PEPFAR: 20 years of triumph in fighting HIV in Tanzania

TWENTY years ago today, United States of America’s President, George W. Bush declared that preventing and treating HIV/AIDS was a foreign policy priority of the United States.

At a time when nearly 30 million people were HIV positive, but very few were receiving life-saving medicines, the President’s Emergency Plan for AIDS Relief (PEPFAR) transformed the global AIDS response and laid a marker for America’s commitment to countries that were impacted the hardest by the AIDS epidemic.
Tanzania has been lucky to be among countries whose battle against HIV got U.S. support through PEPFAR and it is now 20 years since it started receiving the support.

AS the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) marks its 20 years of commitment in fighting HIV/AIDS in Tanzania, there is a remarkable difference now, beneficiaries leading happy lives.
Great strides are evident on the way people behave, making sure they follow directives by medical practitioners in order to either reduce HIV transmission or avoid contracting the virus, making Rujewa a better place to live healthily.
Dr Alick Kayange – Senior Prevention Advisor – U.S. Embassy – Walter Reed Army Institute of Research, Department of Defense (WRAIR-DOD) says that the U.S. Government through PEPFAR makes sure Tanzania has all devices at hospitals and health centres for medical treatment.
Dr Kayange notes that under the programme, another aspect is to ensure availability of drugs needed for clients, babies are born free of HIV, being among the success stories in Mbarali, Mbeya region and the country as a whole.
Medical practitioners are being trained deeply so as to offer quality services, while state-of-the-art laboratories have been brought in the country for quality to measure viral loads, the biggest of the abs being in Mbeya region.
“This is a success story; PEPFAR makes sure that we have all devices needed at hospital, health service givers are also trained for quality services. The laboratories have very high capacity and issue accurate results regarding HIV. Tanzania and the U.S. governments work closely to ensure on daily basis there is no breakdown in service delivery,” says Dr Kayange.

One of beneficiaries of the intervention is being implemented by the Henry Jackson Foundation Military Research International (HJFMRI) under PEPFAR is Mr Anthony Kyando (68), a Rujewa town resident who was found to be HIV+ in 1996 and in a short stint lost hope of life.

Mr Kyando who moved to Rujewa from Makete in 1968 as a fisherman and trader developed big business coming with good fortunes and had several wives who passed, now has another one who has not contracted HIV and they have two children who also are HIV free.

From a state of losing hope, Mr Kyando changed after getting to know that there is still hope even when one has HIV, hence he started sensitizing people of testing to establish their statuses and if needed start medication
It was Mr Kyando and another volunteer who initiated SHDEPHA in the district that has since been receiving funds from PEPFAR to serve clients.
His efforts to sensitise people bore fruits as the patients had hard time financially to travel to Mbeya Town to seek treatment. As per directives, he mobilised more than 50 people in Rujewa township and a centre was built to offer them services.
His wife, Ms Galasia says the family lives happily and her step children respects her much.
PEPFAR is the largest commitment by any nation to address a single disease in history, enabled by strong bipartisan support across ten U.S. congresses and four presidential administrations, and through the American people’s generosity.
Another beneficiary is Mr Douglas Kisunga (70) who resides at Mbeya City. He recalls that on January 31, 1993 he was on his bed at Mbeya Regional Referral Hospital, suffering from several diseases and was advised to go for a test.
“I agreed and I was given the results that I had contracted HIV. I received the news sadly and I was also horrified and worried to the point that I quitted my job as a teacher. I just stayed at home without telling anybody; even my wife for two good years,” narrates Mzee Kisunga.
After the said two years, he noted, he broke the news after realizing that there is still life. He learnt a lot and started raising awareness among people. He also attended different conferences regarding HIV both domestic and international.
Mr Kisunga has since turned to be an activist – sensitizing people of all ages to turn up, get tested to know their status and if they are HIV positive, follow doctors’ advice.
“It is 17 years today since I started using ARVs (medicines). I now work to counsel people about HIV and,” he says.
He is thankful to PEPFAR for the programme it initiated in the country and for saving lives of people for 20 years now. He says he is sure that if it was not for PEPFAR he might have passed on, because he could not afford buying medicines.

Mr Kisunga is optimistic that by 2030 the PERPFAR and Tanzania Government’s objective – the end of HIV/AIDS as a public health threat. He says the goal is ambitious but achievable. Another goal is that by 2025 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 are virally suppressed.

Ms Jane Mwakajumba (41) is another beneficiary who says was married on 2003 and by 2005 she became very sick so she moved back to her parents’ home, where her mother advised she tests. She did so and was found to be HIV positive.
She thanks PEPFAR that she has since been using ARVs, is in good health and got two children who are not infected. However, she says she had tough time in the beginning, due to stigmatization from both families. She now lives happily with her husband in Chunya district.

