Next Saturday, Zimbabwe joins the rest of the world in commemorating World Aids Day. The national event will take place at Glendale Stadium in Mazowe, Mashonaland Central province.
social commentary with Moses Mugugunyeki
The commemorations — running under the theme Know your status — come at a time when Zimbabwe is riding on a successful HIV story.
According to the Zimbabwe population-based HIV Impact Assessment, new HIV infections dropped from over 82 570 in 2009 to an estimated 42 314 last year.
The report says Zimbabwe recorded a decrease in the number of people dying due to Aids from over 3 000 per week in 2004 to less than 900 deaths per week in 2015.
Health and Child Care minister Obadiah Moyo, speaking at the launch of of the World Aids Day logo and theme, attributed the HIV success story to the rapid expansion of treatment services over the years, but emphasised the need for people to know their status.
“Our ambition to achieve the 90-90-90-90 targets and eventual ending of Aids in 2030 may not be achieved without emphasising the need for people to know their status,” he said.
“While promoting HIV testing among the entire population, there are specific population subgroups that we must prioritise — such as sex workers, prisoners, youth, adolescent girls and young women as well as mobile workers who have greater chances of exposure to risk and therefore provide a higher yield of HIV-positive people. We should leave no one behind in that blitz.”
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The Health and Child Care ministry has over the years decentralised treatment to more than 1 600 health centres across the country, which has contributed to the closing the tap of new infections as people who are stable on treatment have low viral loads and, therefore, have less chances of transmitting HIV.
Zimbabwe’s HIV success story was a result of the comprehensive combination of high impact HIV prevention interventions, which included HIV testing services, prevention of mother-to-child infection, condom promotion and distribution, treatment as prevention, behaviour change and voluntary medical male circumcision.
However, Zimbabwe should not sit on its laurels as ending Aids by 2030 requires commitment from everyone.
“That is an interesting story of good achievement! But we still have a long road to travel to get our people to be fully empowered against HIV and Aids. The starting point is one to know their status — it is the single most important intervention that allows people to live and plan their lives productively,” said Moyo.
One such approach of achieving such a target would be for government to explore various ways and mechanisms, including sustainable financing, to enhance the national response to HIV and Aids.
National Aids Council (NAC) board chairperson Evaristo Marowa said there was need to sing from the same hymn book and emphasise the need for increased HIV testing.
“Zimbabwe can only achieve the 90-90-90 fast-track targets by 2020 if we deliberately push for widespread uptake of HIV testing, which is the gateway to accessing the other essential services that make achievement of the second and third 90s possible,” Marowa said.
“Over the years, the National Aids Council has capitalised on opportunity gains and integrated HIV testing with screenings for common non-communicable diseases, sexually transmitted infections, TB and others in a one-stop shop approach.
“Knowing one’s status for all these conditions is a major step towards shattering stigma and accessing treatment. As you can see, the response is becoming more about wellness, which is in tandem with Sustainable Development Goals.”
According to the Zimbabwe Population-Based HIV Impact Assessment (ZIMPHIA) Report of 2016, the goal of ending the Aids epidemic in Zimbabwe by 2030 is within reach, provided there is continued expansion of HIV treatment programmes and targeted HIV-testing, especially for men and young women.
While funding is one of the major challenges for the HIV response in Zimbabwe, countries like the United States have made significant contributions to the cause. The United States President’s Emergency Plan for Aids Relief (Pepfar) has committed $150 million in aid to Zimbabwe for HIV prevention, care and treatment services this year.
Speaking at the Pepfar 15th anniversary reception in Harare recently, US ambassador to Zimbabwe Brian Nichols said Washington had made an immense contribution to Zimbabwe’s HIV success story.
“The US has contributed to major success towards ending HIV in Zimbabwe since 2006. This year we have committed $150 million towards epidemic control,” he said.
Nichols said Pepfar had contributed $1 billion towards HIV prevention, care and treatment services since 2006. He said the money was channelled to government and civil society through the United States Agency for International Development and the Centres for Disease Control and Prevention.
Pepfar coordinator in Zimbabwe Mark Troger said he was impressed by giant strides made towards epidemic control.
“I remember when I came to Zimbabwe almost 8 000 people living with HIV were on antiretroviral treatment, but I am happy to say that today we have more than a million people on treatment,” he said.
Troger said the annual number of HIV-related deaths declined by 70% since 2006 while the number of new HIV infections each year has decreased by 67% since 2003.
Zimbabwe’s own domestic fund, the Aids Levy (National Aids Trust Fund), is inadequate to meet the country’s programming and treatment needs. The situation has been exacerbated by the current foreign currency issues. Procurement of medicines, test kits and other necessities requires foreign currency, which is in short supply in the country.
In pursuit of the goal to achieve the 2030 target, Zimbabwe is prioritising and scaling up high impact HIV prevention services, with particular focus on most at risk and key affected populations, including sex workers, youths, prisoners and cross-border truck drivers, as well as adolescents and young women.
In line with government policy, 50% of the Aids Levy goes towards antiretroviral treatment. Although largely dependent on economic performance, the levy has grown over the years and now supports the provision of antiretroviral therapy to over 232 000 people. In addition, the levy has also supported various community-driven HIV prevention interventions.
However, the biggest undoing of the HIV success story in Zimbabwe is the fact that there are a number of people in the country who do not know their HIV status, hence this year’s theme Know your status.
