Adopting New HIV/AIDS Treatment Guidelines in Zimbabwe
This July, experts from the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) traveled to Zimbabwe as a part of a team to develop an operational plan for national implementation of Option B+, a World Health Organization (WHO) recommended approach within its new 2013 ARV guidelines to provide lifelong antiretroviral therapy (ART) for all HIV-positive pregnant and breastfeeding women. The new guidelines are expected to improve prevention of mother-to-child transmission (PMTCT) services and increase the likelihood that infants born to HIV-positive mothers will be born and remain HIV-negative. In addition, lifelong ART has the potential to improve the health and livelihood of HIV-positive mothers and reduce the spread of infection to uninfected partners.
In February 2013, the Zimbabwe Ministry of Health and Child Welfare (MOHCW) decided to adopt Option B+ as its official PMTCT regimen. Recognizing that the scale-up to Option B+ would hold major impacts across the country’s health care system, the MOHCW requested technical assistance from the Inter-Agency Task Team on the Prevention and Treatment of HIV Infection in Pregnant Women, Mothers and Children (IATT).
“Zimbabwe’s health ministry felt it was important to bring an external, global perspective to the development of the country’s transition approach,” said EGPAF Technical Officer Meghan Mattingly. Mattingly worked alongside EGPAF’s Vice President of Program Innovation and Policy at the Foundation Dr. RJ Simonds (who served as team leader), Dr. Thu-Ha Dinh from the U.S. Centers for Disease Control and Prevention (CDC), and Piya Smith, EGPAF country officer for Zimbabwe.
Building upon Zimbabwe’s existing national strategic plan for the elimination of new pediatric HIV infections, the team developed an operational plan outlining the steps necessary to transition to national implementation of Option B+ in all health care centers in Zimbabwe.The team adopted a collaborative and consultative approach to developing the plan, facilitating open dialogue among key stakeholders from across Zimbabwe’s health system to address anticipated implementation issues and ensure a workable approach to executing this new policy.
After two weeks of focused consultations, the team synthesized inputs from stakeholders into a draft operational plan, which is with the Zimbabwe MOHCW for review. Once finalized, the team plans to host an IATT Webinar to leverage findings from this experience for the benefit of other countries transitioning towards initiating all HIV-positive pregnant women on lifelong treatment.
“There is a lot of positive energy about the opportunities the new guidelines can create for advancing goals within both the PMTCT and ART programs in Zimbabwe,” Mattingly said. “The implementation of Option B+ reflects not only a policy change and new approach within the PMTCT program, but also serves as a leading edge of broader movements within the health sector, such as decentralization of ART and integration of HIV and SRH/MCH with a family-centered approach.”
Stay tuned to the EGPAF blog for more updates on rollout of Option B+ in Zimbabwe and in other countries around the world.
To learn more about EGPAF’s programs in Zimbabwe, click here.
EGPAF’s Chelsea Bailey and Meghan Mattingly contributed to this blog.