Two decades of Kikwete’s legacy in fight against HIV/AIDS

DURING his tenure as President of the fourth phase government of the United Republic of Tanzania from 2005 to 2015, Dr Jakaya Mrisho Kikwete accomplished a great deal for his people and country. However, if you were to ask him today what one of his most significant legacies was, he would quickly and emphatically state that it was the fight against Human Immunodeficiency Virus (HIV) and Acquired ImmunoDeficiency Syndrome (AIDS).

Why? In any case, he was not amused by the reports about the fatal disease that had been compiled prior to his assumption of office.

Then, the Tanzania Commission for AIDS (TACAIDS) had conducted a community-based HIV indicator study in 2003-2004 with the full cooperation of the National Bureau of Statistics. This survey, which included HIV blood testing and covered a larger population, found that the prevalence of HIV among Tanzania Mainland adults aged 15–49 was approximately 7.0 per cent (6.3 per cent for males and 7.7 per cent for females).

This study estimated that by the end of 2004, over two million Tanzanians were living with HIV and AIDS and over two million AIDS orphans had been registered. Over 90 per cent of Tanzanians aged 15 to 49 were aware that having a single, uninfected, faithful partner reduces the risk of contracting HIV. Additionally, four out of five adults are aware that a person who appears healthy could be HIV-positive; however, this awareness did not appear to be accompanied by a change in behaviour.

Therefore, it is not surprising that Dr Kikwete was invited to attend the 20th anniversary celebrations of the President’s Emergency Plan for AIDS Relief (PEPFAR) on February 24, 2023, in Washington DC in recognition of his significant contribution to the success of the Programme.

PEPFAR is a United States government initiative launched in 2003 that provides funding and support to countries affected by the HIV/AIDS epidemic, primarily in sub-Saharan Africa and the Caribbean. The programme was established by President George W Bush and has been continued by subsequent administrations.

PEPFAR aims to prevent the spread of HIV, provide treatment and care to those infected with the virus and support research to find a cure for HIV/AIDS. The programme has been successful in providing life-saving antiretroviral therapy to millions of people living with HIV, reducing the number of new infections and supporting the care and treatment of orphans and vulnerable children affected by the epidemic.

In addition to providing funding and support to countries affected by HIV/AIDS, PEPFAR also works to strengthen health systems and promote sustainable responses to the epidemic. The programme collaborates with local governments, civil society organisations, and other partners to implement effective and sustainable programmes that address the needs of people living with HIV/AIDS.

Overall, PEPFAR is a significant global health initiative that has made a significant impact in the fight against HIV/AIDS, saving millions of lives and improving the health and well-being of communities affected by the epidemic.

Through Dr Kikwete’s relentless efforts to combat the killer disease, Tanzania became a model nation for its efforts to eradicate AIDS, both independently and in collaboration with foreign organisations such as PEPFAR.

In Washington DC that day, Dr Kikwete and Dr Condoleezza Rice joined President George W Bush for a conversation at the PEPFAR at 20th event hosted by the President Bush Institute. The three discussed PEPFAR’s inception, its enormous impact and how the programme benefits both U.S foreign policy and partner countries.

Dr Kikwete stated during the event moderated by Dr Rice: “I became president in 2005.

During the campaigns, I vowed to intensify the fight against HIV/AIDS. When I first started advocating, however, I began with the standard advocacy A-B-Cs: abstain, be faithful and use protection.

“It was inadequate… Consequently, it occurred to me that we ought to do something important. Conduct a nationwide testing initiative. I believed that HIV-positive individuals would know how to conduct themselves if everyone were tested and their status was known. Those who have been notorious but were HIV-negative will have a better understanding of how to act responsibly.

“I had trouble acquiring the test kits. So, I invited the US Ambassador to Tanzania (Michael Retzer) to the State House and informed him that I had a plan to intensify the fight against HIV/AIDS. However, this will only work if you comply with my request. What then is the request? Test kits. Consequently, the US envoy advised the President to just do it. The government of the United States will assist you…. So that was the beginning,” he said.

