Sub-Saharan Africa takes up a large share of population comprising people living with HIV/AIDS globally and studies have shown that Sub-Saharan Africa is home to 90% of children living with HIV/AIDS [i].
United Republic of Tanzania, a respective part of Sub-Saharan Africa, is estimated to have 1.4million people living with HIV/AIDS which contributes to an overall prevalence of 5.6% nationally of whom 160,000 are children living with HIV/AIDS, where this disease contributes to 86,000deaths and 1.3million orphans[ii]
. Mbeya region of Tanzania is known to be one of the highest prevalent areas with HIV/AIDS in the country.
Accessibility to Antiretroviral Therapy is a component of Millennium Development Goals envisioned to prolong lives of people living with HIV/AIDS which has led to enablement of Antiretroviral Medicines upscale globally. Sadly, only 37% people eligible for Anti-Retroviral Therapy (ART) in Sub-Saharan Africa were able to access such service in 2009, although these numbers are even lower for children at 29% in the same year.[iii]
For United Republic of Tanzania in 2010 just 32% of adult population eligible could access Anti-Retroviral Therapy, and for children this was at merely 17% of children eligible receiving ART (iii).
Of the twenty-two regions in Tanzania, Mbeya has an average 25% of total population illiterate[iv]
and is ranked second region on the Food Poverty Rate, has 165/1000 Under-five Mortality Rate as well as being ranked tenth in stunting among other regions of Tanzania[v]
. In fourteen districts where more than 14% children had lost either a mother or a father[vi]
, Mbeya-Urban stands with 16.2% children orphaned in this way.
Baylor International Pediatric AIDS Initiative (BIPAI) is an organization which works globally to make lives better for children living with HIV/AIDS, and Mbeya is one of their intervening regions. Registered as Baylor Children’s Foundation, this organization works collaboratively with public referral hospitals to provide free healthcare services to children from infants till eighteen years of age. This Public-Private Partnership project has a separate building within compound provided adjacent to a public hospital and operates with separate resources to provide free HIV/AIDS (and TB) services for children.
Among resources actively invested into this structure are specialized pediatricians recruited from the United States of America who guide our practices into excellence of service provided. With dynamic training and knowledge sharing, human resources within Baylor makes it a Center of Excellence, and such learning is trickled down into our capacity-building efforts where human resources are invited from other public hospitals for training as well as our human resources conduct outreach activities to provide on-job-training.
Pharmacists are among scarce human resources in Tanzania with national ratio of 0.18 per 10,000 people, also indicating that almost two pharmacists serve for every 100,000people. Recent findings strongly suggest task-shifting being applied to local settings for implementation of HIV/AIDS scale-up in Africa[vii]
being that other cadres involved in health care delivery system could take up multiple tasks in service delivery.
This implies that as we scale up delivery of Antiretroviral Therapy in Africa, tasks of pharmacists shall be handled by personnel other than pharmacist. Under such circumstances it becomes imperative that dispensers are equipped with appropriate tools to delivery optimal practice, especially for children who can easily be subjected to over-dosing, preventable illnesses, adverse effects, drug-interactions and unnoticed resistance to therapy. It is also of utmost importance that as service providers we comprehensively involve patients and their families in delivery of healthcare, which is a rare practice in Tanzanian pharmaceutical systems.