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Medical treatment for people living with HIV/AIDS started in Mali as early as 1997 thanks to civil society. The national response was officialised by the adoption of the Malian Initiative for Access to Antiretroviral Therapy (Initiative Malienne d’Acces aux Antiretroviraux IMAARV). In 2004 ART, drugs against opportunistic infections and basic biological monitoring were made available free of charge by decree. In 2005, decentralisation of health-care to regions and circles became one of the main thrusts of the national strategy for the ght against the pandemic. Sub-Saharan African countries are making signicant efforts to provide full geographical coverage of their national territory. It is in this “scaling-up” context that the Solthis NGO (Solidarite Therapeutique et Initiatives contre le Sida) began cooperating with Malian actors to extend access to quality treatment for patients living with HIV/AIDS in the city and region of Segou. Based on a developmental approach, Solthis opted for continuing in situ technical support for national actors in the ght against AIDS. Thanks to the daily presence of a team “in the eld” Solthis devotes a large part of its activities to capacity-building for health-care workers through an exchange of medical and scientic expertise. Efforts were also made to improve health-care workers’ working conditions and to make various tests and drugs accessible to patients infected with HIV. The initial aim was to encourage universal access to ART. Today, the Segou programme supported by Solthis has developed over 1,500 new treatments in the region. In addition, every PMTCT centre in the region offers prevention and treatment services to mothers and children. Today, the Segou region is an integral part of the IMAARV initiative as a decentralisation pilot project.

Technical support by Solthis for health-care workers in order to decentralise medical treatment for people living with HIV in the Ségou region of Mali