Poverty and Human Development Report 2009 - UNDP in Tanzania

POVERTY AND HUMAN DEVELOPMENT REPORT 2009
Since 2005, there has been a three-fold increase in the number of sites offering VCT, a four-fold
increase in the number of clinics offering anti-retroviral treatment (ART), and a five-fold increase
in sites with services to prevent mother-to-child transmission (PMTCT) (NACP, 2008). However,
the number of people enrolled on care and treatment each year has increased much less quickly
– around 50,000 new patients were enrolled in 2006 and 2007, before picking up to 53,354 in the
first nine months of 2008 (projected annual enrolment of approximately 70,000).
Strictly speaking, the MKUKUTA indicator is defined as the number of people currently on antiretroviral
(ARV) therapy. Presently, this cannot be measured in Tanzania. 42 Therefore, the exact
number of individuals who enrolled on ARV therapy – and are alive and continuing treatment –
is not known. Figure 30 presents a model predicting the number of patients currently on ARV,
based on actual enrolment and assumptions about patient retention, validated by the NACP’s
2005 cohort study. 43 The results predict that the number of patients currently on ART as at
September 2008 is approximately 120,000.
This falls a long way short of the target set in the national HIV/AIDS Care and Treatment Plan
2003/08 – where the number of patients currently on ART was expected to have reached 423,000
by the end of 2008. However, targets were set when HIV prevalence was estimated to be far
higher than present levels, and when it was assumed that all patients enrolled would continue
on treatment.
Figure 30: Annual and Cumulative Enrolment and Projected Numbers Currently
on ART, 2004 – 2008
Number of Patients
250,000
200,000
150,000
100,000
50,000
-
2004 2005 2006 2007 2008
Years
Cumulative Enrolment on ART Annual Enrolment on ART
Currently on ART (modelled)
Source: Cumulative enrolment data from NACP. Annual enrolment data calculated from cumulative figures.
Current enrolment modelled based on historic enrolment and assumptions on patient retention. Targets
from National HIV/AIDS Care & Treatment Plan (MoHSW, 2003).
42 This is because the care and treatment information system does not hold patient level data beyond the clinic
level.
43 The study shows that 63% and 54% of patients remain alive and on treatment 12 months and 24 months
respectively after commencing treatment. This patient retention rate is a little lower than the weighted average
of AIDS treatment programs in sub-Saharan Africa: weighted average retention at 6, 12, 24 months was 79%,
75% and 62% respectively (Rosen, Fox & Gill, 2007).
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