HARARE, Zimbabwe – New prevention and treatment programs are accelerating the response to the HIV epidemic in Zimbabwe, one of the world’s hardest-hit nations. While the peak of the epidemic occurred in the late 1990s, the African nation remains one of the countries with the most cases of people affected by the virus today.
However, action is being accelerated to help the between 1.3 and 1.4 million people with HIV as of 2013—a prevalence of approximately 15%. The Zimbabwean government is taking measures with the goal of ending the epidemic by 2030 and discontinuing AIDS as a public health threat.
The key issue inside Zimbabwe’s borders is young people and HIV. Two-thirds of the country’s population is under the age of 25, and the prevalence of the virus in women aged 15-24 is almost three times as higher as men the same age.
The accelerated response took off in 2000 when the government imposed a taxable income, 3% of which went towards funding programs for AIDS prevention and treatment.
In addition, about a decade later, between 2011 and 2014, domestic funding for such programs increased by 40%. Most funding still comes from international investment, however, as 85% of the total funding for AIDS prevention and treatment programs is contributed by outside nations.
Still, Zimbabwe has been taking steps within its borders to reduce HIV-related deaths and new infections.
Cost-effective programs and partnerships between public and private entities are working, as there has been a 60% decrease in HIV-related deaths since the peak of the epidemic in 1997 and a 75% decrease in new infections in children in the past decade.
The response has been headed by non-governmental, religious and academic organizations (NAC). In addition, partnerships between leadership in the political sector, ministries, parliamentarians, civil society and the private sector has been key to fast-tracking Zimbabwe’s HIV response.
These organizations have been fighting the epidemic through education, voluntary counseling and testing, reducing mother-to-child transmission, increasing condom use and voluntary male circumcision.
There has been an increase in education about HIV in both primary and secondary schools throughout the nation. An understanding and awareness of the virus may result in changes in sexual behavior, leading to a reduction in the number of new infections.
In addition to education, voluntary counseling and testing has shown significant results. Between 2005 and 2010, an additional 823 facilities started offering testing and counseling. In 2011, a total of 1.8 million people received testing.
A shift occurred in 2007 that turned to provider-initiated testing instead of voluntary testing. This shift allowed providers to start offering testing as part of a medical check-up.
Transmission of HIV between mother and child accounts for the second-highest number of new infections, after heterosexual sex. Figures show that 16% of women who are pregnant have the virus, and almost 15,000 children are infected every year.
A new pilot program to prevent mother-to-child transmission of HIV began in 1999 at four different sites in Zimbabwe and is now seen nationwide. The program gives women access to free voluntary counseling and testing, as well as antiretroviral drugs. Today, more than 80% of women are receiving the HIV-suppressing medication, and there has been an overall decline in children living with HIV.
The major factor in the decline of the prevalence of HIV in Zimbabwe, however, is increased condom use. There has been an increase in the number of free condoms being distributed by the government, NGOs and social marketing campaigns. In fact, that number tripled during the 1990s and has increased even more since.
Condom use among women has also contributed to the decline of new infections, as sales and distributions of female condoms are higher in Zimbabwe than in most countries around the world.
The final aspect of Zimbabwe’s accelerated response to HIV is voluntary male circumcision. Research shows that undergoing the medical procedure can help reduce the chance of men contracting the virus through heterosexual sex.
While only a small number of male Zimbabweans take part in circumcision as a cultural rite, a survey showed that 52 percent were reportedly prepared to undergo the procedure after large-scale campaigns.
In fact, Zimbabwe has one of the largest increases in voluntary male circumcision by any country. The number of procedures per year increased by more than 30,000 between 2009 and 2011.
While certain HIV prevention and treatment issues persist in Zimbabwe—displaced people and treatment, the discrimination of homosexuals, gender inequalities and a lack of human resources—the nation has made great strides to reduce the number of HIV-related deaths and new infections.
Specifically, the NAC, though remaining underfunded, has shown significant growth since 2000. Thus, there remains a need for global solidarity when it comes to supporting Zimbabwe’s HIV response.
– Matt Wotus
Sources: AVERT, UNAIDS 1, UNAIDS 2
Photo: Ten Together