Living with HIV as Donor Aid Declines in Tanzania

ABSTRACT

Fluctuations in global health funding can significantly impact the lives of people who depend on donor-funded programs for life-long care. In this article, I examine shifting HIV policies that expanded antiretroviral therapy (ART) while reducing “care” services meant to improve ART access and adherence. I describe how these changes were experienced by HIV+ women accessing ART at a hospital in Tanzania in 2011–2012, highlighting their increasing precarity and uncertainty for care amidst donor instability and eroding program services. This research suggests that stable funding in support of long-term care services is important to help HIV+ people maintain life-long ART.

Video abstract

Read the transcript

Watch the video on Vimeo

KEYWORDS:

• Tanzania
• chronicity
• donor aid
• HIV

Acknowledgments

My sincere thanks to Brenda D’Mello for her critical analyses of Tanzanian health care and maternal health, and to the many Tanzanian women and health care workers who graciously shared their time and insight into their lives and work. I would also like to thank Ben Burgen and Beth Chambless for insightful comments on earlier drafts, and the three wonderfully helpful anonymous reviewers for assistance in strengthening the final version. Finally, I would like to thank the Tanzanian Commission for Science and Technology (COSTECH) and the National Institute for Medical Research (NIMR) for their support of this work and research permission.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This research was funded by a Fulbright Hays Doctoral Dissertation Research Abroad (DDRA: P022A100047) fellowship, and the University of Florida Department of Anthropology and Center for African Studies.

Notes on contributors

Meredith G. Marten

Meredith G. Marten is assistant professor of Anthropology at the University of West Florida. Her primary research interests include equity in access to HIV and maternal health services in Tanzania and northwest Florida, focusing on how volatility in donor aid and health policy affects the health and well-being of women living in poverty.