Side event: Integrated methadone programme with take away doses for people with opioid use disorders in Tanzania

Organized by the government of the United Republic of Tanzania, the European Union, and Fundacion Internacional y para Iberoamerica de Administration y Politicas Publicas (FIIAPP)

Col M.M. Abdallah, Chairman, NDLEA, Nigeria chaired. Welcomes empirical studies, has seen impact when visiting Tanzania, good example of EU and African country cooperation.

Tom Carter, lead of Heroin Route Programme III, Project EU-ACT, welcomed participants.

Céline Gauer, Deputy Secretary General, DG Home/EC: drug policy is very multidisciplinary, EU Action Against Drugs and Organised Crime (EU-ACT) reflects that. Tanzania is a priority country with the only integrated programme in East Africa, including justice and harm reduction. This is a good illustration of EU cooperation.

Dr Cassian Nyandindi, Tanzania Drug Control Enforcement Agency: Tanzania on southern heroin route, but there is also local consumption. It is a big problem among youth which everyone acknowledges. According to expert opinion there are 20,000-40,000 PWID.  The HIV prevalence is between 20-42% and almost 10 times higher than the general population. Gives a list of medical and social complications linked to heroin use, e.g. unemployment. The level of resistance to treatment of HIV and TB among PWID is high. TB rate is 55 times higher than among general population. In Tanzania they adopted the comprehensive package (WHO, UNAIDS, UNODC). There is strong coordination among government agencies. We translated global guidelines into national guidelines and have both community based services (store front, outreach) and facility based services. MAT service providers include nurses and pharmacists. 92% out of a total of 7,600 clients are male. But in one women friendly clinic (pilot project) the female clients went up to 15%. The retention rate is about 80%. Gives list of advantages of medically-assisted treatment (MAT), including improvement of quality of life, reduction of overdose risk. Best practices include the use of a multidisciplinary program team, low threshold model, peer educators, making facility female friendly, take home dose. Challenges include: lack of national data base, only methadone available (not buprenorphine), comorbid conditions, low capacity, coverage, stigma. At the end photos were shared of the transformation of some drug users to campaigners and community outreach workers including wedding photos.

UNODC East Africa: congratulates Cassian and team. It is a challenge to get take home dose for methadone going. In the oldest OST programme in Africa (Mauritius) they still have not managed. What are the selection criteria for take home dosing? What is the total number of active clients?

Wangari wa Kmemia, MdM Kenya: would like more information on HepC treatment, criteria for take home dosis. In Kenya those working in harm reduction still sometimes get arrested. How does drug policing affect the programme in Tanzania?

Bernice Apondi: Quality of life was mentioned: how is this measured and what about stigma, employment? Is there a possibility for abuse of take home dosis as “once a drug user always a drug user”?

Dr Cassian Nyandindi: It was indeed difficult to implement take away dose. Clients need to be mentally stable and have family support. The retention rate is 70-80%. There are specific forms to assess quality of life. HepC treatment very expensive so we don’t have it, we use other medicaments to help.

Rogers William Sianga, Commissioner General of the Drug Control and Enforcement Authority: we developed the current policy with the involvement of 120 stakeholders, including student, parents, people who use drugs. The number of 7,600 clients of the methadone programme is for mainland Tanzania only excluding Zanzibar. We now have 7 clinics, and are ready to scale up to other provinces. Methadone has been abused but they were caught: a group stole the power form from Ministry of Health. We need to care for your clients. Some are given jobs within the methadone clinics e.g. gardening. “Nothing about us without us” – need to involve the drug addicts, we need them as program partners. Advocacy: need to educate and sensitize all levels of society.

Jane Marie Ongolo, Head of Division, Social Welfare, Vulnerable Groups and Drug Control at African Union Commission: want to commend Tanzania. This fits with AU Plan of Action. Countries are afraid but Tanzania is showing that it can be done.

Leave a Reply

Your email address will not be published.