Published on Africa Can End Poverty

HIV/Aids: Still Claiming Too Many Lives

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ImageLet's think together: Every Sunday the World Bank in Tanzania in collaboration with The Citizen wants to stimulate your thinking by sharing data from recent official surveys in Tanzania and ask you a few questions.

HIV/Aids remains one of the deadliest diseases in sub-Saharan Africa, causing misery and suffering to millions of affected people and their families. But there are also signs of hope, as new infections and the number of Aids-related deaths have come down significantly since the mid-2000s. Similar to the broader trend in the region, Tanzania has achieved some success in reducing HIV/Aids:

- HIV prevalence among adults declined from its peak in 1996 (8.4 per cent of those aged 15-49 years) to 5.8 per cent in 2007, though it has stagnated since then.
- The number of people dying from Aids has fallen by about one third, from 130,000 in 2001 to 84,000 in 2011.

The overall HIV prevalence in Tanzania (5.8 per cent in 2011) is lower, for example, than in Zambia (12.5 per cent), Malawi (10 per cent) or Uganda (7.2 per cent). And yet, further reductions in HIV infections could well be more difficult to achieve, as most transmissions occur through unprotected sex while policy has a limited capacity to change the underlying behavior patterns.

What is more critical, however, is that Tanzania is falling behind other countries in the region in reducing Aids-related deaths:
- Between 2001 and 2011, Zambia managed to reduce the number of people dying from HIV/Aids by 57 per cent; Zimbabwe by 61 per cent and Kenya by 52 per cent (compared to Tanzania’s 35 per cent).
- Tanzania currently ranks fourth in the world in terms of the total number of Aids-related deaths (after South Africa, Nigeria and India)
- An estimated 1.3 million children in Tanzania have lost at least one of their parents to the epidemic and are growing up as orphans.

The fact that so many Tanzanians still die from Aids, despite the existence of treatment, signals that the country’s health system does not reach those in need of HIV testing and therapy, and that antiretroviral (ARV) drugs are not accessible to the majority of the population:
- Only 40 per cent of the population with advanced HIV infection are on ARV medication.
- This ARV coverage is much lower than in Zambia (82 per cent), Kenya (72 per cent), Malawi (67 per cent) and Uganda (54 per cent), and far below the MDG target of universal access to ARV treatment by 2010.
- In addition, routine discoveries of counterfeit ARV drugs raise concerns about the quality of treatment available to those in need.

All of this raises the following questions:
- What is the reason for the low ARV coverage in Tanzania? Lack of access? Stigmatization? Poor quality of HIV/Aids counseling?
- Should the Government prioritize funding for HIV/Aids-related health services? Even at the expense of other health sector programs?
Does the Tanzania Foods and Drugs Authority have enough resources to monitor the quality and safety of drugs for the treatment of HIV/Aids?
What is the role of Tanzanians themselves in limiting the spread of HIV/Aids?

Note: The statistics above are derived from the World Development Indicators, UNAIDS data and the CIA World Factbook. All are publicly available.


Jacques Morisset

Lead Economist and Program Leader, World Bank

Jacques Morisset

Lead Economist and Program Leader, World Bank

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