Additional Funding Announced to Fight HIV in Zimbabwe

A new agreement reached in Zimbabwe by the UN Development Programme (UNDP) and the Global Fund to Fight AIDS, Tuberculosis and Malaria is set to provide a major boost in the fight against HIV and AIDs in the country, which is among the hardest hit by the virus in sub-Saharan Africa.

The announcement, made as the two organizations signed an 'Implementation Letter', will see US$ 126 million added to the Global Fund's existing HIV grant in Zimbabwe. The existing grant, agreed with UNDP in 2013, saw US$ 311,175,241 in funding established to support the Government of Zimbabwe in their national response to HIV and AIDS.

The AIDS epidemic is particularly acute in Zimbabwe, with a prevalence rate of 15 percent among adults aged 15-49 years.HIV treatment has seen a dramatic increase in Zimbabwe, with almost three quarters of a million people receiving medication in 2014, up from 566,000 in 2012.

The additional funding will allow UNDP to bolster its efforts combatting the disease, with a new target of 894,000 people receiving HIV treatment. It will also contribute to improved quality of care, reduce new infections and keep people alive, further promoting sustainable human development in the country.The project is now estimated to save more than 58,000 lives per year in avoided HIV mortality.

According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), in 2013 there were 35 million people living with HIV globally, with 13.6 million having access to antiretroviral therapy as of June 2014.

SOURCE

Zimbabwe’s Children Are The Battlefield In War To Contain HIV/AIDS

Figures show that thousands of children in Zimbabwe are infected with HIV – presenting a major battlefield for government efforts to defeat the spread of HIV /AIDS nationwide.

  Many children under 15 in Zimbabwe discover their HIV status only when they fall critically ill later in life. Credit: Jeffrey Moyo/IPS

Fifty-one-year-old Mateline Msipa is living with HIV. Her 17-year-old daughter, born after Msipa was diagnosed with the virus, may also have it, but she has never been tested. “My daughter is not aware of my HIV status and with the stigma associated with the disease, it is hard for me to now open up to her about my status,” Msipa told IPS.

Msipa’s daughter says she has never attempted to undergo an HIV test despite Zimbabwe’s revised testing guidelines allowing children of her age to get one without parental consent.
“I have no reason to get tested for HIV because I have never engaged in sexual intercourse before,” the 17-year-old told IPS.

Figures show that thousands of children in Zimbabwe are infected with HIV – presenting a major battlefield for government efforts to defeat the spread of HIV /AIDS nationwide. The U.N. agency UNAIDS estimates that nearly 200,000 children from birth to age 14 have the virus but are not in treatment because they have not been properly tested. It is a trend that researchers term “suboptimal” counseling and testing in that southern African country. “Children often get tested for HIV [only] when they fall critically ill, which usually doesn’t save them from dying,” Letwin Zindove, an independent health expert who works as an HIV/AIDS counselor here, told IPS.

The new estimate threatens to dash the southern African nation’s effort to meet a U.N. goal of reversing the incidence of infection in the population by 2015. Older children – between six and 15 – who might have acquired HIV at birth are especially vulnerable to a major outbreak of full-blown AIDS. A study last year by the London School of Hygiene and Tropical Medicine found this group received inadequate access to provider-initiated HIV testing and counselling by primary care-givers.
The study found health-care workers were reluctant to offer testing which could expose the child to abuse if he or she tested positive. On top of this, long waiting periods for appointments also hindered routine testing and counseling.

Last year, Zimbabwe launched its revised national guidelines for HIV testing and counselling with special emphasis on couples, children and adolescents as it stepped up efforts to halt the spread of the virus ahead of the 2015 deadline of the U.N. Millennium Development Goals (MDGs).
Under these guidelines, a child aged 16 years or older is eligible to give full consent for HIV testing and counselling.However, the study found that many healthcare workers don’t fully understand the new guidelines.

