drug users, including 30,000 injecting drug users
of injecting drug users in Dar es Salaam live with HIV
of injecting drug users are infected with hepatitis C
These alarming figures highlight the need for a humanitarian mission to Tanzania focussing on health-related issues.
Healthcare for drug users: a humanitarian emergency in Tanzania
Tanzania is one of the capitals of heroin trafficking from Central Asia and drug use has therefore risen, alongside the transmission of AIDS and hepatitis. There are over 300,000 drug users, a tenth of which are injecting drug users.
Due to the lack of sufficient prevention and healthcare services that are appropriate for and accessible to these populations, at-risk practices such as sharing used needles and unprotected sex are widespread. The consequences for people’s health are considerable: more than a third are infected with HIV and a quarter are living with hepatitis C.
Marginalisation of people and their remoteness from healthcare
Although harm reduction (HR) services do exist, including access to opiate substitution therapy and needle exchange programmes, they are still too few in number to meet the need. Stigma and discrimination is common in health services and among the population, forming an additional barrier impeding users’ access to healthcare. The legal framework and repressive political environment further reinforce the marginalisation of people and their remoteness from healthcare.
Our work in Tanzania: caring for marginalised people
The exclusion of certain populations has placed the issue of access to healthcare at the centre of our humanitarian mission in Tanzania.
Combating HIV and hepatitis: the foundation of our humanitarian work in Tanzania
As part of our humanitarian mission in Tanzania, Médecins du Monde teams have been working since 2010 to promote harm reduction related to drug use in Tanzania, and thus fight against HIV and hepatitis.
Between 2010 and 2018, Médecins du Monde implemented the first comprehensive humanitarian harm reduction programme in the country, in Dar es Salaam. Despite the unfavourable political environment, this pilot project incorporated a comprehensive range of services tailored to people’s needs. The teams set up a reception centre and mobile activities to reach out to the most isolated users. Our medical aid in Tanzania allows us to develop adapted services for the most vulnerable.
Striving for the involvement of the Tanzanian authorities
To ensure the sustainability of its interventions, Médecins du Monde has constantly lobbied the authorities to promote harm reduction and strengthen the capacities of local partners through its Training and Resource Centre.
And with positive results, which highlight the effectiveness of our humanitarian mission in Tanzania:
- The hand-over of our programme in January 2019 to a Tanzanian partner, Mukikute, which has since continued to provide harm reduction services to nearly 2,000 users per year;
- The government’s decision to scale up harm reduction services in the country, with Médecins du Monde’s support in technical matters and in coordinating the various stakeholders.
Today, Médecins du Monde plays a central role in mainstreaming and promoting harm reduction in Tanzania. As a national technical expert, in 2020 Médecins du Monde's teams worked to:
- Consolidate the hand-over of the pilot programme to ensure its quality and sustainability in the long term;
- Coordinate the scaling up of harm reduction services which are now in place throughout Dar es Salaam, and which are being implemented in two other locations (Bagamoyo and Tanga), in collaboration with the Ministry of Health and relevant institutions;
- Strengthen the capacity of local organisations and local authorities to implement and monitor quality harm reduction services;
- Support Tanzanian drug users’ network to fight for recognition of the needs of drug users and to defend their rights;
- Support the development of national harm reduction policies and strategies;
- Conduct advocacy work with policy-makers to strengthen the provision of drug-user-friendly healthcare services within the national health system.
Maintaining access to care for vulnerable people during the Covid-19 epidemic
As soon as the first cases of COVID-19 were confirmed in March 2020, Médecins du Monde teams were able to quickly adapt their activities to ensure continuity of services for drug users and to support the national health system’s response to the pandemic. This included:
- Training and raising awareness among more than 250 health workers, local partners, and police in Dar es Salaam to apply and promote prevention measures and medical aid in Tanzania;
- Informing drug users about symptoms and prevention measures (10,000 brochures and 100 T-shirts) adapted to their lifestyles;
Providing essential protection and prevention materials to health workers, local partners and beneficiaries of harm reduction programmes (reusable and surgical masks, mobile hand washing points, hygiene kits, medical equipment, etc.)
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