Country situational analysis [1]

The HIV epidemic in mainland Tanzania has stabilized around 6% since 1997 as also reflected in reported AIDS cases, surveillance among pregnant women and blood donors. According to the 2010 UNAIDS report on the global epidemic, HIV prevalence was 5.6% at the end of 2009, which shows a decline from 7% prevalence in 2004 survey. As of December 2009, there were 1.4 million people living with HIV in the country.

According to the Tanzania HIV and Malaria Indicator Survey (THMIS) 2007-08, the general HIV prevalence in the sexual active population in Zanzibar is 0.6%.

Mainland Tanzania has a generalized HIV epidemic and the primary mechanism for HIV transmission is unprotected heterosexual sex, which constitutes about 80% of all new infections. HIV prevalence is higher among 35 to 39 year olds, followed by 30 to 34 year olds.

There were 199,413 people on antiretroviral treatment at the end of 2009, which corresponds to 30% coverage of all people in need. The percentage of HIV positive pregnant women receiving antiretroviral treatment to prevent mother-to-child transmisison of HIV was 70%.

Key elements of the national response

The Tanzania Commission for AIDS (TACAIDS) is the body that coordinates the national response to HIV. It was established in 2001 to provide strategic leadership in formulating HIV policies, coordinate multi-sectoral HIV responses and support advocacy and resource mobilization.

The National Aids Control Programme (NACP) coordinates the health sector’s response to HIV. In July 2007 Tanzania launched its second National Multi-sectoral Framework (NMSF) on HIV and AIDS for the period 2008-2010. The second NMSF focuses on enhancing the enabling environment; increasing prevention, care, treatment and support; and impact mitigation. The new critical areas addressed in the second NMSF include the key populations at higher risk (women engaging in commercial and transactional sex, sexually abused children, widows and divorcees, men having sex with men, prisoners, refugees and displaced people, people with disabilities and injecting drug users).

Key achievements

• Tanzania mainland began care and treatment services late 2004 where there were 96 Care and Treatment Centers (CTC) targeted to enroll 44,000 patients. By December 2006, CTC sites increased to 200 with total enrolment of 125,139 people.
• Creation of the Tanzanian National Council of People Living with HIV & AIDS (NACOPHA) in 2007
• Strengthened and more inclusive national coordination of the response to HIV. A partnership forum with clearer communication lines and standardized processes across all the sectors and thematic areas has been introduced
• Under the larger Development Partners Group (DPG) a donor group on HIV and AIDS (DPG AIDS) has been created. In 2006 the former Tanzania Assistance Strategy (TAS) was revised and a new Joint As stance Strategy for Tanzania (JAST) was signed in December 2006
• Improved coordination and division of labour among stakeholders
• Although the HIV epidemic in Tanzania is generalised there are key populations at higher risk which need targeted interventions. This has led to re-focusing and developing programmes to address these populations
• The establishment of the Multisectoral AIDS Committees has facilitated scaling up HIV responses from a social-cultural-and behavioural change point of view as opposed to an exclusively medical-epidemiological focus.

Key challenges

• Need to further scale up HIV prevention efforts and mobilize additional resources. A national HIV prevention strategy has not yet been developed
• Need to improve harmonization of strategic information to better guide decision making and strategic planning
• Need to improve coordination between government and private sector in the area of care and treatment
• Despite scaling up prevention efforts, HIV prevalence is increasing among adolescents and women. Existing behavior change interventions have had minimum impact mainly due to limited knowledge of behavior patterns in these groups
• Despite good funding availability government and other stakeholders have shown limited absorption capacity
• Limited capacity of the health sector to roll-out provision of antiretroviral treatment for prevention of mother-to-child transmission
• There is a shortage of human resources, especially in the health sector, which hinders the effective delivery of testing, counseling, treatment and care services

Useful links

• The Second Multi-Sectoral Strategic Framework on HIV and AIDS - 2008-2012
• Tanzania Commission for AIDS - TACAIDS
• Public Expenditure Review. Multisectoral Review: HIV and AIDS, December 2007
• National HIV and AIDS Policy
• HIV Epidemiological Review (2008)
• Health Sector HIV and AIDS Strategic Plan - 2008-2012
• The HIV and AIDS (Prevention and Control) Act, 2008
• National Monitoring and Evaluation Plan
• HIV, Tuberculosis and Malaria survey - fact sheet
• PMTCT and Paediatric Care and Treatment - fact sheet 
• 2010 UNGASS Report

Contacts