As we commemorate World AIDS Day 2015, on behalf of the Development Partners Group for AIDS, I am pleased to join the people of Tanzania to reflect on the progress made toward our shared vision for achieving Tanzania’s AIDS-free generation.
Development partners have continued to support the HIV response in Tanzania, providing both technical and financial assistance. This year, as in years past, our joint total financial investment is over half a billion US dollars. These dollars and our joint efforts have made a huge impact on the epidemic.
As we celebrate our joint successes, we must also deliver a wakeup call to all working in the health and other sectors, and importantly, to Tanzania’s new leadership: in order to end HIV/AIDS as a public health problem by 2030, Tanzania must reach the 90-90-90 targets by 2020 as part of the sustainable development goals (SDG) commitment. These targets mean that by 2020, 90% of people living with HIV must know their status; 90% of those must take antiretroviral treatment (ART); and 90% of those must maintain suppression of the virus – keeping them healthy and reducing the risk for HIV transmission to others.
The next five years, up to the year 2020, are critical. The new government’s leadership will determine the fate of HIV in Tanzania and globally, because of Tanzania’s significant share of the global HIV burden. If we continue business as usual, new HIV infections and deaths will continue and will undermine Tanzania’s economic growth. And the sobering reality is that the international community alone simply will not be able to keep up with the financial requirements to care for Tanzania’s people. As Tanzania moves toward middle income status, the Government must plan seriously and creatively for provision of sustainable, domestic financial support to the health sector in order to care for its population.
Controlling this epidemic requires refocusing resources to locations and populations where the burden of HIV disease is the highest. We need to work together to ensure the highest burden populations are reached with the evidence-based interventions we have focused on over the last few years, including Voluntary Medical Male Circumcision and condoms. Achieving the 90-90-90 goal requires additional extraordinary measures and efforts such as implementation of the World Health Organization’s “Treat All” strategy and delivery of preventative measures such as antiretrovirals for prevention and Pre-Exposure Prophylaxis (PrEP). Tanzania’s development partners call on the new Tanzanian government to support these critical interventions, as well as viral load monitoring for adherence and treatment effectiveness.
Development partners count on the new government to fully support the new priority of focusing on high HIV burden districts and facilities and disproportionately affected population groups. The HIV response requires a strong focus on key populations including commercial sex workers, people who inject drugs, and men who have sex with men, as well as adolescent girls, young women, and children. Identifying and appropriately serving these populations will take concerted efforts across sectors and is everyone’s responsibility. Pediatric antiretroviral therapy (ART) coverage rates are slowly increasing but remain unacceptably low; we also need to retain children on treatment. Adolescent girls experience unacceptable HIV risk and incidence, and key populations continue to be marginalized and discriminated against. High level leadership is required to stop HIV-related stigma and discrimination and to ensure a coordinated and concerted multi-sectoral approach to ending AIDS by 2030.
Providing all people living with HIV with ART in the districts with the highest HIV burden for epidemic control requires finally overcoming policy barriers. These include reducing the testing age of consent, task sharing for HIV testing and treatment services, and considering new community service delivery models to reduce stress on the health service delivery system.
Tanzania’s bilateral and multilateral development partners are committed to working hand in hand with our current partners in the AIDS response. So what’s next?
First, the Government of Tanzania has the obligation and needs to ensure predictable and sustainable financing for its HIV response. Domestic resource mobilization is critical at all levels of government from central to council. The AIDS Trust Fund is a small, important step, but is insufficient at current funding levels.
Second, financial sustainability requires ongoing and enhanced community engagement from civil society organizations and local leaders and enhanced partnership with the private sector.
And finally, Tanzania’s new leaders need to focus critical attention on the long-term economic and stability opportunities associated with ending AIDS – and the grave risks if there is not a full commitment to doing so.
On behalf of the Development Partners in Tanzania, I thank our government, private sector, and other partners for the vision and leadership you have shown on HIV and AIDS – an issue so vital to the future of this nation. I assure you of our firm commitment and continued support to the Government of Tanzania and its many partners as we work together to achieve our common goal: an AIDS-free Tanzania.