Immediate Risks and Disruptions

• Total Pause of HIV Prevention Programming: There is almost complete halt of HIV Prevention interventions that were fully funded by PEPFAR. This includes DREAMS programme targeting vulnerable adolescent girls and young women, orphans and vulnerable children and voluntary medical male circumcision. In addition, there is significant impact to other HIV prevention interventions that were largely supported by PEPFAR including PrEP for at risk populations (key populations). There is the risk of wastage of commodities related to prevention.
• Fear of Service Interruption: There is severe and widespread fear of service stoppage, leading to reports of hoarding antiretroviral (ARV) drugs and patients dropping out of care due to the risk of treatment interruption. There was disruption of samples transportation for testing. Implementing partners with waivers are not fully operational due to slow payment systems among other reasons, thereby affecting efficiency of services.
• ARV Stock: The current ARV stock is expected to last for the next four months and shipments are on their way that will ensure commodity security until the end of 2025. The forecast for 2026 is not clear. Close monitoring is required as the pause in programming might impact the demand and implementation of lab services.
• Technical Support: Technical support to regions, councils, and health facilities has been paused.

Politically Relevant Updates

• Government Actions: The Tanzania AIDS Commission plans to conduct a detailed assessment of the impact of the US funding pause. There are discussions in parliament regarding future budgetary allocations by the government for the purchase of antiretroviral therapy (ART). The government has reassured that there will be no disruption of ARV medications with commitment to allocate adequate funds to purchase and distribute ARVs free of charge.
• Global Fund Discussions: The Global Fund Principal Recipient (PR1) is in discussions regarding the possibility to reinvest savings from the Global Fund HIV grant into HIV commodities to ensure security.
• UN Engagement: UNAIDS and WHO have engaged with the Tanzania AIDS Commission to assess the impact and discuss fundraising modalities to continue ongoing activities.
• Civil Society Response: Civil society organizations are calling for expansion on the implementation capacity of the Global Fund grant to mitigate the impact of the pause.
• Government Mitigation Measures: Strategies are being implemented to absorb the human resources for health (HRH) to ensure continuity in care. The government is in the final stage of launching a web-based Care and Treatment Centre (CTC) database that will mitigate absence of data clerks who were USAID supported; the health care workers will be able to directly feed the database which is integrated to DHIS-2; this will be linked with all the electronic medical records in both private and public facilities. The government will continue to carry out storage and distribution by the Medical Stores Department (MSD) of the Ministry of Health. Plans are also in place to use government postal services for the transportation of lab samples.