PRESENTER: Dr. S. Mtullu PROJECT MANAGER TANGA AIDS WORKING GROUP (TAWG)

1. TANGA AIDS WORKING GROUP (TAWG) TRADITIONAL MEDICINE AND HIV/AIDS-TANGA-TANZANIAPresented at the Training course on local and health practices for MAP project team and NAC’s (Video presentation) 09th Sept. 2005 • PRESENTER: Dr. S. Mtullu • PROJECT MANAGER • TANGA AIDS WORKING GROUP (TAWG) • P.O. BOX 1374, TANGA-TANZANIA • Tel/Fax : +255-27-2642266 • Email – tawg@kaributanga.com

2. BACK GROUND • TAWG is a Non-Governmental Organization born in 1992 by a group of health professionals organised them selves voluntary as a team of counsellors and care providers. • The team is collaborating with traditional healers to provide low cost treatment to People living with HIV/AIDS for 13 years now • The collaboration has extended to involve training to TH’s and research on medicinal plants

3. BRIEF HISTORY • Tanzania is one of the Sub-Sahara Africa highly affected by HIV/AIDS • By the end of 2003, 2.2 million Tanzanians were HIV positive (Prevalence is 7.0%) • Only 400,000 clients are planned to access ART • So far less than 10% of those who qualify for ARV gets them

4. WHY IK PROGRAM ? • Focus on the alternative form of therapy for the rest of the clients is highly needed • TAWG has observed AIDS patients recovering from bed to work after the use of herbal remedies • Note that there is no effective cure or vaccine against HIV infection. Prevention & symptomatic treatment are the only alternatives. • Existing Health services are unaffordable by the poor TRM offers opportunist for reaching the poor at a little added costs • Traditional Healers are always available to the community; Ration of Healer to population is 1:350 while that of medical doctors is 1:20,000 • Collaboration provide opportunities for sharing knowledge in Health Management.

5. OBJECTIVES OF TAWG IK PROGRAM • To provide effective low cost herbal remedies to treat opportunistic infections associated with HIV/AIDS. • To raise awareness among TH’s to safe guard both traditional healers and their clients from being infected during their practices • To build capacity of healers in providing community education and care

6. OBJECTIVES Cont…… • To conduct research on promising herbal remedies in collaboration with TH’s and other scientific institutions • To ensure sustainable supply of medicinal plants in use through conservation and cultivation of the herbal medicinal plants • To build and strengthen bridges to collaboration between traditional and modern health systems

7. TRADITIONAL MEDICINE ACTIVITIES • Provision of Herbal treatment to treat opportunistic infection in PLHA in collaboration with THP • Training of THP on Basic HIV/AIDS knowledge, Safer working environment, counseling, referral criteria, community mobilization and collaboration and networking. • Organizing continuous knowledge exchange meetings between THP themselves and with TAWG • Ethno botanical studies to identify names of the medicinal plants in use

8. ACTVITIES CONT.. • Mini 0bservational clinical efficacy study for Pyrenacantha Kaurabassana on skin conditions • Clinical observational on the efficacy of three herbal plants in use by TAWG • Community to community knowledge exchange meeting between care providers, TH’s and PLHA • Continuous searching for new medicinal plant remedies to be researched and included in TAWG herbal treatment program

9. BENEFICIARIES • People living with HIV/AIDS attending TAWG services. • Traditional Healers who are trained and those who provides Herbs for Care and Research. • Communities served by trained THP. • Government Hospital who are relieved the burden of Care

10. TREATMENT OF OI’s RELATED WITH HIV/AIDS WITH HERBAL REMIDIES • Clients are enrolled after Voluntary Counseling & Testing. The enrollment is optional. • Clients use Herbal medicine collected and prescribed by healer and distributed by TAWG • Patients are treated for Free – we play the healer. • Medicine are given to patients in a powder form to make tea or mix with coconut oil/water for topical applications.

11. TREATMENT CONT…. • Initial treatments six months then the patient can be an off treatment every 2-3 months. • Clients are monitored by professional health workers every two weeks at the clinic. • Serious patients are followed up at their homes. • The standard treatment is 4 plants medicines, but there are 5 other herbs used for different symptoms

12. WHAT DO HERBS HELP • Increase appetite • Gain weight • Stops diarrhea • Reduces Fever • Clears up oral thrush • Resolve skin rashes and fungus • Treats herpes zoster • Heals ulcers.

13. PATIENTS RESULTS • Patient begin showing seeing results/ improvements between one week & 4 weeks after starting treatment. • Patient who survive for 6 months generally live for 2-5 years some patients have 12 years now. • Medicine have not proved very helpful in advanced stage of HIV/AIDS. • Patients uses the herbs for treatment and prevention of OI.

14. PATIENT RESULTS Cont…. • Patients on treatment throughout remain health though in some cases the immunity status may be down. This type of patients normally dies of a short illness and are not bed ridden. • Patients who leaves treatment for a longtime after a period of recovery won’t benefit from the same herbs in the second episode of OI. • Our goal is effective treatment, we provide any treatment traditional or conventional that contributes to the patients well being. • Note: Patients improvements has priority over research.

15. ACHIEVEMENTS • TAWG has so far treated 4,500 AIDS patients with opportunistic infection using herbal medicines. • Currently we have 2,100 patients from six treatment centers. • Build capacity of healers to assess patients progress. • The quality of life of PLHA using TAWG herbs have been improved • TH’s are now powerful community educators and strong partners in IEC distribution • Two clinical observational studies have been conducted so far

16. OUTCOME OF TAWG TREATMENT PROGRAM • Keeping more people alive have automatically maintained the workforce hence reducing the newly orphaned children. • Through this program we have managed to help the Government in respective districts to: - Reduce the cost of patient treatment - Reduce resources spent on Care - Reduce the patient load to hospitals.

17. ADVANTAGES/BENEFITS OF USING IK IN HIV/AIDS • Prolonged use for many years is an indication that they are safe. • Improving the quality of life for PLHA • Lowering the rate of spread of HIV • Reliving day to day health problems by controlling symptoms of AIDS • Improvements of natural immunity • Complementing the conventional therapy

18. CHALLENGES • Increasing number of clients seeking services from TAWG leading to strain on the available resource. • Failure to cope with increasing appetite • Inadequacy of conventional evaluation criteria in treatment results • Research funding • Lack of cooperation between the traditional health system and modern health system. • Bulkiness of the herbs – Social Stigma • Environmental destruction.

19. WAY FORWARD • Continue providing low cost herbal treatment to PLWA • Conservation and cultivation of the medicinal plants • Process validation for the herbs in use the benefit of healers and users • Research on promising herbs

20. WAY FORWARD Cont….. • Strengthening TAWG’s approach in collaborating with traditional healers by establishing a sustainable comprehensive community based training program • To establish a sustainable partnership between TH’s and formal health system (BHW) through education programs targeting both groups • Developing an educational booklet on local medicinal plants for home health care.

21. EXPECTED OUTCOME • Renewal of hope among the poor HIV infected patients through access to low cost treatment • Evidence based validation of the herbs will benefit users and THP’s. • Sustainable supply of the medicinal plants will be enhanced • Forged links between THP’s and BHW’s • Replication of effective best practices within the country and region

22. CONCLUSION • Many more efficacious medicinal plants are available. Through systemic research Traditional medicine has yielded clinically useful drugs such as ant malarial quinine and artemisinin. Let’s explore them, document them, research on them and use them to improve health care of our communities.

23. THANK YOU!ASANTE SANA!