Lack of clear national standards for HIV/AIDS testing leads to confusion and missed diagnoses in some cases. Credit: Jeffrey Moyo/IPS

“They expressed confusion about the age at which a child could choose to test him/herself, what type of caregivers qualified as legal guardians, and whether guardians had to undergo testing themselves first,” it said. The appearance of a slow-progressing HIV disease among children has also contributed to dangerous delays in testing. New research has found that a substantial number of HIV-infected children survive to older adulthood. Delaying testing and diagnosis until symptoms appear results in a high risk of chronic complications such as stunting and organ damage.

Under the U.N.’s MDG Target 6A, countries should have halted new infections and begun to reverse the spread of HIV/AIDS by 2015. Zimbabwe’s numbers of HIV incidence may be high (14.7 percent of adults) but the numbers are higher yet in South Africa (17.8 percent), Botswana (23 percent), Lesotho (23.6 percent), and Swaziland 25.9 percent.Countries with low numbers are Mali, Guinea, Burkina Faso, Benin, Sudan, Senegal, Niger, Mauritania and Somalia – ranging from 1.0 percent to 0.7 percent.

While most countries are achieving a measure of success towards the U.N. goal, two have been a major health care disappointment. Uganda, once hailed as a Cinderella success story, and Chad have seen a rise in infections. It is a disappointing turnaround from the 1990s when an aggressive public awareness campaign that urged medical treatment and monogamous sexual relationships led to a precipitous drop in infection rates in Uganda.

In 2012, H.I.V. infection rates in Uganda were seen to have increased to 7.3 percent from 6.4 percent in 2005. Over roughly the same period, the United States, through its AIDS prevention strategy known as Pepfar, or the President’s Emergency Plan for AIDS Relief, spent 1.7 billion dollars in Uganda to fight AIDS. Activists say children are not immune to the deep-rooted stigma surrounding HIV/AIDS here — another barrier to testing.

“Zimbabweans are one huge community, closely-knit, and once a child is tested for HIV, it becomes difficult for it to remain confidential, resulting in any child tested becoming exposed to stigma,” Sifiso Mhofu, an affiliate of the Zimbabwe National Network of People living with HIV, told IPS.
This problem is very real for orphans like 13-year-old Tracey Chihumwe (not her real name) from Mabvuku, a high-density suburb of Harare, the Zimbabwean capital. “Talk of rejection, talk of stigma and discrimination about HIV-positive people here has rendered me confused on whether or not I should get tested for HIV/AIDS, although I don’t know what killed my parents,” Chihumwe told IPS.
The Zimbabwean government is now struggling to ensure to that 85 percent of the population – including children and adolescents – knows their HIV status by the end of this year, in a desperate bid to meet the MDGs deadline in December.

But this will not be an easy task. “Despite revised guidelines of HIV testing for children, pockets of resistance to get children tested for the virus exist from children themselves, parents and guardians as well,” a top government official, who requested to remain anonymous for professional reasons, told IPS.

SOURCE: mintpressnews

ANTI-GAY LAWS MAY PREVENT ENDING AIDS IN ZIM

Despite a mandate to eradicate HIV/AIDS under the UN Millennium Development Goals (MDGs), Zimbabwe has done little or nothing to reduce the rate of infection among vulnerable gays and lesbians, say activists here. The MDGs are eight goals agreed to by all UN member states and all leading international development institutions to be achieved by the target date of 2015.

These goals range from halving extreme poverty to halting the spread of HIV/AIDS and providing universal primary education.Gays and lesbians activists here say more needs to be done because population groups such as men who have sex with men and transgender people remain at the periphery of the country’s intervention strategies.

Minority

“In as far as combatting HIV/AIDS is concerned, there are no national programmes targeted for minority groups or interventions that can easily be accessible by the LGBTI (lesbian, gay, bisexual, transgender and intersex) community on prevention and care within the public health care system,”Samuel Matsikure, Programme Manager of Gays and Lesbians of Zimbabwe (GALZ), told IPS.

