More than twenty years have elapsed since the HIV/AIDS epidemic was first recognized in Tanzania. During this period, the country has responded in several ways, including formulating and implementing a series of strategic plans and interventions. Many of the initial interventions were geared towards preventing further spread of HIV/AIDS, which was done with little success. However, over time more and more care and support initiatives were introduced and scaled up as interventions became available. These developments notwithstanding, to date the mainstay of managing HIV/AIDS epidemic has remained prevention and advocacy for behaviour change.
Despite of all these efforts, the epidemic has grown and established itself in both rural and urban communities. The epidemic has been more severe in certain vulnerable groups including women, children, youth and migrant populations. As a result of this, more than 2 million people are currently living with HIV/AIDS in the country. This calls for a paradigm shift in our approaches to the epidemic, by strengthening and expanding the care and support component of our interventions. This is what prompted the Government to launch a national programme for care and treatment in 2003. The inclusion of the National Care and Treatment Plan in our current Health Sector Strategy for HIV/AIDS, responds to this shift with the purpose of providing antiretroviral treatment to as many people living with HIV/AIDS (PLHA) as possible.
The National Care and Treatment Plan provide a framework for establishment and scaling up a five year programme that will enrol about 500,000 patients on anti retroviral treatment. This programme will introduce an entirely new intervention that entails training of the entire work force of the health system as well as development of tools to guide safe and effective administration of anti retro viral drugs.
The National Guidelines for Clinical Management of HIV/AIDS is one of the many guidelines that have been developed to provide health care workers guidance on different aspects of care and treatment. This new edition of the National Guidelines for Clinical Management of HIV/AIDS (2nd Edition, April 2005); is a revision of the first edition (April 2002), and is expected to provide more detailed and updated information on each areas of the old guidelines. There is a wider coverage on such areas as; Adult and Paediatric HIV/AIDS management; Nutrition; Care of opportunistic infections; Home Based Care and the continuum of care; counselling and HIV testing including adherence issues. There are also added information materials on health facility certification; standard precautions in care settings and laboratory services; post exposure prophylaxis; ARV logistics and dosages. The guidelines can also serve as reading and reference material for a wide range of health professionals - including, but not limited to, counsellors, nutritionists, laboratory technicians, home based care and prevention of mother of mother to child transmission providers as well as clinicians. Essentially the above professionals form part of the HIV/AIDS Care Team as outlined in this document.
HIV/AIDS is a rapidly changing and growing field; we therefore look forward to receiving feedback from the users on areas that need revision and improvement. We count on your views to keep these guidelines up-to-date all the time.
Dar es Salaam