Online Reporter
Rumbidzayi Zinyuke
Senior Health Reporter
ZIMBABWE is strengthening preparations to apply for validation of the elimination of mother-to-child transmission of syphilis, a milestone that will accelerate its broader push towards gold-tier triple elimination of HIV, syphilis and hepatitis among mothers and infants.
The country is already recording strong performance in HIV and syphilis prevention and treatment and health officials say systems are steadily being aligned with the rigorous World Health Organisation (WHO) validation standards, which assess not only health outcomes but also governance, data quality, service delivery and human rights.
Achieving validation of EMTCT is a tremendous national accomplishment, requiring country-led accountability, rigorous data analysis, intensive programme assessment and multilevel collaboration.
Ministry of Health and Child Care national PMTCT and Paediatric HIV care and treatment coordinator Dr Angela Mushavi, said Zimbabwe was steadily making progress towards validation.
“Some months ago, we were approached to start working towards an application for bronze-tier validation for syphilis. This is because Zimbabwe is doing very well in syphilis prevention, testing and treatment. It is an area where we have solid data and good coverage. Starting with syphilis allows us to test our systems and build momentum,” she said.
She said Zimbabwe had already completed baseline assessments using WHO tools, giving the country a clear picture of where it stood as it works towards higher validation tiers.
Under the WHO framework, countries seeking EMTCT validation must demonstrate sustained impact targets, such as very low rates of mother-to-child transmission, alongside strong health systems, reliable data, quality services and respect for human rights. Validation is conducted in tiers: bronze, silver and gold, reflecting the depth and sustainability of progress.
“We have gone through the process targets and the impact targets, and we have done a baseline assessment to understand exactly where we are. We now know our gaps and what needs to be strengthened. Based on this trajectory, I can confidently say that in the next few years, Zimbabwe will be applying for gold-tier validation. That is our ambition as we work towards the elimination of transmission of all three diseases,” she said.
A key boost to syphilis preparedness has been the rollout of dual HIV-syphilis rapid test kits within antenatal care services, significantly narrowing previous testing gaps.
“Before the dual test kits, we were doing extremely well with HIV testing, but syphilis testing tended to lag. Since introducing the dual kits, HIV and syphilis testing have become almost equal. Treatment has also improved significantly. Last year, treatment for mothers who tested positive for syphilis stood at 93 percent, which is very encouraging,” said Dr Mushavi.
Zimbabwe is also preparing to introduce triple rapid test kits that will allow simultaneous testing for HIV, syphilis and hepatitis B using a single finger-prick, a move expected to further strengthen integrated maternal health services and close remaining gaps in hepatitis testing.
The country began laying the groundwork for EMTCT validation nearly eight years ago, initially focusing on dual elimination of HIV and syphilis. A National Validation Committee was established to drive the process, supported by provincial validation committees to ensure progress reaches all parts of the country.
“One of the things we realised early on is that while you can design strong strategies at the national level, implementation really happens in provinces and districts. Challenges in one province may not be the same as in another, and a one-size-fits-all approach does not work. That is why sub-national leadership became critical for us. By having provincial medical directors leading validation work, we are making sure no place in Zimbabwe is left behind,” she said.
The national and provincial committees meet quarterly to review programme data, identify gaps and address emerging hotspots. Zimbabwe has also worked closely with WHO and UNICEF, receiving technical support and training to ensure a thorough understanding of the validation process.
Dr Mushavi said central to EMTCT validation was a human rights-based approach, which Zimbabwe deliberately strengthened by involving civil society and community representatives in its governance structures.
At the global level, WHO has warned that congenital syphilis remains the tip of the iceberg of a growing syphilis epidemic, but noted encouraging developments, including improved access to benzathine penicillin, the gold-standard treatment for preventing congenital syphilis. Supply chain challenges that once hampered treatment have eased following the WHO approval of additional manufacturers.
WHO has also emphasised the importance of strong laboratory systems, integrated data platforms, high-quality programme delivery and meaningful community engagement, all areas Zimbabwe is actively strengthening as part of its validation journey.
Zimbabwe’s progress, Dr Mushavi said, was supported by sustained national commitment to maternal and child health.
“We have very high political leadership within our country that is deeply invested in health, and particularly in the health of women and children. This leadership has ensured that EMTCT remains a national priority and not a side programme. Political will creates the space for resources to be mobilised and for systems to work. Without it, even the best technical plans cannot move forward,” she said.
For now, the country’s immediate focus was on consolidating syphilis gains, strengthening data and laboratory systems, and maintaining momentum towards full triple elimination.
“There is a lot of good progress happening across the country. We are not very far from applying, particularly for syphilis. Starting there makes sense, but our destination is clear. Zimbabwe is committed to eliminating mother-to-child transmission of HIV, syphilis and hepatitis, so that every child has the healthiest possible start to life,” Dr Mushavi said.
