Implementing a replicable model community-based harm reduction project for/with people who inject drugs in Tanzania (Temeke Model)
Drug use has remained a major driver for HIV transmission among people who inject drugs (PWUD) in Tanzania with visible scenes of high risk sexual and injection behavior. PWUD are challenged by socio cultural determinants that limit their access to comprehensive harm reduction services. Police harassment and incarceration, stigma and discrimination, punitive drug policies, gender based violence, emerging medical emergencies (COVID 19) are major concerns.
In 2018, MUKIKUTE adopted a model community-based harm reduction program to contribute to the mitigation of HIV/AIDS-associated morbidity and mortality amongst PWUD in partnership with Tanzanian stakeholders, specifically to advocate and train for better access to adapted harm reduction services in Dar es Salaam.
Since 2021 with funding from Charities Aid Foundation (CAF) through ViiV Healthcare Positive Action program, the project has enhanced access to quality comprehensive harm reduction services that address the diverse needs of PWUD through HIV prevention and treatment efforts at community safe spaces and during outreach. This is facilitated in partnership and collaboration with stakeholders to achieve the desired impact, meaningfully engaging PWUD in the process. Activities are coordinated with multi diverse partners from the clinic, council health management teams and implementing organizations.
During the first year,
*2,039 PWUD reached with comprehensive HIV services during outreach and at community safe spaces to access HIV Testing Services, antiretroviral therapy, access to sterile needles and syringes and methadone assisted treatment (MAT). Adapted services are availed to women who use drugs and their children considering their vulnerability.
*A steering committee from PWUD networks and CSOs and district Harm Reduction committee headed by District Medical Officer formulated to coordinate, monitor and evaluate progress and to address the bottlenecks experienced during the project implementation. The committees hold regular meetings to deliberate on best practices.
* The project has sensitized 108 staffs from healthcare facilities, council health management teams, law enforcement agency and local government authorities to create an enabling environment to limit HIV services access barriers for PWUD due to stigma and discrimination and prejudice. The clinics have adopted low threshold services delivery models supporting PWUD to access quality HIV services at the facilities, community safe spaces and during outreach.
*Technical staff of 7 CSOs capacitated on community mobilization, advocacy and referral networking to scale up community harm reduction project. The CSOs are technically mentored by MUKIKUTE and internship programs provided over time.
*Facilitated sensitization meeting for 16 constituency representatives of Global Fund Country Coordination Mechanism (TNCM) to provide adequate budget allocation, oversight and to monitor implementation of the activities originating from the national strategies and policies related to HIV amongst PWUD.
*At the national level, 40 members of the Tanzania Parliamentary HIV and Substance Abuse Committee engaged and sensitized to promote adoption of human rights-based policies and laws for PWUD. The committee members resolved to meaningfully engage PWUD communities during the drug policy reforms and address the underlying gaps to human rights based drug policy.
