When a new global pandemic emerged towards the end of 2019, it changed everything in a short space of time.
Governments around the world put in place measures to deal with the latest and deadly disease in the family of pandemics, COVID-19.
Organisations were also forced to make necessary adjustments lest they risked closure due to effects of COVID-19. NewsDay’s Vanessa Gonye (ND) spoke to National Aids Council (NAC) chief executive Bernard Madzima on the challenges facing his organisation in dealing with HIV and COVID-19.
ND: How has COVID-19 programme affected HIV and Aids programming?
BM: COVID-19 definitely affected HIV programming in a big way. You are aware that when it started at the beginning of 2020, President Emmerson Mnangagwa issued guidelines on the lockdown, which involved barring of holding of gatherings.
It included travel restrictions and this had an impact on programming in the sense that our clients and the populace as far as HIV prevention programmes are concerned include gatherings and interactions. So definitely they were affected.
In terms of access to health facilities for drugs or related services, our clients were also affected. This has been the situation over the past year and more because we have been in various states of lockdown.
On resources, at international level, some of the resources for HIV programmes had to be diverted to COVID-19 programmes.
We are dealing with the same partners who are also fighting HIV and they are coming in to fight COVID-19 and their countries have been more affected compared to some of the African countries or developing countries which needed aid.
Domestically, there has also been an effect in that government has had to look for resources to fight COVID-19, both for the prevention programmes and for renovating hospitals to make sure that they can provide services for COVID-19 patients.
If you look at the issue of the vaccination programme, government has had to look for resources to start the inoculation programme and this has affected programming as far as the Health and Child Care ministry is concerned.
As NAC, our revenue also went down because some companies shut down because of COVIC-19. Our Aids levy comes from taxable income of every formally employed worker in Zimbabwe.
ND: What was the magnitude of disruption of services during lockdown?
BM: Health workers were reluctant because there was not enough personal protective equipment, and they were reluctant to attend to patients, and the hospitals were not equipped to deal with some of the cases of COVID-19.
That has been the impact of COVID-19 and how it disrupted services. But when people became more knowledgeable of the disease things eased a bit.
Early in January when we entered the second wave, there was disruption of services.
Essential workers, the frontline workers and the populace got affected because of this disruption.
ND: How was the uptake of ARVs during lockdown?
BM: We are still to measure the uptake of ARVs during lockdown and since the beginning of the pandemic.
We know that at some point, there were some disruption of services, but normally, our data, which comes on a day-to-day basis, shows that there was disruption of services, but the magnitude may take us a year to do the analysis and measure it.
We know that we have done very well in terms of 2020 data. The 2020 data measures the period before 2020 so at the end of this year we should be able to see how much disruption happened as the events of COVID-19 were unfolding.
ND: Some people on ART say they were having challenges travelling to their collection points, how has the issue been dealt with to avoid such occurrences in future?
BM: Yes, ART services were disrupted. People were supposed to provide letters for them to be allowed to travel.
Even if they had letters, the transport itself was limited so there was that disruption but we mainly relied on what we call Community ART Refill Groups.
These are community cadres who work in the community who would go door-to-door, delivering ARVs, but you know there are other things they cannot do which include HIV testing and counselling or provision of laboratory services for CD4 or viral load.
As far as the provision for ARVs we tried to use the community health workers to collect for the families and to distribute, but we know that we have also people, maybe in South Africa or Botswana who were using omalayitsha (transporters) and this was common in Matabeleland South, Matabeleland North and Bulawayo provinces.
They normally get their supply of ARVs through omalayitsha. When borders were closed, they could not access services, so it was a disruption in the programme.
ND: There are always shortfalls in terms of funding, how has the organisation dealt with them?
BM: We continue to experience shortages of funding especially foreign currency because most of our commodities, laboratory equipment, and drugs are bought from outside the country. We use what we collect as foreign currency in terms of the Aids levy.
We also participate in the Reserve Bank of Zimbabwe (RBZ) forex auction system and RBZ has been very supportive.
Whenever we participate we get something and we manage to pay our creditors and suppliers so that we have adequate supplies of ARVs and related commodities.
ND: What is the current status in terms of drug stocks, particularly second line drugs?
BM: National Aids Council procures second line drugs for anti-retroviral treatment (ART) and we are making sure that we have enough, at the moment our stocks are still fine both from National Aids Council Support and from the partners’ support, Global Fund, President’s Emergency Plan for Aids Relief, United States Agency for International Development and anyone else that supports the ARV programme.
We have adequate stocks and we continue to call for redistribution within the country and we try to make sure that the supply chain remains intact even though we know that the shipments might be delayed because of COVID-19.
ND: How are you mitigating the impact on COVID-19?
BM: COVID-19 is with us, we are part of the nation, we continue to monitor its impact, and we continue to monitor the public and to encourage vaccination, to minimise its impact to make sure that there are less cases of severe disease.
We also urge people to follow the COVID-19 stipulations laid down by our government — social distancing, masking up, sanitation and handwashing.
ND: How far have you gone with efforts to end Aids as a public health threat by 2030?
BM: We have recently announced our ZimPhia results of 2019, this is the population based HIV survey, but we have also announced the GAM report which is the Global Aids Monitoring Tool report and both show that we are on track to archive our goals.
ND: Please shed light on the 90-90-90 and the 95-95-95 targets focusing on how far you have gone and the strategies you are using to achieve that.
BM: Firstly we achieved 90-90-90 targets and we are now on track to archive the 95-95-95 targets by 2025.
These targets are 95% of the population with HIV knowing their status, they have been tested and they are positive, 95% of them are on treatment and 95% of those who are positive are on treatment, 95% of them have a controlled or suppressed viral load, so we are on track to ending Aids by 2030.
We are aware that HIV now is no longer very prevalent in the general population, but it’s prevalent in what we call sub-populations.
For Zimbabwe, we have agreed that the key populations based on scientific evidence, sex workers, the young people especially adolescent girls and young women, the artisanal miners, people in prisons, lesbians and gays or those who had sex with these LGBT, and so our programmes are focusing on those and we are making sure that we have specific models of programmes which target those populations.
We also have a mentorship programme we call the Sasa programme for gender based violence victims.
ND: How do you view coverage of HIV and Aids issues by the media?
BM: The media has played a key part, even though we are in this COVID-19 era, issues of HIV and Aids continue to come up in the media, and people should be aware that even though we are experiencing the COVID-19 deaths we are also losing HIV and Aids patients and there are still thousands of people who are positive, but not yet on treatment.
The media should continue to play the role it has been playing — that of information dissemination.
We should use all forms of the media — electronic, print, television and even social media platforms — as long as the information is authentic so that we can reach as many people as we can.