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US smiles at Tanzania’s mode of fighting HIV/Aids
2005-11-22 07:40:12
By Simon Kivamo
United States of America government says so far, it is well satisfied with the Tanzanian government’s efforts of taming the spread of HIV/Aids, and, it hopes that the next President takes a strong stand on AIDS and ensures that all of the Ministries are involved in HIV related activities.
Staff Writer SIMON KIVAMWO held an exclusive interview last week with the USAID’s Mission Director, Pamela White, below are the excerpts from the interview.
QUESTION: Tanzania recently received its first donations of ARVs through the US President’s Emergency Plan for AIDS Relief, what does that mean to the government and its people?
ANSWER: The U.S. government is working closely with the government of Tanzania to ensure that people living with AIDS who need treatment have access to drugs.
To this end, we have signed a memorandum of understanding between the two governments which outlines the responsibilities that each is taking.
The government of Tanzania, utilizing various resources, including those from the government’s coffers, as well as from donor countries and the Global Fund has established a procurement plan.
The U.S. Government will support that plan and purchase drugs for both adults and children to complement those that the government of Tanzania will purchase.
The announcement that your reference is the first delivery of these ARVs that the U.S. government has purchased.
Additional orders have been placed and will arrive over the next six or so months.
Beyond that, the U.S. government expects to provide ongoing support for the purchase of ARVs.
Q: That being the case, how is the US government going to monitor the assistance that basically intends to enable adults and children who require AIDS treatment get it, reaches the people in the remote/rural part of the country?
A: We are working closely with the National AIDS Control Programme and the Medical Stores Department to ensure the efficient ordering, safe delivery, and prescription of all the drugs that are brought into the country to treat people with AIDS.
Over the next year we plan to help Tanzania further strengthen the ordering and monitoring systems to ensure that everyone has access to these life extending drugs.
Q: I know you are still new in office, but still you might have some basic information about Tanzania.
Are you satisfied with the steps that are taken by the government and its people in the fight against HIV/Aids?
A: Yes I am very impressed with the level of commitment by senior Tanzanian health officials.
The Chief Medical Officer has been especially proactive and a wonderful partner.
The Government of Tanzania has set out ambitious plans to care for its people.
Likewise, the U.S. Government has established aggressive targets under the Emergency Plan. Working together and with the support of many other donors, I think we can accomplish our goals.
There are clear challenges. We need to identify ways to get more people tested, to prevent people, particularly girls, from becoming infected, and we must care for people living with AIDS, not just here in Dar es Salaam, but across the country.
We must also combat the entrenched cultural stigma against people with HIV /Aids. We can and will do all of these things together.
Q: What is being done satisfactorily and what still needs more efforts?
A: There is clearly commitment at the highest levels. What we need is continuous coordination to ensure that all the targets are met in a timely fashion.
We need to make sure that we are always looking out for ways to do things better – to care for more people and prevent more infections.
For example, we are hopeful that Tanzania will adopt an ’opt out’ or ’provider initiated’ policy for HIV testing.
This would allow for all individuals who enter the health system to receive an HIV test, unless they specifically state that they don’t want to be tested (thereby ”opting out”).
This practice has become common in many other African countries, including Botswana and other high HIV prevalence countries.
I strongly believe that we need to take on such approaches if we want to reach all the people who require services.
This would make HIV testing routine – similar to testing for syphilis or other diseases which currently occurs in Tanzania when a pregnant woman enters the health system.
There have been some critics that the USG-sponsored youth program has gone beyond the limits of cultural acceptance with their catchy songs and straight messages about safe sex.
A recent study proved that these messages did reach the youth and did change behavior.
I think it is time to take off the gloves – people are dying – we need to be louder, stronger, less nervous about the word sex.
Q: Critics of ABC (A=Abstinence, B=Be Faithful and C=Condom use) are of the opinions that the model tends to ’relax’ the genuine war against HIV/Aids by involving condom use. What are your comments?
A: Regardless of what you call it, it is clear that there are some groups, like youth, who should be abstaining from sex.
There are others, like married couples, who you hope will remain faithful.
Still there are others who may find themselves in a risky situation, in which case a condom, used correctly, is a great way to avoid acquiring HIV.
Q: One of the organisations under USAID, YouthNet/FHI is advocating for behavioural change among the youths, insisting for total abstinence before marriage.
Interestingly, however, there is little mention of condoms if any at all.
Can one conclude that your government, especially, H.E President G W.Bush is working undergroundly to phase out the condom aspect in the ABC model?
A: No, you cannot conclude that. I’m sorry that you were given that impression.
YouthNet and other programs are providing A, B, and C messages.
It just varies by the audience. There is no plot underway to remove condoms as a form of HIV prevention.
Equally, there is no expectation that abstinence or fidelity alone will stop the spread of the epidemic.
We are looking at any number of strategies to help prevent people from being infected with HIV.
Condoms are one such strategy and when used consistently and correctly, are an excellent means to prevent the acquisition of HIV.
Q: How do you view/value the country’s existing policies in the general fight against the pandemic?
A: The Tanzanian and U.S. approaches to HIV are not significantly different. We both want to prevent people from becoming infected. We both want to treat people who need anti-retroviral drugs.
And, we both want to care for children orphaned by AIDS or who are sick but do not yet need anti-retrovirals.
As I said previously, I am hoping that the Government of Tanzania will adopt the ’opt-out’ approach to testing.
If we don’t get more people significantly, tested, we will not be able to stop the spread of HIV/Aids.
If people don’t know their status they cannot plan their futures.
They cannot access drugs or make rational decisions about sexual practices. This must change.
Q: Recently, a group of PLHAs in Dar es salaam, made a ’shocking’ threat that they would intentionally spread the virus among their fellow Tanzanians because TACAIDS was denying them money donated by multilateral donors meant for supporting them (i.e care and support services). What would you comment about the whole scenario?
A: In general, PLHA groups have a lot to offer in the fight against HIV.
We need to find ways to better organize and involve these groups in all our work.
They can have a significant voice and have a real impact on people’s lives.
I know that TACAIDS has been overwhelmed by PLHAs requesting support and is in the process of establishing a more sustainable mechanism for this support.
I believe they will have a more formal announcement in this regard soon. Maj.
Gen Lupogo of TACAIDS is a dedicated and productive public servant who has worked tirelessly in the fight against the spread of HIV/Aids and helping those living with AIDS.
In general, I’m hopeful that we can foster a well coordinated and active network of PLHA groups who are genuinely interested in supporting each other and protecting those not infected by the virus.
Q: Since Tanzania expects a new President, what would you advise him/her to take as his/her first priority/ies in making the war against AIDS rolls on?
A: I hope that the next President takes a strong stand on AIDS and ensures that all of the Ministries are involved in HIV related activities.
I hope that he/she is an HIV/Aids champion and speaks out in support of the fight against HIV/Aids at every opportunity.
I hope he/she will be bold and creative and not afraid of speaking plain truths.
I hope he/she supports the empowerment of women.
There is still a great deal of work to be done and HIV impacts all sectors.
Continuing to support the coordinated multisectoral response to HIV will be critical.
Similarly, creating a climate of accountability for the actions of Government— its officials, policies, and programs— will help to show strong commitment and ensure that HIV is not driven underground.
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