AIDS is widespread in both urban and rural communities and mostly affects persons at the peak of their sexual and economic activity. Death of a young adult often means loss of a father or/and mother and family’s income generator. Studies conducted in Arusha, Kagera and Mwanza regions show a serious and growing breakdown of social network, which have hitherto sustained African societies. Materialistic practices are on the increase; orphans are not only subjected to material, social and emotional deprivation, but also lack of opportunities for education and health care. Widows and orphans are deprived of their inheritance rights by relatives through the application of outdated traditional practices and customary laws. The widows are often blamed for the premature deaths of their husbands.
Despite these challenges experience has shown that the epidemic can be stabilized even reversed, in countries including those with modest resources. Successful programs are characterized by: strong and high-level political leadership for HIV prevention; a national HIV/AIDS strategic plan; adequate funding for HIV/AIDS response; strong and sustained community involvement and initiatives, with supportive policies. Data from Kagera has shown that a combination of all these factors can indeed result in a decline of HIV incidence. Components of a minimum package for HIV/AIDS response are known. They include but are not limited to: blood safety initiatives, STD management and prevention, care and support of people living with HIV/AIDS including access to drugs. Others are functional referral systems and linkages, education to the general community particularly the youth, condom programming, prevention of mother to child transmission (PMTCT) and voluntary counselling and testing (VCT).
One of the most effective interventions currently available for persons living with HIV/AIDS (PLHA), involves the use of various combinations of highly active antiretroviral therapies (HAART). However, the high cost of these drugs and the infrastructure needed to monitor their use have so far put these medications beyond the reach of most PLHA, especially in third world countries. The price of antiretroviral drugs is progressively declining, making access to HAART a realistic dream even to resource-constrained countries like Tanzania. For optimal use of these drugs, capacity building including training of health personnel, infrastructure strengthening, logistic support and central regulation and policy guidance, are extremely essential.