Bloodborne HIV: Don't Get Stuck!

The first nuanced article I have seen on Covid19 in Tanzania comes from a surprising source, Devex, an NGO focused ‘platform’. Read the whole article to find the balance. 

The article acknowledges measures that Tanzania has taken in response to advice from WHO and other parties. It is argued that communications and messaging became confused and ineffective after the country’s initial response. 

However, this analysis raises the question of who was confused? President Magafuli reassured his people that the country would not be taking action that would risk immediate shortages of food and vital supplies, cease most economic activity, and countless other consequences. 

At the same time, NGOs and ‘civil society’, who depend mainly on foreign income to exist, wanted the country to take any measures that their funders insisted were necessary to prevent a major disease outbreak. 

Another news source that beats the drum for NGOs is The New Humanitarian, formerly the UN’s IRIN. They cover Covid19 in Kenya’s most media-friendly slum, Kibera. 

The first photograph, alone, is enough to suggest that Covid19 will never be the biggest threat that people face, on a daily basis, in urban slums. But the article also illustrates how immediate an impact a rash lockdown has on subsistence living, at the best of times. 

We get some insight into NGOs’ need to keep their eye on the diseases, social issues and other developments that are currently attracting funding. The author focuses mainly on one NGO, but they all need funding.

Close to the end of the Devex article we read that some have said: “the decision to avoid a full lockdown might have made sense in the Tanzanian context.” That’s exactly what I would expect people living and working in developing countries to say, although the source of the quote is not clear. 

Devex goes on to quote an NGO in Tanzania that spells out why you can’t impose a rich country solution in a poor country: “You might even be flattening the curve for 10 years without making it possible for our health sector to cope if our caseload and severity had been comparable to the U.S. and the U.K.” 

Data collected a couple of years ago in Tanzania was published recently, with Covid19 bits bolted on, and it finds that compliance for hand hygiene in health facilities is extremely low (7%), glove use is 75%, disinfection of reusable equipment is 5% and waste management scores just over 40%. 

Devex comes closer than others to distinguishing between Covid19, the pathogen, and a country’s response. The virus is said to have infected about 1m people on the African continent, which is about 0.1% of the population. But systematic reporting on negative consequences of the response is rare, notably so in rich countries. 

Confirmed deaths from Covid19 in Africa are about 0.0022% of the population. So, Tanzanian deaths from HIV in one year (2019), even with widespread coverage of antiretroviral drugs, still outnumber deaths from Covid19 for the whole continent. 

Deaths from pathogens that debilitate and/or kill people far exceed those from Covid19, and many of these are also preventable or treatable.

Some would argue that the biggest killers are not pathogens. They are background conditions, such as inadequate healthcare, unhealthy habitation, poor diet and lack of water and sanitation. 

Agreed, things could have been smoother, with Tanzania continuing to issue the data and communications international health and other agencies demanded. But the country seems to have been able to avoid the destructive scaremongering and panic that you’ll find in almost every other country. 

The New York Times claims that “More than 88 days have passed since Tanzania reported even a single new coronavirus case”. Everything reported in the article is at least 88 days old, as well. But it concludes with a reminder about the coming election, in October. 

Civil society, the press, international institutions and foreign experts have little to lose if they are wrong. Tanzanians, including the President, have skin in the game. Magufuli has maintained calm, avoided civil unrest, protected local economies and stood up for his electorate, and will answer to his people. How many others can say the same?