Online Reporter
Dr Bernard Madzima
THE United States’ recent decision to pause and review its funding for HIV and AIDS response programmes, as well as its withdrawal from the World Health Organisation, has sparked concerns about the potential impact of the move on aid to developing countries, particularly with regard to HIV and AIDS response.
In Zimbabwe, the US was providing support of at least US$200 million annually, which was helping support over 1,2 million people living with HIV and AIDS.
In light of these developments, National Aids Council (NAC) chief executive officer DR BERNARD MADZIMA shared his insights into the potential implications of the developments with our reporter EMMANUEL KAFE.
***************
ARV availability
I want to assure the nation and everyone that there are enough ARVs (antiretrovirals) in the country.
At this stage there is no need to panic.
Anyone who requires ARVs just needs to go to the health facility from where they collect their medication and they will get services.
This current scenario, at this stage, has not affected service delivery in terms of ARVs.
But as a country, we need to strategise and deal with the possible scenarios in the future so that we cover that gap, and that gap should not lead to anyone not getting treatment.
I am sure you read from Central Government that as a country, we stand by prioritising health and making sure that anyone who needs treatment will get the treatment that they need.
US’ contribution to Zim’s HIV response
The HIV programme in Zimbabwe is funded by various stakeholders, and amongst them there is the USAID under their President’s Emergency Plan for AIDS Relief, commonly known as PEPFAR.
They are a significant contributor in terms of provision of ARVs and laboratory consumables and they also support various non-governmental organisations in the country.
They support health workers of various organisations, as well as community activities.
So, yes, they are a significant contributor to the HIV response in Zimbabwe and any policy shift, especially if it is sudden, would definitely have an effect on how we provide services for the HIV programme.
Mitigation
Fortunately, there has been a directive from the US embassy that the ARVs or commodities which are in the health facilities can be used despite the freeze.
So, we are happy about that.
Patients will continue to get their medicines; they will continue to get their services through health institutions across the country.
So, no one is not going to get their treatments.
The ARVs, the laboratory services, the sexual reproductive health services which are provided under PEPFAR are available to those who need them.
The AIDS levy is a contributor to the general response, not only in terms of HIV, but also other related health conditions in the country, like non-communicable diseases.
So, as the fund holder for the AIDS levy, the National AIDS Trust Fund, the council really tries to make optimum use of the AIDS levy and make sure that it is put where it is needed most.
It is not enough to cover everything, but we look at those areas which give us the maximum impact and we work together with our stakeholders, mainly the Ministry of Health and Child Care, to identify high-priority areas, which we then support using the AIDS levy.
There is a funding gap in health in general, which has been identified in the last health financing endeavour, which was held late last year, at Rainbow Towers, which looked at the areas where there are gaps.
You also know that the Ministry of Health and various stakeholders have signed what is called the Health Compact, which looks at all the areas that can be looked at and which can be addressed if Zimbabwe is to provide ideal health services.
So, that compact showed that there are gaps and the AIDS levy programme is no exception.
NAC will continue to work with the traditional partners, the UN (United Nations) family, UNAIDS, UNDP, Global Fund, Ministry of Health and Child Care, other ministries, including the Ministry of Finance, Economic Development and Investment Promotion, to make sure that there is no setback to the achievements which have been made so far, as far as ending HIV as a public health threat by 2030 is concerned.
And we will not go backwards as far as the 95-95-95 targets are concerned.
We will continue to be on track and the resources will be found elsewhere in the event that the USAID does not come on board.
So, we want to assure everyone that there will be resources to make sure that people who are on treatment remain on treatment . . .
All those strategies will remain in place and funding will have to be sourced from elsewhere in the event that there is no funding coming from USAID.
Also, the prevention of mother-to-child transmission for HIV will continue to be supported in terms of treatment, in terms of testing, in terms of antenatal care.
The Minister of Health is aware of the challenges which might happen with the withdrawal of USAID, and there are strategies which are being put in place to address these gaps. As NAC, we are ready to support, to redirect some of our resources to those areas which are critical.
And you know, when you are managing a limited resource, priority should be one of the key issues first.
However, note that the AIDS levy is a very limited resource. Remember that part of it is collected in the local currency and it is difficult to then buy things from outside the country. So, it will not be able to cater for all the shortfalls which will happen in the health sector, including the condoms shortage, if funding is withdrawn for condoms.
So, we can only stretch it up to a point.
It’s not an infinite resource; it’s very limited.
We still need to have a sustainable domestic funding for health.
