HIV and AIDS in Tanzania – Trans Tanz working for the access of rural population to free treatment


By Denise Nanni and Milena Rampoldi, ProMosaik. In the following our interview with Kieran of the organisation Trans Tanz, based in Tanzania and delivering transport solutions for people living with HIV and AIDS in the Bagamoyo region. Would like to thank Kieran for the answers and photos. Stigma and transport problems are a big issue in rural areas of the country. 
How extended is the issue of HIV/AIDS in Tanzania? And what are the issues related to the public health system?
HIV/AIDS is a significant issue in Tanzania. The prevalence rate nationally (the percentage of people living with HIV/AIDS is 5.1% and in the Pwani region where we work (north of the capital Dar-es-Salaam) it is 5.9%. The anti-retroviral drugs to treat HIV/AIDS are available for free as a result of international donors but the health systems are weak, in the areas  we work there are shortages of doctors as some do not want to accept placements in rural areas. There are also substantial barriers to accessing treatment as a result of distance, cost of transport and stigma. Trans Tanz provides transport based solutions to connect communities and individuals living with HIV/AIDS with life saving treatment. Our aims are to support the local health system and people living with HIV/AIDS to:
– increase uptake of treatment 
– increase adherence to treatment
– prevent mother to child transmission of HIV/AIDS
– tackle stigma relating to HIV/AIDS 
What are the events that brought to the foundation of TransTanz?
In 2006 one of our founding trustees – Dr Sophie Harman was conducting academic research in the local area. Sophie saw first hand that despite anti-retroviral treatment being made available for free many people living with HIV/AIDS in rural Tanzania could not access it because of the cost of travelling long distances of 80km each way to the small number of clinics. On her return to the UK Sophie shared her experiences and a small group of friends were inspired to form Trans Tanz. Initially the charity ran a free bus service to enable people to attend the clinic and collect their medication. Over time as more clinics have opened we have changed our model and now reimburse patients the cost of attending the clinic each month as this enables us to help more people more cost effectively. We have been running for 10 years now and support over 300 patients every month, a number that is growing all the time. We have helped hundreds more over the last decade too.  
In what ways do you cooperate with the local health system? Do you cooperate with local authorities or other institutions? If yes, how?
Treatment for HIV/AIDS is available for free at care and treatment centres (CTCs) in Tanzania. However, in rural areas like the ones that we work in many patients lack the means to reliably access treatment, often because of the cost of transport. We reimburse patients the cost of attending to remove that barrier. The doctors and nurses who care for the patients are employed by the local health system. We consulted with them when we introduced the service and we work closely with them on an ongoing basis to co-ordinate the support to the patients and monitor attendance. We also work closely with peer educators – volunteers who work at the clinics supported by a national programme to educate patients and tackle stigma.
Do you carry on activities to address prevention?
Ensuring that people living with HIV/AIDS are accessing anti-retroviral treatment is increasingly recognised as a key way of preventing transmission of the disease as treatment reduces the risk of infection being passed on. In addition the clinics we work with are able to offer pregnant women living with HIV/AIDS access to Nevirapine a drug which can prevent the virus being passed on from mother to child. Many women who use our service have given birth to children who are free from infection including Ashura who was initially a patient and now works with us to administer payments to other patients attending the clinic. Finally by encouraging the take up of treatment we believe that we are playing an important role in tackling the stigma around HIV/AIDS in Tanzania which is still a problem in many of the villages we work in.