Diarrheal diseases are the most common opportunistic infections (OIs) experienced by people living with HIV and AIDS (PLHIV) in Africa and elsewhere. HIV and side effects of medications can cause diarrhea, which is an underlying cause of malnutrition. Diarrhea rates are two to six times higher in HIV positive people and acute and persistent diarrhea rates are double in PLHIV populations. The immuno-compromised status of PLHIVs makes them more susceptible to opportunistic infections including those related to water, sanitation and hygiene diarrhea and skin diseases. Most of these diarrheal OIs are water-related and cause significant loss of functional days (missed work and missed school days), loss of income, considerable human suffering, embarrassment, and isolation, increased burden on caregivers, weakening of general health, and eventually death.

There is an existing body of evidence to support the fact that a significant proportion of diarrheal diseases could be prevented by integrating water, sanitation, and hygiene (WASH) approaches (e.g., treating and safely storing drinking water, hand washing with soap, sanitation promotion, and food safety) into existing HIV/AIDS programs. These interventions are central to adult and pediatric care and support programs, with a strong evidence base supporting behavior change activities, reinforcement and follow-up, coupled with product distribution to achieve a positive health impact.

Access to safe water is considered a basic human need and a basic human right (Kamminga 2006) for all people. Yet this basic right remains unrealized for a large majority of people in developing countries, especially in rural communities. The negative impact of low access to necessary quantities of water, to water of reasonable quality, to basic sanitation and hygiene are magnified for HIV-infected, immuno-compromised individuals. The added burden affects not only the HIV infected, but the entire affected family, increasing risk of diarrheal disease and lost productivity. Therefore, PLHIV and households affected by HIV and AIDS have a substantially greater need for WASH services: more water; safe water; easy access to water and sanitation; proper hygiene.

PEPFAR/Tanzania recognizes the importance of safe water provision for PLHIVs in reducing diarrhea incidences. In FY 2010 USG will provide point of use drinking water treatment options using chlorine based agents for the households of PLHIVs. The TBD will procure the water purification tablets and distribute them to community care and support implementing partners to ensure that PLHIV households are receiving safe drinking water. TBD will also have to link with the new TBD on Communication for developing and disseminating messages relating to safe water treatment and storage at household level. USG will continue to explore other partnerships and modalities for provision of safe drinking water through social marketing and public-private partnerships (PPPs)

This will be a national activity, in support of both goal one and two of the partnership framework (PF) on "service maintenance and scale up" and "prevention goal" specifically as it is relating to prevention with positives interventions.

TBD will work with the service providing implementing partners and volunteers at community level to track the quantity of water treatment tablets distributed, determine the consumption patterns and collect evidence based information on health outcome before and after POU water treatment interventions at the household level.

These funds are for procurement of water treatment options for PLWHAs. The commodities are intendes to be distributed to all service delivery partners as part of PwP commodities. These funds will be given toTBD who will handle both the procurement and the distribution of the commodities to the implementing partners.