The TUNAJALI "We Care" program is an initiative supported by the U.S. President’s Emergency Plan for AIDS Relief, through USAID, to assist the Government of Tanzania. Deloitte Tanzania implements the TUNAJALI HIV/AIDS Care and Treatment Program in collaboration with Family Health International and Cardno Emerging Markets, and this was one of several client case studies recently highlighted in the Deloitte 2011 Annual Review.
It has been scientifically proven that the virus that causes AIDS, HIV, continuously mutates. Full adherence to HIV treatment is key to suppressing the spread of HIV. Poor adherence to HIV treatment has the dangerous potential of generating drug-resistant HIV viral strains, which could subsequently be transmitted.
People living with HIV/AIDS (PLIV) on anti-retroviral therapies (ART) must take medication daily for the rest of their lives. The TUNAJALI program experience shows that these patients are highly motivated to take medication initially, but that that changes over time. After nearly three years of treatment, some supported Care and Treatment Clinics (CTC) started experiencing notable losses of patients on ART. Some of the high volume (over 5,000 patients) at CTC sites were reporting Lost-to-Follow-up (LTF) patients between 30- to 40 percent of their enrolled PLHIV. A patient is considered LTF after two to three attempts to contact them within a three-month time period have failed. This raised serious concerns about long-term patient adherence to medication. It was clear efforts had to be made to identify the “lost” patients and to take reasonable steps to prevent “losses” of patients in the future.