Kenya and Tanzania: A year of advancing care for haemophilia and sickle cell disease

Project partners mark one year of accelerating access to blood disorders care in Kenya and Tanzania with four days of meetings and a resolution for achieving greater impact together.

How is care funded? How can we secure the supply of medicines for people with haemophilia? What are the gaps in treating blood disorders in Kenya and Tanzania? What is the role of the medical advisory team in improving access to care? Who should be responsible for advocacy?

These were just some of the questions tabled during four days of meetings, workshops and site visits at Muhimbili National Hospital in Dar es Salaam, Tanzania. One year after the official launch of the Kenya and Tanzania joint project, around 70 people met to review progress, share learnings and strategise next steps in accelerating access to care for people with haemophilia and sickle cell disease in the two countries.

Ms Neema Mohamed and Dr Frederick Okinyi Representatives of Sickle cell federations in Tanzania and Kenya respectively follow proceedings at the Ministry of Health Meeting on 16 November 2021 at Muhimbili National Hospital.

On the agenda were high-level meetings between Ministry of Health officials from Kenya and Tanzania, medical advisory committee meetings and strategy workshops for members of the patient organisations.

Dr Andrew Mulwa, representing the Kenya Ministry of Health, said in a keynote speech that both sickle cell disease and bleeding disorders such as haemophilia are within the scope of the Kenya National Strategy for Non-Communicable Diseases and that guidelines have been developed to ensure standardised, quality care for both diseases.

Dr James Kihologwe, speaking on behalf of Tanzania’s Ministry of Health, underlined the importance of bilateral agreements on blood disorders between the two countries. During a subsequent ribbon-cutting ceremony and site visit, Dr Kihologwe unveiled the newly renovated and equipped comprehensive haemophilia clinic in Muhimbili National Hospital, one of the project’s key achievements in its first year.

Challenging each other to accelerate access

Joint project coordinators Dr Stella Rwezaula, President of the Haemophilia Society of Tanzania, and Dr Kibet Shikuku, Chairman of the Kenya Haemophilia Association, shared a number of achievements over the project’s first year despite the restrictions of the ongoing COVID-19 pandemic.

“There is a sense of positive competition between our two countries now that we are seeing tangible progress, with each team motivating the other to achieve more together,” said Dr Shikuku. “Sharing knowledge and best practices with our partners in Tanzania is exciting because of the potential to broaden our impact by working together and streamlining activities to reach more people with blood disorders.”

One of the joint project’s main objectives is to improve access to blood disorders care infrastructure in both countries. The team is well on its way to establishing or strengthening 16 centres in 3rd and 4th level hospitals and making basic care available in all counties or regions of Kenya and Tanzania. Along with Morogoro, the Muhimbili clinic is one of two centres completed so far in Tanzania, with all others assessed to date. In Kenya, all centres have been assessed and six clinics have been completed, in Kenyatta, Meru, Laikipia, Muranga, Bungoma and Kisii, with three more set for completion in the first quarter of 2022. Three of the clinics in Kenya will also cater for sickle cell patients. In addition, over 200 healthcare workers from both countries have received training.

Mr Samuel Macharia a Kenya Haemophilia Association Board Member, and strategic planning resource person, facilitating a session with members of the Tanzania Haemophilia Society at Muhimbili National Hospital on 18 November 2021.

‘Zero bleeds, zero disabilities, zero deaths: test now!’

With the above slogan setting a clear mandate for action, the project teams wrapped up the four days of meetings with a press statement outlining guidance on the way forward. They recommended that, while donor funding is useful in getting medical services initiated, governments must take responsibility for patients by ensuring sustainable funding and policies to enhance diagnosis and screening, improve quality and quantity of data. The statement also emphasised the importance of including haemophilia and sickle cell disease in the non-communicable diseases alliance and the continued collaboration between the ministries of health in Kenya and Tanzania. All parties agreed on the importance of leveraging the knowledge and advocacy of patient organisations to achieve shared goals.

A roadmap was set for the medical advisory committees to meet regularly on a virtual basis as they work to standardise treatment guidelines, patient registries, training, and diagnosis.  As the joint project enters its second year, the Kenya and Tanzania project team will continue to work towards the goal of being able to diagnose 600 people with haemophilia by leveraging the learnings and experiences from both countries.

Dr Rebecca Mwakichako making a case for increasing blood diseases care capacity in rural hospitals at the joint Kenya-Tanzania medical advisory committees meeting held on 17 November 2021 at Muhimbili National Hospital.