TACAIDS website aims at disseminating and sharing of HIV and AIDS information and experience among stakeholders for proper implementation of various programs.

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Dr. Leonard L. Maboko

EXECUTIVE DIRECTOR

Prevention and Management of Opportunistic Infections

People with advanced HIV infection are vulnerable to infections or malignancies that are called because they take advantage of the opportunity offered by a weakened immune system. Even though there are currently no drugs for the cure of HIV infection, there is treatment for some opportunistic infections resulting from HIV induced immune deterioration.

It should be recognized that only opportunistic infections are treated and cured not HIV itself. In most cases patients dont die from HIV infection but succumb to the complications that the HIV induced immune deterioration cannot handle. Opportunistic infections depend on the level and kind of infections that are common in a given area and so these diseases may also be common diseases that are fond among HIV uninfected population e.g. Tuberculosis, pneumonia, etc. Their management therefore occurs within the normal health care setting.

However, because of the high frequency of certain diseases in HIV infected people, special attention may be provided to AIDS patients or HIV infected patients in terms of prevention and treatment. E.g. the use of fluconazole in the prevention and treatment of fungal infection (The Diflucan Initiative), Isoniazid Preventive Therapy against Tuberculosis. Commonly encountered clinical features in patients with HIV and AIDS include:

  • Fever.
  • Cough and difficulty in breathing (dyspnoea).
  • Oropharyngeal and oesophageal Candidiasis.
  • Vaginal Candidiasis.
  • Weight Loss.
  • Diarrhoea.
  • Persistent Generalized Lymphadenopathy (PGL).
  • Skin rashes, sores and generalized pruritis.
  • Altered mental status.

In resource constrained countries the main challenges is the choice between interventions that alleviate the morbidity and suffering of those in need while not exceeding the financial and technical capabilities of the health system. Effective intervention against opportunistic diseases requires the following strategies:

  • Prevention of exposure to sources of infection where possible.
  • Prevention of active disease using drugs with aim of eradicating existing infection prior to development of active disease or preventing new infection
  • Early treatment of active disease aimed at reducing the source of infection. In addition there is a need to ensure that there is necessary infrastructure to diagnose the condition, monitor the intervention and counsel the patients.

 The inception of Tanzania National HIV Policy, establishment of the Tanzania Commission for AIDS in 2001, and the development of the Tanzania National Multisectoral Strategic Framework on HIV&AIDS (NMSF) have created a solid basis on which to mount an efficient and effective response to HIV.

The NMSF places a strong focus on not only mounting a national response to HIV, but also monitoring and evaluating the effectiveness and efficiency with which the national response is being implemented. In terms of M&E, the NMSF and the Tanzania National Policy on HIV&AIDS stipulate:a

  • That the responsibility for national level monitoring and evaluation rests with tacaid as one of its main functions;
  • The main indicators that should be used to track the goals of the NMSF;
  • That organisations at regional, district and community levels have a responsibility to include the national level data requirements in their own monitoring and evaluation (M&E) systems;
  • That all organisations are required to report progress to tacaid on a quarterly and annual basis;
  • That tacaid will prepare annual report to communicate progress made to stakeholders;
  • That information about progress with the national HIV response would be disseminated once a year at national and district level stakeholders' forums (section 6.4.4 of NMSF 2003-2007; and Policy statement 10.5 (f) of the Tanzania National Policy on HIV&AIDS).

Fighting Stigma, Denial and Discrimination

  • Human rights of PLHIV and their families are safeguarded through nondiscriminatory attitudes in their communities and through improved access to user-friendly and gender responsive HIV services.
  • High level leadership (political, traditional and community based) is maintained to engage in anti-discriminatory and stigma reducing activities.

 In terms of M&E, the NMSF and the Tanzania National Policy on HIV&AIDS stipulate that the responsibility for national level monitoring and evaluation rests with tacaid as one of its main functions;

Advocacy and Political Commitment

  • Maintain and strengthen political commitment, transparency,accountability and popular support for HIV interventions using a human rights and gender responsive approach.
  • Increase public awareness, acceptance and understanding of the needs and concerns of PLHIV and other vulnerable and marginalized groups through sustained advocacy at all levels.
  • Recognize the special needs of specific groups such as women, youth, people with disability and those living in rural areas.
  • Conduct a situation analysis of HIV and AIDS advocacy to identify achievements to date and outstanding challenges and gaps with a view to implementing effective and sustainable advocacy mechanisms and strategies that will counter stigma, discrimination and denial
The fight against HIV/AIDS
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