Zanzibar — ZANZIBAR thinks it can eliminate spread of HIV/Aids under the new global programme to stop new cases, but call for Homosexual freedom spreading in almost all regions of the world, poses a grave threat to war on HIV/AIDS.
In exceptional observations, the Zanzibar minister for health Mr Juma Duni Haji is arguing that call for commercial sex and Homosexual freedom makes fight against HIV/AIDS more difficult because the habits are contrary to the culture in the country. "Zanzibar's permissive culture does not allow homosexual and commercial sex, but call to governments to guarantee freedom to people interested in the behaviours is now a great challenge.
Accepting the unthinkable behaviours of homosexual, commercial sex, and even one's liberty in using drugs, is difficult!" Duni says. He said although Zanzibar has remarkably maintained HIV/ AIDS prevalence at 0.6 for a decade, the spread in Most At Risk Persons (MARPs) including Homosexuals, sex workers, and drug addicts using syringes, have been increasing.
"Homosexuality, having sex with multiple people, and using or sharing syringe for drugs, increases chances of contracting HIV and hepatitis. But these actions are liberty and freedom, particularly at this era of human rights," the minister said, at the 'International Centre for AIDS Care and Treatment Programmes (ICAP)' partners are meeting to discuss "Treatment as Prevention towards HIV elimination in Zanzibar."
He said, although the habits are unacceptable in most societies, it is now difficult to control because of rising demand for freedom to do whatever one likes. "The government can no longer force people out of homosexuality, commercial sex, and using drugs, we can win the war through workable awareness programmes," he said.
Minister joins health officer in Zanzibar to thank development partners and ICAP at Columbia University's Mailman School of Public Health for supporting Zanzibar's campaign against the spread of the disease in the islands through building broad capacity for HIV/AIDS services at the national and local levels.
How Zanzibar has progressed in managing to control the spread.
According to the Zanzibar Aids Control Programme (ZACP) officials, several means of campaign has been used in controlling the spread of HIV/AIDS in Zanzibar as the campaign now moves to 'Treatment as Prevention towards HIV elimination in Zanzibar.'
Media Campaigns: Stigma and discrimination associated with HIV/ AIDS has been a problem in fighting the disease, and ZACP in collaboration with other activists has tried to address this stigma by promoting care and love to people with HIV, through media campaign efforts.
"HIV/AIDS is a cross cutting issue, therefore we have also encouraged ministerial programmes, creating communications awareness, discouraging stigma, and HIV counselling through television and radio, and other public," said Ms Farhat Khalid from ZACP. Voluntary Counselling and Testing: Voluntary counselling and testing (VCT) is essentially both, and this service provides free testing for individuals who do not know their status.
There are 60 centres including 17 in Pemba islands.
Working with High- Risk Groups: we are now working with Most At Risk Persons (MARPs) after many years of isolating the groups like commercial sex workers, homosexual, and injection drug users. HIV/AIDS programmes have now extended to commercial sex workers and Injection Drug users, involving them in various programmes instead of stigmatizing this vulnerable population thus decreasing the likelihood of infection among injection-drug users.
Because of drugs business has not declined, the drug users in the number of drugs users in the islands remains high.
Condom Use: ZACP has managed to promote use of condoms, which in the past few years it was a taboo even to mention. Studies have found that use of condoms is now accepted among risk groups. Prevention: according to Ms Farhat Khalid for the ZACP, Prevention is the main focus of fighting the HIV/AIDS epidemic globally, and should not be overlooked.
Raising awareness and providing means of prevention, are integral in Zanzibar's successful fight against HIV/AIDS. "We have relentlessly promoted different means in combating the spread of HIV/AIDS epidemic," she said as the minister drums for the disease awareness in schools. Prevention of Mother to Child Transmission of HIV: the services started in 2005 aiming to vertical transmission and improve care for infected partners and their children.
There are 111 sites including 44 in Pemba used to offer services of prevention for mother-to child transmission. Access to Anti-Retroviral Drugs: By June this year 6,425 enrolled at the treatment centres including 2,531 patients on ARV, and that on average 1,200 new patients enrolled annually in the past six years.
ZACP official say, that treatment as prevention (TasP) on Zanzibar is important because "relatively small population size and estimated number of people living with HIV, a strategy to de-bridge HIV infection from Key Populations (KPs) to general population, and an opportunity to eliminate HIV in Zanzibar. However, potential challenges in Zanzibar include: coverage of HIV testing, resistance from clients, tracing of lost to follow up, poor ARV treatment adherence, and Drugs resistance.