Mr Anubi Mwamwinde is yet another PEPFAR beneficiary who says he has a wife and six children. She said in 2005 his wife became sick and was later diagnosed to be HIV positive. He too tested and was found with the same condition, hence he was initiated to ARVs three years later. He says he got training from HJFMRI and now he is raising awareness among community members regarding HIV/AIDS.
PEPFAR supports the HIV response in Tanzania through four U.S. government agencies: the U.S. Center for Disease Control (CDC), Peace Corps, United States Agency for International Development (USAID), and the WRAIR-DOD.
HJFMRI is an implementing partner funded by PEPFAR through the WRAIR-DOD, showcases its HIV interventions through DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) activities, Medicated Assisted Treatments (MAT), HIV Research, and Comprehensive HIV Care and Treatment
Not only the above have benefited from PEPFAR’s assistance, as a sizable number of girls and young women in Mbarali district of Mbeya region are all smiles, thanks to the U.S. Government’s efforts to reduce HIV/AIDS and empower them economically.

The district that is in one of the regions hard hit by HIV for years, was identified by the PEPFAR and is up to now getting huge support in establishing economic activities so that they are not dependent or vulnerable to Gender-Based Violence (GBV).
While 62 girls have graduated from DREAMS Vocational Workshops, there are currently 34 undergoing training in different skills, more than 75,000 girls have been reached in different communities under PEPFAR funding through the Walter Reed Army Institute of Research (WRAIR) and implemented by the Henry Jackson Foundation Military Research International (HJFMRI) in the Northern Highlands regions.
Trades that the girls and young women get are such as tailoring, embroidery, batik making, hair dressing, agricultural activities, soap and shampoo making and others. DREAMS stands for Determined, Resilient, Empowered, AIDS-free, Mentored and Safe.
Ms Anusiata Mwamengo, the Tumaini Community Services Organisation DREAMS Coordinator in Igurusi says they cover 20 wards, with girls aged from 15 to 24 years, instilling in them the necessary skills, but also raising awareness about GBV acts, HIV/AIDS.
She says the girls get to know about safe sex, those who suffer from sexually transmitted diseases get treatment and counselling and those subjected to GBV are also well attended. DREAMS seeks to reduce HIV/AIDS through different means – behavioral change, right systems and medications.
The girls are also encouraged to test to establish their statuses, if there is a need are linked with medical centres, and they are also tested for TB cases while those who bear children under age are rightly attended.
The DREAMS partnership is an ambitious public-private partnership aimed at reducing rates of HIV among adolescent girls and young women in the highest HIV burden countries. DREAMS was announced on World AIDS Day 2014.
One of beneficiaries of DREAMS are Ms Neema Mwakyusa (22) who dropped out of school at class five and was subjected to GBV acts. She says her mother had several challenges, so she had to support her socially and economically.
It was difficult for her because as she was seeking to make both ends meet, she was subjected to GBV acts by men, who were ready to offer her little money that she and her mother needed so much.
Last year, a peer educator met her and informed about DREAMS, and since then she started attending at a health centre where training was conducted about HIV and attendants were from time to time encouraged to test so as to establish their status. After resisting for a while, she agreed to test and was found to be HIV negative although she had some diseases that were treated. She is now happy, earning money for herself and the family.

and after long suffering she was identified by DREAM, started training in tailoring and also got loans to initiate agricultural activities on a 1.5 hectare.
Another one is Ms Junnes Mwaisika (18), who says she started facing challenges after her father’s death, while her mother was found to be HIV positive. She struggled in life until she was introduced to DREAMS in July last year.
She is in tailoring, she leads her life in the right way by protecting herself and has since joined a credit society, getting loans for her grain business. She said she has supported her mother, as the latter learnt business from the former.
Ms Clovetha Mathias (19) is another recipient who now practices tailoring and sells grain to support herself and her family. She had economic challenges as she grew up and later, she became sick. She is happy that she was treated.
It was June last year that she heard of DREAMS; she joined the workshops, was tested and got training about safe sex and how to initiate economic activities. She is now a good tailor, a member of a credit society and grain trader.
They thank PEPFAR, U.S Government and all stakeholders for saving them from contracting HIV and supporting them economically.
Adolescent girls and young women account for 74 per cent of new HIV infections among all adolescents in sub-Saharan Africa and nearly 1,000 are infected with HIV every day. Social isolation, poverty, discriminatory cultural norms, orphanhood, gender-based violence, and inadequate schooling all contribute to their vulnerability to HIV and a life not lived to its full potential.
The DREAMS partnership goes beyond individual health initiatives to address these factors, working toward meeting the Sustainable Development Goal of ending AIDS by 2030.
Mbeya Regional AIDS Commission Coordinator, Mr Emmanuel Petro, says HIV was a huge challenge in the region, one of those with highest percentage of prevalence, but they have been trying to implement strategies that are formulated to fight the virus.
He says by PEPFAR chipping in to support the fight, a lot has been achieved in terms of getting people tested, initiating them to ARVs when needed and raise awareness among them on best ways to reduce infections.