The activists have two main demands: “All people living with HIV and AIDS have the right to Anti-Retroviral medicines (ARVs) when their condition applies” and “All AIDS patients have the right to care & treatment) The activists deplore the failure of government to commit itself to providing access to ARVs for all AIDS patients who need them. Instead, the government has adopted an initial target of 400,000 people with the funding available. What criteria will be used to select these lucky 400,000 people, and exclude others? Why doesn’t the government look for less costly generic ARVs, and thereby provide to all in need? Which pharmaceutical corporations are selling the ARVs and under what terms? What process has been involved in selecting them?

Another major issue raised has to do with the sustainability of ARV treatment, given the government’s near complete dependence on donor funding. What steps are being taken to mobilize funds within the country, by taxing the big corporations and investors as a first step, as in the case of VETA? The government has informed the public that the present ARV treatment programme is only for a period of five years. What happens afterwards? Will PLHAs be left to die at the end of this period? What steps have been taken to protect against misallocation of drugs , which reportedly has already begun to take place? How can the public track ARV medicine without having the right information about who is getting what?

Let’s look critically at the following cases: Tatu Omari was brought to the district hospital by her family in near collapse from a bad bout of pneumonia and diarrhea. It took them three hours to persuade the nurses that she was AIDS positive and deserved free treatment. After two days in the hospital, Tatu was sent home, with the words “the pneumonia is under control, there is nothing more we can do.” When diarrhea persisted, her family took her to a traditional healer, but in one week’s time she was dead.

In another case, after losing time from work because of TB, David Kapinga was retrenched by his employer. They had never provided him with support to get adequate treatment for TB and AIDS, and his low salary was not enough to allow David to purchase the medicine himself. Soon he was bedridden, unable to go out in search of work and dependent on his wife and daughter to take care of him. His daughter had to leave school to nurse him. The family did the best they could, with too little money to purchase the drugs and food supplies needed with inadequate information about how to live with AIDS. David died after five months.

The two stories are typical examples facing thousands of Tanzanians who are denied their rights to proper care and treatment by employers and the public health system. Activists trust that these are the kind of issues to be discussed during World AIDS Day on 1st December this year.

In order to influence public debate on and around World AIDS Day and influence policy formulation, implementation and monitoring, the network of activist organizations working on HIV and AIDS issues has agreed on the following objectives:

1) To demand open, transparent sharing of information by government and other agencies about the choices of ARVs available and the system and criteria being adopted to allocate ARVs.

2) To press government, private companies and other institutions to take responsibility for providing care and treatment to PLHAs, including their own employees.

3) To lobby government and health providers to drop home-based care as the main strategy for PLHAs, given the lack of adequate resources in most families and the unfair burden it places on women and children - the major carers.

4) To enhance a public debate on ARVs and home-based care. Health practitioners and activists have also emphasised the lack of adequate resources in the present health system to provide effective care and treatment for PLHAs. The resources in question include a gap of some 10,000 trained health workers, too few beds, and the lack of blood screening equipment to test for HIV and AIDS and to monitor blood counts - which is absolutely necessary to survive with ARV treatment.

Activists welcome the government’s stated commitment to prioritise support for PLHAs and to incorporate HIV and AIDS issues in all key aspects of the new National Strategy for Growth and Reduction of Poverty. The challenge now for all actors, and especially government and the corporate private sector, is to incorporate the views of PLHAs and their organizations, to allocate the major resources needed to provide quality care and treatment for all, and to involve PLHAs as full partners in the implementation and monitoring of HIV & AIDS programmes and strategies.