The United States Centers for Disease Control and Prevention (CDC) has awarded the Supporting Tanzania to Expand, Strengthen, and Sustain Quality HIV Counseling project to IntraHealth International. With this new five-year, $12.5 million cooperative agreement, IntraHealth will continue its successful work in supporting the Tanzanian government to strengthen and expand its work in HIV prevention. This work includes HIV counseling and testing, male circumcision for HIV prevention, and working with people living with HIV. The new project will also expand on the successful Provider-Initiated Testing and Counseling project, which has now reached more than 574,000 people with HIV counseling and testing and reached 37,900 Tanzanian men and boys with male circumcision services for HIV prevention, already surpassing some of the project’s goals.

“This new award offers us a wonderful opportunity to build on successful work and collaborations with the CDC, the Ministry of Health, and the National AIDS Control Programme to offer more Tanzanians HIV counseling, testing, and prevention and help them protect their health and families,” said Lucy Mphuru, MD, who will lead the new project.

Specifically, the new project will seek to support the Ministry of Health and the National AIDS Control Programme through grants, technical assistance, and collaboration to:

• Make HIV counseling and testing services and male circumcision services more widely available
• Create and enact standard operating procedures to guide this work
• Expand collaborative work with people living with HIV, including counseling and training in how to prevent new infections.

Compared to many countries in sub-Saharan Africa, HIV prevalence in Tanzania is relatively low—a little more than 5% of Tanzanian adults, ages 15-49, are infected. Women have higher prevalence when compared to men and are more vulnerable to infection at younger ages. Urban dwellers are also more at risk than people living in rural areas. Recognizing these challenges, the new project’s strategy is to:

• Align the project’s approaches and strategies with national policies and guidelines
• Apply context-specific and cost-effective training approaches to minimize service disruptions
• Engage district leaders in mapping their human resource needs using IntraHealth’s Learning for Performance approach
• Employ a comprehensive, data-driven quality assurance approach that involves clinic staff as well as district, regional, and national stakeholders in a participatory process
• Coordinate closely with donors and partners to maximize the project’s impact and avoid duplication of efforts.

The project will also strengthen the Tanzanian health system, which is largely decentralized with a relatively strong infrastructure. In 2006, the Ministry of Health and Social Welfare and the National AIDS Control Programme adopted the provider-initiated HIV testing and counseling model to encourage more people to be tested and to offer treatment to more people living with HIV. The results have been encouraging: by 2008, 37% of women and 27% of men, ages 15–49, had been tested and received their results, nearly doubling the testing rates since 2004.  Currently, the government manages 65% of health facilities, and about 37% of all health facilities offer comprehensive HIV counseling and testing. Although virtually all hospitals have an HIV testing system, health centers and dispensaries—which are more accessible to the population—are less likely to have HIV testing capability. The new project aims to meet some of these needs by making these services accessible to more people.