Tanzania
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Tanzania ranks 15th on the list of 22 high-burden tuberculosis (TB) countries in the
world. Of the estimated 120,191new TB cases in 2007, 56,233 were sputum smearpositive
(SS+). Due to improved quality of services and evaluation, Tanzania met the
World Health Organization’s (WHO’s) global target of 85 percent in 2007 for
treatment success in 2007. However, the case detection rate for new SS+ TB cases
remains low at 51 percent, well below WHO’s target of 70 percent. Case notification
rates have fallen over the last three years. The HIV/AIDS epidemic is associated with a
60 percent increase in active TB in Tanzania. Fifty percent of notified cases were
tested for HIV in 2007, and the prevalence of HIV infection among TB patients is
estimated at 47 percent. Plans to expand treatment to HIV-positive TB patients will
reduce the death rate, and plans to improve TB reporting systems will improve followup
and reduce patient default rates. Prevalence of multidrug-resistant (MDR) TB
remains low, with about 1,300 cases reported in 2007. Management of MDR-TB
started in 2007, although preparations began in 2006 with the renovations of
laboratories and patient facilities, procurement of new diagnostic tools, and
recruitment of personnel.
USAID Approach and Key Activities
USAID’s approach in Tanzania complements one of the priorities of the government,
the private sector, WHO, and other international technical agencies, which is to
support the National Tuberculosis and Leprosy Program (NTLP) in key areas. With
these partners, as well as additional partners in HIV/AIDS, USAID supports DOTS (the
internationally recommended strategy for TB control) expansion, TB-HIV/AIDS
collaboration, capacity building for improved case detection, and engagement of the
private sector in TB control. USAID provided $2.5 million in funding to Tanzania for
TB programs in fiscal year (FY) 2008.
In 2005, USAID initiated TB activities in Tanzania with a focus on strengthening human
resource capacity, introducing and scaling up TB-HIV/AIDS integrated activities,
stimulating community awareness of TB and TB-HIV co-infection, and mobilizing
communities to reduce stigma. Among TB patients receiving services for voluntary
counseling and testing and for preventing mother-to-child transmission in the 36 target
districts, the program aims to test 80 percent of these TB patients for HIV and to
screen 80 percent of people living with HIV/AIDS for TB. To achieve these goals,
USAID will focus on the following activities:
- Introducing new technology and data management systems in laboratories to
improve TB and MDR-TB diagnostic capabilities, especially for the Central
Tuberculosis Reference Laboratory
- Developing multimedia information and educational materials for social
change
- Reducing stigma and disseminating counseling materials
- Engaging communities in TB control by training private pharmacists,
traditional healers, and village health workers in suspect TB identification and
by supporting TB diagnostic capacity within communities
- Strengthening referral systems between existing TB-HIV/AIDS treatment
programs and increasing the number of TB patients tested for HIV
- Strengthening DOTS skills and increasing collaboration of providers in both
the private and public sectors
- Increasing national capacity to manage MDR-TB
- Supporting the NTLP to introduce the International Standards for Tuberculosis Care (ISTC) into the curricula of five
medical schools
- Improving the capacity of the Ministry of Health to scale up TB-HIV/AIDS collaborative activities by strengthening
routine monitoring and evaluation of TB-HIV/AIDS management
USAID Program Achievements
Since the initiation of support, USAID has provided a range of technical support to Tanzania and achieved the following:
- Formed the National Interim TB-HIV/AIDS Collaborative Committee and developed a draft national policy for
TB/HIV/AIDS collaborative activities
- Counseled more than 99 percent of registered TB patients (nearly 31,300, including 16,700 tested in 2008) for HIV
testing, more than two-thirds of whom were tested for HIV and received their results;
- Expanded TB-HIV/AIDS collaborative activities from 12 health facilities in 10 districts in fiscal year (FY) 2006 to 321
health facilities in 31 districts, including five in Zanzibar, in FY 2008 by recruiting TB-HIV/AIDS collaboration
coordinators
- Supported the review of public and private professional health education institutions’ training curricula to incorporate
ISTC
- Implemented initial social mobilization activities with the media and Community-Own Resource Persons (CORPS)
- Engaged the Association of Private Health Facilities in Tanzania (APHFTA) and supported a coordinated response from
the public and private sectors for TB-HIV/AIDS activities to ensure the best use of all resources and available funding
Case Detection and Treatment Success Rates Under DOTS
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Note: DOTS treatment success rate for 2007 will be reported in the WHO Report 2010.
Source: Global Tuberculosis Control WHO Report 2009 |
Partnerships
The KNCV Tuberculosis Foundation has been a key partner of the NTLP for the past 27 years. In the mid-1980s, the KNCV
Foundation helped Tanzania become the first African country to introduce DOTS. USAID works in close collaboration with the
NTLP, the National AIDS Control Program, PATH, and APHFTA. The Stop TB Partnership provides technical support, assists
with fundraising, and provides TB drugs through the Global TB Drug Facility. WHO provides direct technical support to the Stop
TB Partnership at WHO headquarters and regional offices in Africa. The Global Fund to Fight AIDS, Tuberculosis and Malaria
approved $16.5 million in Round 6 funding for TB control activities.
May 2009
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