United Republic of Tanzania

The Tanzania Youth Alliance (TAYOA) is a national, non-profit organization that empowers young people to engage in meaningful activities that improve their quality of life.
Credit: UNAIDS/AFP - Siegfried Modola

During a visit to the Tanzanian Youth Alliance (TAYOA), a national non-profit organization based in Dar Es Salaam, UN Deputy Secretary-General Dr Asha-Rose Migiro and UNAIDS Executive Director Michel Sidibé praised the young people for the extraordinary responsibility they have shown in addressing HIV.

TAYOA operates a National AIDS Helpline to respond to queries from young people on a range of HIV-related issues. Individuals call the Helpline free of charge using a landline or mobile phone. Medical students volunteer their time to counsel other youth across the country.

Starting with single phone line in 2001, the organization now runs eight lines for 12 hours a day. One thousand callers, on average, are counselled daily, and one million callers have been reached since 2008. Information is provided confidentially.

“Young people like you don’t want to sit around and be passive beneficiaries of programmes—they want to be dynamic agents of change!” said Mr Sidibé, addressing an audience of more than 200 youth at TAYOA headquarters. “What you are doing here to create space for young people is truly inspirational,” he added.

TAYOA’s National Helpline is the result of a unique public-private partnership between the Government of Tanzania, the United States Centers for Disease Control and six national phone operators: TiGO, Vodacom, Airtel, TTCL, Sastel and Zantel.

“In an era of real-time communications, this kind of strategic partnership is the lifeblood of effective HIV responses,” said the UN Deputy Secretary-General, after touring the TAYOA grounds. “I salute the young people who are working on this impressive project,” she added.

According to TAYOA staff, callers ask a range of questions around condom use, sexual relationships, HIV testing, antiretroviral treatment and the prevention of HIV transmission from mother to child. More than 200 young people support the National AIDS Helpline and other TAYOA programmes, including youth outreach clubs and an information technology project.

“One of the great lessons we have learned in our journey is the need to embrace and cultivate a culture of volunteerism in our society,” said Peter Masika, Country Director for TAYOA. “We have learned that when young people are meaningfully engaged, they can take charge and act to improve their own quality of life, and the lives of their friends.”

Over the past decade, young people in Tanzania appear to have adopted safer sexual behaviours: according to a UNAIDS study, HIV prevalence among Tanzanian youth aged 15 to 24 fell by more than 25% between 2001 and 2009.

UNAIDS Executive Director Michel Sidibé (left), Tanzanian President Jakaya Mrisho Kikwete (centre) and UN Deputy Secretary-General Dr Asha-Rose Migiro at the State House in Dar Es Salaam on 4 April 2011.

In a joint mission to the United Republic of Tanzania, UN Deputy Secretary-General Asha-Rose Migiro and UNAIDS Executive Director Michel Sidibé met with high-level government officials on Monday, including the President, Prime Minister, Minister of Health and Social Welfare, and head of the Tanzania Commission for AIDS (TACAIDS).

“Through strong leadership and political will Tanzania has had great success in its response to HIV,” said Dr Asha-Rose Migiro, in a meeting with President Jakaya Mrisho Kikwete at the State House in Dar Es Salaam.

An estimated 52% of people in Tanzania who need antiretroviral treatment are now receiving it, up from virtually zero coverage in 2004. Coverage of services to prevent mother-to-child transmission of HIV reached 70% in 2010, up from 10% coverage in 2004.

“I want your legacy to be zero new HIV infections among children by the year 2015,” said Mr Sidibé, in his meeting with President Kikwete. “I want Tanzania to be one of the first countries to eliminate HIV transmission from mother to child,” he added.

President Kikwete underscored that HIV was a high priority in the country. However he expressed concerns over sustainability of the AIDS response, particularly in the context of the global economic downturn. To address these concerns, the government recently created an AIDS Trust Fund with the aim of reducing the national funding gap for AIDS.

