In recent years, two national studies performed in Niger, one in 2002 and the other in 2006, have shown a tendency for the epidemic to stabilize in the general population aged 15 to 49, with a prevalence rate of 0.70% in 2006. An estimated 16,000 people are in need of ARV treatment and 1,700 of them are receiving treatment.
 
For the prevention of mother-to-child transmission program (PMTCT), an estimated 9,200 pregnant women are in need of treatment, and only 1% of HIV-positive pregnant women have received ARVs for PMTCT. An estimated 8,900 children (0 to 14 years old) are living with HIV, while only 80 of them are receiving ARV.

The fight against HIV/AIDS in Niger is organized around:

● The National Council for the Fight Against AIDS (CNLS)
The CNLS is presided over by the President of the Republic, who approves the orientations and the strategies for the fight against STDs and HIV/AIDS. He approved the National Multisectorial Plan, and agreed to support the mobilization of resources necessary for the fight against STD/HIV/AIDS.

● The Intersectorial Coordination for the Fight against STDs/HIV/AIDS (CISLS)
Directly attached to the President of the Republic, the role of the CISLS is to coordinate, follow up, and evaluate all activities concerning the fight against STDs/HIV/AIDS in the country. At the regional level, the CISLS is represented by the Regional Coordination of the Fight against AIDS (CRLS), which works in close collaboration with Regional, Sub-regional and Community Councils.

The Ministry of Health is also, of course, involved at different levels, in particular via its Sectorial Unit (ULSS).

Finally, the strong support of local associations for people living with HIV/AIDS must also be mentioned. The National Strategic Plan for the Fight Against AIDS (Le Cadre Stratégique National de Lutte Contre le VIH/SIDA) is the basic coordinating body for these partners and the funding mechanism from 2008-2012. In accordance with UNAIDS directives, the national strategy is universal access to prevention, care and treatment.

Program launch date: December 2004
Progam end date: December 2009
Team:   4 expatriates
11  people total based between Niamey  and Zinder
Project leader based in Niamey
Medical coordinator based in Niamey

with ad hoc missions as needed to Maradi, Tahoua, Dosso, Galmi, Diffa, Tera, and Tillabéry.

During 2007 we were able to consolidate our support, in particular by improving the quality of patient follow-up thanks to the use of viral load testing, as well as by improving food support and mother and child patient management.

This last year was important for our work on the law for the rights of HIV-positive patients and on determining the cost of free treatment. The pilot project for receiving and assisting HIV-positive patients at the National Hospital at Zinder was also an important event in 2007.

To continue our support of the Nigerien Initiative for Access to ARVs (INAARV) during this transitional period, the aim of Solthis in 2008 is to help consolidate the patient management network in the capital and regionally, in particular by supporting decentralization of the national program in new prescription centers in the regions of Diff a and Tillabery while providing stronger support to the Tahoua and Dosso regions.

The management of treatment failures with viral load testing in Niamey in collaboration with the laboratory of virology of Pitié Salpêtrière Hospital (Paris) will be a major focus for Solthis support in 2008. Tuberculosis will also be given particular attention, especially as the subject of specific studies on co-infection. Finally management of the medical database will require major efforts from the teams. In the area of PMTCT and pediatric patient management, Solthis will work to finalize the tools for follow-up developed in 2007 and will lobby for delegating tasks to paramedical personnel.