“Whether the Zimbabwean Government likes it or not, it has to face the reality that gays and lesbians exist and should therefore cater for their HIV/AIDS needs in emerging with strategies to combat HIV/AIDS just like it does for all other citizens, for how do we end the scourge if we ignore another group of people who will certainly spread the disease” a civil society activist Trust Mhindo told IPS.

“There are knowledge gaps of health care workers on the needs and best methods on prevention, treatment and care for the HIV positive LGBTI individuals,” adds Matsikure.

 SOURCE :Times of Swaziland

SADC Welcomes Zim Single-Dose HIV Strategy

THE secretary general of the SADC Parliamentary Forum Dr Esau Chiviya has hailed the decision by Zimbabwe to adopt the single-tablet HIV dose, saying the country had shown leadership in the fight against the epidemic. New Zimbabwe.com recently reported on a decision by Zimbabwe to introduce the three-in-one ART tablet as the country fights to contain the HIV-AIDS scourge. According to the online publication, the new single-tablet dose is a combination of three drugs (Tenofovir/Lamivudine/Efavirenz TLE) and is a departure from the previous complicated treatment of three different tablets Tenofovir, Lovovidine and Nevirapine (TLN).

In a statement Chiviya lauded the initiative and said it also marked the beginning of more work for Zimbabwe, where approximately 1,5 million people - about 188 000 of these being children below the age of 15 - are reported to be living with HIV. "Despite well-documented challenges, Zimbabwe seems to be taking leadership in the war against HIV and AIDS in Southern Africa. The reported decision to introduce the three-in-one ART tablet can be viewed as a giant step towards removing barriers to effective treatment of HIV and AIDS," Chiviya said.

CHALLENGES GALORE
Chiviya said for Zimbabwe and many other countries working towards halting and reversing the HIV-AIDS epidemic, the challenge has been on how to keep patients on treatment for life and, specifically, on how to ensure that the patients can afford the treatment; that they can access medication and services and that they can religiously take the medication as prescribed to ensure efficacy under optimal conditions.

"The designers of these medicines require that they are taken at regular intervals, consistently and in the correct doses. Additionally, they require that the outcome of the medication or treatment be monitored continuously to ensure that parameters - either in the patient or the drugs - do not change."
He said this final requirement remained a major challenge on the African continent because even the physical realities under which the medications are taken vary tremendously from country to country.
"For much of Africa, these conditions are typically low resource settings in which affordability is an issue. On some parts of the continent, national health systems are weak and delivering drugs on a regular basis, sometimes for up to 50 years for any particular patient while ensuring that such an individual can remain on treatment and take it at the appropriate doses is not easy."

Experts say storage in the homes across the continent in which these drugs are administered should be done carefully if the drugs are to retain their potency and efficacy. This implies that parameters that include heat and moisture become important given that many of the drugs used to fight HIV and AIDS are designed outside the continent. Unless they are stored properly, they might not produce anticipated results. They may even lead to drug resistance.

Said Chiviya: "The patient must be committed, the health system must be able to deliver the medicines, the country must be able to afford it, and the doctors and other health practitioners must understand the conditions under which these medicines are administered. Yet these conditions can change, even when dealing with the same patient. For instance, the patient's standard of living may fluctuate and with it nutrition, necessitating certain changes to be introduced." He explained that adherence was a major factor in Africa because patients were prone to suffer from conditions for which they may require to take additional drugs.

"Often this is the reality for HIV patients in Africa. More than half of them would also succumb to TB and so they would have to deal with more tablets. The patient may also fall prey to a myriad of other so-called opportunistic infections. Understandably, but erroneously, in the fight against HIV-AIDS many people think of just the administration of drugs for HIV-AIDS when the reality is that often there are more drugs required in treating the patient."

SOURCE -  allAfrica.com

The core business of fighting HIV/AIDS in Zim

Let’s get down to the core. Today we focus on the long term solution per say that could possibly contribute to the reduction of the HIV prevalence rate in the country. For now, the prevalence rate is lingering at 15 for close to three years. Now what’s critical is how HIV and AIDS related incidences can nose dive.

