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Efforts
of Zimbabwean people in fighting HIV and AIDS must be rewarded
Enida Friel
June 14, 2006
This week leaders
from around the world including the Irish Taoiseach Bertie Ahern
are in New York to attend the special UN session dedicated to HIV/AIDS
UNGASS+5. There the UN Secretary General is reporting that Zimbabwe
is one of the few countries in the developing world to have reduced
the HIV prevalence rate. As UNAIDS announced last year the HIV prevalence
rate in Zimbabwe has decreased from 26% in 2002 to 21% in 2004 and
this was a further decrease from rates higher than 30% in the year
20001. Zimbabwe is the only country
in Southern Africa - the region with the highest HIV prevalence
rates in the world- to mark such a decline.
According to
UNAIDS the decline is seen across the different age groups (including
young people of 15-24 years old), among pregnant women screened
while attending antenatal care services and also in rural and urban
areas. This trend has been confirmed by different studies that international
and national scientists have conducted in Zimbabwe and observed
in the ground by Oxfam.
Behaviour change
interventions that promote condom use, reduction of the number of
sexual partners and delay of sexual debut appear to have contributed
to this decline. These interventions often run by dedicated community
based organizations have taken place in a very difficult political
and economic context where donor money is scarce.
For a country
with still a very high HIV prevalence rate (one in five pregnant
women is still HIV positive), in a region, which is sadly, the epicentre
of the AIDS epidemic, Zimbabwe has received little money to support
their HIV/AIDS interventions. In fact Zimbabwe has received the
least of funding compare to other countries not only in Southern
Africa, but also rest of Africa. Of all the major HIV/AIDS sources
of funding (Global Fund for AIDS, tuberculosis and malaria, World
Bank Multi-Country HIV/AIDS Programme for Africa and US President's
Emergency Plan for AIDS Relief) only money from the Global Fund
has been made available to Zimbabwe2.
As part of its
HIV/AIDS portfolio Oxfam is supporting eight local organizations
running programmes that focus on behaviour change, gender, care
and support for HIV/AIDS. This support has been ongoing since 2002
and Oxfam is committed to continue supporting these partners in
the future. However, this support along with that of other international
organizations present in the country, cannot suffice to sustain
nationwide comprehensive interventions that are now needed in Zimbabwe.
Although it
looks like prevention efforts have paid off, treatment services
remain very limited in Zimbabwe. Only 24,000 people out of an estimated
2 million that are HIV positive are receiving antiretroviral treatment
(ART) in Zimbabwe3, while
as much as 70% of hospital bed occupancy could be due to HIV/AIDS4.
Zimbabwe is
now facing a food crisis, reasons of which are political, but poor
rain falls in the country and HIV/AIDS have also contributed to
it. UN estimates that 4 million people are in need of food. This
is in a context where 700,000 people in urban areas have either
been forcibly displaced or affected by the "Operation Clean Up".
Inflation rates have hit 2000% and 80% of population is estimated
to live under the poverty line. Communities are struggling and Oxfam's
partner organizations are no exception. With families unable to
pay transport and hospital fees, the pressure on home based care
volunteers supported by Oxfam is mounting. They are having to be
creative and engage in income generating activities so that the
nutritional needs of their beneficiaries are met. With no option
of ART for their beneficiaries, many volunteers are now also using
herbs that can only treat a limited number of opportunistic infections.
Reasons for
lack of funding to Zimbabwe are clear. Donors do not want to support
a government that is largely blamed for the situation in which Zimbabwe
is today, and also they do not want to risk their funding being
politicised. These are understandable reasons, but at the same time
local efforts that are trying to help vulnerable communities whether
that is in the form of HIV/AIDS support or livelihood replenishment
or simply food should be supported.
UN has a major
role to play in Zimbabwe - they should intensify their efforts in
convincing donors to support aid efforts in the country, but most
importantly they should continue negotiating space and access for
local and international NGOs that are trying to work in Zimbabwe.
The Irish government, which is a donor of Zimbabwe and a contributor
to the Global Fund for AIDS, tuberculosis and malaria, could also
play a role in convincing other donors to 'reward' support to people
that are persevering and having positive results even in difficult
situations.
Zimbabwe was
once considered by health specialists to have one of the best health
infrastructures in Africa to implement an HIV/AIDS programme. With
many qualified doctors and nurses now living Zimbabwe for better
economic prospects in the West, soon it will be too late to sustain
nationwide HIV/AIDS programme that can save lives in Zimbabwe.
At UNGASS+5
we will hear UNAIDS recommending to donors to support evidence-informed
interventions that adhere to the 'Three Ones' principle (one AIDS
national plan, one national coordinating body and one national monitoring
and evaluation system). In Zimbabwe the 'Three Ones' are in place
and there is evidence the HIV/AIDS programmes are working. World
leaders have committed to make access to HIV/AIDS prevention and
treatment universal by 2010 and Irish Government has now committed
to spend ?100 million per year on fighting HIV/AIDS and other communicable
diseases. Zimbabweans however will still have to hear what these
commitments will mean for them.
1. The prevalence
rate is now down to 20%
2. Disbursed so far $10 million
3. UN estimation (20,000 receiving ART through the public system,
4,000 receiving it through the not-for-profit sector MSF, mission
hospitals)
4. Local health workers estimation
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