Zim on course to end AIDS by 2030

Source: Zim on course to end AIDS by 2030 | The Sunday Mail

Zim on course to end AIDS by 2030
Dr Madzima

ZIMBABWE will today be commemorating World AIDS Day, with the main celebrations scheduled for John Cowie Primary School in Rusape. The Sunday Mail’s TANYARADZWA RUSIKE interviewed National AIDS Council (NAC) chief executive officer DR BERNARD MADZIMA on Zimbabwe’s HIV/AIDS response programme and the milestones achieved so far.

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Q: What is the theme for this year’s World AIDS Day and how is it relevant to Zimbabwe’s current context?

A: The theme for the World AIDS Day (WAD) is “Take the rights path: My health, my right!” The world can end AIDS — if everyone’s rights are protected.

With human rights at the centre and communities in the lead, the world can end AIDS as a public health threat by 2030.

This year’s theme is very relevant to Zimbabwe as we move towards ending AIDS by 2030.

Zimbabwe recently achieved the 95-95-95 target, which signifies a great stride towards achieving our goals.Zimbabwe’s HIV response is anchored in the national mantra of leaving no one and no place behind.  We have targeted all vulnerable populations, including key populations in their diversity — adolescent girls and boys, and people with disabilities, as well as women and men.

We are ensuring that everyone who is HIV positive has access to uninterrupted supply of antiretroviral therapy (ART) at no cost.

Q: How is NAC commemorating this day and what activities or campaigns are planned?

A: The WAD commemorations will be held on December 1, 2024 in Rusape, at John Cowie Primary School.

After the national commemorations and launch, each province will then be expected to hold their provincial commemorations.

There will also be pre-launch activities before the main commemorations, including outreach programmes to be held in Vhengere, Headlands, Nyazura and Tsanzaguru.

The outreach programmes will seek to offer health services, which include HTS (HIV testing services), family planning, and drug and substance abuse awareness.

These programmes will run from this Wednesday (last week) up to Saturday.

On November 30, we had a candlelight memorial at Vhengere Hall.

On December 1, there will be a WAD half marathon, starting from 5.30am to 9am.The commemorations will then be held later on that day.

There was also a breakfast meeting on November 28 in Mutare to launch the WAD theme and logo.

The Zimbabwe AIDS Network (ZAN) is planning to have their conference in Rusape before the WAD commemorations.

Q: Can you outline the progress made in the fight against HIV/AIDS in Zimbabwe over the past year?

A: Zimbabwe has achieved the three 95s target set by UNAIDS.

This means 96 percent of those who are HIV positive know their HIV status; 99 percent of those who know their HIV status are on lifelong antiretroviral (ARV) treatment and 96 percent of those who are on treatment are viral load suppressed.

A total of 1 214 545 are on treatment, out of a population of 1 303 305 people living with HIV.

The HIV incidence rate continues to decline and currently stands at 0,14 percent. The prevalence rate has also stabilised at 10,4 percent.

Zimbabwe has achieved epidemic control.

Q: What are the most pressing challenges currently facing the country in terms of HIV prevention, treatment and care?

A: The first challenge is sustainability, where we find that major donors are pulling out or scaling down on funding support.  Zimbabwe has come up with a sustainability roadmap and is mobilising domestic financing to fill the funding gap.

There are also emerging issues where we find that most people on ART are nine times vulnerable to non-communicable diseases (NCDs).

NAC has mainstreamed NCDs response into HIV prevention and treatment programmes by offering screening services at community level through community volunteers and referring those who are positive for treatment by the Ministry of Health and Child Care.

Other epidemics like Covid-19, Mpox and cholera are also a major challenge, and NAC has planned for interventions for pandemic emergence preparedness in all districts across the country. There is also drug abuse, which is affecting most of our population and derailing the HIV response.NAC has, therefore, integrated drug abuse/use interventions, in line with the strategy launched by the President of Zimbabwe on drug abuse prevention.

There is also an increase in new infections among adolescent girls and young women.