Remember, a journey of a thousand miles begins with one step. The step we take today is sexual and reproductive health and rights (SRHR) education for and by the youths. In the words of Drake, we surely have to “start from  the bottom” going up. The child has to be trained in a such way that what he/ she learns about in their youth will never depart from them. 

SRHR is a human rights concept pertaining to sexuality and reproduction which is divided into four parts. These include sexual health, sexual rights, reproductive health and reproductive rights. Today’s agenda will dwell more on sexual rights, where we unravel the ties it has with HIV and AIDS on young people.

Female learners at Kuyasa Primary School in Khayelitsha, watch with curiosity as a Projects Abroad volunteer shows them how to use a female condom.
Photo: Lyndon Metembo

The AIDS fatigue is still very active and continues to hover around the country creating fear. A greater part of the population especially the youth are still afraid of going for an HIV. Some weeks back, I wanted to go for an HIV test, but I just didn’t want to go there alone. After all, we find comfort in numbers. So I told my friends that it would be great if we all went together. They all gave silly excuses such as “I will not be free” or “I have tested before” but the response that got my attention was “right now, I am super health so there is no need. When I fall sick or even go to the extent of being bedridden, maybe I will go.” When I asked why, she said “I have done so many crazy things, and I would rather not know because I don’t want stress in my life.”  The greater stress does not know.  Fear of the unknown is the stress. Once one is familiar with their HIV status then you know what to do next. Simple.

Over the years, the most young people in the country have been brainwashed by the propaganda of “Abstinence”.  Abstinence only prevention programmes or adverts like “Umkhwenyana uqobo uyamelela” have greatly reduced the practice if safe sex. Though there are efforts from Protector Plus, more needs to be done. Condoms must be distributed to children of school going age too. Toilets should be flooded with condoms for them to use so that they can practice safer sex. Not doing so is an infringement of their rights.  As far as the Universal Declaration of Sexual Rights (Hong Kong, 1999) is concerned, it’s their right too. These rights include:

1)    The right to sexual freedom.

2)    The right to sexual autonomy, sexual integrity, and safety of the sexual body.

3)    The right to sexual privacy.

4)    The right to sexual equity.

5)    The right to sexual pleasure.

6)    The right to emotional sexual expression.

7)    The right to sexually associate freely.

8)    The right to make free and responsible reproductive choices.

9)    The right to sexual information based upon scientific inquiry.

10)  The right to comprehensive sexual education.

11)  The right to sexual health care.

The number of new infections per year, exceeds the number of annual aids deaths explaining the rising HIV prevalence rate. More than half of the people living with HIV are part of the education system. How many young people aged between 15 and 29 know all the necessary facts about HIV can be prevented? Lack of clear sex education is the major factor leading to HIV and AIDS. It’s not enough to have access to sex education when one is going for and HIV test. Let the information on SRHR that is so much deprived from the public especially the youth be cascaded to pupils is the primary and secondary set-ups to the students at tertiary institutions. 

Back in the day, abstinence was the order of the day, that is all our mothers and fathers to do. “Wait till you are married.” They would say. High five to that! But now times have moved and things have changed. We are in the era were 12 year olds are engaging in sexual activities which puts them at risk of having more sexually experienced partners who in most cases call the shots. Now that abstinence has become old fashioned, it’s better to empower the youths on sex education. Not the kind that is simplified overwhelmed with euphemism, but the kind that is direct, precise and specific. Words like “penis”, “vagina”, “condom” or “oral sex” should not be excluded in the modules. Once we are direct in sex education we will be direct in our implementation and the results will be on point. Let’s teach condom sense in our schools and make the youths realise that “no condom, doesn’t make sense”. Let such practises be instilled in our DNAs that it becomes abnormal to even think of having sex without a condom.

There is need to move away from abstinence based approaches to prevention especially with the youths. That way the importance of condom use and being faithful could curtail the HIV infections while showing the importance of all three areas of ABC.