25 October 2006

Tanzania: ARV Rollout Slowly Improving

Dar Es Salaam — After a slow start to its antiretroviral (ARV) treatment programme, Tanzania has speeded up the pace, doubling the number of HIV-positive people receiving the drugs over the past 10 months.

According to the National AIDS Control Programme (NACP), 49,315 patients were receiving the life-prolonging medication from state facilities by mid-September, an average of about 2,500 new patients per month since December 2005, when the figure was 23,000.

NACP's head of the care and treatment unit, Emma Msuya Lekashingo, attributed the rise to increased funding and an easier procurement process. Until 2005, when the government made the central medical stores semi-autonomous from the ministry of health, the main complaint of ARV dispensers was the unavailability of the drugs. The supply cycle - from tendering to procurement to distribution - often took many months, sometimes years, to complete.

"The decision-making process is faster than in the past, when unnecessary bureaucracy negatively affected ARV interventions," she said.

The government has also allocated US$22 million in the 2006/07 budget to the NACP to combat the spread of the epidemic. An estimated two million Tanzanians - about seven percent of the population - are living with the virus.

However, the latest treatment figures still fall well below the NACP's national target of placing 66,000 patients on ARVs by the end of 2005, and even further below the target of 104,000 by the end of 2006. The World Health Organisation estimates that some 315,000 Tanzanians need the drugs.

The ARV programme is reaching just 15 percent of those who need the drugs, lagging far behind its East African counterparts: Uganda is reaching more than 50 percent, and a quarter of HIV-positive Kenyans are accessing treatment.

Lekashingo blamed the slow pace of the rollout on the inaccessibility of many areas, and entrenched cultural misconceptions about HIV/AIDS - in many parts of the country people still thought AIDS was a result of witchcraft. More people would also receive ARVs if patients overcame their fear of being stigmatised.

"It is difficult to convince patients that HIV/AIDS is a pure medical condition - most HIV/AIDS patients are initially slow to accept their condition when they contract the virus. When they persist in their beliefs, we cannot force them to join the ART programme," Lekashingo said. "This is despite awareness of HIV/AIDS being higher than 90 percent among the sexually active population in the country."

HIV-positive people in rural areas are often forced to buy the costly drugs privately. "We are rolling out a programme to reach the most remote parts of the country, as well as training caregivers that can dispense ARVs. At present [it] is handicapped by qualified personnel and facilities," she said.

"Take for example, Dodoma [Tanzania's administrative capital] - it has only one hospital that distributes ARVs. The poor who live hundreds of kilometres away from the town cannot afford a return fare of 10,000 shillings [about US$8] to reach the hospital," Lekashingo pointed out.

According to the NACP, the new HIV/AIDS allocation will be spent on purchasing condoms and ARVs for free distribution in more than 10,000 government hospitals and health centres, greatly improving rural access to treatment.

[ This report does not necessarily reflect the views of the United Nations ]

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