USIS Washington File - February 17, 2008

President Bush's U.S. Global AIDS Coordinator, Mark Dybul, called the program a "very innovative and forward leaning plan" that is going to go into neighborhoods, have community groups identify orphans and vulnerable children and the services they need, as well as provide those services.

The American people "through the President's Emergency Plan for AIDS Relief (PEPFAR), along with the government of Tanzania and the Global Fund to Fight AIDS, Tuberculosis and Malaria" are supporting this effort, he said. Dybul told reporters February 17 that Tanzania currently has around 2.5 million orphans and about half of them became orphaned when their parents died of HIV/AIDS.

According to Dybul, the national orphan care plan will be led by the government in each community but will involve a wide array of community-based groups that will be responsible for ensuring that needy orphans get the care they need. This year alone, Dybul said, the American people are going to reach 83 of the 138 districts in Tanzania to roll out this plan. Currently, he said, the United States supports orphan care for about 220,000 of the 1.25 million HIV/AIDS orphans in Tanzania.

"We will be able to expand that dramatically through this plan," he predicted. The real heart of the program, he said, is the intent of the PEPFAR plan -- to "get out into the community where services will make a difference." Additionally, he said, multiple government ministries -- not just the Ministry of Health -- will be involved in this program to give it added effectiveness and momentum.

Dybul said the United States hopes to follow up and spread the program as broadly as possible to other countries.

In addition to launching the orphan care plan, U.S. first lady Laura Bush and Tanzania's first lady Salma Kikwete also visited a madrasa, where lessons on prevention and the impact of HIV/AIDS are taught by faith-based leaders. It is there where young people are being taught to respect themselves, respect others, delay sexual activity and be monogamous, Dybul said. According to Dybul, leaders of other faiths also were present during the first ladies' visit to demonstrate this is an interfaith effort.

Dybul quoted first lady Laura Bush, saying, "We can't win the fight against HIV/AIDS if we don't involve faith-based organizations. They are the ones in the communities. They are the ones with reach and credibility in their own communities."

Such an approach is especially important in Africa, he said, because the World Health Organization (WHO) estimates that 30-70 percent of health care in sub-Saharan Africa is in the faith sector. For that reason, he said, "you can't possibly tackle HIV/AIDS either in the health area or in the behavior change area if you are not dealing with faith-based organizations."

Lastly, he said, both presidents and first ladies visited the Amana District Hospital and a clinic there that had been built through funds made available by PEPFAR. There, he said, the group attended a roundtable with a number of HIV/AIDS positive patients and heard firsthand how their lives had been dramatically changed through the clinic and anti-retroviral drugs and treatment they received there.

At the roundtable, President Kikwete identified one such person, retired military officer and farmer Honorati Valeri Shirima, who was almost near death in 2005 when he came to the hospital. "I'm told when he came here, he was in very bad shape. He was in bad, bad shape. He was almost dying. So he started the program of anti-retrovirals (ARVs), and you can see how he looks now. He looks healthy, he looks much better than what he was.

"So all that I can say ... is words of appreciation and thanksgiving. It has done a tremendous job," Kikwete told the group.

The party heard another story about an HIV/AIDS couple who found out together they were HIV-positive, got married and went on to have a child who is HIV-negative thanks to treatment and education from the clinic.

The group also from Tatu Msangi, a registered nurse at the Kilimanjaro Christian Medical Center (KCMC). Msangi discovered she was HIV-positive when she found out she was pregnant. She enrolled in a Prevention of Mother-to-Child Transmission (PMTCT) program and delivered a healthy daughter named Faith. Msangi, who was recently a guest at Bush's State of the Union Address before a joint session of Congress, now counsels HIV-positive women and encourages them to participate in the PMTCT program.

All three site visits, Dybul says, represent Bush's approach to a new era in development in partnering with and supporting local people.

"We saw that today, the governments together, jointly supporting activities -- working in the community to support community organizations," he said.

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