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HEALTH-TANZANIA: Slowly, a More Enlightened Approach to Drug Addiction

Sarah McGregor

DAR ES SALAAM, Apr 8 2008 (IPS) - If the first step to overcoming drug addiction is admitting you have a problem, then Tanzania may be on the road to recovery.

Medical officials in this East African country say the government has in the past been reluctant to accept substance dependence as a serious health problem, seeing it rather as a matter of law and order.

These days, however, a consensus is building that the largely conservative nation must better care for and support drug addicts, especially in view of their vulnerability to HIV/AIDS.

Growing evidence indicates that the sharing of needles among drugs users is fueling the pandemic; according to figures on the website of the Joint United Nations Programme on HIV/AIDS, adult HIV prevalence in Tanzania stands at 6.5 percent.

"If we continue putting everything against drug use and not actually helping them to quit or to use in a better way, the spread of AIDS will continue," said Geoffrey Somi, head of epidemiology at Tanzania&#39s National AIDS Control Programme, run by the health ministry.

A conference in March on the link between injection of drugs and AIDS underlined the need for a national survey that would help authorities get a grip on the scale of the problem they face.

An initial investigation led by Gad Kilonzo, a psychology professor at Dar es Salaam&#39s Muhimbili University College of Health Sciences, found that about half of the 1,000 substance abusers surveyed in poor, drug-infested areas of the city were HIV-positive.

Prostitution also forms part of the problem. Almost 65 percent of those interviewed for the 2003-2006 study said they had sold sex in the preceding month to finance their habits. With such encounters sometimes unprotected, the risk of HIV infection is increased, Kilonzo said.

In Zanzibar, an Indian Ocean archipelago in a political union with Tanzania, only about one percent of a population of one million is infected with the virus.

But infection rates among addicts and prostitutes on the islands are much higher than those for the general population, according to a 2006 study by health authorities. About 26 percent of 508 users who injected drugs were HIV positive, the survey found.

Root of the problem

According to Kilonzo, one of the key factors underpinning drug use is poverty; the United Nations estimates that a third of people in Tanzania live on less than a dollar a day.

Youth, in particular, take drugs to escape a life of daily hardship, he added. "The highest affected are the young people hanging (out) on the beaches, and touts (bus conductors) with a frenetic way of life. Most are unemployed (and) depend on daily labour to make ends meet."

Exacerbating matters is a lack of therapy, care centres and strategies which could help curb the problem – such as the distribution of clean needles and drug education, said Jessie Mbwambo: a psychiatrist with the Muhimbili Health Information Centre.

On the supply side, police must quell a significant increase in the movement of drugs into and through Tanzania, she added. The nation is at a smuggling crossroads between Asia, the Middle East and Europe, which translates into drugs being relatively cheap and easily available, Mbwambo said.

According to the United Nations Office on Drugs and Crime, inadequate security measures at Tanzania&#39s airports and seaports appear to be encouraging the use of the country as a transit point for traffickers.

Shaboni Robta, a former addict who now works with a youth organisation in Dar es Salaam, emphasises that a hands on approach by parents – and the involvement of the community at large – is central to helping drug users kick their habits.

"Isolation, taking your child away from the home or not talking about the issues, that is not the answer," he said. "Parents shouldn&#39t despair; the community shouldn&#39t turn its back."

Badria Hamyar, a social counselor, says one of the biggest challenges is simply to convince addicts to get tested for HIV.

"Mentally, drug users don&#39t care so much about the problem of HIV. They only care about having drugs – and afterwards, when they quit, never looking back."