The Foreign Service Journal, December 2004

infected with HIV/AIDS. The thousands of truckers and other transport workers who traverse the region, especially along the corri- dor, not only run the risk of becom- ing infected with HIV, but also of spreading it far beyond the two countries’ borders. Ethiopia already has a national prevalence rate of 6.6 percent in the adult population and an esti- mated 13.7 percent in the urban population. With such rates, it is likely that HIV/AIDS will continue to seriously damage and diminish the health, economy and development of the country. Although Djibouti’s HIV epidemic appears to be less severe, with a prevalence rate estimated at 2.9 per- cent in the adult population, the majority of the truckers along the length of the corridor are Ethiopian. Hence, the potential for cross-border HIV transmission is substantial. This past May, I traveled along this expanse of dust-swept road with 15 officials from the Ethiopia and Nairobi regional USAID missions and Save the Children’s office in Addis Ababa. Our goal was to evaluate the work of the USAID-funded Save the Children/U.S. High-Risk Corridor Initiative pro- gram, a comprehensive HIV/AIDS-prevention, care and support activity providing assistance to thousands of people in Ethiopia and Djibouti. For five days our delegation talked to resident cit- izens, officials and public health workers in both countries in order to learn about and see first-hand what types of HIV/AIDS projects are being imple- mented, identify areas for potential growth, and come up with recommendations for future directions. In the process of traveling the cor- ridor, I could not help but absorb the austere beauty of the land, the profundity of its history, the splen- dor of its people, and the sheer devastation that the HIV/AIDS epidemic has inflicted in the region. An Initiative Is Born To address the cross-border epi- demic in the region, the USAID mission in Ethiopia established the High-Risk Corridor Initiative pro- gram in 2001. Originally a three- year, $3 million program, the HRCI now operates in 25 sites along the corridor (21 in Ethiopia, four in Djibouti) to publicize and implement HIV/AIDS prevention practices and thereby encourage the demand for them; increase the availability of services improving both availability and quality of care and support services for people living with the disease, as well as orphans and vulnerable children; and enhance the livelihood and security of people (particularly children) affected by HIV/AIDS. Specifically, HRCI uses HIV/AIDS Information Centers to train peer educators; develop behavior change and communication materials that are sensi- tive to the local culture; conduct awareness-raising sessions with hotel and bar owners; improve access to, and the capacity of voluntary counseling and test- ing for HIV; provide access to screening and treat- ment for sexually transmitted infections; provide access to opportunistic infection treatment services; provide home-based care and psychosocial support to people living with AIDS; establish community-based child care centers; and provide material support to orphans and vulnerable children. As this list of ser- vices suggest, HRCI offers a truly comprehensive, holistic approach to the epidemic. Since their establishment, the 25 HIV/AIDS infor- mation centers in Ethiopia and Djibouti, along with other prevention programs and services, are now pro- viding approximately 100,000 at-risk youth, transport workers, sex workers, dock workers, orphans and vul- nerable children with the necessary information and services to protect themselves against HIV/AIDS. In F O C U S 38 F O R E I G N S E R V I C E J O U R N A L / D E C E M B E R 2 0 0 4 Dr. Jeffrey Ashley is director of regional HIV/AIDS programs in East and Central Africa for USAID’s Regional Economic Development Services Office in Nairobi. A public health scientist specializing in inter- national health and epidemiology, he has been a USAID Foreign Service officer since 1995, serving in Tanzania, Cambodia and Angola. He has spent the majority of his professional career in wartorn areas of the world. The program’s 25 HIV/AIDS Information Centers offer a truly comprehensive, holistic approach to the epidemic.