In 1991, a review of the situation called for the development of a national policy that would provide guidelines for dealing with AIDS. The review identified the following major issues:

• care of people with AIDS
• pre- and post-test HIV counseling
• AIDS orphans
• AIDS education in schools

The second medium-term plan reiterated the need for a national policy and added several additional policy issues that needed to be addressed, including:

• support for family members of people who have died from AIDS
• loss of productivity
• protection of the legal rights of AIDS patients and people living with HIV and AIDS
• use of condoms

According to Tanzania's Global Fund Country Coordinating Mechanism, "active political commitment" vis-à-vis HIV/AIDS began to accelerate in December 1999, when President Mkapa declared HIV/AIDS a national disaster and called for the entire nation, especially political, civil, and religious leaders, to take new measures "on a war footing" against HIV/AIDS. On World AIDS Day 2000, the president announced the formation of the Tanzania Commission for AIDS (TACAIDS) to lead the multisectoral response to the epidemic.

In November 2001, the National Policy on HIV/AIDS was approved. Its overall goal is to provide a framework for leadership and coordination of the national multisectoral response to the epidemic.

Specific objectives:

• prevention of transmission of HIV/AIDS
• HIV testing
• care of PLWHA
• sectoral roles and financing
• research
• legislation and legal issues

The NMSF (National Multisectoral Strategic Framework) translates the National Policy of HIV/AIDS by providing strategic guidance to the planning of programs, projects, and interventions by various stakeholders. It delineates the basic approaches and principles that guide the national response and identifies goals, objectives, and strategies. It also outlines a monitoring and evaluation system and the institutional, coordination, and financial frameworks of the national response.

The NMSF has nine goals:

1. reduce the spread of HIV
2. reduce HIV transmission to infants
3. ensure that political and government leaders consistently give high visibility to HIV/AIDS in their proceedings and public appearances
4. ensure that political leaders, public and private programs, projects, and interventions address stigma and discrimination and take the human rights of PLWHA into account
5. ensure that HIV/AIDS concerns are fully integrated and prioritized in the National Poverty Reduction Strategy and World Bank Tanzania Country Assistance Strategy
6. reduce the prevalence of STIs
7. increase knowledge of HIV transmission
8. increase the number of PLWHA with access to a continuum of care and support from home and community to hospital levels (including ARVs)
9. reduce the adverse effects of HIV/AIDS on orphans

In September 2003, Churches United in the Struggle against HIV/AIDS in Southern and Eastern Africa (CUAHA), a coalition of Finnish and African churches, met in Dar es Salaam to pool resources and create a strategy in the battle against HIV/AIDS. CUAHA, established in 2002 and largely funded by the Finish Ministry for Foreign Affairs, has concentrated on five focal areas:

1. theology and ethics of HIV/AIDS
2. the caring ministry
3. education and training
4. information and communication
5. and networking

CUAHA members acknowledge that there is a need to overcome the churches' initial reluctance to tackle HIV/AIDS. Regarding the controversy over whether churches should be seen to advocate the use of condoms, CUAHA said that theologians were still discussing the issue.¹

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1 UN Office for the Coordination of Humanitarian Affairs, TANZANIA: Churches gather to coordinate action plan against HIV/AIDS. 2003: DAR ES SALAAM.