On 14 July 2007, Dr Kikwete launched Tanzania’s nationwide campaign at the Mnazi Mmoja garden in Dar es Salaam, with one goal in mind – how to encourage an otherwise fearful public to undergo HIV-AIDS testing voluntarily.

“People feared testing. Therefore, my wife and I decided to lead by example by being tested. And we decided that we should not do it inside the tent, where nobody can see us. Clearly, we were under a tent, but we invited TV cameras in to transmit the exercise live, as or blood was being drawn, taken to the lab and tested.

“My veins were straightforward, whereas my wife’s were problematic…” he said jokingly with a laugh. “Multiple attempts were required before they were successful. I felt awful for her – but that is the price of leadership.

“And because I was tested that day, many others followed suit and were tested as well. Approximately 11,000 people were tested at Mnazi Mmoja on that day. And that was to be the beginning of testing standardisation. Then, a routine began to develop. According to reports, the number of Tanzanians voluntarily undergoing testing has now surpassed 20 million. The fact that both the President and his wife had tested for HIV-AIDS reduced public’s apprehension regarding the procedure. It also diminished stigma” he recalls.

Dr Kikwete acknowledged that it was PEPFAR that gave him the audacity to launch the nationwide HIV/AIDS campaign, describing the programme as a tremendous help.

“When I was president, the prevalence was 7 per cent; by the time I left office in 2015, it had fallen to 5.1 per cent, and it is significantly lower today. Thus, it is evident that the PEPFAR initiative has saved many lives. In addition, the use of ARVs as well as the expansion of viral load testing capabilities have protected a substantial number of individuals from infection.

“Another benefit of PEPFAR is that it assisted us in developing response initiatives. Through a CDC programme, it also assisted us in training about 750 health care professionals. In addition, 44 of our laboratories were internationally accredited. Why shouldn’t things work given all of this?

“PEPFAR has been an outstanding endeavour. In addition, the United States is the only nation in the world that focuses on fighting a single disease. I therefore appreciate your generosity. Also, I would like to thank Congress. Because PEPFAR would not have been funded if the government had presented this decision to Congress and received a negative response. The most important thing, however, is that we thank the American people,” he said.

Dr Kikwete informed President Bush, Dr Rice and the audience, which included former House Speaker Nancy Pelosi that Tanzania has a new president,  Dr Samia Suluhu Hassan, a lady who he said is doing exceptionally well.

“Madame President extends her compliments to you,” he said. “She admires your brilliant idea to establish PEPFAR. She extends greetings and gratitude to all administrations that have worked on this issue, in addition to Congress and the American people. She requests that you continue the excellent work, collaboration, and cooperation until this menace is vanquished,” he said.

Dr Kikwete stated that the target date for eradicating the disease is 2030, and he expressed optimism that this goal will be attained.

“If everyone is resolute, we will reach our destination. Since the infection rate was 85 per cent in 2010 when I was president, and is currently 46 per cent, I am confident that we can achieve our goal of eliminating HIV/AIDS by 2030,” he said.

In his second and final term (2010-2015) as President of the United Republic of Tanzania, his enthusiasm for serving Tanzania and its people continued. With his assistants and friends, he began to consider what he would do after retirement. The discussion centred on how he could profitably apply the knowledge and experience he has gained during his more than four decades of public service.

He states, “I was leaving office in 2015, at the age of 65, in good health, neither too old nor too weary. I would still have a substantial energy reserve, which, when combined with my love and passion for service to humanity, would enable me to make significant contributions to the advancement of people in Tanzania, Africa, and around the globe.

“I thought that I would need a mechanism to assist me with this. This is why I conceived and established the Jakaya Mrisho Kikwete Foundation (JMKF),” he revealed.

Dr Kikwete said that of the vehicle of his passion and vision for the transformation of people’s lives through collaboration and partnership to enhance and complement the government’s and other stakeholders’ development efforts in Tanzania, Africa, and the world.

Through the JMKF, Dr Kikwete uses the same vision, enthusiasm and commitment towards programmes that address and promote maternal and new-born health and improve skills of health care workers.

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