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THE UNITED REPUBLIC OF TANZANIA
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TANZANIA COMMISSION FOR AIDS
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Tanzania began to provide care and treatment services including the provision of anti-retroviral drugs (ARVs) in October 2004. The target for the first year was to cover 44,000 patients on ARVs. 96 care and treatment providing facilities were selected to initiate the services. They included;

4 referral hospitals (Muhimbili, KCMC, Bugando and Mbeya), all regional some district, private and faith based organization hospitals. During that period, the national guidelines for management of HIV/AIDS in Tanzania and other programme management tools were developed.
The tools were for assessment of facilities providing care and treatment services, monitoring and evaluation of patients and overall programme monitoring. Training curriculum and materials for capacity building of health care workers on the comprehensive management of HIV/AIDS were also developed. By December 2005, a total number of 23,951 patients were on Anti-retroviral Therapy (ART).

During the second year of implementation (January - December 2006), the target number of patients to be on ART was increased to 100,000 and therefore the number of facilities providing care and treatment services was increased to 200. The new included 104 health facilities were; the remaining district hospitals, some private, faith based and army-owned hospitals. Cumulatively, by end of October 2006, the Programme had enrolled a total of 115,597 patients. Of them 54,264 were on ART.

On the third year of the Programme (January -December 2007); the plan was to roll-out care and treatment services closer to the community through primary health care facilities (health centres and dispensaries). The facilities were assigned different roles; as ART initiating, refilling or outreach depending on the existing capacity (infrastructure, human resources, laboratory services, record and reporting system). Capacity building on management of HIV/AIDS for 1,333 health care workers from 500 primary health care facilities was conducted. By end of December 2007, a total of 263,000 patients were enrolled and among them 135,696 were on ART.
The Ministry of Health and Social Welfare (MOHSW) continues to expanding its efforts to ensure that all eligible patients are enrolled and provided with ART. However, utilizing Voluntary Counseling and Testing (VCT) services as the key entry point for care and treatment services will not be sufficient to enable and complete the enrolment of the estimated number of eligible population for ART. An approach of Provider Initiated Testing and Counseling (PITC) is being adopted to allow more people who come into contact with health care facilities, mainly at the outpatient clinics and in-patient to be offered HIV testing to determine their HIV sero-status.

Furthermore, the National HIV and Counseling and Testing Campaign to mobilize more people to be tested and determine their HIV sero-status was launched on July 14th 2007 by His Excellency the President of the United Republic of Tanzania, Hon. Jakaya Mrisho Kikwete. About 4.1 million people were expected to be tested during the campaign. The campaign was intended not only to increase the numbers of people to know their HIV status, but also to establish linkages between prevention, care, treatment, social support and intensify community actions against social issues related to HIV/AIDS such as stigma, discrimination, violence and other violent consequences related to disclosing ones status to others. By December 2007 a total of 3,174,396 clients throughout the country had undertaken the HIV test voluntarily to know their HIV sero status. Of those tested the male-female ratio was 0.82 in which 1,434,738 males and 1,739,658 females were tested.

The National HIV Testing Campaign has provided a unique stimulus to the general HIV/AIDS response in the country. While so far more than 3 million people have tested in all districts of the country, the campaign also served to augment the scope and scale of other intervention components of the national response. The areas that have benefited from the campaign include advocacy, general behaviour change communication, community mobilization and reduction of stigma, strengthening of laboratory services and training of health care workers.

The formulation of the new Health Sector HIV/AIDS Strategic Plan 2008-2012 that will guide the fight against HIV/AIDS pandemic in the next 5 years was completed in June 2007. The editing process by the National AIDS Control Programme (NACP) secretariat has already began and will soon be completed after which the document will be printed and disseminated to all stakeholders throughout the country. The process to review the National Guidelines on management of HIV/AIDS in Tanzania that started in May 2007 is in the final stages. These guidelines were reviewed to accommodate the revised WHO recommendations on care, management and support of HIV/AIDS.
For the past three years, the National HIV/AIDS care and treatment programme has been receiving funds from different sources. The major contributors include; the Government of Tanzania, Global Fund, the Governments of Canada, Sweden, Norway, Netherlands and the United States of America as well as the Clinton HIV/AIDS initiative (CHAI).