Why Tanzania ranks high in HIV/Aids deaths

A person taking a blood test at a roadside AIDS testing table in Langa, a suburb of Cape Town. South Africa has the highest AIDS incidence in the world. Tanzania is not far behind Photo | AFP 

Although Tanzania, like the rest of the world, has made remarkable progress in taming the HIV/Aids pandemic, the country still ranks high globally in the number of deaths caused by the deadly virus. Using 2009 figures, the US Central Intelligence Agency (CIA) ranks it number four in a new report, with an annual estimate of 86,000 deaths, which puts it on top in the East African Community (EAC) in the number of victims dying from the scourge and associated diseases.

According to the current CIA World Factbook, Tanzania is followed by Kenya in the EAC bloc where the estimated deaths are 80,000 and which is ranked number six globally. Uganda with 64,000 deaths and ranked number eight in the world is third followed by Burundi and Rwanda, which are globally ranked number 19 and 43 with the number of deaths put at 15,000 and 4,100, respectively.

The CIA HIV/Aids rankings, which have been faulted by the local authorities as unrealistic, is led by South Africa, Nigeria and India, where the fatality figures are 310,000, 220,000 and 170,000, respectively. Globally, the annual number of people dying from Aids-related causes has been steadily decreasing since 2005 with many deaths largely averted by the introduction of antiretroviral therapy.

The World Health Organisation (WHO) advocates that the number of deaths can be significantly reduced with enough investment in HIV prevention, testing and counselling, treatment and care services.

The organisation says in a new report that countries with the highest fatalities like Tanzania are yet to achieve the universal access to antiretroviral therapy, which is at least 80 per cent of the people eligible for treatment.

“The global incidence of HIV infection has stabilized and begun to decline in many countries with generalised epidemics. The number of people receiving antiretroviral therapy continues to increase, with 6.65 million people getting treatment at the end of 2010,” the UN agency notes in the Global HIV/Aids Response Progress Report 2011.

“Recent published evidence from clinical trials has confirmed the powerful impact antiretroviral drugs have on the epidemic as part of an effective package of options for HIV prevention. Despite these advances, still too many people are acquiring HIV infection, too many people are getting sick and too many people are dying,” it adds.

Anti-retroviral therapy

The WHO statistics show that the reported number of people receiving antiretroviral therapy in Tanzania increased by 29 per cent between 2009 and 2010 from 199,413 to 258,069. There are about 1.4 million people living with HIV/Aids in the country, whose estimated antiretroviral therapy coverage by 2010 was put at 42 per cent compared to 55, 34 and 26 per cent in South Africa, India and Nigeria, respectively.

WHO says that the annual number of people dying from Aids-related causes worldwide is steadily decreasing from a peak of 2.2 million in 2005 to an estimated 1.8 million in 2010. It adds that introducing antiretroviral therapy has averted 2.5 million deaths in low- and middle-income countries globally since 1995.

Commenting on the CIA rankings, government officials dismissed the report as misleading since it did not reflect the current situation on the ground, which they said has improved tremendously.

They however admitted that the country still faces enormous challenges mostly in terms of inadequate health services infrastructure and financial resources to deal with the problem.

Health and Social Welfare minister Hadji Mponda also pointed at a serious shortage of skilled human resources in the health sector and the entire work force in general. He said another major setback in dealing with the pandemic was the prevailing stigma and discrimination against victims, which prevents uptake of available HIV and Aids services.

“Inadequate and unpredictable financial resources to sustain a comprehensive national response that includes HIV prevention, care, treatment and support is still a problem in Tanzania,” he observed.

Dr Mponda said that despite these shortcomings, remarkable success has been attained in the fight against the disease in the country. The major achievements include reduction in HIV prevalence from seven per cent during 2003/4 to around five per cent at the moment.

There has also been expansion of HIV-related services such as counselling and voluntary testing. By December last year, some 15 million people, more than 37 per cent of Tanzania’s population, had already been counselled and voluntarily tested to know their status.

In addition, there are 1,100 health facilities all over the country that are currently providing antiretroviral treatment (ART) services. The government puts the number of people living with HIV/Aids enrolled at health facilities providing HIV care and treatment services at 746,756 with about 52 per cent of them already receiving ART services.

The executive chairwoman of the Tanzania Commission for Aids, Dr Fatma Mrisho, said the level of HIV/Aids awareness reached in Tanzania has significantly reduced the number of death cases. Although she did not give figures, Dr Mrisho said evidence of the steady progress Tanzania has made in fighting the scourge is the drastic reduction in the prevalence rate.

The Tanzania Network of Organisations of People Living with HIV/Aids also attributes the high number of Aids deaths in the country to refusal of some patients to take antiretroviral (ARV) drugs due to various reasons, such as prevalence of fakes, which have adverse side effects.

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