Bridging the Gaps: Tanzania Network of People who Use Drugs

Although Tanzania has one of the largest harm reduction projects in the whole Sub-saharan region, access to HIV prevention, harm reduction and drug treatment is still very limited: needle and syringe programmes are available only in Dar es Salaam and provided by an Medicind de Monde in collaboration with Mukikute (Tanzanian NGO). People who use drugs are involved in service delivery but not in service design and evaluation. Outside Dar es Salaam, the only alternatives available to people who use drugs are rehabilitation and incarceration. The HIV epidemic is concentrated among people who use drugs compared to the general population. In 2014, Tanzania National AIDS Control Programme (NACP) estimates there were 30,000 people who inject drugs in the country, 35% of whom were living with HIV. The HIV prevalence among women who inject drugs is thought to be twice that of their male peers. Human right violations are frequent and the perpetrators are not hold accountable. Stigma and discrimination against people who use drugs results in numerous murders via "mob justice", unadressed by the relevant organs and officials. Zanzibar and Pemba are autonomous territories within Tanzania which serve as gateways to the African continent and are situated along a major corridor for drug trafficking, and historically have had a long exposure to drug markets. Here people who use drugs are organised around "sober houses", the only "treatment" available.There is little awareness about human rights, harm reduciton and HIV prevention interventions. The legal environment is repressive, legitimising police violence. Given the specific environment of small islands, people who use drugs are visible and exposed to high levels of stigma and discrimination. In August 2016, Tanzania cracked down on civil society that ‘support homosexuality’ and subsequently enacted a partial ban on the import, sale and distribution of lubricants. In February 2017, Tanzania declared a "war on drugs": almost 5,000 people are arrested under drug trafficking charges in the first half of the year, with the majority being people who use, rather than deal drugs. Cases of police violence are documented, but there is no capacity to initiate litigation. Needle and syringe programmes are reduced to "experimentation sites", which in fact equates with a scale back in harm reduction provision.