Drug Resources Enhancement against AIDS and Malnutrition (DREAM)

Category 1

The Drug Resources Enhancement Against AIDS and Malnutrition (DREAM) project was first implemented in Mozambique in 2002 with the aim of introducing the essential components of an integrated strategy for the prevention and treatment of HIV/AIDS among the poor and for pregnant women and their children. It has since been expanded to include ten African countries where it applies the same comprehensive strategy that provides ART while also treating other health ailments and emphasizing education.

Goal of the Practice
  • Within the framework of the national health system, the DREAM project aims to introduce the essential components of an integrated strategy for the prevention and treatment of HIV/AIDS. The project is intended to serve as a model for a wide-ranging scale-up of the response to the epidemic.
Core Components
  • Voluntary counseling and testing for HIV status: Training of local staff (doctors, nurses, laboratory technicians, health workers, and training staff)
  • Health education, especially for at-risk populations, with mothers with HIV playing a key role as peer educators: Highly Active Antiretroviral (HAART) therapy for preventing mother-to-child transmission of HIV infection during pregnancy, birth, and breastfeeding
  • ARV drug therapy for people living with AIDS: Expanded laboratory facilities to monitor patients receiving ARV drug therapy
  • Monitoring of blood donations: Prevention and care of diseases linked to AIDS (opportunistic infections, sexually transmitted diseases)
  • Nutritional education and supplements for people living with AIDS: Home care for the seriously ill
Noteworthy Results
  • DREAM has a 95% adherence rate for its ARV patients
  • Of babies born to HIV positive mothers 98% are HIV negative due to the PMTCT vertical prevention program
  • 500,000 people have received assistance from the DREAM program, including health education, nutritional support, distribution of water filters, mosquito nets etc.
  • Successful replication of the DREAM model to nine additional African countries
Lessons Learned
  • DREAM has capitalized on unique support approaches to ensure adherence. In the case of 'Mulheres para o DREAM', women have set up an association to support patients receiving treatment to adhere to treatment protocols. They do so by sharing their own positive experiences with ARV treatment.
  • The holistic approach and strong focus on nutrition also contributes to high adherence and enhances the positive effects of ARV treatment.
  • Engaging the MOH as a central partner has provided DREAM with central locations in existing public hospitals and maternity wards.
Focus Areas
Counseling and Testing
Implemented By
Community of Sant'Egidio
Participating Organization
Mozambique Ministry of Health
Clinic/Health facility
Target Population
  • Infants (newborn to 24 months)
  • Females
  • General Public
  • People Living with HIV (PLWH)
> 50000
Implementation Years
01/2002 - 12/2008