December 1, 2022, Lindi, Tanzania
Your Excellency, The President of the United Republic of Tanzania, Samia Suluhu Hassan
Prime Minister, Hon. Kassim Majaliwa
Hon. Lindi Regional Commissioner, Zainab Rajab Telack
Hon. Ummy Mwalimu, Minister of Health
Dr. Leonard Maboko, Executive Director TACAIDS,
Ms. Winnie Byanyima, Executive Director UNAIDS
Zlatan Milicic, Resident Coordinator of the UN System,
People Living with HIV,
Ladies and Gentlemen, All Protocols Observed.
It is a great pleasure to once again be part of Tanzania’s World AIDS Day commemoration events. I would like to extend a warm congratulations to the TACAIDS and the Regional Government authorities, led by Regional Commissioner, Honorable Zainab Rajab Telack for organizing this important event here in Lindi.
First and foremost, I would like to thank you, Your Excellency, on behalf of the U.S. government for your commitment to the HIV response in Tanzania, demonstrated by your participation in this important event today. As president, you have made the health of your people a priority – and we can all see the results. Congratulations, Your Excellency, that Tanzania has vaccinated more than 85% of the eligible population against COVID-19. In Tanzania’s HIV response, your leadership through the Ministry of Health, PO-RALG, and TACAIDS has been unwavering and is keeping Tanzania on the path to HIV epidemic control.
I am also pleased to welcome Ms. Winnie Byanyima (Byah-Nyee-Mah) back to Tanzania. Ms. Byanyima, I’m honored to share the stage with you today. Your efforts with UNAIDS to ensure that HIV/AIDS does not fall off our list of pandemic priorities is essential as the world continues to struggle together to overcome the COVID pandemic.
Today, on World AIDS Day, we have the opportunity to reflect on the progress made in the HIV response, to remember and honor the millions of people who have died from AIDS-related illnesses around the world, and to remind ourselves of the work still ahead. We are here to remember where this work began and how far we have come. We are also here to rally together to commit to reaching the final mile of epidemic control in Tanzania – a goal that is very much within reach.
As the U.S. Ambassador to Tanzania, health, and in particular our efforts to end HIV, is one of my top priorities. I am proud of the work accomplished through the U.S. President’s Emergency Plan for AIDS Relief – or PEPFAR. As the largest commitment by any nation to address a single disease in history, PEPFAR has committed over $6 billion to support Tanzania’s HIV response since 2003. The U.S. government’s theme for World AIDS Day 2022 is “Putting Ourselves to the Test: Achieving Equity to End HIV,” which emphasizes accountability and action. This theme echoes the U.S. government’s dedication to ending HIV/AIDS as a public health threat through PEPFAR by addressing health disparities in communities, disparities that existed even before we were challenged by COVID-19, monkeypox, and other disease outbreaks. This theme also aligns perfectly with UNAIDS’ Worlds AIDS Day Theme: Equalize. Ending the HIV epidemic is only possible when all sub-populations – children, adolescent girls and young women, and key populations – have reached the 95-95-95 objectives.
As the U.S. Government prepares to celebrate PEPFAR’s 20th anniversary next month, we are reflecting on all the achievements to date here in Tanzania. Twenty years ago, for example, there were only 1,000 people on ARV treatment in Tanzania. This meant that HIV was often a death sentence. Today there are more than 1.5 million Tanzanians who are receiving this life-saving treatment. With proper care and treatment, people living with HIV can now live healthy, fulfilling lives.
We recognize the leadership of the Government of Tanzania under the Honorable Prime Minister and the Honorable Minister of Health through TACAIDS and NACP. You ensured that Tanzania adapted evidence-based policies and programmatic best practices to ensure people living with HIV have access to HIV testing, have the best drugs, adhere to treatment, and stay in care. I also commend PO RALG who has been able to adapt to the changing HIV response through strategic oversight of service provision at regional and local levels. Tanzania’s HIV response is truly a whole-of-government effort.
