Dar es Salaam. The United States yesterday warned the government against its decision to ban HIV/Aids services at 40 health facilities, and introduce new guidelines for Key Populations (KP), saying the move could cause a flare-up of the epidemic among those afflicted.
In a statement, the US embassy in Dar es Salaam said the decision could impact HIV/Aids programmes funded by the American government, and impede progress made over the years in addressing the epidemic in Tanzania.
“The Government of Tanzania has not provided to the United States, any official notification of these changes, which could impact US Government funded programs…” reads part of the statement posted on the embassy’s official Facebook page on Friday night.
Earlier in the day, the Ministry of Health, Community Development, Gender, Children and the Elderly banned the provision of HIV/Aids services in the facilities, known as drop-in-centres, which the authorities have accused of clandestinely promoting homosexuality. And in her response regarding the US statement, Health minister Ummy Mwalimu told The Citizen on Sunday yesterday that since October last year, discussions between funding agencies and the government on the matter had been on-going, and it reached a point where the government had to make a decision.
“[Regarding] the Guidelines for HIV/Aids for Key Populations…there are areas which we agreed and some which we did not…In the end, we had to come up with a position,” she told The Citizen.
The minister was emphatic that the key principle in carrying out HIV/Aids interventions for Key Populations was that the services offered to those afflicted by the disease should not contravene the laws of the land, including those that prohibit the promotion of homosexuality.
Ms Mwalimu announced that health workers in the banned centres would now be shifted to public health facilities where they would be allowed to offer HIV/Aids services to those afflicted by the disease.
She said the government’s decision was an informed by a recent investigation by a special task force appointed by her ministry, which revealed that drop-in-centres, mainly funded by foreign agencies, were providing lubricants such as K-Y jelly that lured many youth to engage in homosexuality.
But the US embassy said: “We anticipate that the Government’s publicly-stated decision…would result in fewer Tanzanians receiving life-saving services and expand the epidemic among those most in need of viral suppression.”
The HIV prevalence among gay men is higher, at 25 per cent, compared to other groups. Over 1.4 million people are living with HIV in Tanzania, which is 5 per cent of the country’s population, according to the Tanzania Aids Control Commission (Tacaids).
The minister says the country has about 4,700 health facilities that offer HIV/Aids services, and these would continue operating—except those that were, according to government, found to offer services to gay men and women.
However, according to the US embassy, the absence of the banned facilities—drop-in-centres—would create a gap in the provision of HIV/Aids amenities across the country.
“Data clearly shows that the delivery of services for the most-at-risk populations through community outreach, including drop-in/resource centres, is an effective way to reach these populations and to reach other vulnerable and underserved populations, including youth who generally do not access health facilities,’’ said the embassy in its statement.
Sources show that currently, about 3,000 health facilities have no capacity to provide HIV/Aids services. This means there will be a shortage of centres to take care of people living with HIV/Aids, as soon as government’s ban is implemented.
The minister says the government will intervene through special outreach services by deploying health workers from public health facilities to cover the gap.
Since last year, the government announced plans to scrap off sections in some HIV treatment guidelines that allowed provision of the lubricants to gay men and women in the country.
“Lack of access to appropriate lubricants and violence against sex workers all have close links to higher prevalence of Sexually Transmitted Infections(STIs),’’ notes part of the guidelines