by ROBERT TAPFUMANEYI (Staff Writer)
World Leaders are meeting in New York City at the United Nations (UN) General Assembly High Level Meeting on AIDS. The gathering of Heads of State and other leaders from government, the scientific community, civil society and the private sector offers a unique opportunity to review progress, share lessons learned and chart the future course of the global AIDS response. The high level meeting extends from June 6-10, 2011.
Now, three decades into the epidemic, what is the global scorecard for the AIDS response?
Globally, Zimbabwe remains among the countries with high HIV infection rates; it carries the third largest HIV burden in Southern Africa and has one of the highest rates of premature adult mortality, largely due to HIV-related illnesses.
Geographically, the Zimbabwean HIV epidemic is quite homogenous, with similar HIV prevalence levels across provinces and rural and urban zones. However, the disease burden is distributed among provinces disproportionately, as population density in the provinces varies.
According to National Aids Council, heterosexual sex accounts for the bulk of new adult HIV infections in Zimbabwe: this includes transmission within unions or regular partnerships, extra-marital relations, casual heterosexual sex and sex work. The key drivers of the HIV spread include low and inconsistent levels of condom use, multiple concurrent partnerships, age disparate sexual relationships and low rates of male circumcision.
Mother to child transmission (MTCT) remains the second significant source of new infections: approximately 1 in 3 infants born to HIV infected mothers are HIV infected. Availability and accessibility of ART has drastically decreased the HIV-related mortality. However, AIDS is still a leading cause of mortality in Zimbabwe. It is estimated that in 2010 alone 59,318 adults and 11,981 children died of HIV-related illnesses. HIV/TB co-infection is high and contributes to mortality among PLWHA. AIDS related deaths have left in their wake large numbers of orphans and vulnerable children: it is estimated that 25% of all children in Zimbabwe have lost one or both parents to AIDS. Zimbabwe is however committed to achieving the vision of zero new HIV infections, zero discrimination, zero AIDS-related deaths.
The National AIDS Trust Fund (NATF) collected and disbursed, in line with the Zimbabwe National AIDS strategic plan priorities, USD5.7 million in 2009 and USD15.9 in 2010. The NAC and partners have succeeded in attracting a significant amount of external and internal resources. Bilateral and multilateral agencies contributed a total of USD38 million in 2009 alone.
The Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM) has contributed and committed about USD158.7 million towards the HIV response (rounds I, V and VIII funding) during the ZNASP I implementation. A consortium of bilateral development partners have supported the national HIV response through the Expanded Support Programme (ESP), which has contributed a total of USD66 million over 2007-10.
Universal access to HIV services will be achieved through rigorous, sustained scale up in availability, accessibility and quality of prevention, treatment, care and support as delivered at all levels by public, private and civil society service providers. Necessary effort will be invested in creating an enabling environment for more effective and efficient responses, in particular in strengthening the national regulatory frameworks and practices and effective functioning of mechanisms to ensure protection and fulfillment of human rights and gender equality.
In scaling up the HIV services, the country will aim to achieve equitable access to products and services; it will prioritize interventions that address the key drivers of the HIV epidemic; meet the needs and ensure participation of the most vulnerable and most affected populations; have proven effective internationally and nationally; have a potential to produce the greatest impact on the course of the epidemic; and deliver value for money in the most effective and efficient way. Special emphasis will be placed on integrated provision of services, with strong service linkages and operational referral mechanisms, for optimized expenditure, increased service coverage and improved prevention, treatment and care outcomes.
The key principle of the country’s response, with one multi-sectoral action framework, one national coordinating authority and one monitoring and evaluation system guiding and consolidating HIV-related action at all levels across sectors. NAC said particular attention will be paid to ensuring genuine participation in the responses of public sector and civil society, including people living with HIV; special effort will be put in supporting partnership and coordination mechanisms at the national and decentralised levels.
Statistical data used in this article was made available by the National Aids Council of Zimbabwe.
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