Zim moves to end mother-to-child HIV transmission

Rumbidzayi Zinyuke-Senior Health Reporter

Zimbabwe is among African countries that have made significant strides in adopting strategies towards meeting global targets for the elimination of mother to child transmission (EMTCT) of HIV and syphilis.

The country has been rolling out dual EMTCT of HIV and syphilis since 2018 and recently adopted the triple elimination strategy which will usher in the testing of hepatitis B virus along with the first two.

This sets the country on course to attain World Health Organisation validation for achieving the reduction of mother-to-child transmission to a level where it is no longer a public health threat. 

Speaking at a fourth quarter 2023 national validation committee meeting on EMTCT of HIV, syphilis and hepatitis B held recently, Ministry of Health and Child Care HIV/AIDS and STIs deputy director, Dr Tsitsi Apollo said Zimbabwe had made notable progress. 

“WHO Africa convened a dissemination meeting of guidelines for HIV, sexually transmitted infections, TB and viral Hepatitis B and C which we attended. We are quite ahead, that is what we observed. As a country we have done well in terms of reducing new HIV infections. Zimbabwe was actually on top; we reduced by 76 percent HIV infections in the last 12 years since 2010. 

“In the Eastern and Southern African region, we are also leading because we have actually reduced HIV infections by 57 percent,” she said. 

A series of guidelines and regulations had been shared at the meeting, and Zimbabwe was already implementing many of them.

These include the dual HIV and syphilis rapid diagnostic tests that could be used in antenatal care which the country was already implementing. 

“Looking at countries in Africa, you find that some countries are ahead, like us, and some are still lagging behind in terms of following the guidelines on dual HIV and syphilis testing. Many other countries are still discussing this three testing strategy to minimise misclassification of infections but we have already adopted this strategy,” she said. 

WHO recently updated its global guidance on criteria and processes for validation of EMTCT of HIV, syphilis and hepatitus B..

Achieving validation of EMTCT was a tremendous national accomplishment, requiring country-led accountability, rigorous data analysis, intensive programme assessment and multilevel collaboration.

According to national paediatric HIV care and treatment coordinator Dr Angela Mushavi, Zimbabwe was aiming for gold in EMTCT. This means that by 2026, the country should have at least 95 percent of all pregnant women in antenatal care, 95 percent HIV, syphilis and hepatitis B testing and 95 percent of those in need of the relevant medication should be initiated on treatment and be virally suppressed.

“In the last half of this year we have seen our antenatal attendance going up to 92 percent which is good. Before Covid, our antenatal attendance was 94 percent so we dropped but now we are going up. We would like to test at least 95 percent of women in antenatal care and make sure that 95 percent of all the women who need the medication services are receiving antiretroviral treatment. 

“Not only that but that they are virally suppressed and that we reduce the mother to child transmission rate to less than 5 percent,” she said. 

However, Dr Mushavi said if the country achieved 90 percent for viral hepatitis testing, it would be good enough to be recognised in the gold tier. 

Zimbabwe launched the triple testing this month and this will push coverage for all three diseases. 

“We now have a plan that is running from 2023 to 2026 and within that plan, we definitely want to meet the targets that have been set by the WHO for us as a country to be validated. 

“Basically what we are saying is, it is not enough to just push for eliminating HIV, we have to try and do all three. I am happy to say that in the last era, we introduced dual test kits and that really helped to bring up testing coverage for HIV and syphilis and now as a country we will now implement innovations that will also help us to do triple tests. 

“For example, you prick a woman and in that one prick you are able to get a result whether the mother has HIV, syphilis or hepatitis B virus. 

“Those are some of the new innovations that we are looking at and of course in this new plan, we are very clear on the activities we need to implement to make sure that we are pursuing triple elimination of HIV, syphilis and hepatitis b virus,” said Dr Mushavi during a panel discussion at the International Conference on Aids and STIs in Africa held in the country recently.