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In no event shall WHO be liable for damages arising from its use. ©Julie Pudlowski/WHO ©Julie Pudlowski/WHO ©Julie Pudlowski/WHO Contents LIST OF FIGURES iv CHAPTER CHAPTER LIST OF TABLES iv LIST OF ABBREVIATIONS iv 01 02 APPRECIATION v FOREWORD vi Effective leadership Reducing the burden and partnerships for of communicable health diseases INTRODUCTION vii 1 3 HIV/AIDS 3 Tuberculosis 6 COVER PHOTO CREDITS Viral Hepatitis 7 Malaria 7 (Bicycle): Brendan Howard/Shutterstock Immunization and Vaccine Development 10 (Woman in field): Julie Pudlowski/WHO (Girl): Julie Pudlowski/WHO Neglected Tropical Diseases (NTDs) 11 (Homes): nutsiam/Shutterstock Road Safety Programme (Scale): Mkama/WHO Reducing road traffic (Water): Travel Stock/Shutterstock deaths and injuries 13 ©Riccardo Mayer/Shutterstock ©Riccardo ©Julie Pudlowski/WHO Reinch/Shutterstock ©Nataly CHAPTER CHAPTER CHAPTER CHAPTER 03 04 05 06 Promoting health Health Preparedness, Corporate services throughout the systems surveillance and and enabling life-course strengthening response functions 17 23 29 31 Improving the health of Health financing 23 Cholera outbreak response 29 Human resources 31 mothers, newborns, children and adolescents 17 Improving access to Ebola virus disease (EVD) Premises and working essential medicines 23 preparedness 29 environment 31 Nutrition 21 Strengthening health Strengthening disease Funding 31 information systems 24 surveillance 29 Administrative key Leadership and governance 25 performance indicators (KPIS) 31 Protecting the human environment (wash and Information climate change adaptation) 27 communication, technology and management (ITM) 31 LIST OF FIGURES List of Figures Figure 1: Priority areas of the Country Cooperation Strategy 2016-2020 vii Figure 2: Country Office programmatic clusters 1 Figure 3: HIV Situation in Tanzania in 2018 (Source: THIS Report (2016/2017)) 3 Figure 4: HIV Treatment Cascade based on the Tanzania HIV Impact Survey (THIS) Report (2016/2017) 4 Figure 5: Progress towards 2020 Goals in Elimination of TB in Tanzania 6 Figure 6: Notified TB cases from 2012 - 2018 7 Figure 7: Macro-stratification; malaria epidemiological and operational strata 8 Figure 8: Road traffic fatalities in different country income groups 14 Figure 9: Trends in child mortality 1990-2016 17 Figure 10: Trends in maternal mortality 1990-2016 18 Figure 11: Star Rating reassessment results 2017-2018 19 Figure 12: Trends in nutrition status in Tanzania 1990-2016 21 Figure 13: Health Sector Strategic Plan IV 25 Figure 14: Health Sector Policy Commitments 2018-2019 26 Figure 15: EVD preparedness 29 List of Tables Table 1: Percentage availability of medicines in outlets in regions surveyed 24 Table 2: WCO Funding Structure 2017-2018 31 Table 3: Administrative KPIs scores 31 List of Abbreviations AMR Anti-Microbial Resistance ATM HIV/AIDS, Tuberculosis and Malaria CBS Case-Based Surveillance CCS Country Cooperation Strategy CSU Country Support Unit CTCs Care and Treatment Centres DFID Department of International Development DHIS2 District Health Information Software 2 (DHIS2) DPC Disease Prevention and Control DPG H Development Partners Group for Health DTG Dolutegravir ECD Early Childhood Development ENAP Every Newborn Action Plan EPI Expanded Programme on Immunization ESPEN Expanded Special Project on Ending Neglected Tropical Diseases ETL Electronic TB and Leprosy FRH Family Planning and Reproductive Health GATS Global Adult Tobacco Survey Gavi Global Vaccine Alliance GHRS Global Hepatitis Reporting System GTS Global Technical Strategy for Malaria HBHI High Burden High Impact HiAP Health in All Policies HIVDR HIV Drug Resistance iv | WHO Tanzania Biennial Report LIST OF ABBREVIATIONS HPV Human Papilloma Virus HSS Health Systems Strengthening HSSP Health Sector Strategic Plan HTS HIV Testing Services IDRS Infectious Disease Reporting System IHR International Health Regulations KPIs Key Performance Indicators KVP Key and Vulnerable Populations LLINs Long-Lasting Insecticidal Nets MCC Multisectoral Coordination Committee MOHCDGEC Ministry of Health, Community Development, Gender, Elderly and Children MTR Mid-Term Review MUHAS Muhimbili University of Health and Allied Sciences NACP National AIDS Control Program NBS National Bureau of Statistics NCDs Noncommunicable Diseases NHLQATC National Health Laboratory Quality Assurance and Training Centre NMCP National Malaria Control Program NMF National Multi-Sectorial Framework NSP National Strategic Plan NTLP National TB and Leprosy Programme PO RALG President’s Office Regional Administration and Local Governments PrEP Pre-Exposure Prophylaxis PSI Population Services International REC Reach Every Child RMNCAH Reproductive, Maternal, Newborn, Child and Adolescent Health SDH Social Determinants of Health SWAp Sector Wide Approach TDHS Tanzania Demographic Health Survey TWGs Technical Working Groups WCO WHO Country Office WHO AFRO WHO Africa Regional Office Appreciation The World Health Organization in Tanzania appreciates the • Department of Foreign Affairs, Trade and Development following partners for their financial contribution and partnership (DFATD), Canada in enabling the organization to achieve its mission to promote the • DG for International Cooperation and Development (DEVCO), attainment of the highest sustainable level of health by all people European Commission living in the United Republic of Tanzania: • GAVI Alliance • Germany • Bill & Melinda Gates Foundation • Republic of Korea • Bloomberg Family Foundation • Rotary International • CDC Foundation • United Kingdom of Great Britain and Northern Ireland • Centres for Disease Control and Prevention (CDC), United • United States Agency for International Development (USAID) States of America • World Bank • People’s Republic of China • Department for International Development (DFID), United Kingdom WHO Tanzania Biennial Report | v FOREWORD Foreword We, World Health Organization (WHO) in Tanzania, are pleased to share with you a summarized account of our work in 2018 and 2019. This report guides you across several stops and describes how WHO Tanzania worked in collaboration with government departments, international and national organizations, and donors to improve the health of