Liberia is a country of fewer than 100,000 km2 and a population of 3.5 million inhabitants. A civil war lasted 15 years, caused over 300,000 deaths and displaced tens of thousands of people. This war destroyed most of the country's infrastructures. Women and children were the victims of violence, aggression and violations of human rights. Numerous children were enrolled in the rebellion and today find themselves with neither education nor families. 75% of the population lives with less than US$1 per day. The population is mostly urban.
The prevalence of HIV/Aids in Liberia is officially estimated at between 5 and 6% and between 9 and 10% in certain regions. A survey of 4,216 pregnant women undergoing prenatal consultations at watchdog sites revealed a prevalence of 5.7% (239 positive) with a prevalence of 6.8% in the 30-34 year age bracket and 9% in the East region. In the Department of Infectious Diseases at the JFK Hospital, 41 patients were tested and 21 were seropositive. Two to three new patients are admitted to the department every day. As in all African countries, HIV/Aids concerns the most active group of the population with a female predominance. Transfusion safety is not systematically ensured. Stigmatisation is extremely high.
The Ministry of Health and Social Affairs is in reconstruction and had a total budget for 2007 of US$12 million including US$2 million for the John Fitzgerald Kennedy Hospital (the total budget for the Liberian government for 2007 was US$128 million). A "National Health and Social Welfare Plan" is being drafted with the fight against infectious diseases (including HIV/Aids) a determining factor, along with the reinforcement of human resources in both quantity and quality throughout the territory. The National AIDS Control Program (NACP) steers and coordinates the fight against HIV/Aids. The NACP is having difficulties fulfilling its mission owing to a lack of qualified human resources.
The country has financial backers: the Global Fund (Round 6) granted US$12 million in March 2007. Numerous partners have mobilized for HIV/Aids in Liberia: the European Union, DFID, USAID and the Clinton Foundation. Liberian civil society is beginning to organize itself.
ARV therapy is free. Detection is in particular little developed in the country with very intense stigmatisation of PLWHA. CD4 counts are only available at three sites: Firestone Hospital, Mamba Point Hospital and St Joseph Hospital. Measurement of viral load is not available in Liberia. Psychosocial care is more or less inexistent. Only private centres have counsellors and support groups. On a national level, PMTCT is also more or less inexistent. As for paediatric care, it is supposed to begin.
The five ARV dispensing sites in Monrovia are the JFK Public National Reference Hospital, Firestone Hospital, St. Joseph Catholic Hospital, ELWA Protestant Hospital and the MSF-F Hospital in Mamba Point.
At the end of January 2007, 750 patients were receiving ARV therapy in the entire country.
In August 2007, Mamba Point Hospital closed and transferred its patients to JFK Hospital, which is monitoring 200 patients receiving ARV therapy.