Mr Sidibé echoed the President’s concerns over the lack of predictable and long-term funding for HIV responses. About 96% of people on HIV treatment in the African continent are currently funded through external sources, he said. Mr Sidibé urged Tanzanian authorities to lead a debate at this year’s General Assembly High Level Meeting on AIDS over country ownership of HIV responses.

Helen Clark meets with beneficiaries of an HIV project in Timbuktu. 04 May 2010. Credit: UNDP

The Administrator of the United Nations Development Programme (UNDP) Helen Clark recently ended a four-country tour of Africa to highlight progress towards the Millennium Development Goals (MDGs) in the run-up to the MDGs Summit in September 2010. Ms Clark travelled to Mali, Burkina Faso, Tanzania, and South Africa.

“Achieving the MDGs means quite simply a better life for billions of people,” Helen Clark said. “...Reaching the Millennium Development Goals is possible, and there is a range of tried and tested policies which ensure progress, particularly when backed by strong partnerships.”

UNAIDS participated in one leg of the tour as part of a joint mission with UNDP. UNAIDS Executive Director Michel Sidibé accompanied Ms Clark to Mali on a four-day mission where he reiterated his call for preventing HIV transmission from mothers to children. "I am honoured to join Helen Clark on her first visit to Mali, which is a clear sign of the UN's commitment to reach zero new HIV infections," Mr Sidibé said.

Ms Clark met with Heads of State and Ministers, touched base with women leaders and members of civil society, and visited development projects.

Mali has been making important headway in tackling the AIDS epidemic, having reduced national prevalence from 1.7% in 2001 to 1.3% in 2006 and dramatically expanding universal access to HIV services.

Ms Clark also reiterated the importance of empowering women to achieving the Millennium Development Goals, describing “economic empowerment, access to legal rights, including inheritance rights, and participation in decision-making” as key steps toward achieving women’s empowerment.

In Burkina Faso, she toured a project which facilitates access to energy for rural women, and visited one of 176 UNDP-supported AIDS community associations where she spoke with sex workers about their concerns for the future.

The prevalence rate of HIV in Burkina Faso has dropped from 7% in 2002 to 1.6% in 2008, one of the lowest in West Africa. Despite this progress, the country still faces an epidemic mostly affecting women between 15 and 24 years old.

In Tanzania, Ms Clark met with the Minister for Finance and Economic Affairs, Mustafa Mkulo, to discuss the country’s progress towards the MDGs, particularly on the AIDS response, empowering women, and enrolling children in primary school. She also travelled to Zanzibar and visited the Jozani-Chwaka Bay Conservation Area, the single most important site for the conservation of the island’s biodiversity.

Ms Clark toured the National Electoral Commission’s voter registration facilities where she spoke to first-time voters planning to take part in the national elections this October. UNDP’s support to Tanzania’s election process includes voter education, training for media and political parties, and training domestic observers.

In the last leg of her Africa tour Ms Clark visited South Africa, where she launched an MDGs campaign song in Johannesburg for the 2010 FIFA World Cup, "8 Goals for Africa". The song encourages commitment to the achievement of the MDGs.

“There can be no spectators in the fight against poverty,” she said at the launch. “Everyone has a role to play in scoring the 8 Millennium Development Goals, which if reached would improve the quality of life for hundreds of millions of people across developing countries.”

Ms Clark ended her four-country tour of Africa by launching the second annual Picture This photo contest in Johannesburg in partnership with Olympus Corporation and the Agence France-Presse (AFP) Foundation. The contest, titled Picture This: We Can End Poverty, seeks to show the inspirational work that is being done in many countries to achieve the MDGs.

“Through the photo contest this year we want to show that the MDGs can be reached, even in the poorest and most disadvantaged countries,” Ms Clark concluded.

