Opinion & Columnist

‘Let’s maintain gains in HIV prevention’

President Mnangagwa delivers his International Aids Day message at State House in Harare. — Picture: Kudakwashe Hunda

STATE OF THE NATION ADDRESS BY HIS EXCELLENCY THE PRESIDENT MNANGAGWA ON HIV AND AIDS, 30TH NOVEMBER, 2020. TODAY THE WORLD COMMEMORATES WORLD AIDS DAY

Fellow countrymen, as our nation prepares to join the community of nations in commemorating this very special day, set aside to galvanise national attention towards the Aids pandemic and to:

Remind the nation that the Aids pandemic is still around and killing our people,

Remember those who have died of Aids,

Motivate our people to seek and utilise HIV prevention and treatment services, and,

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Assure the nation of the commitment of my Government to creating an enabling environment and the provision of leadership for the pursuit of objectives of the national response.

The commemoration this year is special in that it is occurring at a time when the entire globe is confronted with a new pandemic in the form of Covid-19.

Our theme this year, “Global Solidarity, Shared Responsibility”, is thus befitting the circumstances we find ourselves in, as we all have to adjust to the new normal.

For the first time since the World Aids Day was commemorated, this year’s commemoration will be virtual, in line with Government policy to minimise the risk of the transmission of Covid-19.

One of the lessons that we have learnt from the emergence of Covid-19, is that, in line with this year’s World Aids Campaign theme, we cannot address HIV and Aids alone, in isolation, without paying critical attention to the entire health delivery system.

Thus my Government has embarked on a process of restructuring the Ministry of Health and Child Care, in order to make it more responsive to modern national health challenges at all levels, including addressing the emerging non-communicable diseases.

Although this will be a long process aimed at restoring both the quantity and quality of services offered, including health infrastructure, drug availability and optimal human resources, my Government is working on long term solutions to address perennial strikes by health workers and in restoring public confidence in the public health delivery.

Following years of neglect, my Government has embarked on a process of restoring the past glory of our health delivery system, through a deliberate deployment of resources. From community level to district level, work is in progress to ensure universal health coverage for our people. Both public and private investments in health will be prioritised as we move to make our health delivery system world class by 2030.

Although the implementation of the bulk of planned HIV and Aids interventions was disrupted by Covid-19, this did not affect Government’s focus on the HIV pandemic.

Even though Zimbabwe remained saddled by a heavy burden of HIV and Aids, I am glad to note that we have made commendable progress, as a nation, in reversing the course of the Aids pandemic, particularly through prevention of new HIV infections and provision of treatment to those who are infected, in line with the pursuit of 90-90-90 by 2020 targets, wherein:

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(a) 90 percent of people living with HIV should know their status by 2020;

(b) 90 percent of all HIV positive people should receive treatment by 2020;

(c) 90 percent of all people on treatment should have their viral load suppressed by 2020.

Fellow Zimbabweans, I am glad that in the context of the 90-90-90 targets, our country is now closer than ever to the goal of ending AIDS pandemic by 2030.

The very encouraging results of the recently held Zimbabwe Population-based HIV Impact Assessment (ZIMPHIA 2020) indicate that on the first 90, 86,8 percent of people living with HIV now know their status.

This is a 10 percent increase from 76,8 percent recorded in the previous survey in 2015. I am also happy to inform you that 97 percent of people living with HIV are now on lifelong antiretroviral therapy (ART), which is quite an improvement from the previous 88,4 percent.

For those on antiretroviral therapy, 90,3 percent of them have achieved viral load suppression, compared to 85,3 percent in the previous survey.

HIV prevention is a very critical pillar of these targets and remains Zimbabwe’s number one priority in the national response.

In this regard, it is pleasing to note that new infections have declined from 47 000 in 2016 to 40 000 in 2019. This reduction had been on account of the comprehensive combination of high impact HIV prevention interventions, which include HIV testing services, prevention of mother-to-child infection, condom promotion and distribution, treatment as prevention, behaviour change and voluntary medical male circumcision.

