Empowering communities: The impact of the Afya Hatua project in Mombo

IN the serene, sunbathed town of Mombo, nestled in Tanzania’s Tanga Region, along the Tanga -Arusha Highway, a quiet revolution is underway. The battle to end HIV as a public health threat by 2030 may seem ambitious, but for the healthcare workers at Mombo Health Center, the mission is deeply personal.

Supported by the CDC/ PEPFAR through the “Afya Hatua Project,” implemented by the Tanzania Health Promotion Support (THPS), they are transforming lives, one antiretroviral treatment (ART) at a time. The region now stands as a beacon of hope in Tanzania’s HIV fight.

The ongoing Afya Hatua Project, which spans four regions including Tanga, is at the forefront of the HIV response in Tanzania.

From 2021 to 2026, the project provides essential services like Voluntary Medical Male Circumcision (VMMC) and the DREAMS Program for young women and girls. DREAMS—Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe—is a comprehensive program offering interventions aimed at reducing vulnerability to HIV.

According to Victoria Mcharo, the CTC Adherence and Psychosocial Retention Field Officer at Mombo Health Center, as of July 2024, a staggering 99 per cent of the 1,487 recipients of care enrolled in ART services at the facility have achieved HIV viral load (HVL) suppression.

“This extraordinary achievement speaks to the dedication of both the healthcare workers and the community,” says Ms Mcharo. “The strategic efforts we implement help keep life-saving treatments within reach for the most vulnerable,” she adds.

A Holistic Approach to Retention and Care Mombo Health Center’s success is driven by a comprehensive approach to retention and care, ensuring that patients remain engaged in their treatment journey. Joint supportive supervision between project staff and the Regional and Council Health Management Team (RCHMT) ensures that healthcare workers receive the support they need.

“Every quarter, this team visits the facility to monitor and mentor, helping navigate challenges and improve service delivery,” Ms Mcharo explains.

One of the innovative strategies at Mombo Health Center is the ‘Watejamarafiki’ initiative, which connects newly enrolled recipients of care with Peer Educators (PE) who have experienced the treatment journey.

This peer-to-peer system provides new patients with guidance, motivation, and an example of what is possible when treatment is adhered to. According to Saumu Omari, responsible for Treatment and Care at the centre, the facility emphasizes a close, personal bond between providers and patients.

“We follow them up at their homes. This ensures that any barriers—whether psychological, logistical, or health-related—are swiftly overcome,” Ms Omari says, adding that this compassionate care is key to the centre’s success in achieving high viral suppression rates. Sylvia Komu, a Peer Educator at the centre, recalls how most new patients arrive feeling hopeless. “We revive their hope by staying close to them and recounting our own experiences,” she says.

Ms Komu, who has been on anti-HIV drugs since the 1990s, uses her story to inspire others. “We chat with them through phone calls, share stories, and support one another, which helps bring in new service recipients,” she recounts.

A Global Effort: The PEPFAR Impact

The success of HIV prevention efforts at Mombo Health Center is not just a local triumph—it is part of a larger global story. Since 2003, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has invested over USD 7 billion in Tanzania, with remarkable results. Jessica Greene, PEPFAR Tanzania Country Coordinator, notes that the goal to end HIV/AIDS as a public health threat by 2030 is ambitious but achievable. She highlights that when PEPFAR began in Tanzania, fewer than 1,000 people had access to life-saving treatment. “Today, over 1.5 million Tanzanians are receiving antiretroviral therapy, and AIDS-related deaths have plummeted by 76 per cent, with new HIV infections dropping by 58 per cent.” These milestones are driving Tanzania towards the UNAIDS 95- 95-95 goals, where 95 per cent of people living with HIV know their status, 95 per cent of those diagnosed are on treatment, and 95 per cent of those on treatment achieve viral suppression. Greene emphasizes that achieving these goals by 2025 will bring the end of the HIV epidemic within reach. Tanga Region Leads the Way The Tanzania HIV Impact Survey 2022-2023 (THIS 2022-2023) offers compelling evidence of the progress being made. Tanga Region, in particular, stands out with an impressive viral load suppression rate of 93.5%. “This progress shows the effectiveness of local health systems, collaborative efforts between government and international partners, and the resilience of communities affected by HIV,” Greene explains.

THPS: A Lifeline for Tanzanians

THPS, a local NGO established in 2011, has been tirelessly working to ensure that all Tanzanians have access to high-quality healthcare. According to Henry Mazunda, THPS Communications and Advocacy Manager, the NGO collaborates with the Tanzanian government and various ministries to address HIV and AIDS, tuberculosis, reproductive health, and gender-based violence, among other issues. “By strengthening health and community systems, THPS plays a crucial role in Tanzania’s public health infrastructure,” Mazunda notes.

A Future Without HIV

The fight to end HIV in Tanzania is far from over, but the tireless efforts of healthcare workers, supported by projects like Afya Hatua, bring hope to thousands of families across the country. As Tanzania moves closer to achieving the UNAIDS 95-95-95 targets, the gains in places like Mombo Health Center are a testament to the power of community, partnership, and compassion. With ongoing dedication, Tanzania is well on its way to achieving an HIV-free future by 2030. The world watches as this East African nation continues to inspire with its relentless pursuit of health equity and human dignity.