Online Reporter
Rumbidzayi Zinyuke
Senior Health Reporter
ZIMBABWE is strengthening efforts to eliminate mother-to-child transmission of HIV, syphilis and hepatitis B, with renewed focus on improving paediatric HIV treatment, antenatal care and prevention services for pregnant and breastfeeding women.
This comes as nearly 3 000 new paediatric HIV infections are projected this year, highlighting the need to close remaining gaps in treatment and prevention.
Ministry of Health and Child Care National Prevention of Mother-to-Child Transmission (PMTCT) and Paediatric HIV Care and Treatment Coordinator Dr Angela Mushavi recently said 2 813 new paediatric HIV infections were projected for 2026, with mothers who were not on antiretroviral therapy (ART), those who dropped out of treatment and women who acquired HIV during pregnancy or breastfeeding accounting for a significant proportion of new infections.
The country has made significant progress in HIV treatment among adults, with ART coverage now at about 98 per cent, while PMTCT coverage stands at 92 per cent. However, Dr Mushavi said paediatric ART coverage remained low .
“Children are lagging with ART coverage of 53 percent. Surprisingly, while adult ART coverage is about 98 percent, children are still lagging significantly, and this is something that we really need to address,” Dr Mushavi said.
Zimbabwe currently has about 65 000 children aged between zero and 14 years living with HIV, while between 43 000 and 44 000 pregnant and breastfeeding women require services for the triple elimination of mother-to-child transmission of HIV, syphilis and hepatitis B.
Dr Mushavi said although PMTCT coverage stood at 92 percent, the country was falling short of several key targets required to achieve the World Health Organisation’s gold-tier validation for triple elimination.
The WHO gold-tier targets require the mother-to-child transmission rate of HIV to be below five per cent, while new HIV and syphilis infections should each be below 250 cases per 100 000 live births.
However, Zimbabwe’s vertical HIV transmission rate at the end of breastfeeding currently stands at 6,48 percent.
Dr Mushavi said antenatal care attendance was also a major concern, with coverage falling below the 95 percent target.
“ANC attendance was 85 percent in the first quarter of this year. Very worrisome, because our target is at least 95 per cent or more. So, just looking at these numbers, you know where our work is cut out for us,” she said.
Although HIV testing among pregnant women remained strong at 99 percent, syphilis testing dropped from 95 percent to 81 percent during the first quarter of 2026, largely due to shortages of dual HIV and syphilis test kits.
Hepatitis B testing remained particularly low, rising only marginally from 15 per cent in 2025 to 22 percent during the first quarter of 2026. Treatment coverage for hepatitis B-positive mothers improved from 82 per cent to 87 per cent over the same period.
Dr Mushavi said the high number of adolescent pregnancies was another major concern, with adolescent girls and young women aged up to 24 accounting for 51 per cent of antenatal care attendants.
She said the group was particularly vulnerable to acquiring HIV during pregnancy or breastfeeding, even when they tested negative at the beginning of pregnancy.
The data showed that mothers who were not receiving ART contributed the largest share of new paediatric HIV infections, followed by women who had started treatment but were not retained on ART.
Women who acquired HIV during pregnancy or breastfeeding were also contributing significantly to new infections.
“We have a problem. We have to look after these young girls. We have to put them on pre-exposure prophylaxis and encourage other biomedical interventions so that these young girls remain HIV negative, whether they are pregnant or breastfeeding,” Dr Mushavi said.
She said early treatment was critical because HIV-positive infants who were not initiated on treatment faced a high risk of death.
Zimbabwe tested about 87 000 HIV-exposed infants in 2025, while testing within two months of birth improved to 92 per cent, although the programme had recorded a slight decline from previous performance.
Dr Mushavi said the country was now developing a new triple elimination plan for 2027 to 2030, with support from UNAIDS, UNICEF, WHO and the National AIDS Council.
As part of preparations for the next Global Fund grant, 20 districts accounting for about half of the country’s HIV-positive pregnant women have been prioritised for targeted interventions.
The priorities include increasing testing and retesting of pregnant women, expanding ART coverage, strengthening early infant diagnosis and paediatric case finding, and addressing structural factors such as child marriages, stigma and gender-based violence.
The programme also intends to expand prevention services, including long-acting pre-exposure prophylaxis for adolescent girls and young women who are HIV-negative.
Dr Mushavi said improving maternal services alone would not be sufficient unless Zimbabwe also addressed the treatment gap among children, particularly through stronger early infant diagnosis, linkage to care and sustained paediatric ART coverage.
