SALT: the needed revolution to achieve the three zero's.

[Jean-Louis Lamboray]

Zero new infections, AIDS deaths zero, zero discrimination: UNAIDS has just offered the world a definition of victory in the fight against HIV and AIDS. This is the first time in thirty years that the leadership of this organization takes such a risk. As the success was not defined, we could not lose. Now that success is defined in terms of measurable and verifiable, the failure also became possible. Let us be grateful to Michel Sidibe and his team for taking this risk as by taking it  we can  regroup to achieve this clear and achievable objective.
This definition of victory is not wishful thinking, because there are communities that have already achieved. Indeed, populations of Phayao Province, in Northern Thailand  have already achieved these goals, and they have done in the space of ten years. While in 1992 18% of military conscripts from the province were HIV positive, the same proportion was less than 1% in 2002.  Excess adult mortality due to AIDS has disappeared and people living with HIV and AIDS lead a normal life in society.
What is their secret? Local communities have taken ownership of the problem. They have looked at the reality, and discussed its causes. They have acted to reduce and eliminate those causes. Public discussion of the problem and collective reflection leading to action: that is the revolution necessary ingredients for victory in a decade.
UNAIDS calls for a revolutionary approach to prevention. If one draws from the Phayao experience, this revolution will consist in the recognition that each community has within itself the resources to act against AIDS. One thing is to preach and teach at communities, but another is to accompany them in their discussions, in their public reflection and in their collective  actions.
This revolution is not just about prevention. It extends to inclusion and care. Once the local debate and reflection on AIDS are launched, communities act to include the affected families in their midst and use their own solidarity mechanisms to support the patients in their life long treatment.
The Constellation, a non-profit association under Belgian law accompanies thousand of communities in over thirty countries. Its facilitators practice and approach called SALT: To stimulate discussion and reflection, learn and appreciate the strengths and achievements of communities, linking communities with the resources available in their environment, transfer lessons learned in other contexts. The results are convincing. Thus in the DRC, the collaboration between PNMLS, Constellation and its member organization RDCCompétence have applied the SALT approach in 15 cities. In eight months, 622 communities (community-based organization, churches, fishermen, farmers, groups of moms, soldiers, prisoners, choirs, sex workers) have measured by themselves the progress they had achieved. So they undertook 1383 actions to reduce their own vulnerability. 943 PWA came out of hiding because they felt secure after  confident after the community conversations. 104,055 people sought to know their HIV status in Voluntary Testing Centres. 629,574 condoms were distributed. Members of these communities have raised awareness of 168,094 other people. On average, each community mobilized two other communities to take action.

The victory against AIDS is at hand. But it will not happen without a profound revolution in organizations. The revolution is not so much required from the communities. What needs to change are the attitudes and practices of organizations that for thirty years are living from AIDS. Will we have the courage to take off  our cloths of experts to join millions of communities on the path to victory?