Protecting Togo Military From AIDS

This article was written by U.S. Ambassador to Togo Karl Hoffman for the "Ambassador's Corner" portion of the web site of Family Health and AIDS, an initiative of the West Africa Regional Program, of which PSI is a key member.

Ambassador to Niger Barbro Owens-Kirkpatrick provided an excellent overview of the opportunities and challenges facing us USAID non-presence posts in fighting HIV/AIDS in West Africa. Many of the issues and programs she highlighted in her first submission to the "Ambassador's Corner" are equally valid for Togo. Let me concentrate therefore on one exciting new initiative here that we believe will pay dividends out of proportion to our investment: our HIV/AIDS awareness, prevention and education program with the Togolese Armed Forces.

PSI in Togo
Population Services International is SFPS's prime implementation partner in Togo. Thanks to SFPS (Santé Familiale et Prévention du SIDA) funds, PSI has been able to promote and market male and female condoms nationwide, and to reach the general public in Togo with clear and frequent messages about HIV/AIDS prevention. Last year PSI sold more than 8 million condoms. A second component of PSI's AIDS program is to target Togo's high-risk groups with specially tailored HIV/AIDS campaigns. Truckers along the major transportation routes learn about how to prevent HIV/AIDS through billboard campaigns ("Roulez Protegé!") and interpersonal communications. Specially trained peer educators work with these truckers as well as with commercial sex workers - 80% of whom are seropositive - to teach them how to lower their risk of contracting disease. In high schools, peer educators reach more than 130,000 young people each year with messages of AIDS prevention, and with condoms. And in the military, a new peer education program combined with voluntary HIV testing and counseling, as well as STI treatment, will help to lower the HIV rate in this high-risk population.

The FAT and Togo's Democratic Difficulties
Togo was among the first African countries to end the one-party era, in 1990, but the transition begun then toward a functioning multi-party democracy remains largely unfinished. International donors began to withdraw from Togo in response to a poor political environment and because resources could more profitably be invested elsewhere. The EU instituted sanctions in Togo and halted most development aid in 1993; USAID closed its Togo mission in 1994.

In this context, the Forces Armées Togolaises (FAT), closely associated with the ruling party and specifically with President Eyadema, lost many of its professional military relationships with the West. General human rights concerns and the international community's desire to signal displeasure with Togo's halting democratization made the FAT off-limits for many donors.

And yet, we know that the armed forces are often a key vector for HIV. Reliably paid, mobile, holding positions of power and authority, the military is a prime AIDS target. We decided to step into this void.

Funding
Deputy Chief of Mission Bill Fitzgerald bird-dogged funding for an anti-HIV effort in the FAT with DOD's LIFE initiative, a $10 million program launched in 2000, designed to help African militaries deal with the scourge of AIDS.

In addition, Embassy Lome also identified security assistance funds in Togo's prior-year account at DOD. With the help of DOD's Defense Security Cooperation Agency, we added an additional $100,000 to the program.

HIV/AIDS Program with the Forces Armées Togolaises
In May 2001, PSI/Togo submitted a proposal to the U.S. Department of Defense for funding of a 5-year HIV/AIDS Prevention project with the armed forces of Togo. This funding was approved for one year, with the U.S. Embassy acting on behalf of the Department of Defense to disburse funds and monitor project progress. In October 2001 we began activities of Operation Haute Protection — Forces Armees Togolaises or OHP — FAT (translated as Operation Full Protection — Armed Forces of Togo) in four military bases, with the cooperation and participation of the Armed Forces of Togo.

Our activities to date include peer education of soldiers by soldiers, behavior-change campaigns, STI diagnosis and treatment, and the establishment of HIV voluntary counseling and testing (VCT) services in the armed forces. Three years ahead of schedule, the VCT component of the project was accelerated to accommodate the requests of our military counterparts in Togo to provide access to VCT to soldiers and their families at the earliest possible opportunity.

For the second year of project activities, we propose to extend the reach of our first year's efforts, by targeting soldiers in four more bases, by adding STI and VCT services, and by developing on program activities for members of the rest of the Uniformed Services: police, prefectoral police, customs officers, and firemen. By broadening our primary beneficiary base, we will reach roughly double the number of people with peer education and HIV/AIDS prevention. Our secondary beneficiary group - wives and family members of all military and uniformed service personnel - will likewise double.

And more than simply add greater numbers to our Year 1 effort, we will also include two new program elements to Operation Haute Protection. The first of these will be to strengthen groups (such as non-governmental organizations) who support people living with HIV/AIDS. These groups are prepared to offer long-term guidance and support to the HIV-positive, but will need financial and administrative help if they are to accept all the new members that our VCT program will refer to them. The second new program component is to offer counseling and drug treatment to the pregnant, HIV-positive wives of military and Uniformed Service personnel, in order to prevent transmission of HIV from mother to child (PMTCT). PMTCT will be offered in our two existing VCT sites: the military health clinics in Lome and Kara.

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PSI/Togo produced these posters as part of their campaign to reach Togo military personnel with safer-sex messages.