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Press Releases 2011

Medication Assisted Treatment Program Launches at Muhimbili National Hospital in Dar es Salaam

February 10, 2011

Dar es Salaam- On Thursday, February 10, the launch of Medication Assisted Treatment (MAT) was held at Muhimbili National Hospital in Dar es Salaam. Guests included the Minister of Health and Social Welfare, representatives from the Government of Tanzania, representatives from the United States Government, Muhimbili Hospital directors and staff, and local and international NGO directors.

Medication Assisted Treatment (MAT) has been recognized as an essential element of comprehensive services for Injection Drug Users (IDUs), contributing to reduction of HIV incidence among IDUs and established as an effective treatment for opioid dependence. This treatment utilizes individualized dosing of medication to people who inject drugs. The MAT program in Tanzania will begin with methadone, which stops opioid withdrawal while simultaneously reducing drug cravings. It helps people achieve stability and return to healthy and productive lives. This therapy reduces risky behaviors related to injection drug use and helps prevents HIV transmission while improving adherence to anti-retroviral treatment (ART).

In May 2010, the Drug Control Commission under the Prime Minister’s Office and the Ministry of Health and Social Welfare (MOHSW) jointly launched five documents for opioid dependence including:

  1. Outreach Service Guide for HIV Prevention among Drug Using Population;
  2. Minimum Standards for Health Facilities Officering Medication Assisted Treatment of Drug Dependence;
  3. Guide for Screening and Brief Intervention for Substance Abuse Disorders at Level One Health Care Settings;
  4. Medically Assisted Treatment for Opioid Dependence;
  5. Minimum Required Standards for Establishment of Medication Assisted Treatment in Tanzania.

Tanzania is the first Sub-Saharan country in Africa to provide this novel treatment. Funding for MAT comes from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) via the Centers for Disease Control and Prevention (CDC) with technical support from Pangaea Global AIDS Foundation. The collaboration between the Ministry of Health and Social Welfare, Muhimbili University of Health and Allied Sciences, the Tanzanian Drug Control Commission, and CDC covers community outreach services and supports four non-governmental organizations (NGOs) in Kinondoni district of Dar es Salaam. These NGOs include: Youth Volunteers Against Risky Behaviors (YOVARIBE), Center for Human Rights Promotion-TZ (CHRP-TZ), Kimara Peers, and Blue Cross Society of Tanzania.

The first site providing MAT services in Tanzania is located at Muhimbili National Hospital, an MOHSW public health facility, and has been prepared according to all standards outlined in the five national documents. Members of both clinical and academic departments at MNH and MUHAS have taken part in numerous trainings and have actively planned for MAT services in Tanzania. MAT expansion to Mwananyamala Hospital and Zanzibar are anticipated within this calendar year.

Community preparedness has been a top priority in MAT planning. Training to conduct drug user/injection drug user outreach services, peer education and HIV prevention interventions was provided to the participating NGOs who in turn trained their field officers. Currently, each NGO serves about 100 new injection drug users each month and provides services including voluntary HIV, Hepatitis B and C screening and testing through mobile caravans that circulate Kinondoni Municipality of Dar es Salaam. The NGOs also offer recovery and psychosocial counseling to support adherence to Antiretroviral Treatment (ART), TB and Sexually Transmitting Infection (STI) treatment. These NGOs identify and recruit candidates for MAT who are committed to stopping their dependence on opioids and who have taken initiative to seek services.

The MAT clinic established at MNH is the first of its kind in Tanzania and the staff are fully aware that challenges will likely be encountered whilst services are being established and rolled out. Efforts have included anticipating and addressing these challenges through close and continuous follow-up in all phases of the planning process. As the first site in mainland Sub-Saharan Africa to launch methadone services, the world’s attention will be focused on the success or failure of the program. Therefore, the program will start slowly and will document every step of the initiation to carefully ensure troubleshooting occurs and solutions to challenges are found early.

The experiences of Medication Assisted Treatment in Tanzania will help inform other African settings with generalized HIV epidemics in designing and providing comprehensive and evidence-based IDU services, in countries where injection drug use is identified as contributing to the spread of the epidemic.

“Medicated Assisted Treatment is a proven effective and essential component of comprehensive HIV prevention for people who use drugs. Tanzania has bravely and remarkably paved the way in adopting ground-breaking HIV prevention strategies... It is my hope that other countries in Africa and beyond will look to our intervention and make MAT programming a priority wherever services for drug using populations are being established or expanded,” said US representative, Eva Matiko of the Centers for Disease Control and Prevention.

The event concluded with a tour of the MAT clinic and community caravans providing services to Injection Drug Users (IDUs) in and around Dar es Salaam. For more information on Medication Assisted Treatment contact the Tanzania Drug Control Commission.