Noe Sebisaba and his STOP SIDA NGO are helping to mitigate the impact of HIV in Burundi
Courtesy of UNHCR

Noe Sebisaba knows how to turn an adverse situation into something life-affirming. In 1996 he and his family were forced to flee a Burundi in turmoil and ended up in the Kanembwa refugee camp in Tanzania. While in the camp, in 1998, he discovered that he was living with HIV. His wife, who was also HIV positive, died of an AIDS-related illness. On World AIDS Day 2001, at an event organized by the UN refugee agency UNHCR, Mr Sebisaba decided to openly declare his own HIV status, the first known African refugee to do so. He has never looked back. As he says, “I decided to let HIV know; ‘I’ll control you, you’re not going to control me’…I was tired of silence and I found a new reason to live. To challenge HIV and preach forgiveness and love.”

Although initially rejected by his family and community, the disclosure helped galvanize him to challenge the stigma and discrimination rampant among refugees and the host population in Tanzania. He developed a grassroots, community organization, STOP SIDA (STOP AIDS), to intensify the involvement of refugees and the local community in the AIDS response and to disseminate HIV awareness messages at public events, through individual contacts, visits and peer groups.

Active in a number of camps across western Tanzania, STOP SIDA distributed educational materials and advocated support and care for those infected with and affected by the virus. Using himself as an example, Mr Sebisaba found a unique way to help individuals and communities become agents of change in challenging HIV. And he was able to confront some of the particular vulnerabilities faced by refugees whose lives have been uprooted due to conflict, persecution or violence.

There are myriad factors that can increase the vulnerability to HIV of the many millions of refugees and internally displaced people around the world. They often lose their source of income and may have to resort to high-risk behaviour to satisfy their needs. Health and education services often lapse and sources of information on HIV prevention and treatment provision can be disrupted. Social and sexual norms, networks and institutions can also break down and women can be especially vulnerable as rape is often used as a weapon of war during conflicts. In fact, Mr Sebisaba’s wife was herself raped by soldiers in Burundi during the civil war.

The fact that STOP SIDA was able to have an impact in Tanzania was a testament to Mr Sebisaba and his partners’ will and determination. He showed that refugees are not only passive recipients of aid but have powerful coping mechanisms, resilience and ingenuity. Many refugees and members of the surrounding communities participated in STOP SIDA activities and there was a marked increase in take-up of voluntary counseling and testing.

Burundi’s President Pierre Nkurunziza visits STOP SIDA
Courtesy: Noe Sebisaba

In 2005 Mr Sebisaba was repatriated to Burundi by UNHCR and was able to continue his work. In the last seven years the agency has helped nearly 500,000 Burundians return home and supports their continued access to treatment and HIV prevention programmes.

Since 2006, STOP SIDA-NKEBURE UWUMVA has operated in the country, especially in areas with a large number of returnees. Supported by UNHCR and other partners, with offices in the capital Bujumbura and the eastern Cankuzo province, the NGO continues to spread the message of prevention, behaviour change, tolerance and the need for voluntary counseling and testing. Outreach has been especially important in rural areas where AIDS information and anti-stigma messaging find it difficult to penetrate.

In addition, STOP SIDA has become an implementing partner of UNHCR in three camps for Congolese refugees in Burundi where staff use their expertise and experience to help mitigate the impact of the epidemic, including ensuring that clients can receive drug treatment from local hospitals.

Some 450,000 people, both former refugees and those who stayed behind, are being reached by STOP SIDA activities in the eastern provinces of Cankuzo and Ruyigi. In the Congolese camps and surrounding communities some 25,000 are benefiting from the NGO’s initiatives.

UNHCR, the lead UN agency for challenging HIV among refugees and internally displaced people, has co-produced a video about the organization called Love in the time of AIDS, which will be featured during the UNAIDS Programme Coordinating Board thematic session on forced displacement at the Board’s 24th meeting on June 22 to 24. STOP SIDA is highlighted as a best practice of community leadership and mobilization.

What gives Mr Sebisaba the most satisfaction is the feeling that he and his fellow activists have been able to help people accept a positive HIV diagnosis with a degree of hope and optimism and have encouraged people to talk about the epidemic.