NAC is implementing a cocktail of prevention programmes targeting the adolescents, like the Sister-to-Sister programmes; Brother-to-Brother programmes; peer education programmes; and involving traditional leaders in social mobilisation campaigns like the “Not in my village campaign”

In response to these challenges, we are also scaling up pre-exposure prophylaxis (PrEP) among the key populations and mobile populations.In addition, we are also scaling up self-testing and ensuring availability of ARVs at all health centres.

To prevent new infections among young people, we are increasing peer education among girls, scaling up parent-to-child communication and introducing HIV and AIDS education in school and out of school.

Q: What initiatives are being implemented to reach and engage key populations, such as sex workers and people who inject drugs?

A: We are rolling out programmes that include peer education, promoting correct and consistent use of condoms, providing PrEP for the sexually active, promoting harm reduction among those injecting drugs and providing psychosocial support for those addicted to drugs.

Q: How are stigma and discrimination impacting these populations’ access to HIV services?

A: Stigma and discrimination are still a challenge and, as NAC, we address it through counselling and education.

Q: Given the significant strides made in HIV prevention and treatment, when does NAC anticipate reaching the goal of zero new HIV infections in Zimbabwe?

A: Zimbabwe is on course to achieving the target of ending AIDS by 2030.

New infections may not get to zero, although this is our vision. Statistically, if new infections get to less than 6 292 and sustained at that level, then we will have ended AIDS. The main focus will be to stop new infections, make sure all who are HIV positive are tested and put on treatment and should be viral load suppressed.

Addressing emerging issues like NCDs and pandemics will ensure Zimbabwe achieves its goals.

Q: What specific strategies and targets are in place to achieve this ambitious goal?

A: We have a cocktail of strategies in place that include scaling up HIV testing (including self-testing), prevention of mother-to-child transmission, providing ARVs to all who need them, integrating NCDs and STI prevention in the HIV response, heightening PrEP to the sexual active and the discordant, involving traditional leaders in the response and increasing male mobilisation initiatives.

Q: How has the Covid-19 pandemic affected HIV prevention, testing and treatment services? What measures have been taken to mitigate the impact of future pandemics?

A: Covid-19 affected the people living with HIV, especially those who had NCDs, because the death rate increased.

However, we found that being on ART was protective to Covid-19.

There was also limited movement of people, which affected collection of ARVs, although the Government intervened to allow essential services to continue.  NAC also increased its outreach services to reach those in remote areas in the provision of ARVs.

Q: How is NAC addressing the dual burden of HIV/AIDS and NCDs like cancer and diabetes? Are there any integrated strategies to prevent and manage both sets of diseases, especially considering the shared risk factors?

A: NAC is scaling up wellness programmes across the board. We are screening all people living with HIV (PLWH) and making sure those who are positive are treated.

In addition, we are working with labs and hospitals in facilitating the provision of essential equipment and medicines, including reagents.

Q: How effective has Zimbabwe been in preventing mother-to-child transmission (MTCT) of HIV? What are the future plans to further reduce MTCT rates?

A: Mother-to-child transmission currently stands at 7,4 percent and the target for virtual elimination is 5 percent and less.

That means we are still behind in achieving the target. The future plans are to make sure all pregnant mothers access antenatal care (ANC) services through local health centres.

Those who are HIV positive should access ARVs to prevent mother-to-child transmission and for their own treatment and their partners. Exclusive breast feeding should be encouraged for the first six months.

Mothers should be counselled to avoid getting HIV infection during breast feeding.

We are also using traditional leaders to mobilise mothers for ANC, while integrating HIV into outpatient and maternity services.

Q: How is NAC ensuring the sustainability of HIV programmes in the long term?

A: We need to mobilise domestic financing, including introducing a national health insurance scheme.

We also have to maximise on efficiency gains through implementing high-impact initiatives at low cost.

Over the next five years, we will be prioritising sustaining epidemic control, providing ARVs without interruption, ensuring viral load suppression to all on treatment, focusing on interventions at community level, involving the traditional leadership in the response and strengthening community systems.

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