GOAL 6: COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES
(National Target Seven: Halt and begin to reverse the spread of HIV and AIDS
National Target Eight: Halt and begin to reverse the spread of malaria and other major diseases)
NATIONAL TARGET SEVEN: HALT AND BEGIN TO REVERSE THE SPREAD OF HIV AND AIDS
Status and Trends
HIV prevalence in adults is estimated at 7 per cent of the population (7.7 per cent for females and 6.3 per cent for males). This implies that currently 1 million adults aged 15 – 49 years in Tanzania are HIV positive. These estimates are lower than previous estimates. HIV and AIDS ailments present a heavy burden to society including treatment, provision of care and addressing the issue of orphans. HIV prevalence is higher in higher income groups. More than 50 per cent of the hospital beds in Tanzania are occupied by patients with HIV and AIDS-related conditions
Supportive Environment
Tanzania has HIV and AIDS policy that places more emphasis on prevention. Emphasis is also being directed at care and mitigation such as through use of ARVs. The government has brought on board Non-state Actors (NSAs) including Faith Based Organizations (FBOs) in the fight against HIV and AIDS.
The strategic plan for HIV and AIDS has been developed with support from Development Partners. Scaling up the availability of ARVs to the needy is another measure being taken by the government. The budget for availability of supplies and other commodities such as condoms has increased, and the logistics for distribution is in place. Additionally, a national programme to address the triad of diseases including AIDS, Tuberculosis and Malaria ( ATM) exists.
Prevention of Mother To Child Transmission (PMTCT) of HIV now includes treatment of the mother with ARVs (after counselling).
Major Challenges and Priorities
Overall increase in HIV prevalence has led to an increase in TB patients by new cases and re-emerging ones. The infections are now growing resistant to conventional therapy and require multi-drugs treatment. Even with this approach, resistance still re-emerges. Knowledge regarding HIV transmission or prevention is wide spread. However, men and women have not transformed this knowledge to behavioural change. Similarly, knowledge of the prevention of mother to child transmission is not wide-spread. Also, many people are not willing to undertake HIV Testing through the established VCT services centres, the main reason for this reluctance being the wider spread stigma and discrimination attached to HIV/AIDS.
Quick Impact Interventions
- Stepping up efforts to effect behavioural change;
- Promoting home-based care for victims; and
- Increasing coverage of ARV recipients.
NATIONAL TARGET EIGHT: HALT AND BEGIN TO REVERSE THE SPREAD OF MALARIA AND OTHER MAJOR DISEASES
Status and Trends
Malaria is a leading cause of morbidity and mortality in Tanzania. Malaria accounts for about 40 per cent of all outpatient attendances. In recent years malaria disease pattern has dramatically changed, spreading to areas previously known as being malaria-free. With regard to TB, there has been an increase in number of cases and deaths.
Supportive Environment
The Government of Tanzania recognizes the negative impact of diseases to the economy and health systems. To this end the government has taken several measures and strategies to combat diseases. Such measures include strengthening the health systems through health sector programme support and reforms and through its disease control programmes such as malaria, Tuberculosis/leprosy and HIV/AIDS, among others.
With regard to malaria, Tanzania is committed to implementing Roll Back Malaria initiatives, implemented through the National Malaria Control Policy and Strategy. The primary objective of the Roll Back Malaria Initiatives is to increase access to the most suitable and affordable protective measures such as use of insecticides treated nets (ITNS), increase coverage of prompt and effective treatment of malaria, as well as use of intermittent preventive treatment of malaria among pregnant women.
Scaling up availability of ITNs and change of the treatment regime from SP to Artemether Lufantrene Combination Therapy (ACT) has taken place. The logistics are now in place to meet the demands of the population, and the government is also initiating the application of Indoor Residual Spraying using DDT.
The Ministry of Health through a five year National Malaria Medium Term Strategic Plan 2002 –2007, advocates four main strategies to fight against malaria. They include; improved malaria case management, vector control through the use of ITNs, prevention and control of malaria during pregnancy and epidemic preparedness, prevention and control.
Major Challenges and Priorities
Despite all these efforts, morbidity and mortality due to communicable and non-communicable diseases remains a big problem. Malaria continues to pose high burden in both social and economic terms leading to low productivity. It is the leading cause of death in all age groups except for children under-five years, where it ranks sixth among top ten causes of deaths. The situation differs between urban and rural areas, with the latter suffering more.
The challenges include high cost of malaria treatment, increasing resistance to cheap anti-malarial drugs such as chloroquine and sulfadoxine pyrimethamine, leading to frequent change of malaria
treatment guidelines to expensive Artemisinin-based combination therapy. Also, high prevalence of HIV and AIDS which increases prevalence of other diseases such as malaria and general poverty level especially in rural areas, affecting issues such as access to mosquito nets and affordability of malaria treatment, also pose challenges.
Quick Impact Interventions
- Subsidizing costs of prevention and treatment;
- Containing HIV and AIDS spread; and
- Increasing household incomes to improve on affordability of malaria treatment.
Reference:
Ministry of Planning, Economy & Empowerment (MPEE). Millennium Development Goals, Progress Report. December 2006. Available at http://www.povertymonitoring.go.tz
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