Tanzania’s response to the HIV epidemic has made significant progress over the last several years. Since the last Tanzania HIV Impact Survey in 2016-2017, the program made significant pivots to address shortcomings in case identification and to ensure that we are supporting activities in geographic areas with the greatest treatment gap. We are now well underway for the latest Tanzania HIV Impact Survey, to be completed in 2023, to guide the program in reaching the last mile of epidemic control.
Although Tanzania has made significant progress towards achieving epidemic control, there are still areas we need to address together to end HIV in Tanzania. We must lean into the science and focus on scaling up the initiatives that work. We must ensure pre-exposure prophylaxis, or PrEP, is made even more widely available to prevent new infections for vulnerable populations. We must identify adults, adolescents and children who don’t know their status – especially those who are hard to reach – link them to treatment and ensure they achieve viral suppression. We must continue to work together to ensure HIV services are client-centered and tailored to the populations who are most affected by HIV.
Finally, while we celebrate the progress we have made, we must recognize that the difficult task of achieving epidemic control is made more difficult by stigma, discrimination, policies, and practices that make it harder for some of the populations most vulnerable to the epidemic to receive the HIV services and community support they need. In addition to investments in HIV prevention and treatment services, we must also prioritize efforts toward a more inclusive democracy – a healthy democracy with broad civic participation contributes directly and indirectly to community health. We are encouraged by President Hassan and President Mwinyi’s task forces consisting of political parties, religious leaders, and civil society organizations to address governance gaps and make recommendations for addressing those gaps.
We have seen a number of initiatives emerge to address the disproportionate impact of the HIV epidemic. The regional UN Women’s initiative on championing the priorities of women and girls in the HIV response was hosted in Tanzania this year to advocate for policy change that is driven by the leadership and voices of adolescent girls and young women. Additionally, Tanzania signed on as a key partner in the Global Alliance to End AIDS in children by 2030, a partnership that was announced earlier this year. With pediatric populations lagging behind their adult counterparts across the 95-95-95 cascade, there is no time to waste in addressing these challenges. Through our PEPFAR programming, the United States is committed to ensuring that all children living with HIV can access treatment and to putting an end to mother to child transmission.
To maintain the gains Tanzania has made, and to achieve our shared goal to end AIDS by 2030, we can’t overlook the need shift our focus to sustainability. The U.S. Government’s PEPFAR program, the Global Fund to fight AIDS, Tuberculosis and Malaria, and the UN Family provide significant financial and technical support to Tanzania’s HIV response. In the face of diminishing budgets and competing public health priorities, that support in its current form won’t be available forever.
We recognize that achieving long-term sustainability requires a substantial reorientation of the way the entire HIV/AIDS ecosystem works. I applaud the Government of Tanzania for taking an important first step by committing to establish a sustainability technical working group. Its important work will include reviewing all components of a sustainable HIV program from domestic resource mobilization to ensuring sufficient human resources for health to robust surveillance and disease response systems. Sustainability is not measured in dollars or shillings, but on political leadership.
The U.S. Government encourages the Government of Tanzania to double down on their commitment for sustainability across all three pillars – political, programmatic and financial – to lead, manage, and monitor the HIV response and sustain HIV impact in a transparent, effective, equitable, and enduring manner.
Coming back to this year’s UNAIDS theme for World AIDS Day, “Equalize.” This is a call to action to boldly recognize and address the inequalities which are holding back progress in ending AIDS by ensuring equitable access to essential HIV services in every community – particularly for adolescent girls and young women, people who use drugs, and other vulnerable populations. This theme should inspire us all to act together, as partners, alongside the Government of Tanzania, to end the HIV/AIDS epidemic globally.
In closing, let us be reminded that global inequalities affect us all, no matter who we are or where we are from. We must ensure that everyone, everywhere has equal access to HIV prevention, testing, treatment, and care. Health services should be adapted to reach and meet the needs of populations most at risk and affected, and this includes implementing a ‘zero tolerance’ policy to stigma and discrimination in all health services. Together, we will continue to make progress to improve the health of the Tanzanian people. I can see that all of us gathered here today are ready to renew our commitment to combat inequalities and end HIV.