3039.0: Monday, October 22, 2001 - Board 1

Abstract #25528

Addressing the politics of HIV/AIDS reform in Tanzania: Succeeding where others have failed

Adeline I. Kimambo, MPH1, Joseph Temba, MD2, Catherine Severo, MPH3, and Saul Helfenbein, PhD3. (1) Tanzania Public Health Association, Dar es Salaam, Tanzania, (617) 524-7799, development@msh.org, (2) Independent Consultant, (3) Strengthening Health Services Program, Management Sciences for Health, 165 Allandale Road, Boston, MA 02130

Tanzania, like its neighbors in sub-Saharan Africa, is struggling to confront the burden of HIV/AIDS. Facing prevalence rates varying from 7% to 30% across districts, Tanzania recognized the need for an institutional mechanism to coordinate a response to the epidemic and mitigate its effects in all sectors.

This presentation will show how building consensus with stakeholders—coinciding with growing public demand for government leadership—was essential to successful reform. It will explore factors leading to the creation of a new national commission, despite significant opposition from the Ministry of Health. Finally, it will compare Tanzania's experience to that of neighboring countries.

Though a National AIDS Control Program was established within the Ministry of Health in 1987, its actions were limited. Despite repeated reviews, recommendations for strong national leadership through a dynamic coordination body had never been implemented.

In 1999, a team was charged with assessing the capacity of the NACP to lead the national multi-sectoral response. Working closely with representatives of government, community, donors, and the private sector, the team identified the needs and expectations of stakeholders. NACP procedures and performance were reviewed. In collaboration with the Civil Service Department and the Ministry of Justice, five new options were defined and stakeholders were invited to respond. Together, they selected a semi-autonomous, multi-sectoral commission as the most powerful option. Although the Ministry of Health formally opposed this recommendation, on 1 December 2000, Tanzanian President Benjamin Mkapa declared the creation of TANAIDS, a national multi-sectoral commission, to lead the fight against HIV/AIDS.

Learning Objectives: At the conclusion of the session, participants will be able to: 1. List critical factors that contributed to approval of the TANAIDS Commission in a politically charged context. 2. Describe the role of consensus building in overcoming political and professional opposition. 3. Compare this process to that followed by other East African countries in creating their HIV/AIDS Commissions. Can they learn anything from this session they may apply in their work?

Keywords: HIV/AIDS, Health Reform

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Management Sciences for Health Tanzania Public Health Association
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment

The 129th Annual Meeting of APHA