Tanzania: What Breakthrough is Needed to Combat HIV/Aids?
By, Salma Maoulidi, Fahamu, November 30, 2006
It is over two decades since the first AIDS patient was diagnosed in Tanzania. In response, a number of measures were devised and adopted by the government to respond to the pandemic. These measures reflect the progress in official understanding and attitudes about the disease. Initial responses were comprised mainly of health measures designed to address curative aspects of the disease. Then, denial about HIV/AIDS, even in official quarters, hampered more effective responses to the disease.
The rise of associations of people with or affected by HIV/AIDS, parallel to existing responses, spearheaded psycho-social and policy responses. This brought about two major benefits in the fight against HIV/AIDS. Foremost, it "outed" the disease enabling HIV/AIDS activists to focus more deliberately on addressing stigma, a major barrier in addressing the pandemic at the personal and institutional level. Similarly, concerted advocacy by HIV/AIDS activists brought the disease out of a medical isolation where it was viewed purely in health terms, to the level of considering non-medical dimensions.
The progression from National AIDS Programmes to an AIDS Commission in the late nineties heralded the multi-sectoral approach currently adopted.
For the most part, HIV/AIDS associations have confined their responses to the impact on the individual and community. Overwhelmingly, their response is service oriented e.g. provision of home based care; nutrition programmes; provision of legal services; widow or orphan care; and HIV/AIDS support groups something that hinders their ability to focus on more strategic concerns related to HIV/AIDS. Only a small number of associations mix advocacy with service provision. Accordingly, while Tanzania in the mid nineties declared HIV/AIDS a national calamity, few organizations have built upon this opportunity to advance HIV/AIDS advocacy efforts in a meaningful manner.
Instead, what is new in existing and upcoming HIV/AIDS initiatives is the location; or the gender and youth focus.
HIV/AIDS organizations, mainly veteran associations that have introduced policy advocacy initiatives in their programming, require capacity in translating this in practical policy results and interventions. For example, some HIV/AIDS organizations are pressurizing the government to make ARVs accessible to People Living with HIV/AIDS (PLWHA). While the government receives due attention in taking measures to make this a reality, little attention is given to the role of pharmaceuticals in facilitating treatment options. Surely, other than an official commitment in principle to facilitate treatment, there is very little the government can do, in practical terms, to provide ARVs on a mass scale.
This, however, is something local pharmaceuticals can and should be obliged to do. And a few have risen to the challenge, leading discussions with the government under various trade agreements like the East African Community Treaty on Common Markets. Local pharmaceutical companies like the Tanzania Pharmaceutical Industries (TPI), not HIV/AIDS associations, are challenging the monopoly of foreign companies in the production and distribution of ARVs. They capitalize on their geographical location to build a case for ARV production more suited to local populations and at more affordable rates. An added benefit to their proposal is the prospect of creating jobs for local the population. Certainly this development presents an opportunity for partnership between the HIV/AIDS community and the business community that includes aspects of HIV/AIDS advocacy and corporate social responsibility yet to be explored. However, it is a sector HIV/AIDS activist are noticeably absent and silent from.
Equally important is the need for more strategic responses vis á vis the HIV/AIDS pandemic, not only by the government but also by community institutions. The policy and legal framework focuses on "formalized" aspects of discrimination against PLWHA or those affected by HIV/AIDS. Thus due attention is given to the employer-employee relationships; access to health care; and to a smaller extent the question of legal services to PLWHA and their families. These measures, however, fall short of infusing the radical spice to significantly impact PLWHA or their families since they fail to address the primary cause of unhindered HIV/AIDS transmission: the traditional interpretation of the family institution and the unequal relationship between parties in the family union.
Indeed, transmission patterns in Africa, Tanzania included, are largely heterosexual.The majority of those affected or infected with the HIV/AIDS virus are married men and women - not sex workers and not single women or homosexuals. This is important to consider as it dispels a major stereotype of HIV/AIDS victims and transmission of the virus.
It was this breakthrough that enabled HIV/AIDS researchers in the west to begin expanding their investigation of the disease and its transmission beyond the homosexual community or intravenous drug users. The fact that HIV/AIDS in Africa and Asia is transmitted mainly through heterosexual contact debunked the Sodom and Gomorrah theory which confined the problem to a particular group in the society considered immoral to be dispelled.
What is interesting is that in spite of this knowledge, most institutions representative of patriarchal authority lack the will to redress this situation. For example, they fail to focus on the unequal relationship between man and wife that allows the man unfettered sexual access, thereby compromising the health and life of his spouse. Many times this is done with the full endorsement of public and legal institutions under the rubric of preserving the religious or cultural order. In effect, the interest is rather in preserving the status quo rather than guaranteeing equal protection and treatment to both spouses even when this is required by the constitutional order.
