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Report on HIV and AIDS in Zimbabwe: January 2006-December 2007
United Nations General Assembly (UNGASS)
September 05, 2008

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Status of HIV epidemic

Zimbabwe with a projected adult (15-49 years) population of 12 million people is one of the countries in Sub-Saharan Africa that has been severely affected by the HIV and AIDS epidemic1. According to the National HIV Estimates of 2007, the estimated HIV prevalence among adults 15-49 years is 15.6%2. An estimated 1,320,739 (adults and children) were living with HIV and AIDS and of this population, an estimated 102 566 were estimated to be in urgent need of antiretroviral therapy by the end of 2007.

The country is experiencing a decline in HIV prevalence that is supposed to have started in the late 1990's. A decline was observed in both sentinel surveillance of pregnant women and in the National HIV Estimates process that models available data using the Epidemic Projection Package (EPP) and Spectrum software. Among pregnant women (15-49 years), HIV prevalence declined from 25.8% in 2004 to 17.7% in 2006. In the general population, using the current 2007 EPP and Spectrum software, HIV prevalence in Zimbabwe was estimated to be 26.5% in 2001, and therefore declined to 23.2% in 2003, and 19.4% in 2005, and to 15.6% in 20073. The decline in HIV prevalence is attributed to a combination of mortality and a decline in HIV incidence due to behavior change.

Response to HIV and AIDS epidemic

The Government of Zimbabwe has continued to scale up the multi-sectoral response to HIV and AIDS based on the Zimbabwe National and HIV AIDS Strategic Plan (ZNASP) (2006-2010) that was launched in July 2006. This plan builds on lessons learnt in implementation of the National AIDS Policy of 1999 and the National HIV and AIDS Framework (2000 -2004). The strategic plan continues to highlight HIV and AIDS as an emergency that requires Government and all stakeholders urgently mobilize the required resources in order to fight the epidemic.

Universal access to care and treatment is one of the main goals of the ZNASP. Zimbabwe continued to scale up access to care and treatment for HIV, AIDS and related opportunistic infections in the period 2006-2007. The number of people on antiretroviral therapy increased from 25 000 adults on ART at the end of 2005 to just over 60 000 adults and children in 2006 and slightly over 100 000 adults (including 10 000 children) at the end of 2007. While this number represents 38% of adults needing treatment, this increase reflects the efforts that the Government of Zimbabwe is making in a resource constrained environment.

One of the greatest negative impact of HIV and AIDS is the increase in vulnerability especially among children. It was estimated that in 2006 and 2007 there would be 1,008,542 and 975,956 HIV and AIDS orphans in Zimbabwe4. The National Plan of Action for Orphans and Other Vulnerable Children (NAP FOR OVC) to guide the care and support of orphans and vulnerable children in Zimbabwe was launched in 2005. The principal mode of HIV transmission in Zimbabwean is heterosexual contact.

According to the Zimbabwe Demographic and Health Survey (2005/06), the level of knowledge about HIV and AIDS is high with 75.7% women (15-49 years) and 81.3% men (15-54 years) knowing that condoms can be used to reduce the risk of getting HIV. Recognizing the need to move from awareness to action, Zimbabwe has put in place a National Behavior Change Strategy (NBCS) covering the period, 2006-2010. This plan provides guidance to all stakeholders on their contributions to behavior change promotion using key prevention elements such as condom use, reducing multiple partners and promoting faithfulness as a way of addressing root causes of risk behaviors.

The second most important is perinatal transmission in which the mother passes HIV to the child during pregnancy, at birth or during breastfeeding. The NBC strategy also encompasses a plan of scale up of prevention strategies such as Prevention of Mother to Child Transmission of HIV (PMTCT) and strategies to reduce the incidence of HIV infection especially among youth 15-24 years.

The country was able to fund its response through various funding mechanisms. Zimbabwe is a signatory to the Abuja declaration of 1998, where governments committed that a minimum of 15% of government budget should be go towards health care for the nation. The Zimbabwe government raised money through the fiscus and through the National AIDS Trust Fund (NATF), a 3% levy collected from taxable income from all sectors to mitigate the impact of HIV and AIDS and is channeled to the National AIDS Council by the Ministry of Finance. The Government of Zimbabwe through Ministry of Finance contributed US $ 14 700 000 in 20055, US $ 63,437 000.00
(Z $ 101 500 000 000.00) in 2006 and US $ 86 256.00 (Z$ 345 025 716 293.71) in 20076 towards HIV and AIDS programs. These amounts reflect the Ministry of Finance's budgeted expenditures and include the National AIDS Levy.

Despite several economic challenges, Zimbabwe was able to use 13.7% of the total government spending on health related expenditures in 2007. In support of government efforts, bilateral partners contributed US $ 64 300 000.00 in 20055 and US $41,930 856.00 in 2006 towards HIV and AIDS programs 7. The Multilaterals (UN) contributed US $ 10 432 191.00(2005) and US $ 24 148 770.00 (2006)7. Additional funding for the period under review was received from Global Fund (GFTAM) Round 5 amounting to US $60 Million and another US$ 50M was mobilized under the Expanded Support on Health Programs (ESP) by a consortium of partners under the chairmanship of NAC in 2007.

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