Tanzania’s anti-gay effort raises risk of HIV rebound

Colin Stewart is a 45-year journalism veteran living in Southern…

Tanzania’s anti-gay crackdown is starting to harm anti-HIV efforts, as predicted. The Washington Post reports:

Tanzanian Health Minister Ummy Mwalimu claims that lubricants encourage homosexuality. (Photo courtesy of Alchetron.com) — Tanzanian Health Minister Ummy Mwalimu says she’s concerned that anti-AIDS programs for gay men promote homosexuality. (Photo courtesy of Alchetron.com)

Last month, the minister of health announced that Tanzania will ban HIV/AIDS outreach projects aimed at gay men, pending a review. That forced the closure, at least temporarily, of U.S.-funded programs that provide testing, condoms and medical care to gays. About 30 percent of gay men in Tanzania are HIV-positive; now health workers say that figure could rise.

Tanzania’s actions appear to mark the first time that a country has suspended parts of the United States’ hugely successful foreign HIV/AIDS initiative in an attempt to crack down on the gay community. The U.S. PEPFAR campaign, backed by $65 billion since it was founded in 2003, has been credited with saving millions of lives.

The ban comes after months of bitter speeches and threats from Tanzanian officials aimed at the gay community and at organizations treating its HIV/AIDS patients. This year, police raided two U.S.-funded HIV/AIDS organizations and seized confidential patient information and supplies, officials said. In September, the deputy minister of health, Hamisi Kigwangalla, accused HIV treatment organizations of “promoting homosexuality.”

“Any attempt to commit unnatural offenses is illegal and severely punished by law,” Kigwangalla said in the statement. People convicted of same-sex liaisons in Tanzania can be jailed for up to 30 years.

The health minister, Ummy Mwalimu, explained in a statement last month that officials had suspended HIV/AIDS outreach programs for gay patients to review whether they promoted same-sex relationships.

The move has sent a shock wave through a community still grappling with the virus, even as modern medicine and treatment have dramatically improved victims’ chances of survival.

“In the short term, there are people who won’t go to [health] service centers, and if they aren’t on antiretrovirals, what happens? It’s a major concern,” said Warren Naamara, a doctor who is the director of the U.N. program on HIV/AIDS in Tanzania, referring to the drugs that suppress the virus. …

PEPFAR, or the President’s Emergency Plan for AIDS Relief, launched by George W. Bush with bipartisan support, has become one of the most important U.S. assistance programs ever in Africa. Tanzania is an example of its success. Since 2002, the overall HIV/AIDS rate in the country has declined from 12 percent to 5 percent. The number of people receiving treatment has grown in the past five years from 289,000 to over 700,000. …

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The U.S. government has hired health organizations such as Jhpiego, which is affiliated with Johns Hopkins University, to provide HIV tests, condoms and doctor referrals for gay men, sex workers and other vulnerable Tanzanians who are afraid to visit a public hospital. Those visits often take place in homes and informal community centers. The Jhpiego project was awarded $73 million over five years beginning in 2015. But such groups have had to cease their outreach efforts in gay communities.

“PEPFAR recognizes the importance of these key populations,” said a U.S. official who spoke on the condition of anonymity because of the sensitive situation in Tanzania. “And in order to reach many of them, you have to go where they are.”

Without access to those vulnerable communities, “it prolongs the epidemic in the end,” the official said.

U.S. officials said they are hopeful that the outreach programs will soon be restored, noting that the health minister has said the government is considering which HIV services would be appropriate for the gay community. But members of that community are pessimistic.

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“It’s clear that the government doesn’t care whether we live or die,” said one 22-year-old gay man who spoke on the condition of anonymity because of fear of punishment. …

A 29-year-old gay man in Dar es Salaam who is HIV-positive said that he was diagnosed four years ago. Since then, antiretroviral drugs have helped him stay relatively healthy and health workers have provided him with condoms, lubricants and information about safe sex so he does not infect his partners.

But now he had gone two weeks without medication. To get it, he would have to go to a public hospital, and he said he fears retribution.

“In this environment, it’s not safe to be a known gay man in the open,” he said.

Each week a patient is off his antiretroviral drugs, the virus grows more crippling — what doctors call a “viral rebound.”

“These interruptions in treatment are very dangerous,” said Naamara of the U.N. program, known as UNAIDS.

For more information, read the full Washington Post article, “Tanzania suspends U.S.-funded AIDS programs in a new crackdown on gays.”

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