We are still far off the mark of achieving zero new infections and should therefore redouble our HIV preventions efforts, focussing particularly on geographical areas and populations sub-groups with highest risk and new infections.

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What is now important is to sustain the gains we have recorded in HIV prevention and ensure that interventions are scaled up in specific population pockets where HIV transmission remains high.

Evidence has shown that although overall HIV incidence has declined by 51 percent from 0,99 percent in 2010 to 0,49 percent in 2019, it remains high among adolescents, girls and young women, sex workers and key populations.

That is the HIV prevention gap we must address to put us in a better stead to achieve the related fast-track target by 2020 and end Aids by 2030.

I am therefore challenging the Ministry of Health and Child Care, the National Aids Council and their partners to forge new strategies to reach those people who are holding back from HIV testing, and ensure they are tested and are linked with relevant services.

My Government, fully cognisant of the fact that children are the future and the future is children, regards the death of children due to Aids as anathema.

Although the prevention of mother-to-child transmission coverage has risen to 91 percent in 2019 from 87 percent in 2016, I am concerned about the number of new infections among children, which is still too high at 5 000, and our inability to reach the required five percent target of virtual elimination of mother-to-child transmission in 2019.

Guided by the Start Free, Stay Free, Aids Free Framework, we have to expend coverage and ensure that no child gets infected with HIV, in an environment that in fact has adequate services and widespread awareness.

Fellow countrymen, ladies and gentlemen, comrades and friends, I am glad that our nation has also achieved commendable coverage in providing antiretroviral therapy to those of our people who are HIV positive.

Of the 1,3 million HIV positive people in Zimbabwe, 97 percent are now on antiretroviral therapy, up from 88 percent in 2015. Through a robust national ART programme that has been enhanced by high retention, the number of people dying due to Aids has also significantly fallen to 20 000 in 2019 from 22 000 in 2018 and 23 000 in 2016.

What is most pleasing is that we have recorded these achievements despite our economic challenges.

My Government remains committed to addressing the challenges we have faced related to the availability of foreign currency for the purchase of antiretroviral therapy medications.

I want to assure all people living with HIV that my Government, in this new dispensation, will continue to prioritise allocation of foreign currency for the purchase of ARVs, related medical commodities and medications for the health of our people.

I would like to express our gratitude to the international community for continuing to honour their pledges in support of our response to HIV, even in the face of challenges in their own countries. While HIV has been significantly contained, it is the associated non-communicable disease that are now reaching epidemic levels, and therefore threatening the quality of life of HIV positive people.

The Sustainable Development Goals make a strong call for ending not just Aids, but non-communicable diseases too, by 2030.

It has been noted that as more people age with HIV due to availability of treatment, they now face challenges of morbidity and mortality from Non-Communicable Diseases (NDCS), most of which are strongly associated with HIV.

These include cancers, heart diseases, stroke, diabetes and metabolic complications, kidney ailments, liver diseases, and mental illness. I am therefore encouraging our people to get screened for these diseases and seek early treatment.

As our response towards the achievement of fast track targets by 2020 and the eventual ending of Aids by 2030, we have to ensure that recorded achievements in HIV prevention and treatment are not reversed. At the same time, we have to work in solidarity with our regional and global counterparts and partners in preventing and containing Covid-19 and other such epidemics that have the potential to reverse our gains.

My Government will prioritise investments for the entire health delivery system and restoring the quality of health services, without discounting attention towards HIV and Aids.

At this juncture, I would like to thank the Ministry of Health and Child Care, the National Aids Council, all our partners and donors as well as the entire nation for the dedication and fruitful work in 2020 as we focus towards ending Aids by 2030. Ending AIDS and all epidemics requires global solidarity and shared responsibility.

I thank you.

HERALD