Source: http://allafrica.com/stories/200611301107.html
It is over two decades since the first AIDS patient was diagnosed in Tanzania. In response, a number of measures were devised and adopted by the government to respond to the pandemic. These measures reflect the progress in official understanding and attitudes about the disease. Initial responses were comprised mainly of health measures designed to address curative aspects of the disease. Then, denial about HIV/AIDS, even in official quarters, hampered more effective responses to the disease.
The rise of associations of people with or affected by HIV/AIDS, parallel to existing responses, spearheaded psycho-social and policy responses. This brought about two major benefits in the fight against HIV/AIDS. Foremost, it "outed" the disease enabling HIV/AIDS activists to focus more deliberately on addressing stigma, a major barrier in addressing the pandemic at the personal and institutional level. Similarly, concerted advocacy by HIV/AIDS activists brought the disease out of a medical isolation where it was viewed purely in health terms, to the level of considering non-medical dimensions.
The progression from National AIDS Programmes to an AIDS Commission in the late nineties heralded the multi-sectoral approach currently adopted.
For the most part, HIV/AIDS associations have confined their responses to the impact on the individual and community. Overwhelmingly, their response is service oriented e.g. provision of home based care; nutrition programmes; provision of legal services; widow or orphan care; and HIV/AIDS support groups something that hinders their ability to focus on more strategic concerns related to HIV/AIDS. Only a small number of associations mix advocacy with service provision. Accordingly, while Tanzania in the mid nineties declared HIV/AIDS a national calamity, few organizations have built upon this opportunity to advance HIV/AIDS advocacy efforts in a meaningful manner.
Instead, what is new in existing and upcoming HIV/AIDS initiatives is the location; or the gender and youth focus.
HIV/AIDS organizations, mainly veteran associations that have introduced policy advocacy initiatives in their programming, require capacity in translating this in practical policy results and interventions. For example, some HIV/AIDS organizations are pressurizing the government to make ARVs accessible to People Living with HIV/AIDS (PLWHA). While the government receives due attention in taking measures to make this a reality, little attention is given to the role of pharmaceuticals in facilitating treatment options. Surely, other than an official commitment in principle to facilitate treatment, there is very little the government can do, in practical terms, to provide ARVs on a mass scale.
This, however, is something local pharmaceuticals can and should be obliged to do. And a few have risen to the challenge, leading discussions with the government under various trade agreements like the East African Community Treaty on Common Markets. Local pharmaceutical companies like the Tanzania Pharmaceutical Industries (TPI), not HIV/AIDS associations, are challenging the monopoly of foreign companies in the production and distribution of ARVs. They capitalize on their geographical location to build a case for ARV production more suited to local populations and at more affordable rates. An added benefit to their proposal is the prospect of creating jobs for local the population. Certainly this development presents an opportunity for partnership between the HIV/AIDS community and the business community that includes aspects of HIV/AIDS advocacy and corporate social responsibility yet to be explored. However, it is a sector HIV/AIDS activist are noticeably absent and silent from.
Equally important is the need for more strategic responses vis á vis the HIV/AIDS pandemic, not only by the government but also by community institutions. The policy and legal framework focuses on "formalized" aspects of discrimination against PLWHA or those affected by HIV/AIDS. Thus due attention is given to the employer-employee relationships; access to health care; and to a smaller extent the question of legal services to PLWHA and their families. These measures, however, fall short of infusing the radical spice to significantly impact PLWHA or their families since they fail to address the primary cause of unhindered HIV/AIDS transmission: the traditional interpretation of the family institution and the unequal relationship between parties in the family union.
Indeed, transmission patterns in Africa, Tanzania included, are largely heterosexual.The majority of those affected or infected with the HIV/AIDS virus are married men and women - not sex workers and not single women or homosexuals. This is important to consider as it dispels a major stereotype of HIV/AIDS victims and transmission of the virus.
It was this breakthrough that enabled HIV/AIDS researchers in the west to begin expanding their investigation of the disease and its transmission beyond the homosexual community or intravenous drug users. The fact that HIV/AIDS in Africa and Asia is transmitted mainly through heterosexual contact debunked the Sodom and Gomorrah theory which confined the problem to a particular group in the society considered immoral to be dispelled.
What is interesting is that in spite of this knowledge, most institutions representative of patriarchal authority lack the will to redress this situation. For example, they fail to focus on the unequal relationship between man and wife that allows the man unfettered sexual access, thereby compromising the health and life of his spouse. Many times this is done with the full endorsement of public and legal institutions under the rubric of preserving the religious or cultural order. In effect, the interest is rather in preserving the status quo rather than guaranteeing equal protection and treatment to both spouses even when this is required by the constitutional order.
Source: http://allafrica.com/stories/200611301107.html
posted by AIDS-Care-Watch at 11:39 am
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