Pangaea Helps Tanzania Address Drug Dependency and Reduce HIV Transmission – Africa’s First Methadone Clinics to Open Later this Year

Tanzania is poised to become the first country in sub-Saharan Africa to provide comprehensive treatment for both drug addiction and HIV to injection drug users (IDU’s), including a methadone treatment program. A joint announcement by the Tanzanian and U.S. governments was made about the program on May 18, 2010. Two pilot methadone clinics are scheduled to open in Dar es Salaam later this year as the first phase of this effort gets underway.

Over the past two years, Pangaea Global AIDS Foundation has been assisting the Drug Control Commission (DCC) of Tanzania and the Zanzibar AIDS Control Program (ZACP) with the development of a national framework to address drug dependency and reduce HIV transmission as part of Tanzania’s Second National Multi-Sectoral Strategic Framework (NMSF) on HIV and AIDS (2008-2012). This pilot program is being funded by PEPFAR.

“Sexual transmission is still the primary driver of the HIV epidemic in Tanzania and throughout sub-Saharan Africa, but HIV infection associated with injection drug use is definitely on the rise,” said Pangaea CEO Ben Plumley. “It’s been demonstrated in other parts of the world that HIV transmission among IDUs can be effectively controlled by a comprehensive treatment plan that addresses both drug use and HIV. The Tanzanian government is ahead of the curve in establishing this program now before the IDU problem gets out of hand.”

It’s estimated that there are at least 25,000 injection drug users in Tanzania and that 40% of the IDU population is HIV positive. So although this group currently accounts for just a fraction of the one million Tanzanians living with HIV, these statistics set off a warning bell for the government.

According to Yovin Ivo Laurent, IDUs coordinator for the Tanzanian Drug Control Commission , “Injection drug use is still a relatively small problem in Tanzania, but we want to keep it that way. We believe that by instituting a comprehensive harm reduction program now, which will eventually include methadone, needle exchange and medical and mental health treatment, we’ll be able to stop the spread of drug use and allow these people to become productive members of society once again.”

The Pangaea team, including Dr. Douglas Bruce, a leading international expert in the establishment of harm reduction programs, is assisting in the development of this comprehensive plan for treatment for IDUs, including a guide for screening for and treating addictions in primary health settings. In addition, Pangaea has helped the DCC develop a national guideline for the introduction of methadone, clinical guidelines for its use, standard minimum criteria for health facilities that would provide the methadone, and an operational plan for the full spectrum of services necessary for implementing methadone.

The initial pilot in Dar es Salaam that will kick off in July will provide methadone to 200 injection drug users. Assuming that the pilot goes well, the Tanzanian government will seek additional international funding to expand the program to cover a large percentage of the drug users in Tanzania, including the semi-autonomous region of Zanzibar. The ultimate goal is to provide comprehensive medical and harm reduction services to injection drug users in Tanzania to improve their health outcomes

“As someone who has worked extensively on harm reduction programs in Eastern Europe where stigma directed at the drug-using population is a huge barrier to treatment, it’s refreshing and very hopeful to see the Tanzanian government and people take such a practical and proactive approach to treating injection drug use,” says Dr. Bruce. “The successful introduction of methadone is really the key to unlocking a number of interconnected problems and giving IDUs control over their lives once again.”

Dr. Bruce concludes, “Once the pattern of illegal drug use is broken, we can begin to address the health issues that drug users face, including providing treatment for HIV. If we can bring drug users into treatment, we can stop the IDU-fueled portion of the HIV epidemic in Tanzania.”