HIV information among antenatal clinic attendees is available from Tanzania since the mid-1980s. In Dar es Salaam, the major urban area, HIV prevalence among antenatal clinic attendees tested increased from 4 percent in 1986 to 15 percent in 1999. In 2002, HIV prevalence among attending ANC clinics in Dar es Salaam was 11.5 percent. In 2002, the median HIV prevalence at 24 antenatal care clinics in 6 regions was 8.1 percent. The highest prevalence was reported in Mbeya region (median 17.2 percent) followed by Dar es Salaam.
Information on HIV prevalence among sex workers in Dar es Salaam is available since the mid-1980s. HIV prevalence among sex workers tested increased from 29 percent in 1986 to 49.5 percent in 1993. In 2001, nearly 70 percent of sex workers tested in Mbeya were HIV positive.
In Dar es Salaam, HIV prevalence among STI clinic patients tested increased from 13 percent in 1986 to 24 percent in 1994. In 2000 and 2001, over 40 percent of STI patients tested positive for HIV in Dar es Salaam. Outside of Dar es Salaam, the majority of data on HIV prevalence among STI clinic patients comes from Mbeya. HIV prevalence among STI patients tested in Mbeya increased from 22.5 percent in 1988 to 27 percent in 1997.
A macroeconomic simulation model estimated that the impact of AIDS on the growth path of the Tanzanian economy would be to reduce GDP by between 15-25% by the year 2010, and to reduce per capita income by between 0-10%.
One study by the ILO suggests that the size of the labor force will decrease by 20% by 2010 due to the impact of HIV/AIDS, and there will be a decrease in production as younger, less experienced workers replace those who have died.
The total cost to care for an HIV-infected adult in 1987-88 in Tanzania when both direct and indirect costs are included for low-cost sources was estimated to be US$2462, while the cost for using private sources was US$5316. Indirect costs include appropriately discounted years of healthy life lost, based on wage rates available at the time.
Providing triple combination antiretroviral therapy to HIV-positive adults in Tanzania would cost 51% of the GDP, according to one recent estimate.
Source: Lori Bollinger, John Stover, Peter Riwa “The Economic Impact of AIDS in Tanzania” September 1999. The Futures Group International in collaboration with: Research Triangle Institute (RTI) The Centre for Development and Population Activities (CEDPA)
Some of the findings from a study completed by the ILO in 1995 examining the economic impact of HIV/AIDS on eight organizations in Tanzania were as follows:
Medical costs for the Tanzania-Zambia Railway Authority workers associated with AID-related diseases increased over a one-year timeframe from Tsh2.8 million in January to Tsh4.6 million in December, a 63% increase.
Overall, the study estimated that the organizations were losing employees at the rate of 0.5-1.5 percent per year due to AIDS-related deaths.
The age at death for the employees ranged between 31 and 38.7 years old. If the retirement age is assumed to be 55 years, then years of lost productivity per worker per AIDS death ranges between 16.3 to 24 years.
Another more recent study collected information on the economic impact of AIDS for a variety of businesses in Dar es Salaam, including annual medical costs per employee per year, and annual burial costs per employee per year. The average annual medical costs increased from Tsh22,400 in 1993 to Tsh100,200 in 1997, and the average annual burial costs increased from Tsh700,000 to Tsh4.279 million over the same period of time.
Source: L. Bollinger, J. Stover, P. Riwa “The Economic Impact of AIDS in Tanzania” (September 1999) The Futures Group International in collaboration with: Research Triangle Institute (RTI) The Centre for Development and Population Activities (CEDPA)
USAID/Tanzania works with both the public and private sectors to implement its HIV/AIDS activities. The Mission has supported the development of networks of indigenous NGOs to address HIV/AIDS, dissemination of HIV/AIDS behavior change communication information through various media outlets, social marketing of male and female condoms, and strengthening of the Tanzanian leadership for development of national HIV/AIDS and health care programs.
Through CARE, Health Scope, and Johns Hopkins University, USAID supports the Voluntary Sector Health Program to provide NGOs with grants to encourage and support public-private partnerships to improve HIV/AIDS prevention, care and support services. USAID also supports the Tanzanian Ministry of Health, through Management Sciences for Health, to develop a strategy for public-private partnerships and support for the scaling-up of HIV/AIDS interventions.
The Johns Hopkins University/Population Communication Services project assists the Tanzania Commission on AIDS with implementation of HIV/AIDS information, education, and communication activities.
The Futures Group International/Policy Project seeks to improve the policy environment for HIV/AIDS. Objectives include building and strengthening the capacity of government and civil society groups to advocate for policy change to improve the design, implementation, and evaluation of HIV/AIDS prevention, care, and support programs.
USAID supports the African Medical and Research Foundation in implementing a 3-year program to enhance same-day HIV voluntary counseling and testing (VCT) within the voluntary and public sectors in Tanzania. Fifteen sites will be supported to improve the quality of VCT services.
In addition, USAID supports the Zanzibar NGO Cluster to implement education and communication activities to reduce the prevalence of HIV/AIDS and STIs.
In recent years, Tanzania has demonstrated growing political commitment to fight HIV/AIDS, giving the issue high priority for resource mobilization and setting up new structures to integrate HIV/AIDS strategies with other development sectors. In December 2000, the government created the Tanzania Commission on AIDS, managed out of the Prime Minister’s Office, to allow leaders at the highest levels of government to mobilize an accelerated, multisectoral and multi-faceted response to the epidemic. The Commission guides national policy, acts as a clearinghouse for AIDS activities, and helps mobilize additional funds to fight the epidemic on a national level. The current Strategic Framework for the Third Medium Term Plan for Prevention and Control of HIV/AIDS/STDs, 1998-2002, was developed in consultation with Government Ministries, donors, nongovernmental organizations (NGOs), and private sector partners. The Framework emphasizes programs to:
Provide appropriate STI case management services;
Reduce unsafe sexual behavior among highly mobile population groups;
Reduce HIV transmission among commercial sex workers;
Prevent unprotected sexual activity among the military;
Reduce vulnerability of youth to HIV/AIDS/STIs;
Maintain safe blood transfusion services;
Reduce poverty leading to sexual survival strategies;
Promote acceptance of persons living with HIV/AIDS;
Reduce unprotected sex among men with multiple sex partners;
Improve educational opportunities, especially for girls; and
Reduce vulnerability of women in adverse cultural environments.
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