Case Study 1 - HIV, TB and Malaria
Boureima lives in a rural village in Burkina Faso, West Africa. Every morning he wakes at sunrise and washes his face with water that his wife Aminata has collected from a nearby well. Then Boureima sits down to eat breakfast with his family. At seven-thirty a bell rings through the village, calling students to school. Boureima is proud that his two daughters remain in class throughout the year instead of leaving during the rainy season to help him in the fields. His wife Aminata, who is five months pregnant, spends the morning gathering firewood and pounding millet grains into flour in preparation for lunch. It will take her three hours to make the meal, and in the afternoon she will join Boureima in the fields where he is preparing the land for the rainy season. The rains only last for three months, but Boureima hopes to grow enough millet to feed his family for the next year.
 Boureima understands the importance of keeping his family healthy. When an AIDS workshop passed through the village last year, he and Aminata attended. Afterwards, they agreed not to get involved in relationships that would put the family at risk. As the rainy season begins, another health concern arises. Mosquitoes come out of the swamps and begin their three-month reign in the village. Aminata has never had malaria; like many villagers she has developed a natural immunity to the parasite. But because she is pregnant, she is vulnerable. One day Boureima returns from the fields and finds Aminata shivering violently on the bed mat. He has seen enough people like this to recognize the onset of malaria. The next day, instead of returning to the fields, Boureima walks 10km to the region's health center and buys medication for his wife. The mefloquine is very expensive; Boureima has to use the money that was supposed to pay for his daughters' school fees. Since Aminata requires several weeks of rest, Boureima has no choice but to take his daughters out of school. They will cook and clean in the mornings, and help him in the fields in the afternoon.
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As the rainy season wears on, some of the farmers develop serious coughs. Boureima worries about TB, a highly contagious airborne infection that hits the village every year as people exhaust themselves in the fields by day and sleep in damp mud huts by night. Boureima instructs his daughters to stay away from anyone with a cough and he tries to do the same himself, though village custom requires him to greet and shake hands with the other farmers each morning. If anyone in the family gets sick with TB, it will cost about US $10 for a full treatment, which is money that Boureima does not have. If Boureima catches the infection, even if he can borrow money for medicine he will still be in bed for three to four months, and most of the family's crops for the upcoming year will be lost. People in the village try to look after each other, but with so many deaths from AIDS, TB and malaria, most families are already stretched to the limit.
Boureima is just one of millions of people whose lives are at risk because of AIDS, TB and malaria, yet all three of these diseases are preventable. Over the last few years, countries have recognized that these diseases require a global solution. The Global Fund to Fight AIDS, Tuberculosis and Malaria is a new organization leading a worldwide effort to fight these diseases. The Fund says that with an annual budget of US $10 billion it will be able to curb the spread of AIDS, TB and malaria significantly.
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