Healthcare systems in developing countries with resource-poor settings are inadequate. Therefore, efforts to tackle major infections like HIV/AIDS, TB and malaria need to be integrated into national health systems and not established as vertical, disease-specific programmes. Moreover, a holistic approach that also deals with other health and social problems is recommendable.

Ethiopia has the third largest population of HIV-infected individuals in the world, with almost half these cases in Addis Ababa. The Integrated Holistic Approach/Urban Development Program (IHA/UDP, www.ihaudp.org), now known as Community Based Integrated Sustainable Development Organization (CBISDO) is an NGO operating in one of the poorest areas, near Teklehaimanot parish in Addis Ababa. It is the first NGO to introduce the integrated, holistic approach project aimed at intervention in the country. The project has three main components, which include 52 programs integrating efforts for over 42,000 poor inhabitants of whom 50% are children under 16 years. The primary health care programme was aimed at improving people’s health and quality of life through education and preventative healthcare. The project as a whole provides a novel approach i.e. providing full community participation in the process of planning and

implementation, and aiming from the start towards sustainability.

Project: Since 1993, the Association of Ethiopian Health Professionals in Sweden (AEHPS,

http://aehhps.tripod.com) in collaboration with Sida, (the Swedish International Development Cooperation Agency) has been assisting the primary healthcare (PHC)  programme that includes HIV/AIDS prevention, care and support for PWHA and orphans within the IHA/UDP functioning in 4 of the poorest slum areas of Addis Ababa. The supports were with material, financial and human resources. The HIV/AIDS project is incorporated into the PHC program and is based on effective HIV/AIDS prevention and control strategies to curb the spread of the epidemic primarily among the so-called "windows of hope", these are children of 5-15 years of age living in these targeted and neighbouring communities. The primary objectives of the HIV/AIDS project are:

• to give information on STDs, and in particular HIV/AIDS to the targeted group,

• to implement a rehabilitative programme i.e. to accommodate the orphans of AIDS to other families within the community,

• to give counselling & care for HIV-infected community members and their families in a sustainable and appropriate manner,

• to give VCT (Voluntary Counselling and Testing) and promote MTCT (Mother-to-

Child Transmission) prevention programme.

Results: These initiatives have resulted in enhancing the knowledge on the danger of the HIV/AIDS and are altering the spread of the epidemic. Furthermore, significant achievements have been gained in overcoming the traditional taboo associated with HIV/AIDS, have created openness and led to free discussions and awareness that have consequently contributed to the observed reduction in the spread of HIV, including mother-to-child transmission of the virus in the projected communities.

In conclusion, HIV/AIDS and also TB and malaria interventions in a holistic approach can be designed in synergy with activities in education, family planning and reproductive health, maternal and child health, small economic activity development and agriculture and natural resources to protect the livelihood of families. Implementing an integrated and participatory development approach, based on the local needs of the community in which people can live healthy and work in a harmonious society are the prime targets. The Sida/AEHPS/IHA-UDP collaboration has brought significant changes to the life of the people in the area. Holistic approaches are necessary towards tackling the closely interrelated problems of poverty, ignorance and ill-health that are rampant in poor communities in countries like Ethiopia.

References:

(1)- W. Mamo & B. Wondimu (2004). The role of African health professionals in Diaspora against the spread of HIV/AIDS: Experience & a model from Ethiopia. The XV International AIDS Conference, July 11-16, 2004, Bangkok, Thailand. MedGenMed. 2004 Jul 11; 6 (3) (http://www.ias.se/ejias/show.asp?abstract_id=2171783).

(2)- B. Wondimu & W. Mamo (2001). "Cross actions" between sub-Saharan Africa and Europe on the prevention of HIV/AIDS: An experience of the Association of Ethiopian Health Professionals in Sweden (AEHPS). In: The VI International Workshop of European Partenariat Between African Communities and Health Partners for HIV/AIDS Prevention.  January 10-13, 2001, Madrid, Spain.

(3)- W. Mamo, B. Begashaw, F. Maru, & B. Wondimu. (1999). The role of Ethiopian Health Professionals residing abroad in the battle against HIV/AIDS pandemic in Ethiopia.  An applicable model? In: The First International Conference on AIDS in Ethiopia.  November 7-10, 1999, Addis Ababa, Ethiopia.

(4)- W. Mamo, J. Teffera, B. Begashaw & M. Moussa (1997). The significant contribution of community development in improving community health. An experience from an integrated and holistic community development project in Ethiopia. The XIII International Conference of Ethiopian Studies. December 12-17, 1997, Kyoto, Japan. In: Ethiopia in Broader Perspectives, Fuku. K, Kurimoto. E and Sheigeta M (Eds), pp 721-725, ISBN: 4- 87974-978-8 C3039.

Key words: Health development, HIV/AIDS prevention, Holistic approach

Wubshet Mamo, PhD, Associate professor

AtraZeneca R & D, Södertälje

wubshet.mamo@astrazeneca.com

Birkenesh Begashaw, GP nurse

Karolinska University Hospital, Huddinge

birkenesh.begashaw@chello.se

Biniyam Wondimu, DDS, PhD

Karolinska Institutet, Huddinge

biniyam.wondimu@ofa.ki.se