"Capacity building" and mutual learning for a more stable healthcare system in Tanzania

"If people with HIV are treated, they don't infect anyone. In theory, medication is there for everyone. Unfortunately, this is not the case in reality." Prof. Maja Weisser Rohacek is concerned with the question of why HIV is still an unsolved problem today. In her office at Basel University Hospital, she talks about her work and experiences in Tanzania. She has been working for many years with the "Chronic Disease Clinic Ifakara" for HIV and tuberculosis, in a rural referral hospital with 400 beds under Tanzanian management.

There are many reasons why the necessary medication does not reach many people in Tanzania, says Weisser Rohacek "First and foremost, it is the stigmatization of the disease that leads to treatment not being started or being discontinued. Transport difficulties, long travel distances, costs and long waiting times at the hospital are also obstacles." In southern Africa, young women and adolescents are particularly vulnerable groups: sexual violence is a problem, as women in particular are economically and existentially dependent on relationships, explains the infectiology specialist.

In her office at the USB, the dimensions that HIV takes on in Tanzania seem far away. In Switzerland, the vast majority of people with an HIV infection are well treated and the treatment success rates are among the best in the world. We should really be grateful that we live in a country with a stable healthcare system and high-quality healthcare. The USB contributes to various scientific and educational projects in order to provide long-term support to the healthcare staff in the Tanzanian clinic for a stable healthcare system. A central pillar is "Capacity Building", in which Prof. Maja Weisser Rohacek is also involved. The aim is to promote the training and further education of employees in the healthcare sector. USB employees provide specific training for Tanzanian staff, who in turn pass on their knowledge, for example on practical skills in everyday clinical practice. In addition, young Tanzanian doctors are supported in completing Master's and PhD programmes and medical specializations.

All projects are about improving health, learning from each other and supporting the local healthcare system.

Weisser Rohacek's team will continue the measures in 2024 and would like to become more active in prevention. "The previous prevention programs have been effective, but we now need a push to ensure that the success of the HIV programs is maintained. According to current calculations, the number of HIV infections is rising again in certain parts of the world."

In addition to the HIV focus, the USB supports other activities at St. Francis Referral Hospital. For example, USB employees are involved in various courses for healthcare workers. This can improve cardiac clarifications in the clinic, for example, or the care of intensive care patients. According to the doctor, connecting patients from remote locations for the treatment of chronic diseases after their hospital stay remains a challenge. This is because Tanzania does not yet have universal health insurance, which makes the population dependent on their own financial resources. In future, cooperation with the local health authorities is therefore to be further expanded and improved. In order for this change to be long-term and sustainable, it must be supported by the local healthcare system, emphasizes Weisser Rohacek.

What Weisser Rohacek has learned in Tanzania is the flexibility to adapt to situations. Especially in rural areas, where supply and funding are a problem, this ability to innovate - independently of government programs - often leads to creative solutions. "My takeaway from this is that changes can also be supported by society. That's something we can also learn for our healthcare system."