DREAM 2.0 A Replicable Model

  • Paola Germano
  • Abdul Majid Noorjehan
Part of the TELe-Health book series (TEHE)


The rapid expansion of DREAM over the last 16 years is due not only to the widespread presence of the Community of Sant’Egidio in many countries in Africa and to the work of many African health professionals but also to the collaboration with many religious congregations, NGOs and volunteers, who have decided to join us in the fight against AIDS and in treating many chronic pathologies. One of the secrets of this success is to have created a model that is certainly complex but that can also be replicated. Some of DREAM’s characteristics are essential and represent its uniqueness: the excellence of the diagnostics and of the therapy; the centrality of the patients who are treated from a holistic point of view as individuals, including the context in which they live; the use of management software that helps look after every patient correctly; training for the local staff with periodic training courses; the fact that the treatment is free of charge; and the decision to set up light healthcare with excellent daytime clinical centres are just some of the characteristics that explain how DREAM has expanded so rapidly.

As we fully explained in Chap. 3, when we started working on the DREAM programme, many people considered our dream to take the AIDS therapy to Africa, a utopia: a beautiful, ambitious project but impossible to carry out. Over the years the interest shown throughout the world and the funds raised to fight the disease have not only led to the development of new groups of drugs but also to a greater possibility of diagnosis and treatment in many areas of the world, including Africa.

Today, over a decade later, also thanks to DREAM, which has the merit of having created a model that can be adapted and replicated, by now it is possible to prevent and treat HIV/AIDS in every country in Africa.

One of the fulcrums of the DREAM programme has been—and still is—the prevention of the mother-to-child transmission of the HIV infection. This is a clear example of the fact that the DREAM model can be replicated and adapted. The programme started administrating the triple-antiretroviral therapy to HIV-positive pregnant women in 2002 in Africa with a success rate over 98% (Palombi L, Marazzi MC, Voetberg A, Magid NA. Treatment acceleration program and the experience of the DREAM program in prevention of mother-to-child transmission of HIV. AIDS 2007). DREAM was the first example of a high-standard PMTCT protocol in sub-Saharan Africa. It is also thanks to DREAM that all the international organisations gradually modified their recommendations (Option B, Option B+, etc.) (WHO Antiretroviral drugs for treating pregnant women and preventing HIV infections in infants 2010).

DREAM’s experience in PMTCT demonstrated that treatment and prevention are two aspects that are to be addressed together. Treating HIV-positive pregnant women has a double benefit: it reduces maternal mortality, and it eliminates the mother-to-child transmission of the virus. The result is healthy children with safe mothers. Since 2002, DREAM has intended to overcome the dichotomy between treatment and prevention, with the idea of holistic treatment as the only way to reach the success in the fight against the HIV infection.


DREAM programme AIDS HIV Prevention of mother-to-child transmission (PMTCT) 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.‘DREAM Program’, Community of Sant’EgidioRomeItaly
  2. 2.‘DREAM Program’, Community of Sant’EgidioMaputoMozambique

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