either unemployed, single mothers, or had no family support were created. The locations have been used as a permanent environment for awareness and mobilization against HIV and AIDS.
In the early 1990s, Issoufou worked as an intern in an accounting firm while leading the executive committee that coordinated AAS. Although self-taught in the AIDS field, he helped create the first association fighting against AIDS, which was legally recognized in 1997 as a non-governmental organization. In 1990, at a time when most illnesses were thought to be AIDS, Issoufou witnessed the death of one of his close friends wrongly diagnosed with AIDS. As he began to look for information on the disease, Issoufou met a consultant from OXFAM-UK who gave him advice on creating an organization to make the information he sought available to other young people. In 1991, he and a group of other young people founded the AAS, the first Burkinabe youth organization committed to AIDS prevention. In 1997, Issoufou and AAS focused their efforts on bringing affordable medication to people with HIV. That same year, Issoufou learned that he was infected with HIV.