“With my decision to say openly that I’m living with HIV, I’ve done my part to try to change the face of the virus. I think I’ve shown that it’s not an automatic death sentence and that you can still lead a rich life. Where I’ve worked, people have been more able to talk openly about having HIV and more people are getting tested. I never have a moment’s regret about disclosing my status. I think it’s really making a difference.”

"Supporting the educational needs of HIV-positive learners: Lessons from Namibia and Tanzania”.
Credit: UNESCO

According to a new UNESCO report the learning needs of HIV-positive children in Namibia and Tanzania are currently not being met by their education sectors whose AIDS responses are described as wanting in many respects.

The United Nations Educational, Scientific and Cultural Organization (UNESCO) says that schools and the education sector have an opportunity and responsibility to support HIV-positive children in their leaning and social development. To enhance the capacity of the education sector, they commissioned this first report specifically on the educational needs of HIV-positive learners.

“Supporting the educational needs of HIV-positive learners: Lessons from Namibia and Tanzania” identifies the challenges facing educational institutions who want to respond to the needs of children and young people living with HIV and makes recommendations and guidelines on how best to support them.

The pervasive theme of stigma and discrimination is one of the most striking findings in the study. Every HIV-positive child interviewed in both Namibia and Tanzania described personal and ongoing experience of the negative consequences of disclosing their HIV status. Each felt that there was greater safety in keeping silent. Stigma was described as “more killing” than the disease itself.

The studies found that the information on HIV shared in schools was often “depersonalized and remote from the needs of the individuals infected and affected by the disease.” Associated with this sense of denial and silence surrounding HIV is a lack of effective communication about sex or reproductive health. In many schools this subject was found to be treated “flippantly.”

The review found that the school environment has the potential to offer important social and developmental support to a child. Families of HIV-positive children can themselves be adversely affected by HIV and this means teachers’ and peer support can be a valuable supplement to a child. As many HIV-positive children live in residential homes rather than family setting, the school becomes an important adjunct to institutional care.

The report argues that gaps in data and a lack of research are masking the extent of the failures to support HIV-positive learners. Meanwhile evidence of reduced school fees and expanded feeding schemes for children orphaned or made vulnerable by HIV as well as children living with HIV, suggests that “things are getting better.”

Improving the equitable delivery of accessible, quality education for all children is recommended by the UNESCO report is as important a focus as specific interventions for children living with HIV.

At the Olympic torch press conference held
in advance of the relay, Dhamiri Mustapha
spoke about her experience of living with
HIV and urged young people to protect
themselves. Photo credit: UNAIDS.

Dhamiri Mustapha, a young Tanzanian woman living with HIV, was one of the 80 dignitaries who carried the Olympic flame during the five-kilometre torch relay in Dar Es Salaam, Tanzania, on 13 April.

Dhamiri was thrilled to take part in such a high–profile event in her own country, and it provided a welcome opportunity for her to speak out on behalf of people living with HIV (PLHIV) in a public forum. “I’m happy to represent other Tanzanians living with HIV in this positive way”, she said. Dhamiri is a board member of the Tanzania National Council of People Living with HIV and AIDS (NACOPHA) and a member of the Network of Young People Living with HIV and AIDS (NYP+).

Her tiny frame and shy smile betray the twenty-three-year old’s extraordinary energy and courage. At the Olympic torch press conference held in advance of the relay, she spoke about her experience of living with HIV and urged young people to protect themselves. Dhamiri is not afraid to address the issue of condom use in the region. “Condom distribution is a major problem, given that there is hesitancy among some sectors of society to support their use in HIV prevention. More condoms are necessary for young people to reduce infections among this group,” she stated.

A student at Kibaha Teachers Training College, Dhamiri expects to graduate in 2009, when she hopes to find a place teaching primary school. Her studies are being sponsored by the WAMA Foundation, a non-profit organization founded by the First Lady of Tanzania, Mama Salma Kikwete. With assistance from the UN, the WAMA Foundation provides teachers with training on HIV. It also supports young positive Tanzanians, like Dhamiri, to become future educators.

