Summary: Tanzania has a high prevalence of HIV/AIDS, and the rate of HIV infection is rising rapidly. The first cases of AIDS in Tanzania were reported in 1983. Four years later all regions of Tanzania reported cases. According to the National HIV/AIDS/STIs Surveillance Report between January and December 2000, HIV prevalence among pregnant women attending an antenatal clinic for the first time ranged from 4.2 – 32.1%. HIV prevalence in the adult population (15 – 49 yrs) is estimated to be about 12%. It is estimated that two million people have been infected with HIV.
Main objectives: • Prevent the spread of HIV in Tanzania and minimize its impact on Tanzanian society.
Main activities: • Empower communities and districts (public, private, NGO and faith based actors) by building their capacity to plan and implement effective strategies for prevention, care, support and mitigation of HIV/AIDS • Protect young people in primary schools in the target districts from contracting HIV by providing correct information in order to empower them to adopt protective behaviours regarding HIV/AIDS • Intensify the fight against HIV/AIDS in the informal sectors in urban and peri-urban areas, through condom programs, provision of preventive information and education and by increasing access to HIV preventive medical services (clinics dealing with sexually transmitted diseases, voluntary counseling and testing (VCT) centers).
Anticipated Results: • Renovate 50% of VCT centers in six districts • Renovate/construct six information centers • Implement a plan for dissemination of information in information centers in 12 districts • Train district trainers in three districts • Sensitise 50% of the primary schools in 3 districts regarding accurate HIV/AIDS inforamtion • Collect and analyse school data in 12 districts.
Summary: Effective management of malaria cases is the most important component in malaria control aiming at reducing malaria morbidity and mortality. In the past the malaria treatment policy adopted by the Revolutionary Government of Zanzibar was the use of monotherapy i.e. chloroquine for the first line management of uncomplicated malaria and sulphadoxine/pyrimethamine for second line. Due to the increased parasite resistance to the above mentioned antimalarial i.e. 60% and 13% total treatment failure for first line and second line drugs, respectively the government reached a consensus to change its old monotherapy Chloroquine malaria treatment policy to a combination malaria treatment policy. The new combination therapy uses Amodiaquine and Artesunate as the first line antimalarial drugs. It also encompasses the use of Coartem and Quinine as the second and third line antimalarial drugs, respectively as well as specific and intermittent preventive therapy (IPT) for pregnant women, which uses Sulfadoxine Pyrimethamine(SP). The policy in Zanzibar is expected to ensure rapid and long lasting clinical cure and to prevent the progression of uncomplicated malaria into severe and potentially fatal disease. It is expected also to reduce the impact of placental malaria infection and maternal malaria associated anaemia through IPT. The correct application of the policy will minimize the chance and rate of development of drug resistance. Early diagnosis, prompt and effective treatment are an integral part of new national malaria treatment policy. The latter enables the population at risk to have access to safe, good quality, effective, affordable and acceptable antimalarial drugs. Over the three-year period, the program will be implemented throughout the Country which include Zanzibar and Pemba.
Target Groups/Beneficiaries: The entire Zanzibar population is at risk of malaria throughout a year, in this case all age groups will benefit from the process of implementing new antimalarial drug policy.
Goal: To provide safe, effective and good quality antimalarial drugs in order to reduce malaria mortality and morbidity.
Main objectives: Early recognition and effective treatment of malaria cases at all health care delivery facilities in Zanzibar to reduce severe malaria and malaria mortality in under five children and pregnant women.
Strategies: • Capacity building of both public-private health care providers • Procurement and distribution of the quality antimalarial drugs • Advocacy, information and education on the new antimalarial treatment policy • Quality assurance of antimalarial drugs • Monitoring of the efficacy and safety of the new drugs
Main activities: • Development of Guidelines for malaria diagnosis and treatment • Development of annotated versions of new antimalarial treatment guidelines (malaria control series) as training modules for District Health Management Teams (DHMTs) and Primary Health Care Workers (PHCWs) • Orientation on new policy for DHMTs • Training of health care providers on the use of new antimalarial guidelines • Procurement of antimalarial drugs (Amodiaquine+Artesunate and Artemether-Lumefantrine (Co-artem®)) • Conduct quality control of antimalarial drugs • Monitoring of the antimalarial drugs efficacy at the sentinel sites • Conduct Advocacy, information and education on new policy including distribution of Information Education and Communication (IEC) materials and guidelines at all levels of health care. • Monitoring and evaluation of the new antimalarial policy at community and health facilities levels. Intended Results: • By the end of year 2003, increase to 80% the proportion of clinicians who will manage malaria cases effectively based on new standard treatment guideline. • By the end of year 2003, increase to 80% proper management of uncomplicated malaria to under-five children in accordance with new malaria treatment guidelines (Appendix B) • By the end of year 2003, 80% of health care providers trained and use antimalarial treatment guidelines at all levels. • By the end of year 2003, 100% of health facilities at all levels will receive new treatment guidelines and other IEC materials. • By the end of 2003, all health facilities will have adequate and quality antimalarial drugs according to new policy. • Efficient quality control system will be in place to ensure drug safety by the end of 2003 • By 2004 the existing sentinel sites will be performing the efficacy studies. • By 2004 increase to 80% the proportion of caretakers who correctly provide management of fever at home. • By 2004 a comprehensive system of dissemination of information and education operates effectively and used by the beneficiaries.
Initial Country Coordinating Mechanism, Tanzania (Zanzibar) CCM, Members: The composition of the Country Coordinating Mechanism may change from time to time. At the time of signing of this Agreement, the Country Coordinating Mechanism included: • Chief Minister’s Office • The Ministry of Health and Social Welfare • Ministry of Youth Employment, Women and Children’s Development • Zanzibar Aids Commission • Catholic Church Reverends (Christian Faith based organisation) • WAKFU - (Muslim Faith based organisation) • World Health Organization (WHO) • UNICEF • Representative from High Learning Institutions • Representative from Civil Societies in Zanzibar
