Nadoum, Frontline AIDS’ flagship programme in the Middle East and North Africa (MENA), was launched in 2019 with funding from the Global Fund, operating across Egypt, Jordan, Lebanon, Morocco, and Tunisia. The programme targeted highly marginalised communities facing criminalisation, stigma, and underfunded health systems, where political complexity makes the delivery of HIV and sexual and reproductive health services particularly challenging. Rather than providing services directly, Nadoum focused on strengthening communities, empowering civil society, and addressing barriers that prevent key populations—including men who have sex with men, sex workers, trans people, people who use drugs, and people living with HIV—from accessing the care they need.
Operating in a highly complex and often hostile environment, Nadoum partnered with 23 national and regional organisations and networks, while engaging governments, regional coalitions, and international donors to ensure context-sensitive and locally-led programming. The programme navigated multiple crises, including COVID-19, the Beirut port explosion, the Morocco earthquake, and rising anti-rights movements targeting LGBTQ+ communities, all while keeping communities central to its work. Despite some organisations being forced to close, Nadoum’s partners demonstrated resilience, adapting and advocating under challenging conditions.
The programme targeted six strategic areas, including advocacy for inclusive policies, improving service delivery, and strengthening regional collaboration. An independent evaluation in June 2025 confirmed Nadoum’s impact, highlighting 33 tangible changes across structural, institutional, and behavioural levels. The programme’s strategic focus ensured resources were directed to areas of greatest need, with country-specific adaptations that maximised relevance and effectiveness.
Concrete successes included a new model of care in Alexandria, Egypt, developed by Caritas, which improved HIV services at seven hospitals, attracting regional interest. In Morocco, community feedback led to hospital reforms addressing stigma, while in Tunisia, networks documented human rights violations and advocated for protection. In Lebanon, amidst economic collapse and political paralysis, community organisations became lifelines, sustaining harm reduction and HIV services. In Tunisia, five civil society organisations piloted integrated support for pregnant women, survivors of gender-based violence, and refugees, incorporating HIV testing into routine services, reducing stigma, and strengthening trust between communities and providers.
Nadoum’s work demonstrated that even in restrictive environments, collective action can survive and thrive. Civil society organisations persisted, protecting vulnerable populations and promoting inclusive, non-discriminatory care. The programme leaves a strong foundation for the Global Fund’s Catalytic Regional Multi-country MENA grant 3 (MCMENA 3), which will continue to support sustainable, community-led HIV responses across the region. Nadoum showcased the resilience, creativity, and bravery of local partners, highlighting that meaningful change is possible even in the most challenging contexts.
The programme also underscored the importance of collaboration among governments, regional networks, and international donors in scaling up effective interventions, ensuring communities remain at the centre of the response. Nadoum’s end-term evaluation reflects both the measurable impacts and the human stories of perseverance and hope, demonstrating the value of sustained investment in community-led approaches to HIV prevention, care, and advocacy in MENA.
