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The Aids pandemic has been our nation’s biggest public health emergency over the past 30 years. It accounts for a high number of deaths and illnesses. It destroys families and livelihoods as parents fall sick and cannot work, or die and leave spouses and children alone in poverty. Of the country’s estimated 1,2 million orphaned children, about 890,000 are orphaned by Aids and resources are being spent in looking after them.
There indeed have been gains in recent years as medication is prolonging lives of those infected with HIV and the level of stigma associated with the virus is on the decline as more people now accept the condition like any other. According to dozens of studies carried out on the subject in recent years, knowledge of HIV and Aids in terms of prevention mechanisms, treatment and care is improving. Partly because of this, the country recorded a total of 57,300 new HIV infections last year, from 77,300 in 2010.
The latest edition of the five-yearly Zimbabwe Demographic Health Survey (ZDHS) highlights these positive developments but also points out a number of factors militating against the advances.
“The results of the ZDHS confirm significant progress towards achieving the 90-90-90 targets. This is confirmed by the 2015 HIV estimates that show a 25 percent decrease in new infections, from one percent in 2010 to 0.74 percent in 2015,” reads the survey report.
We take the progressive decline in the number of new infections between 2010 and 2015 as an important indicator as to where we are going as a country in relation to the fight against the pandemic. We say so because the globe’s biggest public health emergency started with an infection. Therefore, a decline in the number of people contracting the virus suggests that if it is maintained, we would, at some point, have a country that is free from HIV and Aids.
The fall in new infections can be attributed to the facts that the sexually active population is taking all the measures available to reduce risky sexual behaviour. They are using condoms, being faithful to one partner and abstaining from sex. These must be encouraged. For those already infected, we say they should also practise the foregoing, in addition to adhering to their drugs.
However, 57,300 new infections is too high. Admittedly, it will be difficult for the country to attain zero infections, but there is nothing wrong with us sticking our heads out to declare that we expect this goal to be achieved. This is possible and statistics tracking the history of the epidemic since the first confirmed case in the 1980s can be an indication. The Aids burden peaked around 2001 when the national adult prevalence rate was 33.7 percent yet 15 years on the rate is down by more than half to 15 percent. Therefore, zero infections are possible.
On the negative side is the fact that the ZDHS notes that, while knowledge on HIV and Aids has generally improved, there are still a few pockets where ignorance remains prevalent. The report says that less than half of adolescents aged between 15 and 24 years, who are the most vulnerable group have comprehensive knowledge about HIV prevention. In addition, young women with only primary school education and young people living in rural areas have the least knowledge about HIV.
“The knowledge of HIV prevention methods among the most vulnerable youth is unfortunately going down. Teenage pregnancy is still too high and around half of 15 to 24-year-old men and one third of 15 to 24-year-old women have never tested for HIV.”
These gaps demand more action from the government, its partners and the people themselves to work harder to defeat ignorance. Special activities and tools need to be strategically targeted at the youths broadly and young women specifically. The activities and tools should be carried out and deployed in rural areas, farms and mines too, not only in towns and cities.
So whereas we recognise the positive developments that have taken place, or are taking place in the country’s response to HIV and Aids, we don’t forget that challenges remain. We need to consolidate the gains while working out strategies to resolve emerging challenges so that the country does not relapse to 2001.
For now, the ZDHS is the most comprehensive instrument to assess the Aids burden and drop pointers on how it can be lessened. However, it does not provide the finer details that the country wants for a better response to the Aids pandemic. Development practitioners cite a number of reasons, chief among them that the ZDHS is markedly removed from communities, or the persons it surveys and also that it covers too long a period, five years. Its findings are important, yes, but can leave holes given the way the data is gathered.
This is why we cannot wait for the ongoing Zimbabwe Population-based HIV Impact Assessment to end and its findings released. It will yield more detailed information on the epidemic, its impact and show the efficacy of existing intervention mechanisms because it goes down to the household, to the infected and affected with a more pointed set of questions and should get more specific answers.
Online Reporter