Mukikute has seen the need to tackle harm reduction in the different areas that we serve. This is because there is a need to ensure that there is access to health for people using drugs (PUD) and hence organizes sessions through its centres for PUDs such as HIV testing, advocating for the prevention of sexually transmitted infections through the dissemination of condoms and having needles and syringe programs preparations for methadone. Through the organization, different advocacy efforts towards reducing HIV infections around people using drugs (PUDs) have seen the communities that they serve have access to HIV interventions. We focus on these particular groups because they are most at risk of acquiring TB and they are mostly left behind in most health programs hence not fully able to access the care they need.
Drug use is a worldwide problem with about 16 million IDUs in 151 countries. Out of that 3 million of IDUs have HIV. HIV prevalence in this group is very high due to risky behaviour among this group like sharing of injecting equipment, unsafe sex, multiple concurrent partners and stigma by the community as well as by the health facility. According to the definition of the International Harm Reduction Association, “harm reduction’ refers to policies, programs and practices that aim primarily to reduce the adverse health, social and economic consequences of the use of legal and illegal psychoactive drugs without necessarily reducing drug consumption.”
It is estimated that 10,000 people who inject drugs live in Dar es Salaam and 30,000 nationwide while the total number of people who use drugs across the country is believed to be around 200,000. The World Health Organization (WHO), has proposed the following nine harm-reduction interventions:
• Needle and syringe programs (NSPs)
• Opioid substitution therapy (OST) and other evidence-based drug dependence treatment
• HIV testing and counselling (HTC)
• Antiretroviral therapy (ART)
• Prevention and treatment of sexually transmitted infections (STIs)
• Condom programs for PWID and their sexual partners
• Targeted information, education and communication (IEC) for PWID and their sexual partners
• Prevention, vaccination, diagnosis and treatment for viral hepatitis
• Prevention, diagnosis and treatment of tuberculosis (TB)
Mukikute has been involved in the prevention, diagnosis and treatment of TB which is one of the harm reduction interventions. MUKIKUTE realized the need to support key populations and that’s why we started with the harm reduction program. Mukikute started working with key populations in 2010 with the first Drop-in Center (DIC) for drug users opened in 2012 in Keko, Tanzania. Now the organization is running one resource centre in Temeke district. The harm reduction program team at the organization comprises 12 outreach workers, 35 peer educators, one coordinator and one data clerk.