While Covid-19 has been grabbing the headlines this year, the most serious public health concern in Zimbabwe remains HIV despite the remarkable progress we have made in bringing that viral infection under control, helping those infected to live long and normal lives and reducing our death rate.
President Mnangagwa was right on the eve of World Aids Day to stress the achievements we have made as a nation and to call for the serious efforts we all have to make if we want to see HIV disappear.
On the positive side, 97 percent of the 1,3 million Zimbabweans living with HIV are on antiretroviral therapy (ART), and of those just over 90 percent have achieved viral load suppression. So we have exceeded our 2020 targets and in the ART measure have exceeded them spectacularly.
The President also assured those 1,3 million that Government will continue to ensure that the required drugs, and the medication needed to treat AIDS-related illnesses, are imported in adequate quantities and that our health services will be continually upgraded for all who need help and care.
These achievements were all made despite the economic challenges facing Zimbabwe and show that the Government is able to set and fund priorities and able to do this year-after-year.
So the 2030 target of making our health systems first class is not some pipe-dream, but an actual practical goal.
The President thanked donors for the support Zimbabwe continues to receive, but the fact remains that donors were always more willing to help those who were already making their own significant efforts to help themselves.
And on the practicalities, pumping support into functioning national programmes is far easier than trying to create these in a desert.
The President noted that the new challenges presented by the global Covid-19 pandemic had disrupted implementation of further efforts to combat HIV and Aids, while stressing that Government continued to give priority to HIV. The statistics show that was done.
But Covid-19 also showed as a country we can unite against disease, we can follow medical advice and we can win against a pandemic.
While we have been battling HIV since the first local infections were recorded in the mid-1980s, and many might believe this virus is some old menace, the fact remains that we still have a lot of people living with HIV and we need to renew our efforts in the battle against this illness.
The sombre fact remains that, despite our many achievements, we still saw around 20 000 people die last year from HIV-related illnesses, down from the 22 000 the year before and way below the well over 100 000 deaths a year we were seeing in the early 2000s.
But we still have people dying earlier than they would otherwise have done from illnesses and conditions that would not have killed them so soon if they were not living with HIV.
Estimates from the medical world suggest that the death rate will continue to fall this year, but we can still expect thousands of premature deaths from a wide range of illnesses that were able to take hold because of the weakened immune systems of patients living with HIV.
The other sombre fact is that people are still being infected, and yet almost all infections are easily preventable if every single person takes responsibility.
Economic and social conditions, and regrettably some cultural attitudes, make it difficult for everyone to avoid infection.
This is why we see the most vulnerable groups being adolescents, girls, young women and sex workers, and why a clear majority of those living with HIV are women who, we must remember, were infected by men.
Major efforts have been made, from constitutional reform downwards, to protect the most vulnerable, and especially girls and young women, but the figures show that we still need to keep up the pressure and redouble our efforts so that everyone can make informed choices when it comes to something so personal and intimate as sexual relations and, most importantly, can be in control of their lives and can insist on high levels of responsibility from those they are close to.
Many of these efforts will have nothing specifically to do with HIV. Simply pulling the majority of Zimbabweans out of poverty, as our economic programmes are now starting to do, will be a major practical factor in emancipating young women and giving them practical control of their lives.
Continually improving education, both at the lower levels and in access to higher education, has the side effect of reducing the size of the vulnerable groups.
Girls and young women with a brighter future ahead of them cannot be pressured into unsuitable early marriage or into less desirable relationships, and can take control of their lives more effectively.
The same goes for young men who if they have a brighter future are far less likely to drift into the sort of drinking and drug taking that leads to risky behaviour, often, and especially in urban environments, with similarly-placed young women who want to “live life for today”.
Our long battle against HIV and Aids has not been travelled down a single road.
We have made progress because we tackled causes as well as results, because we tried to combine as many approaches as possible: education, special protection for the most vulnerable, easy access to protection for safer sexual relations, a widespread testing programme, guaranteed access to ART and better care for those with Aids-related illnesses. Those efforts need to continue at ever higher levels.
The important two points that the President stressed were that we are on the path to victory over HIV, but that we still have a long way to go to achieve the target of zero new infections and total care for those who will still be living with HIV long after the last new infection.
Health experts talk about growing complacency in the battle against Covid-19. That battle fatigue can be seen in the bigger battle against HIV, even an attitude of “oh well I can always take ART if something happens”.
So programmes might need continual refinement and adjustment, as well as new initiatives. But we can win. It just requires, as with so many health issues, everyone to take responsibility.