Beating back AIDS in Tanzania

Tanzania has an estimated 1.6 million people living with HIV and, while the incidence of AIDS-related deaths has halved since 2010, the disease remains of epidemic proportions. And nowhere in the country is the scourge of HIV as common as in the southern highlands of Tanzania, where HIV prevalence in a region such as Njombe is 11.4% - more than double the national average of 4.9%.

In tackling HIV/AIDS, the government and society of Tanzania are not alone – several international governmental and nongovernmental organisations have joined the battle. One of these is the United States Agency for International Development (USAID) which, in 2016, announced the launch of a new programme targeting, in particular, HIV/AIDS in Tanzania’s south.

The programme, named USAID Boresha Afya – Southern Zone, is nothing if not ambitious. Co-ordinated by Deloitte Tanzania, its vision is to create a properly integrated platform for the delivery of health services which maximises the various resources of government, health facilities and communities, with intensified co-ordination and collaboration. USAID Boresha Afya is due to run until 2021 and, in particular, aims to intensify the fight against HIV and AIDS. Being implemented in no fewer than 43 councils in the Iringa, Njombe, Morogoro, Lindi, Mtwara and Ruvuma regions, USAID Boresha Afya involves thousands of role players and the deployment of considerable resources.

USAID has a responsibility to ensure that the financial resources deployed on behalf of US taxpayers are both effective and transparent. So, USAID engaged Deloitte Tanzania to plan, implement and oversee USAID Boresha Afya over its five-year lifespan. Working with technical partners on the ground including scores of PLHIV peer educators, health facilities and professionals is a mammoth task requiring large-scale project management skills, resources and experience; Deloitte Tanzania has exactly those skills and that experience. (“PLHIV” stands for People Living with HIV and the involvement of these infected individuals in USAID Boresha Afya is vitally important in an area where being HIVpositive carries considerable stigma.)

In scattered communities, villages and towns and working under Deloitte’s direction, health officials and nongovernmental organisations are making slow but very measurable gains through a more targeted approach towards achieving truly effective healthcare interventions. These interventions include regular, sustained follow-ups with PLHIVs on their antiretroviral treatment, as well as reaching their sexual partners.

Deloitte Tanzania’s responsibilities include effective, accountable delivery – and monitoring programme effectiveness. Owing to programme interventions, as of September 2019, some 203,931 HIV positive clients were on antiretroviral therapy (ART), equivalent to almost 19% of over 1.1 million Tanzanians on ART. In a similar vein, the programme had managed to lower clinical malaria cases to 0% in Lindi, Mtwara, Morogoro and Ruvuma regions.

Headed by Deloitte’s Consulting Partner in Tanzania, Carlton Jones and Chief of Party, Dr Marina Njelekela, and a dedicated team of 229 individuals plus support staff, USAID Boresha Afya is on track to help Tanzania achieve its commitment to UNAIDS’ 95-95- 95 target to end AIDS. That target envisages that, by 2030, 95% of PLHIVs will know their status; 95% of those diagnosed will receive ongoing antiretroviral therapy and 95% receiving treatment will have achieved viral suppression.

In southern Tanzania, it is now – finally – becoming possible to believe in a generation without AIDS.

Chief of Party, USAID Boresha Afya – Southern Zone Program, Dr Marina Njelekela
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