The participation of Dhamiri in the
Olympic torch relay was facilitated by the
International Olympic Committee (IOC)
and UNAIDS. Photo credit: UNAIDS.

The participation of Dhamiri in the Olympic torch relay was facilitated by the International Olympic Committee (IOC) and UNAIDS and is the result of their partnership, which aims to emphasise the role of sport in HIV prevention and promote AIDS awareness activities with coaches, athletes and sports personalities at global and national levels.

In a joint message IOC President Jacques Rogge and Dr Peter Piot, Executive Director of UNAIDS, underlined how sport can break down barriers, fight discrimination and make a difference in the AIDS response. "One third of the approximately 33 million people living with HIV are young people under the age of 25, many of whom are involved in sports, either as spectators or as participants. Sport offers a perfect platform to make young people aware of the issue, to promote preventive messages, and to ensure that persons living with HIV are not discriminated against. Discrimination towards a country, or a person on grounds of race, religion, politics, gender, or otherwise, is incompatible with the principles of the Olympic Movement.”

As part of the collaboration, UNAIDS and the IOC have developed the publication ‘‘Together for HIV Prevention: A Toolkit for the Sports Community”, featuring information about HIV and includes messages from international sport stars, some of whom are HIV-positive. A Swahili version of the toolkit is being produced and is expected to be launched in Tanzania in June 2008.

The UNAIDS and IOC partnership is also sponsoring the production and distribution of HIV awareness cards and red ribbons which will be inserted in the welcome kits of the 11,000 athletes taking part in the XXVIII Olympic Games in Beijing in August.

When young Tanzanian Vumilia Omar told her husband she had tested HIV positive, his reaction was one of anger and fury. “He didn’t want to look at me or our children,” she said, telling how her husband then left the family home taking all their possessions with him and leaving Vumilia and her children with nothing and nowhere to go.

Over time, Vumilia has slowly rebuilt her life – seeking advice from counselors and choosing to stand up against the stigma and discrimination she has often faced because of her HIV status. She now runs a successful tomato-selling business in the markets of Dar-es-Salaam and discusses her experiences as a young mother living with HIV in her own column in a popular magazine.

“I use more and more of my time to educate people on HIV and give advice to young people about living positively and how to live with hope,” she said.

Vumilia’s story is one of a collection of 26 similar testimonials of Tanzanians ‘living positively’ with HIV that feature in the book ‘Yaliyopita Si Ndwele’ (Life goes on), which was launched today in Dar-es-Salaam.

The book – produced jointly by UNAIDS and non-governmental organization FEMINA-HIP, with funding from Development Cooperation Ireland – was launched by UNAIDS Executive Director Dr Peter Piot at a special ceremony held as part of the high-level joint mission to the country of HRH Princess Mathilde of Belguim and the Executive Directors of UNAIDS and UNICEF.

The joint mission is visiting Tanzania from 14-17 February to gain a deeper understanding of the challenges AIDS poses for children and young people and the country’s AIDS response to date.

At the book launch ceremony, one of the collection’s authors, 13-year old Irene Kabaka, gave a statement to the delegation before handing a special copy of the book to HRH Princess Mathilde.

“Although there are only 26 stories, I am sure many people will relate to them,” she said.

In the foreword of the book, the head of the Tanzania Commission for AIDS (TACAIDS), Major General Lupogo said, “I’m impressed with the bravery of all who have broken the silence, by sharing their stories. They give strength and understanding to other citizens who will now understand their situation with empathy and humility,” he added.

‘Yaliyopita Si Ndwele’ (Life goes on) is available in Swahili. For more information, please contact FEMINA-HIP at femina-hip@raha.com

Read Vumilia’s full story from the collection, in English  

Read the foreword of the collection by Major General Lupogo, Head of TACAIDS 

Read Irene Kabaka’s statement at the book launch ceremony