A delegation of the UNAIDS Programme Coordinating Board (PCB) conducted a field visit to Zimbabwe from 2 to 4 June to get a first-hand look at how the country is fast-tracking its national AIDS response to end the epidemic as a public health threat by 2030.
Zimbabwe has one of the largest HIV epidemics in the world, with an estimated adult HIV prevalence of 15% and 1.4 million people living with HIV. However, the country is accelerating action and increasing investment in its HIV prevention and treatment programmes to reverse this situation.
Zimbabwe laid the foundations for accelerating its response when, in 2000, it introduced an innovative levy on taxable income, where 3% would be dedicated to funding AIDS programmes. Thanks to the tax levy, the country increased its domestic financing for HIV by 40% between 2011 and 2014 and together with international investment—which currently accounts for 85% of the total funding— the country is achieving positive results. Zimbabwe has seen a 60% reduction of HIV-related deaths since the peak of the epidemic in 1997 and a 75% reduction in new HIV infections among children in the past 10 years, according to national estimates.
“Zimbabwe is pioneering programmes that are reaching out to an increasing number of people in need. Things that seemed impossible, like stopping new HIV infections among children, are now a tangible reality for the country,” said UNAIDS Deputy Executive Director Jan Beagle, who led the visit. “Zimbabwe’s decision to invest scarce resources in the national AIDS response demonstrates that cost-effective programmes, with significant use of public–private partnerships and community delivery systems, are smart investments providing positive results.”
At a gathering with government health and finance representatives, the private sector, development partners and international and regional nongovernmental organizations, PCB members discussed opportunities and challenges in meeting ambitious Fast-Track targets to ending the AIDS epidemic by 2030. All partners highlighted the need to put the AIDS response on a sustainable footing. They agreed that despite progress and increased commitment to investment from Zimbabwe’s government, including its ambition to reach 30% of HIV expenditures from domestic resources by 2018, there will still be need for global solidarity in support of the response over a number of years.
The increasingly important role played by the private sector in reaching people was recognized, as well as the opportunities that the sector offers to contribute even further to the AIDS response.
“In Zimbabwe, there is strong engagement in the response across political leadership, ministries, parliamentarians, civil society and the private sector,” said Tapuwa Magure, Chief Executive Officer of the National AIDS Council. “This multisectoral cooperation is key to Fast-Track the AIDS response, which Zimbabwe is committed to do, including action to achieving the 90–90–90 treatment targets.”
Young people and HIV
The issue of young people and HIV was high on the agenda during the field visit. Two thirds of the population in Zimbabwe is under 25 years and HIV prevalence is almost three times higher among women aged 15 to 24 than among men of the same age.
The PCB delegation discussed accelerating the AIDS response with adolescents and young adults at a school visit, at meetings with youth networks and in a meeting with young sex workers. Central issues that emerged included the importance of assisting all children to go to school and ensuring that they receive age appropriate, evidence informed sexuality education. How to better use mobile phone and social media technologies in HIV prevention were also high on the agenda. Young people were particularly concerned about improving access to HIV services in rural settings.
The PCB delegation included representatives from Zimbabwe, Switzerland, Ukraine, Morocco, Poland and United Kingdom, as well as from the non-governmental organizations represented on the PCB, and from UNAIDS Cosponsors. During the visit, the delegation met with national partners involved in the AIDS response, including representatives of government, the National AIDS Council, development partners, community and civil society organizations, the private sector and the United Nations country team. The delegation also visited several sites in and around Harare as well as Hwange District to see examples of provision of HIV and wider health services and community empowerment. Visits included clinics and community-based treatment delivery and HIV workplace programmes.
